STRATEGIC PLANNING

Finding New “Front Doors” for Patients to Engage With Health Systems 

Changes in consumer behavior in the three years since the start of the COVID-19 pandemic have had a significant impact on the way the public engages with health care, influencing the way people access services and providers. 

To adapt to these changes, health systems need to rethink the ways in which they communicate with patients and deliver care services to them, according to Dan Clarin, managing director at health field consultant Kaufman Hall, and Suzanne Borgos, chief strategy officer at Capital Health, a two-hospital health system in New Jersey. This strategy includes reconsidering the health system’s “front door” or the first point of contact for patients, and ways to optimize the relationships it initiates. 

Clarin and Borgos shared their thoughts on these issues in a session titled, “Keeping Pace with the Patient Journey Transformation” during the SHSMD Connections Conference last September. 

As a society, “we’re more individualized, more fragmented, and that makes it even more challenging to build the relationships that we want to have with consumers,” Clarin explains. 

Meeting consumers, or patients, where they are and providing real-world solutions for their needs is key, he adds. 

Consider these statistics from a recent consumer study conducted by Kaufman Hall: As of last fall, roughly six in 10 adults in the United States had not yet returned to their normal activities prior to the pandemic, according to Clarin. In addition, nearly one in three workers nationally reported that they did not work in their employers’ offices in 2021, a figure that’s up 18% from the period immediately prior to the public health emergency, he adds. 

Furthermore, with more people spending greater amounts of time at home, e-commerce doubled in the United States between 2019 and 2022, with nearly $1 trillion in sales in the third quarter of last year alone. Over the same period, consumer preference for online grocery shopping increased 50%. 

Image Courtesy of Kaufman Hall

“It’s interesting how quickly these things become so second nature to us that we don’t even realize how much our lives have changed,” Clarin notes. However, “these realities also play into health care.” 

Although overall consumer interactions in health care have remained stable over the past four years—with total visits up 5% over the period—volume is shifting, the Kaufman Hall data revealed. For example, urgent care visits nationally are up nearly 25% since June 2019, while outpatient surgical cases have increased 4% over the same period. Conversely, the past four years have seen an 8% drop in inpatient hospital discharges and a 12% decline in inpatient surgical cases. 

At the same time, 40% of respondents to the Kaufman Hall study indicated they were offered one health plan choice through their employers, including “more ‘virtual’ plan options,” Clarin points out. 

Perhaps not surprisingly, given that last statistic, new entrants in the health care field are capitalizing on the rise in online-based subscription services to “build tighter relationships” with patients, he says. These include companies that offer their members 24/7 virtual care, in-person primary care and lab services, and same or next-day appointments, as well as those providing virtual primary care clinics with board-certified primary care physicians.  

In the mental health space, some companies promise to develop personalized behavioral health plans with video-based therapy. 

New “Front Doors” at Capital Health 

Although traditional health systems can’t move all their services online, they can take steps to change the ways in which they connect and communicate with patients, according to Borgos. She and Clarin describe this as taking a “consumer integration” approach to outreach efforts, essentially borrowing concepts from online retailers. 

Indeed, Capital Health, located in central New Jersey about an hour from both Philadelphia and New York City, has taken this “consumer-centric mindset and translated it into a number of strategies that build trust and relationships with the consumers in their market,” says Clarin. 

Among other initiatives, Capital Health has focused its strategy on growing its primary care services, which Borgos describes as the health system’s “front door” to health care, in part by creating additional access points to care by opening more than 20 new clinics in New Jersey and Pennsylvania and creating a new online platform for virtual appointments. In addition, the system has created Capital Healthy Living, a concierge care program designed specifically to help seniors aged 65 years and older and their children and caregivers. 

Thanks to the primary care program, Capital Health Medical Group’s covered lives have increased by 89% over the past three years, according to Borgos. This has enabled inpatient discharges to hold steady despite a declining number of discharges in the regional market. 

With this initiative the message is: “We’re going to be serving patients where they live. 

“When we began this journey, we looked at where our patients were coming from and found the best spots,” says Borgos, who joined Capital Health in 2013 and is responsible for the health system’s long-term strategic planning as well as all community partnerships and new business opportunities. “We seek out every Dunkin’ Donuts, Starbucks, favorite [local] pizza place and restaurant, and we make sure we are within that shopping center. It’s consumerism and it has been very, very successful.” 

Meanwhile, patients with new or acute conditions who can’t wait for an in-person appointment are directed to virtual primary care, which operates from 8:00 a.m. to 10:00 p.m. daily, from Capital Health’s answering service. Patient volume in virtual care increased to an average of 340 patients per month between 2021 and 2022. 

More importantly, the program has a 93% patient satisfaction rating. 

“The service is attracting patients who may have otherwise used urgent care or another online service,” Borgos explains. 

The goal of Capital Healthy Living is to help seniors live independently while providing support to families and caregivers. Participants (who pay a monthly fee of $49.99) are assigned a life care manager, who helps in scheduling of appointments (including coordinating specialist referrals) and, if needed, arranges transportation. There’s also a wellness center with classes and exercise programs, including chair yoga, as well as social events. 

The program launched just before the pandemic and has more than 100 senior patients enrolled. 

“We talked to both seniors and their children,” Borgos says, “and asked: What do they need? What could we offer? And truly, how can we help seniors stay independent and not make health care so complicated and daunting?” 

The ultimate message of these initiatives is that health systems need to understand the needs of their communities. This starts with a community health needs assessment. 

“Health care utilization has changed,” Clarin says, meaning health systems need new ways of “building relationships with patients.”