Healthcare in 2020 required constant adaptation—leaving little time to reflect. As the year draws to a close, we’re checking in with what researchers and business leaders have to say about running urgent care centers with high quality of care and and sustainable business.
The following post summarizes some essential themes of research and best practices for urgent care operations in 2021, from the most recent evidence on the virtual patient experience to the role urgent cares will play in vaccination.
The Amazing Expansion of Virtual Urgent Care
Early in the COVID-19 pandemic, policy changes opened the gates for a rapid increase in telemedicine, and providers in every corner of the country stepped up to address the need. Avoidance of medical care during the pandemic has been widespread, but virtual care has played a critical role in filling in the gaps. Looking back, we know so much more now about the possibilities and limitations.
The Journal of the American Medical Informatics Association zeroed in on the experience at NYU Langone Health, where virtual urgent care visits increased by 683% between March 2 and April 14. This rapid and massive adoption of virtual care is a testament to the flexibility of providers, who saw workflows transformed almost overnight.
“The impact of widespread video visits on team-based care is also being reimagined, with new roles for ambulatory nurses, medical assistants, and front desk staff being created,” according to researchers at the NYU Grossman School of Medicine.
Virtual care also helped people access traditional urgent care when needed. The CDC looked at data from four large national telehealth providers during the early pandemic and found that 3% of virtual visits resulted in an urgent care referral.
Telemedicine visits may decrease as the pandemic resolves, but virtual visits will have an important place in urgent care—and as an influence on standards of service in traditional in-person care. “This experience will likely create future expectations of care convenience and accessibility that will be hard to reverse once the COVID crisis abates,” according to the NYU researchers.
New Patient Experience Skills
Connecting with patients virtually is a different skillset than hands-on care. Practitioners may need training to optimize the virtual visit for successful and meaningful patient interactions. New phrases like “webside manner” have entered the lexicon – prompting the AMA to offer provider training modules.
In the Journal of General Internal Medicine, a Harvard Medical School research team reviewed the latest literature on virtual care—including many sources developed since the onset of the COVID-19 pandemic. Sarah Onorato et al. found that many clinicians had never done telehealth prior to the pandemic and that few medical schools offer any training.
If your urgent care center adopted telehealth in a haste last spring, now is a great time to polish the program with some key tips from the Harvard team:
- Establish clear roles. A medical assistant should provide clear instructions on how to access the visit.
- Optimize the video experience in every way possible. This means, for example, optimize internet, camera, and microphone quality. Ensure adequate lighting for patients to see facial expressions well. And maintain a neutral background.
- Look directly at the camera to communicate eye contact: “When it is necessary to look at the keyboard, notes, or a computer monitor or to interact with the electronic health record during the visit, clinicians can communicate their actions to the patient to reduce the likelihood of appearing distracted.”
- Avoid the “doorknob phenomen.” This simply means to make sure that the patient, rather than the clinician, ends the call. This practice creates space for the patient to express any final thoughts.
Patient experience has always been an important metric for success, but COVID-19 has changed the landscape in many ways. Those urgent cares that adapt and thrive will need to learn new communication skills and develop new strategies.
Changes Coming: New Billing Rules
Are you ready for the 2021 E/M coding changes? Optimizing workflows and EMR systems in 2020 to capture these changes is a critical step to maximize the revenue opportunity in 2021. Urgent care industry leader Experity says that the biggest effect of the changes is the focus on medical decision making (MDM) or time.
“Starting January 1, history and exam elements should only be captured when clinically appropriate. Providers can use whichever method—MDM or time—that is most beneficial for each visit,” said Phyllis Dobberstein, Compliance & Security Manager at Experity.
Dobberstein explains that, even though tracking time isn’t often used in urgent cares, it’s important for your staff to understand how it’s done. Her summary of the coding changes notes several nuances for time tracking. Relevant to virtual care, for example, she notes that the criteria for time does not require the patient to be in the office.
Change Is Here! The Vaccine
By the time this blog post is published, your team may have already received the first dose of the COVID-19 vaccine. Urgent care centers can provide valuable resources as the nation as a whole moves towards vaccination. The vaccine doses require follow-up visits and monitoring.
Another Experity expert recently weighed in on the critical role that urgent cares can play in a safe roll-out.
“This is another key advantage for the urgent care industry since it has been converging with primary care for years and many clinics already have established longitudinal care capabilities in place, such as long-term patient health record data,” wrote Monte Sandler, Experity’s EVP of Revenue Cycle Management.
Sandler points to a recent Blue Cross and Blue Shield study that found one-third of millennial patients don’t have a primary care provider. Clearly, in 2021, urgent care centers will continue to be a lifeline—providing safe COVID treatment, testing, and vaccination.
In early 2021, we’ll revisit the topic of vaccination in the urgent care setting in its own post.
The urgent care industry is experiencing rapid changes, but the fundamentals still hold true. Providing safe, quality patient care – regardless of the modality, is still the target. By embracing the changes and revitalizing urgent care operations to reflect the new environment, urgent care centers can look forward to a successful 2021.
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