Improving Patient-Reported Outcomes through Enhanced Prescription Ordering and Filling Services

Background: Optimizing Prescription Fulfillment for Improved Patient-Reported Outcomes

A leading healthcare service provider manages prescription ordering and filling through their contact center operations. With the increasing emphasis on Patient-Reported Outcomes (PROs) in healthcare, especially for prescription services, the provider recognized the critical need to implement timely systems to capture and utilize this data. According to new CMS guidelines, providers must begin collecting baseline Patient-Reported Outcome Measures (PROMs) starting July 1, 2024, with outcomes to be publicly reported in 2027. This data provides valuable insights into patients’ health conditions directly from their perspective, covering areas like symptom burden, quality of life, and functional status.

What are Patient-Reported Outcomes (PROs)?

Patient-Reported Outcomes (PROs) refer to reports from patients about their health conditions and treatment outcomes, without interpretation from healthcare providers. These outcomes provide essential insights into symptom burden, quality of life, and functional status, and they are crucial for understanding the effectiveness of healthcare services from the patient’s perspective. Under CMS guidelines, healthcare providers are required to start collecting preoperative and postoperative PRO data for certain procedures beginning July 1, 2024, with the first submission deadline set for September 2025.

Challenge: Enhancing Patient Experience through Contact Center Support

As the healthcare landscape shifts toward more patient-centered care, the healthcare provider faced increasing demand for better management of patient-reported outcomes. Challenges included handling a high volume of patient inquiries about prescription orders, addressing concerns about medication side effects, and ensuring that patients adhered to prescribed treatment plans. Delays, long wait times, and inefficient call routing led to dissatisfaction and negatively impacted the overall patient experience.

DATAMARK Solution: Optimizing Contact Center Services to Improve PROs

Moreover, to address these challenges, DATAMARK partnered with the healthcare provider to enhance their contact center operations. The solution aimed to improve the patient’s experience and support better outcomes through efficient prescription
management. Key elements of the solution included:

• Real-Time Prescription Updates using Self-Service IVR: Automated updates provided through a self-service Interactive Voice Response (IVR) system. This system allows patients to check their prescription status at any time without needing to speak to a live agent, which reduces the need for follow-up calls, increases efficiency, and boosts patient satisfaction. The timeliness of these updates plays a crucial role in reducing patient anxiety and improving adherence to medications.

• Predictive Call Routing: Leveraging data from previous interactions, the contact center system routes patients to the most qualified agents based on their needs. This reduces the number of transfers and ensures that concerns are addressed promptly and efficiently. The rules governing predictive routing are continuously updated to ensure patients are connected with agents who are most capable of handling specific queries, leading to faster resolutions and enhanced patient outcomes.

• AI Call Summarization and Keyword Detection: This advanced technology detects adverse events and adverse reactions during calls. AI-driven summarization and keyword detection automatically flag critical information, such as potential side effects or medication-related issues, enabling rapid follow-up and ensuring that patients’ health concerns are addressed swiftly. The timeliness of detecting these events during the calls is critical, as it allows for immediate action to be taken to address patient concerns, thus improving overall patient safety and satisfaction.

Results: Improved Patient Satisfaction and Health Outcomes

The integration of advanced call center technology not only reduced average handle times but also played a crucial role in supporting patient-reported outcomes. By streamlining prescription management and enhancing patient communication, the healthcare provider saw significant improvements in the following areas:

• Increased Medication Adherence: Patients were more likely to adhere to their prescribed medications, leading to better health outcomes.

• Enhanced Patient Satisfaction: With reduced wait times, proactive communication, and real-time prescription updates, patient satisfaction scores improved, reflecting the positive impact on their healthcare experience.

• Improved PRO Collection: By incorporating tools to collect and analyze PROs, the healthcare provider was able to gather valuable insights that helped further refine their contact center services.

Conclusion

In summary, through DATAMARK’s innovative contact center solutions, the healthcare provider successfully enhanced its prescription management operations, improving patient satisfaction and health outcomes. The seamless integration of self-service IVR, predictive call routing, and AI-based tools for adverse event detection contributed to the overall success. Timeliness in rule application and response played a pivotal role in ensuring the efficiency and effectiveness of these solutions, demonstrating the value of patient-centered technologies in the healthcare space.