4 Ways to Build Consumer-Friendly Physician Practices

Atrius Health has designed its physician practices and online presence with consumers in mind.

This article appears in the September/October 2020 edition of HealthLeaders magazine. 

One of the largest physician practice organizations in Massachusetts has prioritized consumer-friendly features in its operational model.

In recent years, health systems, hospitals, and physician practices across the country have been working to become more consumer-oriented in line with other service-sector organizations. Patient experience is five times more likely to influence brand loyalty than conventional marketing tools such as billboards, or television, print, or radio ads, a Press Ganey report says.

Newton, Massachusetts–based Atrius Health operates 30 medical practice locations in Eastern Massachusetts. The organization employs more than 700 physicians and primary care providers, along with more than 400 additional clinicians.

Atrius Health has made catering to consumers a primary objective, says Marci Sindell, MBA, former chief marketing officer and senior vice president of external affairs, who left the organization recently.

"Being consumer-friendly starts with how you design your physician practices. At Atrius Health, we serve a very diverse population across all dimensions, and our goal is to make sure we can meet their individualized needs both for care and how they communicate with us. We also try to ensure patients are receiving the right care, which builds trust," she says.

There are four primary consumer-friendly facets at Atrius Health, Sindell says.

1. Access

Atrius Health provides 24/7 access to advanced practice providers, Sindell says. "When our practices close, patients can still call 365 days a year, 24/7, and get a nurse practitioner or physician assistant with access to the patient's medical record who can address medications, schedule an appointment for urgent care, or give medical advice."

Same-day appointments at primary care practices are the key element of the organization's urgent care model, she says. "For us, urgent care is really extended primary care, and we have that available throughout our region 365 days a year, which allows us to keep people from going to an emergency room unnecessarily."

On a regional basis and at larger practice sites, Atrius Health has additional staff available to make sure there are an adequate number of same-day appointments during regular business hours. Atrius Health also has evening hours until about 8 p.m. during the week, and it typically has sites open from 9 a.m. to 3 p.m. or 8 a.m. to 8 p.m. on Saturdays and Sundays.

2. Technology

Atrius Health has several technological consumer-friendly features.

Data from 2019 shows the organization's online portal is popular with patients:

• More than 590,000 patients were registered on the portal, accounting for about 80% of Atrius Health's patient population
   
• More than 2.1 million lab results were released to patients through the portal
   
• Patients used the portal to send 1.5 million messages to Atrius Health clinicians and administrative staff
   
• 56,000 appointments were booked through the portal
   
• Atrius Health used the portal to send out 273,000 offers for an earlier appointment and 15,000 of those offers were accepted

This year, Atrius Health launched a new portal feature called Scheduling Tickets, Sindell says. "If a primary care doctor gives a patient a referral for a specialist, the patient gets a scheduling ticket if they are on the portal, so they can go ahead and book the specialist appointment themselves."

The Atrius Health website also generates a high level of patient engagement, she says. "Our website had 3.4 million visits last year. So, the website is a way to make sure that patients have the information that they need—that's one of the reasons why we are moving forward with building a new website that is set to be launched in 2021."

Atrius Health is working with Boston-based Kyruus to add an enhanced provider directory to the new website, Sindell says.

Currently, Atrius Health patients have relatively limited options to search for primary care doctors and other clinicians such as searching by specialty, location, or the name of the provider. The new website will allow patients to search the clinician directory with thousands of consumer-friendly terms, she says.

"For example, if a patient is looking for a provider who treats breast cancer, today the patient would have to look up hematology-oncology, which they might not know to do. With the new website, patients will be able to look up breast cancer and find our breast surgeons and oncologists who specialize in breast cancer."

Atrius Health has had a tele-dermatology program for more than four years.

If a patient sees a primary care doctor and presents with a mysterious skin condition, the clinician takes a photo of the skin and an Atrius Health dermatologist examines the image within 48 hours. The Atrius Health dermatology department then contacts the patient directly.

"About 60% of those patients do not need to come in and see a dermatologist—they can be cared for via telemedicine. "In 2019, we had 8,500 tele-dermatology visits," Sindell says.

Atrius Health conducts e-consults for several other specialties, she says. "We save the patient a specialty visit by having the primary care doctor reach out and consult electronically with a specialist, who reviews the patient's medical record and writes up a summary for a treatment plan. We did nearly 4,000 of those e-consults in 2019."

Many Atrius Health patients use the organization's online bill pay service, Sindell says. In 2019, the organization collected nearly $22 million through online bill pay.

3. Convenience

Most Atrius Health locations are designed as "one-stop shop" operations, she says.

Pharmacies and specialists are co-located with primary care practices. "One of the reasons why we have on-site pharmacies is so that physicians who are at that location can have particular medications and medical supplies on hand. For example, a podiatrist will have orthotics at his site's pharmacy, and patients can get a discount," Sindell says.

4. Price transparency

Atrius Health has a price transparency phone line in its billing department that patients can call before getting services, she says.

Typically, patients call about advanced imaging such as MRIs as well as colonoscopies and lab tests. The service price that patients receive includes insurance coverage.

Coronavirus pandemic impact

The coronavirus disease 2019 pandemic has prompted Atrius Health to introduce new consumer-friendly services designed to protect patients and staff, Sindell says.

Atrius Health quickly established a call center manned with about 80 staff members—mostly nurses. The call center has directed patients to drive-through coronavirus testing sites, arranged home visits for care follow up, and set up telehealth and urgent care visits.

"Out of 11,000 calls handled in this way during a busy three weeks from the end of March to early April, fewer than 100 people were directed to a hospital emergency department. Additionally, many of the doctors have done telephone encounters, especially in situations where either a visual encounter with the patient was not needed or where the patient did not have telemedicine-capable technology and needed to be treated," she says.

Expansion of telehealth services has been a crucial element for patients to conveniently access safe care, says Christopher Andreoli, MD, chief transformation officer at Atrius Health.

"Toward the beginning of the pandemic, we trained over 700 clinicians in telehealth across specialties and service lines. The response from patients and effort from our clinical and IT teams has been incredible. Prior to COVID-19, we had 500 telehealth video visits since 2016. Now, we are doing about 2,500 per day. We are hopeful that policy measures taken during the pandemic to reimburse telehealth at the same rates as in-person care become permanent, so that patients can continue to benefit from better access to care," he says.

Atrius Health has also expanded pharmacy services during the pandemic, including free prescription mail service and contactless curbside pickup of prescriptions, Andreoli says.