How the multi speciality group deployed Elaborate to automate patient education in result delivery workflows to reduce clinical admin tasks and close high-value clinical quality gaps.

Summary

Backstory

Westside Family Medicine (WFM) is an independent physician-owned, multi-speciality clinic serving patients throughout the greater New York metro area. With primary care providers specializing in wellness care, LGBTQ+ care, adult, pediatric, and GYN specialty care, weight management medicine, and mental healthcare for adults and children, WFM has become a trusted market leader for outpatient services. WFM has invested in providing a superior digital patient experience, including open access availability, on-demand scheduling, and access to care teams through online messaging platforms.

As practice leaders executed their vision of a differentiated and seamless patient journey, one problem continued to plague the provider team and create an outsized clinical admin burden: communicating and answering questions about lab results.

WFM recognized an opportunity to partner with Elaborate to educate patients about their results upon delivery, eliminating the back-and-forth questions and getting patients to clinically indicated next steps, faster.

Challenge

As is the case for healthcare organizations across the country, WFM’s process of communicating new health data to patients was highly manual, repetitive, and time-consuming. Providers found themselves writing the same comments to summarize labs, educate and, discuss approrpriate next steps, multiple times a day.

As the organization made investments to offer patients a digital-forward experience, the time required to manage this inbox work became untenable for providers.

Why? Providers focused on delivering exceptional care during the working day found themselves inescapably falling behind in their daily lab queues. Patients anxious to understand their health, who now had near real-time access to their labs, would consult unreliable online sources like Google in an attempt to interpret their own results. But, because Google doesn’t know the patient or their medical history for context, search results are intentionally vague and comprehensive, leading patients to diagnose themselves with irrelevant health conditions and panic unnecessarily.

To alleviate the panic, patients turned to their trusted health partner, their provider. However, the team was ill-equipped to manage this burgeoning influx of panicked patient messages.

WFM is not alone. Many organizations have seen inbox administration time double over the course of just two years. [MedPage, 2023]

The leadership team at WFM realized that their providers faced a risky choice:

1. Rush to send the patient a hurried interpretation before the patient began searching their results online resulting in unnecessary panic;
2. Take the time to do the work right, with a fresh set of eyes, and risk an influx of additional messages that created more administrative work with no clinical quality gain.

Furthermore, leaders remarked that the workflow today did not support clinicians in identifying clinically significant findings, leaving the practice exposed to clinical errors of omission and missing opportunities for early health intervention.

Solution: Elaborate

WFM and Elaborate partnered to offer patients a white-labeled, customized lab delivery experience.

Using an evidence-based algorithm developed by clinicians with decades of on-the-ground experience, Elaborate took new incoming lab results and adjudicated them into actionable insights that gave patients clarity about what their results meant and what they needed to do next.

The technology produced reports tailored to the patient’s history using clinically-validated evidence-based guidelines from primary sources such as UpToDate, as well as the customizations from the clinical protocols created by WFM.

Elaborate also incorporated customized next steps into the solution, routing patients to revenue-generating visits when clinically necessary and providing opportunities to proactively educate the patient and ensure follow-up to close care gaps.

During onboarding, the Elaborate and WFM team worked hand in hand to deeply personalize the clinical workflows to ensure the product fit neatly into providers’ existing workflows.

Most importantly, clinicians were able to test and validate the system, both before launch and during the pilot, easily adding customizations along the way to better reflect their clinical nuance and style of practice.

Within 3 months, over 89% of all lab results were delivered via this new platform and process.

For providers, workflows stayed largely unchanged, with no new portals or workflows to manage as Elaborate was embedded into the EMR. Self-reported data from providers indicated significant time savings within the first 3 months of using the product, as well as clarity on how to use the product and the scope of ownership in the clinical partnership.

Outcomes

Very quickly, the WFM provider team saw a reduction in administrative time and task load. On average, providers’ self-reported time savings averaged over 3 hours per week. About 50% of this time was recycled into additional visit capacity; the remainder was invested into provider well-being time and retention initiatives.

Time savings were driven both by eliminating manual, redundant data communication workflows, as well as by a 90%+ reduction in unnecessary panicked patient calls.

Patients adopted the product quickly, with low adoption friction and utilization rates that nearly doubled previous access rates: previous access rates of ~40% increased to 89%+ within 3 months. Patients from varied socioeconomic and demographic cohorts were able to access the product at equivalent rates.  Providers reported that adding consistency to the process reduced their fear of failing to communicate clinically significant findings to their patients.

Patients’ feedback was overwhelmingly positive, with a Net Promoter Score of 92 (scale of -100 to 100), with weekly qualitative reviews reinforcing a preference for the new process.

Patients especially appreciated receiving hyper-personalized educational content simultaneous to new results, plus the ease of following next steps within the tool.

Additionally, WFM asked Elaborate to analyze the tool’s impact on delivering better clinical quality and closing care gaps.

The analysis leveraged patients’ lab results, performed at an interval of 3-9 months, to capture which patients had improved, worsened, or stayed the same.

In all three chronic conditions assessed, the data indicated that the overall patient population was improving as measured by standard blood testing. Specifically:

• Diabetes (Primary markers analyzed: HbA1c, fasting blood sugars)
• Lipids (Primary markers analyzed: LDL, cholesterol ratios, CVD risk score)
• Thyroid disorders (Primary markers analyzed: TSH, Free T4)

As an example, one of the findings suggested that before Elaborate, 24% of all patients had in-range HbA1c levels of <5.7% and 8% indicated elevated or worsening levels. Within 6 months, more than 41% of patients had in-range HbA1c levels, with 11% of all patients improving or stabilizing their blood sugar levels.  Notably, the composition of the patient population was constant over the observation period.

Ongoing analyses continue to demonstrate similar outcomes. The WFM team continues to partner with Elaborate to expand the scope of its population health programming.

Conclusion

Through its partnership with Elaborate, the WFM leadership team saw substantial operating improvements to inbox management, addressing a top provider challenge, increasing appointment availability, driving incremental revenue streams, and enhancing the robustness of its clinical quality programming.

In terms of outcomes, WFM measures ROI in three areas:

• Improve staff retention: WFM providers saw an overall reduction of ~35% of inbox messages and eliminated 3 hours of work weekly. These improvements to administrative workload have a material impact on self-reported feelings of provider burnout.
• Increase clinical capacity: In the current climate of provider staffing shortages, WFM aimed to more efficiently leverage existing headcount. With Elaborate, the team saw an increase in the appointment capacity per provider of 3%. This increase allowed the practice to offer reduced wait times relative to competitors, one of the leading factors that influence patient choice when considering switching healthcare providers.
• Drive quality-based reimbursement: WFM has robust protocols to support providers in their goals of delivering high-quality care. However, the impact of such programming is often stifled by poor patient adherence to the next steps. By tying the next steps into the experience of receiving results, Elaborate increased participation in asynchronous clinical programming by up to 4x. This has proven to have a substantial and measurable clinical impact.

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