Improve the Reach and Cost-Effectiveness of Panel Management Calls for Cancer Screening with Automated Outreach: UCSF Health

As part of an organizational commitment to providing the highest quality patient-centered care across the healthcare continuum, UCSF Health maintains their own rigorous performance standards and compares the outcomes of their care with those of top medical centers nationwide. This case study was adapted from an article appearing in the Journal of Ambulatory Care Management, April/June 2020 – Volume 43 – Issue 2.

CHALLENGE

In an effort to improve patient safety and clinical outcomes, UCSF Health uses CipherHealth to efficiently reach and offer meaningful services to a larger number of patients each week/month than they could reach manually. The use of CipherHealth aligns well with both clinical and strategic objectives within the UCSF Health organization, as engaging patients for routine cancer screenings is a priority across many payer and government value-based care programs. An improvement of a few percentage points in cancer screening rates can have major financial implications, as well as impact the quality of care and outcomes. They considered three practices within their system (family medicine, women’s health, and general medicine) for a study to compare the effect of combining CipherHealth’s automated call system (ACS) with staff outreach on clinical efficacy and cancer screening rates. Each practice had one full-time panel manager on staff who was responsible for reaching out to patients to close preventive and chronic care gaps. Because the manual approach to panel management outreach is labor intensive, there is considerable interest in determining whether automating some or all of the process may yield efficiencies.

SOLUTION:

UCSF Health conducted a comparative effectiveness study to assess the reach, effectiveness, and cost-efficiency of different panel management approaches. In this study, they compared a two-week period of standard outreach at the family medicine and women’s health practices with a two-week period of outreach supported by CipherHealth’s Preventive Outreach program at their general medicine practice, between 2017 and 2018. All patients with at least one in-person visit or patient-initiated electronic message in the prior 36 months were considered. UCSF Health uses cancer screening registries extracted from the electronic medical record (EMR) database to generate monthly reports for each practice indicating which patients are overdue for cancer screening and eligible for panel manager outreach. At the time of the study, the registry indicated that 13,128 patients at these practices were overdue for at least one cancer screening.

RESULTS:

The process incorporating CipherHealth allowed the panel manager to focus on patients who responded to the automated calls, thus engaging many more patients compared to a panel manager working manually to contact patients by phone. Automating a portion of the outreach work was associated with almost twice as many completed cancer screenings with half the amount of labor.

Specifically, a comparison of manual call outreach versus ACS-assisted calls yielded the following insights for UCSF Health

• The panel manager who was assisted by the ACS technology from CipherHealth completed outreach workflows for 43% more patients than the two panel managers who conducted the calls manually.
• A preventive screening gap was closed for 78% more patients in the panel management program assisted by CipherHealth.
• Adding the Preventive Outreach program markedly improved the cost-effectiveness of panel manager outreach, reducing the cost per closed care gap by nearly two-thirds, from $45.39 to $15.85.

This study suggests that an ACS-assisted method improves the efficiency of panel management outreach, allowing more patients to be reached and increasing the productivity of panel manager staff.

The electronic dashboard provided by CipherHealth may also have improved the efficiency of documenting panel management activities and increased the panel manager’s sense of accountability for outreach tasks.

UCSF Health has adopted CipherHealth technology for all its primary care practices. They have also pursued advanced technical integrations between CipherHealth and their EMR, which has allowed them to develop additional panel management-driven workflows, such as hypertension management and depression care management.

The Process:

UCSF Health compared the results of one panel manager assisted by automated technology at one primary care practice with those of two unassisted panel managers using the standard approach of manual phone calls at comparison practices.

Without CipherHealth:

In the standard approach, if the patient answered and was still receiving care at UCSF Health, the manager explained that they were overdue for a cancer screening. If the screening had not been conducted elsewhere, the panel manager offered to help schedule the needed test. Panel managers would attempt to reach a patient up to three times, leaving a message asking for a call back if no one answered.

With CipherHealth:

In the ACS-assisted outreach, cancer screening registry data were uploaded into the CipherHealth dashboard, and the system was programmed to call 50-60 patients who were overdue for a cancer screening, daily. CipherHealth added a predetermined number of patients to the call list every day.

The automated call made through CipherHealth delivered a message recorded by a UCSF panel manager about routine cancer screenings. The patient was then presented with a series of questions including if they wanted UCSF Health staff to help to schedule a screening, and if so, when someone should call back. The responses were fed back into the CipherHealth dashboard, where the panel manager was able to identify those requesting a call back.

Reach and Cost-effectiveness of Automated Call System-Assisted Versus Standard Method

Source: (An Automated Telephone Call System Improves the Reach and Cost-effectiveness of Panel Management Outreach for Cancer Screening), The Journal of Ambulatory Care Management, April/June 2020 – Volume 43 – Issue 2

CLIENT: UCSF Health Primary Care Practices (Family Medicine, Women’s Health, and General Medicine), SOLUTION: Care Continuity, PROGRAM: Preventive Outreach for Cancer Screening, DATA PERIOD: 2017 – 2018

CipherHealth is an award-winning and proven technology solutions partner committed to enhancing communication and care throughout the patient journey. Since 2009, CipherHealth has helped shape the patient engagement category, delivering groundbreaking products to help care providers effectively and efficiently provide quality care for their patients. CipherHealth’s suite of patient engagement software sets new standards for care and empowers healthcare organizations to foster meaningful connections to ensure the best possible outcomes for staff members, patients, and their loved ones.

Read the full article from UCSF Health. Contact us to learn how CipherHealth can help improve your outreach workflows to reach more patients and close care gaps.