How Covid-19 Has Transformed the Patient Check-In Experience
The Covid-19 pandemic forced us to rethink a lot of things that we used to take for granted. Eating in restaurants, visiting friends, taking public transport, and other mundane activities suddenly become as risky as skydiving.
Nothing felt as high-risk as visiting a medical clinic. From the patient’s perspective, it meant sitting in a waiting room with sick people, any one of whom could be carrying the virus. From the clinician’s perspective, it was a race to protect patients and staff while still delivering care.
Many clinics switched entirely to telemedicine for a while. When they started to reopen, they had to rethink that seemingly mundane part of the process: the patient check-in.
What the check-in process means for patients and clinicians
The check-in process can potentially expose people to infection. But it’s also an essential part of the healthcare experience for both the patient and the clinic. Consider some of the key elements of a standard check-in.
First, the patient presents at reception and confirms that they are attending their consultation. The clinic checks the booking and confirms that the appointment is going ahead as scheduled. Usually, this is face-to-face, although some clinics have implemented automated check-in kiosks.
Value: The clinic and patient are both assured that the consultation will proceed as expected. If either party has any issues, they can raise them at this point.
Potential Covid-19 risk: Face-to-face contact between patients and staff places both at risk of exposure. Kiosks require decontamination between uses.
If the patient is new to the clinic, they need to complete a registration form. Registered patients might have to confirm or update their details. Usually, this process involves paper forms that patients return to the staff.
Value: The clinic can gather accurate data for all patients, including contact information, insurance details, and medical history.
Potential Covid-19 risk: Patients can’t share pens and clipboards as before. Admin staff risk exposure when handling forms.
Triage and observation
Clinic staff are the first point of contact, so part of their duty is to observe patients and identify anyone who requires urgent attention. They can also flag patients who might be carrying an infectious illness that they could transmit to others in the waiting room.
Value: Staff can optimize patient flow through the waiting area and ensure that priority cases receive immediate attention. Thay can also redirect anyone who poses an infection risk.
Potential Covid-19 risk: Desk staff may not have sufficient training or tools to identify patients with worrying symptoms. They have no way to identify asymptomatic patients, who may not realize that they’re carrying the virus.
Billing and insurance
The payment process involves two steps: insurance processing and direct payment. The clinic will typically confirm the patient’s coverage and process accordingly. In some instances, the patient may have to make an immediate payment to the clinic.
Value: Upfront billing reduces the time spent chasing invoices. Billing transparency means that patients understand all costs.
Potential Covid-19 risk: Payments might mean handling cash, checks, or credit cards, which leads to direct contact between patients and staff.
Preparing the patient
Check in is a chance to let the patient know what to expect and what they need to do next. This includes things like:
- Confirming the patient has prepared appropriately, such as fasting for the required time
- Accepting and storing any doctor-requested samples from the patient, such as blood or urine
- Acquiring consent for any necessary procedures
Patients also want to know how long they will have to wait before they can go in.
Value: Staff can ensure that the patient is ready to begin the consultation with delay. They can also set expectations about wait times and answer any questions about the consultation.
Potential Covid-19 risk: If a virus carrier sits in the waiting room for a substantial length of time, they could pass the illness to others
A good check-in process can help to improve data quality, while also creating a friendly, stress-free patient experience.
The question is, how do you keep all of those benefits of the check-in process while reducing the risk?
5 High-tech Improvements to Patient Check-In
Technology has changed every aspect of healthcare, including the initial check-in experience. Here are five trends that are reshaping the patient experience.
Mobile Appointment Check-in
Mobile check-ins have been around for a while, but they really came into their own during Covid-19. Apps like Medical Check-In, Jayex, and Intouch with Health all offer a function that allows patients to confirm their appointment from a cellphone. The typical mobile check-in process usually goes like this:
1.The patient receives an SMS or other message, asking them to confirm their attendance.
2.The patient clicks the link and completes a short webform.
3.The system acknowledges confirmation and updates the scheduling system.
4.The system then tells the patient precisely when to arrive.
This system means that patients don’t have to speak face-to-face to confirm their appointment. They also don’t have to use a touchscreen that may carry germs from the previous patient.
In fact, patients don’t even need to be in the building when they’re checking in. A user could confirm their appointment from their car and wait there until the appointment time. This means that they don’t spend time in the waiting room, which greatly reduces the risk of infection.
Analytics-driven waiting lists
Time is a factor in Covid-19 transmission, with 15 minutes the generally accepted rule of thumb. Ideally, nobody would spend more than 15 minutes in a waiting room, but delays and overruns can lead to long waits. How can you accurately forecast the start time for every consultation?
Same way we predict everything else: with analytics. Services like NextME use powerful algorithms to study historical data about the flow of patients through the clinic. Using that information, you can get a pretty good idea of how long each consultation will last, which helps predict exactly when the next appointment will start.
Online patient billing
Most people are used to digital billing now, and they manage everything online from their Netflix to their mortgage. Online billing for healthcare providers seems like an obvious next step.
Of course, clinics can’t simply use Venmo or PayPal. Healthcare billing is too complex, plus HIPAA means that there are strict privacy requirements about using third-party systems. Fortunately, there are multiple HIPAA-compliant solutions on the market, such as Kareo, CGM DAQBilling, and athenaOne.
These systems can also deal with complex workflows, including insurance copays and eligibility assessments. The result is a reliable, transparent system that benefits both patients and clinics.
AI-driven prioritization and triage
During Covid-19, most clinics have had to break their waiting areas into two zones: a cold hub and a hot hub. The cold hub is reserved for non-Covid patients; while the hot hub is for Covid-positive or suspected Covid cases requiring regular medical attention. Often, the hot hub is the parking lot, and doctors come out to the patient’s car.
Of course, this raises an issue: how do you decide whether a patient goes to the cold hub or hot hub? This question goes beyond Covid-19. There are other highly transmissible conditions that clinics have to keep out of the waiting room, such as norovirus or seasonal flu.
AI is starting to help healthcare providers identify and categorize patients, even before they have seen a doctor. One such tool is the Qure.ai system. It’s already in use in British ERs, where it can identify pneumonia in chest x-rays and flag possible Covid-19 cases. Over time, tools like this might help general practice clinics triage and categorize all incoming patients for a range of conditions.
Digital medical assistants
The check-in process tells us a lot about the nature of the doctor-patient relationship. Patients see their doctors relatively infrequently. They discuss treatment during the consultation, and then the patient is on their own until the next appointment. It’s up to the patient to adhere to the medication regimen and to attend the next appointment.
Digital medical assistants are starting to change that, however. These are tools like Florence, a friendly virtual nurse who communicates with patients over Facebook Messenger or Skype. She can record vital readings, tell patients when to take their medication, and remind them of treatment plans. Similar tools can help book appointments or prepare for the next consult.
Florence isn’t a real nurse, of course. It’s a conversational AI that follows pre-programmed instructions. But tools like can help guide patients through the check-in process. For example, Florence can remind the user that they need to fast for 24 hours, or that they need to bring a urine sample to the clinic.
Will clinics, surgeries and ERs ever go back to the old way of doing things?
It seems unlikely. Many of the new processes have been a long time coming and patients seem to be happy about many of the recent changes.
Many clinics needed this motivation to make long-overdue changes. The result: safer conditions for staff, reduced waiting time for patients, and more efficient clinics. Rather than going backward, now is the time to think about how to keep moving forward.
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