When well visits were first covered by most insurers, as well as through federal programs, health experts envisioned a clear path towards building healthier populations. Patients would be motivated to take a more proactive approach to their health. Yet removing or subsidizing the cost wasn’t the only barrier standing in the way of well visit adoption. Hospitals and health systems quickly learned the barriers that keep people from following through on well visits were as diverse as the individuals themselves.
Finding a solution to overcoming these barriers falls not on the patient, but on the health system that serves the patient and their family. It’s a deft mix of the right communications at the right time, combined with the right in-person care, that will drive patients to schedule and attend well visits and set the stage for a more comprehensive healthcare approach to caring for themselves and their families.
Anatomy of a Well Visit
So, what exactly is a well visit? They are designed to be a critical piece of preventive care and can facilitate early detection of potential health issues. A well woman visit for women’s healthcare can include things like blood pressure check, a clinical breast exam and a pelvic exam, and an opportunity to talk about broad health areas like mental health or immunizations. Another type of well visit is for seniors. Those with Medicare Part B insurance for longer than 12 months receive a yearly wellness visit. These annual visits are encouraged to “develop or update a personalized prevention plan to help prevent disease and disability, based on your current health and risk factors.”
Still, there is a lot of confusion around well visits or wellness exams; many see these as the same or similar to annual checkups or physicals. An annual physical involves additional lab tests and bloodwork. Its primary purpose is to look for health problems. Wellness visits are an important building block for moving healthcare to seeing the patient as a whole person, and to move patients to better engage with their primary care physician. Well visits help to identify gaps in care and improve care quality. Think proactive, preventive and holistic rather than reactive and episodic.
So Why Aren’t People Scheduling Well Visits?
From lack of transportation to fear of what the visit might indicate in terms of their health outcomes, the reasons why well visits aren’t being used as the effective tool for disease prevention and management they could be are widespread.
“[…] if you get your results, you’re scared and you’re panicking, so that’s probably why a lot of people don’t want to go to the doctor. They’re scared of the results,” says a study participant from the Well-Woman Project. The pandemic has a further chilling effect on patients scheduling their well visits, and uncertainty lingers with regard to hospital capacity for routine care. Dr. Mary Rosser, director of Integrated Women’s Health at Columbia University Irving Medical Center in New York, is particularly concerned about women putting off mammograms. “Women have been so focused on their families… and their own careers and jobs they’ve been taking care of during this pandemic. It’s really time to say, OK, please don’t forget to focus on yourself.”
Significantly, members of some groups may be less comfortable in a typical healthcare setting. Past experiences with discrimination, disrespect or outright mistreatment in a healthcare setting can lead many to avoid well visits.
While the pandemic may have delayed well visits, it did demonstrate the importance of self-care. Clinicians urged those coping with the isolation and anxiety of living through the pandemic to prioritize self-care. It’s also a two-way street; those on the front lines of the coronavirus pandemic must practice the same self-care they’re urging on their patients.
A well visit lays the groundwork for strengthening the relationship between patient and primary care physician, and helps the PCP see the patient as a person and not a set of conditions or risk factors. It encourages the PCP to be fully present, attentive to and interested in the patient. As one physician observed, “(it’s about) finding the patient’s hidden agenda and listening to what the patient is actually saying.”
Out of this more collaborative relationship, the patient is empowered to take responsibility for their health. Using the well visit to express their concerns, push for clarification when they don’t understand a recommended treatment or description of their health status, and to cooperate with agreed-upon treatment plans, schedule and attend recommended screenings, etc.,—this helps both patient and PCP get the most out of the appointment.
Use Precision Nudging™ to Encourage Well Visits
Overcoming the barriers to well visits, and leveraging the renewed focus on self-care, requires effective communication to position them as part of a personalized disease and disability prevention plan. These efforts begin with harnessing behavior change artificial intelligence (AI) to assemble and deliver hyper-personalized communication matched to each person within a population.
Using hundreds of tailored behavioral interventions to promote well visits, Lirio uses Precision Nudging™, its behavior change AI platform, to match the right intervention to the right person at the right time. We recently launched a women’s well visit solution for Rochester Regional Medical Center (RRH).
The solution was co-developed with RRH to encourage more women to leverage well visits, as one-third (1/3) of all women aged 18-44 do not follow recommended well visit schedules and 40% of women are not aware that they are eligible for well visits at no cost under the ACA. The deployment with RRH is focused exclusively on women’s well visits and is designed as a clinical trial for which Lirio has submitted for Independent Review Board (IRB) approval.
“Rochester Regional Health is proud to partner with the communities we serve to support and empower women in proactively managing their health” said Meghan Aldrich, DNP, Vice President of Women’s Health. “Lirio’s Well Visit solution allows us to reach a larger population with personalized messaging and drive better health outcomes for women in our community.”
Lirio has a proven track record for boosting patient engagement with well visits. In a single quarter, one client scheduled 191 more women’s wellness appointments as a result of Lirio’s tailored behavioral interventions. An effort to improve patient engagement with scheduling mammograms for another Lirio client also generated positive results, especially among high-risk, high-cost patients.
The Digital is Always in Service to the Physical
Whether it’s telehealth visits or using behavior change AI in patient communications, digital efforts enhance — not replace —the PCP/patient relationship. Changing people’s behavior through an intentional, behavior science-informed AI like Lirio’s is aimed at knitting together the digital elements of healthcare with the physical well visit into a cohesive whole. Nurturing the PCP/patient relationship, and making each patient feel “known,” lays the groundwork for the well-being of patient populations and leads to a healthier society for all.
Meet Lirio at HIMSS21
If you’d like to learn more about how Lirio can help your healthcare organization respond to these and other patient engagement and communication challenges, we’d love to meet you at HIMSS21. Stop by Booth #4443 to chat with our team, and check out the following in-booth educational sessions hosted by our AI and behavioral science experts:
- The AI You Don’t Have: Scaling Personalized Behavioral Interventions: Tuesday, August 10 | 11:00 a.m., 1:00 p.m., 3:00 p.m. | Chris Symons, Ph.D., Chief Artificial Intelligence Scientist
- Personalization Activates. Behavior Change AI Scales It: Wednesday, August 11 | 11:00 a.m., 1:00 p.m., 3:00 p.m. | Chandra Osborn, Ph.D., Chief Behavioral Officer and Amy Bucher, Ph.D., Vice President of Behavioral Design
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