How Digital Health Can Improve Patient Retention

Interview with Dr. Kevin Spencer, President and CEO of Premier Family Physicians

Digital health, telemedicine, and telehealth have received a lot of attention in the past year and more, as many hospital systems and primary care practices adapted to needing to see patients quickly and safely, minimizing the chance of exposure to COVID-19 by addressing patient issues via a telehealth visit. There’s one benefit of telehealth that doesn’t get as much exposure, and it’s one that matters a lot to hospital networks and healthcare systems: retaining patients by stopping or reducing what is commonly referred to as patient referral or network leakage.

What is Patient Leakage?

There are two types of patient leakage. Network leakage is patient induced and depends on whether a patient chooses their own in-network resources for their healthcare needs. Referral leakage is provider induced and depends on whether a provider sends patient referrals to in-network or out-of-network resources. Anytime a patient receives treatment outside of the connected network of a PCP or hospital system, leakage has occurred. Both network and referral leakage represent missed revenue opportunities for a health system. 

A common situation in this context is when patients seek medical attention after normal clinic hours or on weekends — many visiting an urgent care clinic or emergency room that is close to home. This is a common example of leakage, especially because the ER or urgent care clinic does not typically follow up with the patient’s primary care physician, instead recommending that the patient do so. But patients do not always follow up with their primary care doctors; this lack of awareness with the PCP not only highlights poor communication, but can lead to tangential health issues when patients are seeking urgent care for chronic conditions that their PCP has knowledge of.

How Can Telemedicine Reduce Patient Leakage?

Digital tools and telemedicine can help reduce patient leakage by offering after-hours telehealth visits as a partner for PCP practices and hospital systems, some even with an option to white label virtual care and use it as part of an existing brand. In addition, digital health companies like CareHive can navigate patients to high-quality, lower-cost in-network options as escalation requires, keeping them within the same family of healthcare partners. As an extension of the practice’s brand, CareHive works to resolve a patient’s medical needs without sending them to an ER or urgent care clinic, but should that be necessary, the service also notifies the practice and follows up with the patient to ensure they are seeking follow-up care from their PCP.

Dr. Kevin Spencer, CEO & President of Premier Family Physicians (a 7-location, 80,000+ patient primary care clinic system) in Austin, Texas, has been working with CareHive for two years now. “We knew that we were having leakage especially in our younger insured population,” said Dr. Spencer. “What we wanted is when we turned our phones off after hours, we had a partner that could escalate the patient issue via a telehealth provider that we have white labeled.”

PFP’s brand is now “you can get care anytime,” said Dr, Spencer. “It’s not a nurse hotline, we can actually solve their problems around the clock. We call it Premier On Demand powered by CareHive, and it’s truly an extension of our practice. Any time CareHive has interactions with our patients we get a notation on the patient’s electronic record, as opposed to an ER visit in which the patient is the one that has to reach out to us the next day.” 

Because CareHive has access to patient records, it can offer wraparound care benefits after hours, including follow-through to resolution, refer patients to a specialist or to lower cost options, provide patient education on the cost of urgent care versus regular wellness visits, and implement proactive lab testing before urgent care is needed in the case of chronic medical conditions. As a partner for a PCP or hospital system, CareHive not only has access to patient data, but it also ensures that patients are referred back to their PCP — and follow up to ensure that happens.

COVID-19 and the Acceleration of Telemedicine Adoption

Dr. Spencer explained that, while his practice’s partnership with CareHive goes back two years, “the use of telehealth became the norm overnight during the pandemic. We had the service white labeled and in place when the pandemic began. People who think they have COVID symptoms are not going to wait, they are scared of going to hospitals or the ER, so having wraparound services allowed us to provide care at all hours. At the height of the pandemic, we saw 80-90% of our business on telehealth.” And CareHive kept this under PFP’s brand.

He offers another example. “During the 2021 winter storm in Austin, our offices were shut down because we had no power or water. CareHive was able to step in and offer services around the clock, despite the arduous conditions.” 

We cannot predict a global pandemic, but we’re in one. Texas didn’t expect a winter storm to take out its entire power grid, but it did. Dr. Spencer said, “If you’re a true primary care office and part of a medical community, telehealth is really lower cost net-net. If you’re delivering wraparound care, when your partner is an extension of your practice, they can access patient files so that they understand what their issues may be. These are medical professionals on the line, starting with a RN who can triage patients, and having access to patient files they are able to see the most recent visits, chronic conditions, doctor’s notes, and so on. They can escalate to a licensed professional who can perform a telehealth visit.” 

As far as the other benefits to his practice, Dr. Spencer said that “the high level of customer service and accessibility that my practice has by being able to provide 24/7 care is top of the list. The second factor is that patient visits to the ER are unnecessary most of the time, so we’re saving a lot of unnecessary ER utilization. CareHive not only provides care, but also technology solutions — an app on the patient’s phone so that there is asynchronous communication with their provider.” 

“Our patients are pleased,” he added. “We hear stories all the time about how well we’ve been able to become a team with CareHive and how comfortable patients feel having CareHive’s after-hours access.”