Self check-in: A well-oiled patient throughput machine

Meghan Kerrick is the director of administrative operations of Virginia Urology, the largest urology group in central Virginia. Read on to learn how athenahealth helps streamline patient self-check-in, improve digital patient engagement for an older patient population, and create operational efficiencies across the practice.

Q: Why is digital patient engagement so important for Virginia Urology?

A: It’s definitely difficult to engage [patients] digitally, at least historically. A large part of our population is 65 and older, not as comfortable with technology. It’s important for us to engage them digitally to make efficiencies in the clinic. If we can have people preregister before they come into the office, it just makes things faster and smoother once they get to the clinic.

I think people who are engaged digitally, whether it’s with their Patient Portal, receiving appointment reminders, I think they’re more likely to follow through with their health care. They’re more engaged. They’re getting answers to questions that they have because they don’t have to make a phone call and wait on hold. They can get the information they need at their convenience.

Q: Which patient digital engagement tools are making the biggest difference for your practice?

A: We use Enhanced Self Check-In, we also use the portal, we use campaigns. Pretty much everything you can use within [athena]Communicator.

I would love to see our patient self-check-in rate be somewhere in the 70 to 80% of our patient range. That might be a hefty goal, but I would love to see that.
It just streamlines the processes of in-person visits. At our main location, we can see up to 600 patients a day coming through our doors. And if all 600 patients need to be registered when they come in, it’s going to create a clog, and then clinics are going to run behind and providers are going to be upset. And it’s just a snowball effect. So, if patients can preregister and complete their self-check-in, they come in, they check in, they sit down, it just keeps things moving.

Q: How do you encourage portal adoption and digital engagement across an older patient population?

A: It starts when a patient calls in as a new patient to register them. Our call center agents encourage them to register for the portal. They’ll push an invitation to them. When the patient comes in for an appointment, if they haven’t registered for their portal, we have a conversation with them at the front desk. The physicians and the nurses play a huge role in this as well, because they tell the patient, look, if you sign up for the portal, you’re going to get your results quicker. You can reach us quicker. You don’t have to wait on hold when you call, because our call volume is so high. So, it’s a conversation at multiple points throughout their visit.

Actually, prior to athenaOne®, I don’t really think our physicians cared about the Patient Portal, and now they do. They love to communicate with patients through the portal. It’s quick. It’s easy. So, they’re encouraging patients, which gets their buy-in.

We help a lot of patients for the first time that they’re doing something when they come into the office. So, we may walk them through the Enhanced Self Check-In interview, step by step and explain things. And once they kind of see how easy it is, they feel better about it. Same thing with the portal. We’ll help get them set up if they come into the office and they just can’t figure it out. And then once they do it and get the hang of it, they seem to be okay.

Q: What changed when you moved to athenahealth Enhanced Self Check-In?

A: We used a third-party vendor that we had been with since we were on athenaPractice™, back since 2018. And it’s just clunky. It doesn’t talk to systems appropriately. Data didn’t flow seamlessly. But we did use the third party to push a registration, digital forms, ID and payment capture.

I came to Thrive last year and attended a workshop on Enhanced Self Check-In. I knew our contract with our third party was coming to a close, and so we needed to make a decision. Obviously, the goal was to save some money and utilize services that athenaOne provided that we were already paying for. I sat in the workshop, asked a couple of questions, and felt like I had a good foundation to start building it.

I did attend several webinars, and then I did the athenaOne training sessions that were offered. Actually, it was something that I sat down and built over Christmas break when most people were off. I had some quiet time, and it’s so easy how it’s set up. It’s probably one of the best things I think athenahealth has rolled out. As far as being able to build something on your own, I am not IT. It’s all kind of in one area in athenaOne, and it kind of walks you through step by step what needs to be done.

Q: How did you roll out Enhanced Self Check-In across the organization?

A: I engaged with our middle level management that’s in charge of our clinic operations and day-to-day patient front desk experience. We all created test patients. I had everybody go through from start to finish so that they could understand the process from the patient perspective. And then also, once they put their test patient in and registered them, doing what they needed to do on our end, how do you complete your registration? What do you need to do if a patient missed a form? And really had several hands-on training sessions with them until they were comfortable. And then from there, we deployed it by location to our team leads and our office staff.

We did a wave rollout. So, we knew our contract with our third party was coming to an end. We had an end goal of the end of March of 2025. And so, we started with our smallest location first, and we did it week by week up until the end of March.

It’s so easy. Enhanced Self Check-In is so easy. I don’t want to say it requires no training, but it’s very straightforward. When we onboard new employees, they get a whole session on athenaOne. So, they’re doing the training sessions. They’re getting one-on-one training with a coworker in that department as well, to show them how to do it.

Q: What kind of operational impact are you seeing from digital self-check-in?

A: Since we’re a specialty practice, and we are the largest urology group in central Virginia, we have a lot of referrals that come in. So, they’re able to now dedicate their time to reaching patients, to get them in, to see one of our urologists much quicker than we were before. We used to have a pretty big delay in reaching out to referred patients. And now, whatever comes in, we’re reaching out to them the same day, so there is no delay anymore.

If they’re tech savvy, it takes under five minutes. And I think people who struggle a little bit more, maybe they’re in the five-to-seven-minute range. If a patient comes in and needs help completing that at their visit, it’s five minutes or less. So, a huge opportunity there with time at the front desk.*

Q: Which Enhanced Self Check-in features have been most valuable for staff and patients?

A: Probably all of them. We push screeners. All of our consent forms are through Enhanced Self Check-In, family history, medical history, any type of health history we use, social history, med reconciliation. It helps a lot with MIPS capturing data. So, really, we use all of it.

Because of our age population, we use the fall screening risk. Actually, I was really excited when I first built Enhanced Self Check-In. They only had the full version, not the abbreviated version. And so, a couple months ago, they released the abbreviated version. And that was a huge win for everyone because it’s three questions. So, we push that to all of our 65 and older patients.

If they do the screener ahead of time, once they get called back by medical assistant to our intake, it’s already done. And it takes one more thing off of the intake team. So, they’re already going through vitals and asking all of these questions. And if the screener’s done, they check the box and they move on. They don’t have to do that face to face with the patient.

Q: How is digital collection of insurance and payments improving the front-desk and billing experience?

A: Lots of patients doing that digitally. I think nobody likes to fumble through their wallet and take out their insurance card. We have patients that are making their co-payment right through Enhanced Self Check-In. It’s quicker. Nobody wants to sit at the front desk when they come to the doctor. So, we do have buy-in with people just doing that and completing as much as they can prior to coming in.

We ask our call center agents to try to collect insurance information when they’re calling to schedule the patient, but at best, you’re getting maybe 50% accuracy. And so, when they’re providing that insurance card ahead of time, we do have our front desk team go through and just check eligibility, make sure everything’s green, as we say. And anybody that isn’t, they’re able to reach out ahead of time and talk to the patient.

I don’t have an exact percentage, but it’s a lot. We take a lot of payments ahead of time. Patients, I think, are more willing to pay on their balance as well, because it’s just presented and they’re like, okay, why not? And it eliminates that conversation with a front desk person who may not be comfortable having that with a patient. Anything that we can collect upfront is savings for us.