Patient-Initiated Collaborative Texting with Dr. Keith Dressler on The Podcast by KevinMD

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Dr. Kevin Pho:

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Welcome to The Podcast by KevinMD, where we share the stories of the many who intersect with our healthcare system but are rarely heard from. Here's your host, Dr. Kevin Pho.

Hi, welcome to the show where we share the stories of the many who intersect with our healthcare system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at kevinmd.com/rate. Subscribe at kevinmd.com/follow. Today's show, we have Keith Dressler. He is a healthcare executive. We're going to talk about his KevinMD article, Three Reasons Practices Should Implement Patient Initiated Collaborative Texting. Keith, welcome to the show.

Dr. Keith Dressler:

Thank you. Thank you for having me, Kevin. I come from a multi-generational physician family. My dad's a retired OB-GYN, pioneered laparoscopy throughout the Southeast. He owned a hospital. So literally I've just grown up within the healthcare world. I was sort of the outcast orthodontist. I am an orthodontist in my day job, so to speak. But serial entrepreneurship is really my love. My brain for whatever reason is a Lean Six Sigma process type of thinking guide that wants things as simple and easy as possible and as efficient for both patients and the staff and practitioners.

I'm a serial entrepreneur. This is what I do. When I see a need, I try to solve it. I am not a technology for technology sake person, meaning we have to bring real value, and real-world improvements for me to look to get in and to either invent or evolve a technology to help the healthcare world. I felt communication is really where it needed to be at this stage and time of the country.

Dr. Kevin Pho:

I talked to a lot of healthcare professionals who want to go into entrepreneurship. Now, as a successful entrepreneurial yourself with of course a healthcare background, what would you say is your number one tip for those clinicians who want to pursue entrepreneurship?

Dr. Keith Dressler:

I would say you've got to have persistence. Especially if you're an out-of-the-box thinker like I am, you're going to have a lot of naysayers. I think when you're dealing in the healthcare world, you have to understand the sales cycle is going to be much, much slower than in any other industry. We have a lot of legacy thinking. We have a lot of cautious people before they really do things, they have to think through it. Of course, you have this huge resistance to change. So I think patience, and persistence would be my two biggest things that I would give the audience for people wanting to be entrepreneurs.

Dr. Kevin Pho:

All right. So let's jump right into your KevinMD article titled Three Reasons Practices Should Implement Patient Initiated Collaborative Texting. Now, for those who didn't get a chance to read your article, just walk my audience through it and share the story of why you decided to write it.

Dr. Keith Dressler:

The biggest reason I decided to write it is patient engagement has been a topic in all of healthcare for a long time and actually improving the patient experience, so forth and so on. I think the problem that we have is that communication changed in 2007, where texting became the dominant form of communication versus voice, yet practices still require patients to voice call. In my mind, that's like using when telephones came in and you had a teletype, it's like never moving to the telephone and just using the teletype still.

I think we have to understand that you've got to look outside the practitioner side of things. Meaning patient engagement was how can I improve my, the office's, engagement with the patient, not considering how can I improve the patient's ability to communicate with the practice or the healthcare facility or whatnot. So there's a huge gap.

To me, patient engagement, is it all, and that's why I say it's not just doctor-initiated things that I, the practitioner, can communicate better with the patient, but it's allowing the patient to communicate better with you, which means modernizing your communication, meeting patients where they live and allow them to choose which form of communication they want with your practice. That's why I've named it patient-initiated collaborative communications, because when you can convert a voice call to a text message coming in, then what has occurred is the phone stops ringing.

You are going to get a 70% decrease in phone calls and so that means only 30% are going to call you. Guess what, you've got plenty of time in your day to pick that up and talk, whether it's your receptionist or whomever. They're not being sent to voicemail. They're not having to leave a message. The efficiency of what goes on is phenomenal. In the article, I share with you that the Rhinogram practices across the country that have implemented patient-initiated communications, SMS, MMS, no downloading of an app, no logging into a portal, making it as simple and easy as it is.

Rhinogram basically gives the practice a HIPAA-compliant textable number that matches their voice number. So the number that patients already have in their phone and are voice calling with, it's very easy to convert them to texting by saying, "Hey, do you realize you can text me now?" Now, when they begin texting in, you can handle, the practice can handle six to 10 different patient communications in the same amount of time it takes to speak on the phone to one patient.

Now, let's imagine this: Of the benign things coming in that could be understood through our natural language translations AI, ML, and for those in the audience who may not know those acronyms, that's artificial intelligence, machine learning, those questions can be answered automatically with nobody touching them. So imagine somebody calling in and saying, "Hey, do you take this insurance?" You're a person who's answering the phone, "Yes, we take that insurance," and so forth. But that type of question can be answered through a text automatically with nobody having to touch it.

What are directions to this location? Again, these types of benign things can now be handled where it's going to then give back time to everyone. I would also share with you that those practices that have initiated this idea of patient-initiated communications, also are able to decrease the number of people needed in their organization. Most have decreased 30 or greater percent. So in today's world, with employee shortage and doctor burnout, and employee burnout happening, this allows organizations to just simply do this one thing, and now they're more efficient than they were when they were more fully staffed.

With a 30% decrease in staff, they actually still get one to two hours of time back a day, which then gives practices the opportunity, to get back to my dad's day, which is getting to know the patient, getting to spend lots more time with the patient and do what they really got into medicine to do and that cares for the patient in all kinds of ways there.

I want the audience to divide that in their mind into two areas of care. Most practices are going to view virtual care, that word, from a clinical standpoint. That's a video visit of some sort, that's remote patient monitoring of some sort. They call that virtual care, with the word virtual, meaning the patients at home or not in the office.

I want you to understand there can be and is plenty of virtual administrative care. Administrative is all the things that you can think of, meaning from inbound forms to what's your insurance, and you could take a quick selfie of the front and back of an insurance card, and send it in. You operate very much like how you operate in your everyday lives with your friends and family, where the patient can simply do things that they do with their friends and family with your practice, things like a prescription refill, for example.

Our natural language translation would understand this patient has texted in a prescription refill. It routes that automatically to a refill team who gets a notification, "Oh, I have something to do." That refill team begins to do whatever it is. My vision for the future would be, yeah, it gets routed there. They check it. The patient gets a text back and it says, "Hey, we have got your prescription. It's going to be delivered to your home in two hours." For those patients who are homebound, cannot drive and who rely on their family to pick up the prescriptions for them, this would be a huge, huge convenience for everyone involved.

That's a lot of people that you don't even think about. But this is how I see it going. The reason we use the word collaborative in this is the beautiful part of everything is that you have real-time team awareness of everything that's going on. So for example, in my practice, when patients really get into this patient-initiated communications in December, without prompting, I'm getting the front and back of an insurance card texted into my practice saying, "Hey, I want you to update my insurance." But then it's also asking, "Hey, can I get an account balance?" Within that same text, it's saying, "I need to change my appointment from this week to this week,"

The beautiful part of our system is it allows us to bring in three different teams, three different individuals. It can be doctors, it can be anybody, but we would bring in the insurance team, we would bring in the appointment team, we would bring in the financial team, and all three of them in real-time are communicating back to the patient.

They're basically saying, "Hey, thank you. We've updated your insurance." That's the insurance team communicating. The financial team would say, "Hey, attached is an invoice. We have a text to pay. If you'd like to pay your balance, you can do it." Then the appointment team may say, "Hey, we have the same day and time next week or the following week. Would that be okay with you?" They say yes and you've handled all three just like that and all three teams are aware at the same time of that conversation.

Likewise, when it's a clinical thing. So let's say somebody has just had a wound or they've been surgerized and they think the wound is not healing right. They snap a picture of it, and send it in. Then the doc who did the surgery, or a care team, it doesn't even have to be the doc, can look at that, gets pulled into the conversation to look at that picture to tell the patient is that something that you need to come in and be seen about or is it healing just fine.

Those are the types of efficiencies that are built into this whole thing and the whole idea about patient-initiated communications which in my opinion is the biggest thing that will cause a practice to run so much more efficiently, smoothly, with fewer people, and what I would consider give patients what I call communication equity, where it's not just the doctor sending the patient stuff. That's not communication equity in my mind. It's the patient being able to communicate with you the way they want to when they want to how they want to.

Dr. Kevin Pho:

One of the barriers that I often hear that prevents more patients from texting, of course, is the privacy barrier, the HIPAA compliance barrier. So tell us how your solution gets around that.

Keith Dressler:

If you're aware, and again, the listeners' aware we have two compliance things. One is with patients and then one is doctor to doctor if you're in referral, okay? When it's doctor to patient, it's patients rule the day. They tell you, the doc, how they want to be communicated with. So it's consent. It's all-around consent. In our platform, we have consent management that we share with them that we protect their stuff on our end, it's up to them to protect their stuff on their end.

Then when you look at most people are hung up because when texting was first described, it was described really doctor to doctor or referring doctor to doctor. Basically, that law states that you must be encrypted end to end. If you're going to talk doctor to doctor, that is how you have to talk, okay? We do have end-to-end encryption for that form of communication between doctors within our platform. But when we're talking to patients, we have consent management built in for all the various things, because it's not just HIPAA and privacy that you're dealing with.

You're dealing with TCPA, which is the Telephone Consumer Protection Act, which basically says you're not allowed to text anyone without their consent about anything other than an appointment reminder. You can do that without their consent. But if you're going to text them their bill, then you have to get a bill consent. Meaning, can I send you this? If you're going to use marketing materials and market, then you have to get that.

The reason that law is in place is there are still plenty of people who pay per text and know the business, whether your healthcare or otherwise, is allowed to run up a patient's bill without their consent. So when you text them and they're paying individuals, they're not on an unlimited plan, you're soliciting them about something and that's really against the law. So we have consent management built into our whole system. It'll protect the practice, protect the doc, and it really won't allow certain things to happen without their consent.

Dr. Kevin Pho:

We're talking to Keith Dressler. He's a healthcare executive. His latest KevinMD article is titled Three Reasons Practices Should Implement Patient Initiative Collaborative Texting. Keith, what are some of your take-home messages that you want to leave with the KevinMD audience?

Dr. Keith Dressler:

I would say that for all of you who feel overwhelmed day in and day out, we're here for you. Because we want to give you your life back. We want to have you going in and having really a pleasant happy day, lets you focus on what you got into medicine to do or dentistry to do and that's to treat patients. You're not there to run on this mouse wheel that you're on and be frustrated every day and get burned out very easily. I could share with you that the doctors that use our program have much, much happier lives. They have much, much happier days at the office and so do their staff. That would be the number one takeaway.

Dr. Kevin Pho:

Keith, thank you so much for sharing your time and insight. Thanks again for being on the show.

Dr. Keith Dressler:

Thank you Kevin for having me. More than happy to come back anytime.

Dr. Kevin Pho:

Thank you for listening to The Podcast by KevinMD. For more stories, please visit www.kevinmd.com.

Read Next: After the Podcast Q&A with Dr. Keith Dressler.