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Week 17: Secure messaging– the why and how
Hopefully, you can now recognize the importance and power of message center as a central location for interacting with new information about your patients and with your healthcare team. Having an integrated solution for interacting with your patients asynchronously opens a world of possibilities if you know why you are bothering and how to do it. Unfortunately, these things are rarely taught. Instead, we fumble through using secure messages often becoming frustrated when it seems to be creating more work. But it doesn’t have to be that way if we embrace its purpose and use it the right way.
Why Secure Messaging? The simple answer is “because patients demand it”. That’s also the wrong answer. Patient satisfaction does not improve healthcare outcomes (in fact it makes them worse – but that is another discussion). The goals of secure messaging are simple: (1) improve patient engagement and (2) improve healthcare delivery proficiency.
PATIENT ENGAGEMENT: Simply put, patients that are active participants in their healthcare are healthier, have better clinical outcomes, and are less expensive. This active participation is becoming known as patient engagement and SHOULD matter to you because it does improve outcomes. And it isn’t just the patient's responsibility. How you engage with your patients is a significant factor in how they engage with the healthcare system. And messaging is one part of that. Several chronic disease management studies have shown that regular interactions using messaging can significantly impact both process measures (such as checking blood sugars) and outcomes (such as A1C levels or mortality). So stop thinking about messaging as “another task” and instead consider it an opportunity to engage with your patient quickly and efficiently to improve their health.
IMPROVE HEALTHCARE DELIVERY: When done well, secure messaging can ensure that patients are getting the right care at the right time by the right person in the right way. In most locations, however, secure messaging has been seen as an afterthought and not as a major opportunity to engage with patients. Messaging your patients should be handled strategically by your healthcare team. That means having a plan that creates a consistent experience for both the patient and the staff (including yourself). Messages can reduce appointment requirements and often is an avenue for patients to get their needs met in an expeditious way. And – if you strategically plan for this engagement – it can also help your healthcare delivery.
How Secure Messaging? This could probably be a blog in itself, but I wanted to give some helpful tips that may assist in turning messages from a burden to an opportunity. Here's a very uncomprehensive hit list of hints to optimizing the secure messaging experience.
1. You are a secure messaging's best advocate. If you aren’t discussing secure messaging (and the portal) then you aren’t fully engaging your patients. Physicians discussing the portal is the #1 reason that patients engage in the portal and secure messaging use. Remember, engaged patients, are the best care for patients, so ignoring this is like not prescribing certain medications because it seems inconvenient for you.
2. Messages should be personal. Secure messages should NOT routinely be used to give administrative information (with some exceptions below). If the message does not contain PHI then you are probably choosing the WRONG modality. Patients will actively disengage from messaging when they get messages that do not directly relate information that can only be done in the portal. Going through DS logon to see an office time change is frustrating and unnecessary. Don’t do it. Don’t let your organization derail your engagement by doing it.
3. Strategize your secure messaging:
a. Be prompt. Come up with a way that messages get triaged and a response gets to the patient immediately. Message pools in GENESIS are great for this. In Relay Health my nurses were the first line of defense.
b. Create autonomy. Often someone else is the best person to answer certain messages. Create nursing protocols on how to answer certain messages to reduce the back and forth.
c. Make time. Create some space in your day to engage with secure messages. Actually, this deserves its own bullet…
4. Treat secure messages as an asynchronous virtual visit. Many times we are doing this in our “spare time” (whatever that is), but these are often value-added patient visits. Do you currently book asynchronous virtual visits into your virtual slots? Why not? I’d recommend having your nurses book an appointment and respond to the patient with “I’ve booked you into a virtual encounter at 1400 today for your doctor to review your message. Expect a response by 1430 in Relay Health.” Then make sure you respond. Wanna convert it to an audio call, V3, or face-to-face? Easy enough, but this gives you the time to fully engage.
5. Code correctly. Ok, this pains me. I hate I just wrote that. But we have to get our leaders to understand the volume and value of asynchronous care. This isn’t about productivity as it is about showing that we are engaging with our patients and we need resources to have the best outcomes.
6. Introduce yourself. Start your messages with who is responding instead of waiting until the end. It can be confusing to patients (just like a normal email string) as to who is actually writing. Make it clear upfront.
7. Say "hi". When you arrive at a new duty location I recommend that you “introduce” yourself virtually to all of your patients. Although skirts my rule above to not use it for administrative tasks, this is highly personalized for your patients and immediately creates an underlying opportunity for engagement.
8. Say "goodbye". In the same way that saying hi engages patients, saying bye is a great bookend to reaching out to your patients. It also sets up the next person for a more successfully engaged patient population.
9. Track and report secure messaging use. Make it a priority by showing the level of patient engagement by both the staff and the patients. Don’t refer to it as volume (that is a burden), instead see every message as a successful patient engagement opportunity.
Hopefully, that is a good starting point to rethink and reframe your secure messaging attitudes and strategy. It can be an incredible tool if we learn how to use it.
Next week: Introduction to better metrics
GENESIS 101: Each user can create their own library of auto-text (dot-phrases) that work like AsUType. Type a small number of characters to generate a full text.
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