I’m happy to write this piece as a follow-up to my September/October 2014 ME article, Patient Check-In: Is It Time To Go Digital? In that column, I lamented over the lack of good digital patient check-in solutions and quipped in the last line, “Anybody want to join my new startup?”
Fortunately, pretty soon after that article was published, I came to know of a nascent NYC startup that was hoping to solve the same problem. After multiple discussions and meetings, I joined Yosicare Health last year as one of its founders. Last month, YosiMD 1.0 became available in the iPad app store, allowing any practice to immediately offer seamless patient check-in technology to their patients.
Read any doctor review on Yelp, Vitals, or any proliferating online review sites and you will notice a few common threads. Almost uniformly, negative reviewers complain about the wait time, and some dispute billing, insurance, and coverage. Conversely, most positive reviews applaud a nice staff, cleanliness, and overall efficiency.
Patient reviews—which are mostly written by Internet-raised millennials and post-millennials—are paradoxically all about process and have nothing to do with diagnostic accuracy or competent treatment, ie, medical care. But that’s another issue.
With value-based payments and the pay-for-performance (P4P) model arriving in earnest, maintaining an efficient and positive office experience becomes even more important, directly affecting the bottom line. To do this, medical practices must include technology.
MILLENNIALS: ACCUSTOMED TO SMART TECHNOLOGIES
Ubiquitous technologies such as Uber and OpenTable are valued in the billions because they have successfully removed friction from everyday tasks, thus becoming the default ways we summon car service and make restaurant reservations. Many ME readers under 35 probably groan if they have to actually call a restaurant to make a reservation—working through the phone tree options, listening to often-unbearable hold music, being told by the hostess to wait 1 more minute, struggling through repeated attempts to articulate the correct spelling of your name … and then having to actually record that verbal RSVP somewhere in your calendar (and hopefully not on a loose piece of paper).
Calling a doctor’s office is often worse. Front-desk staff at most private practices are beyond overburdened by pharmacy call-backs, insurance prior authorizations, eligibility confirmations, and the actual patients in the waiting room. Once you arrive at the office, you are handed stacks of paper to be filled out by hand, long form, using a pen, on poorly photocopied forms. Imagine the horror for millennials and even more so for the Internet-native Generation Z.
REMOVING PATIENT CHECK-IN FRICTION
From a physician, practice staff, and patient point of view, everyone wants the most effortless, friendly, accurate, and quick intake experience possible for new patient visits. At my practice, we have been using Yosi to eliminate the manual paperwork from the waiting room (now dubbed the reception lounge) in two ways: (1) encouraging previsit mobile sign-in via the Yosi mobile app or (2) utilizing YosiMD iPad tech in the reception area.
Nowadays, before we head to the airport, we have already selected our seat and even checked in on the airline’s mobile app. The same should be possible for a medical appointment, and Yosi technology enables it. After a new patient visit is scheduled with my practice, our staff members utilize the Yosi dashboard (from their browser) to send an SMS appointment reminder to the patient. The message not only confirms the scheduled appointment time and date but also provides a link to prefilling the forms directly on his or her smartphone. Yosi then collects not only the patient’s demographic and medical information but also a copy of his or her ID and insurance cards. This information is then auto-populated in my practice’s existing intake forms and shows up digitally on the practice dashboard as complete. All of this occurs long before the appointment, necessitating only an ID confirmation at check-in.
Once in the Reception Lounge
Patients who have not prefilled their forms are handed an iPad preloaded with the YosiMD app for their intake. Then the user is instructed to snap a photo of his or her ID and insurance card. This auto-populates all of the demographic and insurance fields instantly. The next few screens gather other pertinent medical history information in an extremely user-friendly manner. For example, under past medical history, just entering the first few letters will generate a dropdown, autocomplete list of choices. For pharmacy, a dropdown list of all pharmacies close to the patient’s zip code is shown. Once completed, the patient can eSign the practice forms and hand the iPad back to the receptionist.
On the receptionist’s end, the practice’s own legacy intake forms are now digitally typed in, including photos of the ID and insurance cards, with signatures. With certain EHR platforms, this information is then directly inputted in the practice management system. If the interface does not yet exist (Yosi plans to integrate with all willing EHR/PMs), the practice has still saved valuable patient and staff time with an accurate typed form that can be imported into the EHR as a PDF.
New features such as automatic eligibility and benefits verification are about to be released, and many others are in the pipeline, including collecting patient copayments directly from the app. Eventually, my front desk will be free to take on higher-level customer service tasks to ensure patient efficiency and satisfaction. By having eligibility and payment performed by the patients themselves, there will be less likelihood for misunderstandings about their payment responsibility.
My practice has been beta-testing YosiMD for months, and the recent 1.0 version is now our office check-in technology for all new patients. Our patients absolutely love it, frequently remarking how cool the tech is, and question why every office doesn’t have it. Just as importantly, my front-desk staff likes it for making their lives easier. Yosi is now being utilized by many NYC medical practices ranging from primary care to dermatology to dentistry, and a future feature will allow direct patient referral—along with all of the patient’s demographic and medical information—securely to another physician.
For the many independent medical practices faced with onerous administrative challenges, Yosi levels the playing field with the mega hospital conglomerate and allows doctors to offer slick technologies to their tech-addled patients.