The following is a guest article by Carlene Anteau, MS, RN, Vice President, Marketing, Twistle.
Adhering to an episodic or long-term health treatment plan can be overwhelming for many patients. They often do not remember everything their doctor tells them during visits, health portals are cumbersome and difficult to access, and the healthcare literacy level of patients can vary widely. Secure, HIPAA-compliant communication pathways can keep patients on track by providing step-by-step guidance for anything from routine preventive care to complex medical procedures. By prompting patients to adhere to their care plans using simple, easy to understand messages, healthcare providers are able to effect better outcomes, the care team is significantly more efficient, and patients are more satisfied.
The ability to activate patients in their own care consistently delivers a demonstrable return on investment. Patients enrolled in a Twistle pathway are better prepared for procedures, receive timely information throughout their journey, and have a close connection to the care team as they recover. Average results include:
- 38% reduction in 30-day hospital readmissions
- 84% reduction in phone calls
- 50% reduction in no show rates
- 30% improvement in medication and medical device adherence
- 93% patient satisfaction rate
The opportunity to improve patient engagement is nearly endless. The following use case examples depict strategies used across the country to optimize patient outcomes, quality of life, and provider efficiency across a variety of procedures, health conditions and research.
Engaging With Patients; Driving Results
Use case 1: Remote Monitoring of COVID-19 Patients
Providence was the first to encounter the COVID-19 pandemic’s expansion to the United States. They quickly recognized the need to prepare for a surge, and an important part of their plan was to keep hospital beds open for patients with severe viral illness.
Providence collaborated with Twistle to build and deploy clinical communication pathways to address a variety of COVID-19 patient engagement needs including at-home monitoring of infected, stable patients. Sherene Schlegel, Executive Director of Telehealth Clinical Operations said of the program, “This solution dramatically improved the effectiveness of our nurses. While starting at a 1:25 ratio of patients to nurses before Twistle, a week after deploying, Providence reached a 1:50 ratio. We then iterated pathways and streamlined internal processes to reach a safe and effective ratio of 1:85.” Since March, Providence has safely monitored 16,000 patients at home as they recover from COVID-19 and sustained an 87% engagement rate across an entire 14-day pathway, with high patient satisfaction. Download the complete case study.
Use case 2: Collecting Research on the Long-term Effects of COVID-19 Exposure
COVID-19 is a new disease and its clinical manifestations have not been well documented. As a result, clinicians are inhibited in their ability to properly set patient expectations post-recovery and identify long term COVID-19-related complications.
Providence is using its patient engagement platform to support COVID-19 research aimed to understand disease progression and define its long-term clinical manifestations – both common and rare — in a year-long data collection and analysis project. COVID-19 positive patients are invited to enroll in the program and prompted to document their physical and emotional symptoms at predefined intervals. The research is designed to capture disease manifestation on the work and daily activities of participants. This data will be analyzed using natural language processing (NLP) to identify themes and understand disease progression. The MyCovidDiary research project will also identify COVID-19 symptom duration and risk factors for progression to severe disease. Of the project, Ari Robicsek, MD, Chief Medical Analytics Officer, SVP Research at Providence said, “This is a fascinating example of how we can make use of new technologies to engage patients much more deeply than we’ve been able to before – in this particular case – both to learn about the clinical and the social manifestations of this pandemic.” Watch an on demand webinar to learn more.
Use case 3: Improving Detection and Management of Postpartum Hypertension
Clinical leaders at ChristianaCare sought to improve early detection of postpartum hypertension by overcoming low attendance for follow-up office visits. They deployed Twistle’s remote patient monitoring platform to engage new mothers after discharge.
Patients are prompted to report their blood pressure reading and answer a short survey. Replies for responses that are in a normal range offer immediate reassurance to the patient, Abnormal responses are escalated to the care team for follow-up, providing an opportunity to titrate medications before the patient requires admission for hypertensive crisis.
Open bi-directional texting solidifies engagement, builds trust, and helps the care team identify other concerns, such as lactation issues. When asked why the program has been so successful, Dr. Matthew Hoffman, Marie E Pinizzotto Endowed Chair of Obstetrics and Gynecology, commented, “The program works because of the radical convenience. Our patients love the ability to monitor their blood pressure from the comfort of their own homes, and without having to leave their newborn for a simple blood pressure check. We have had so much positive feedback from patients, doctors, and staff.”
The program has successfully reduced postpartum hypertension-related readmissions and eliminated long-standing racial disparity. While only 30% of patients attended in-person postpartum office visits, the remote monitoring program drove 91% of new mothers to submit at least one blood pressure reading (a 203% increase in hypertension screening), and decreased 30-day readmissions by 55%. Download the complete case study.
Use case 4: Reducing Readmissions and Length of Stay After Colorectal Surgery
To support their Perioperative Surgical Home (PSH) for colorectal surgical patients, Advocate Lutheran General Hospital relies on automated surgical pathways to deliver information and prompts for patients to keep the care team informed about their recovery.
Patients can send messages and images to the care team, reminders are sent to patients, and Advocate can collect patient-reported outcomes to better understand the patient experience. This holistic approach to care facilitates the identification of potential risks, improves management of the care process, and equips patients with the tools that are required to recuperate quickly and without complications. In analysis of their Colorectal Program in 2019, they found a 51.7% reduction in average length of stay and 11.7% fewer readmissions. Patients reported that they felt well prepared before surgery and that the automated Twistle messages sent before and after surgery helped them with recovery.
Project Manager for the Perioperative Surgical Home, Flo Kiokemeister, RN, MS said, “The Twistle platform helps us supplement our care and promote coordination between our providers and our patients. It allows our team to focus on those really sick patients that have multiple comorbidities.” Download the complete case study.
Use Case 5: Reducing Colonoscopy Cancelations and Increasing Facility Efficiency
To reduce the number of colonoscopy no-shows and cancelations and ensure they had enough time to backfill vacated appointments, Swedish deployed a 14-step patient engagement pathway that guides patients throughout their colonoscopy experience.
Secure messages provide gentle nudges to keep patients on track, confirming appointments, ensuring proper bowel preparation, and promoting timely arrival through reminders and educational videos.
“Our patients really like the coaching and support they receive throughout the bowel prep process, and we appreciate having enough advanced notification about cancelations to be able to service our waiting list,” Dr. Amir Bastawrous, MBA said of the program. Swedish has seen a 44% decrease in cancelations and has been able to reduce no-show rates. This has improved their ability to screen more patients and improve operational efficiencies. Download the complete case study.
Why Twistle?
The Twistle platform is exceptionally configurable and flexible to meet the unique needs of each organization. Its team provides expert guidance on patient engagement best practices and monitors metrics so providers clearly understand their return on investment. Robust integration with a wide variety of upstream and downstream systems ensures a seamless experience for providers and patients alike. With Twistle, care providers can meet patients where they live their digital lives and achieve high rates of engagement and satisfaction. In addition, by automating administrative tasks the care team can apply their clinical expertise where it’s needed most.
If you would like to learn more about the Twistle platform, visit www.twistle.com or email info@twistle.com. Schedule a demo today!
About Carlene Anteau
Carlene Anteau, MS, RN, Vice President, Marketing, leads all aspects of Twistle’s marketing strategy including demand generation, communications, digital and sales enablement. Carlene began her career as a critical care nurse, then transitioned to roles in health information technology to impact patient care delivery on a larger scale. Her background includes 30+ years of marketing, sales and clinical experience at leading EMR, population health and clinical communications companies.
