How to Automate Patient Feedback at Federally Qualified Health Centers

Author: Ravi Kalidindi
CHC FQHC Annual Patient Survey

CHCs (Community Health Centers) and FQHCs (Federally Qualified Health Centers) rely on grants from federal programs such as HRSA (Health Resources & Service Administration). Some funding is also tied to certifications such as the PCMH (Patient Centered Medical Home) certification. In addition, health centers may rely on grants from state programs and private foundations as well.

Each grant program can be specific about its reporting needs. These reports help a grant program determine whether patient access and quality-of-care standards are being met, and whether a health center should be considered for future grants.

These reports often require inclusion of patient satisfaction survey results. The intent for the surveys is to (a) provide insight on patient experience with the care and services they receive, (b) identify opportunities to improve patient access to care and services, (c) establish an internal baseline and track quality improvement over time, and (d) potentially compare performance with external organizations that are similar.

Given the criticality of patient surveys from both funding and operational perspectives, health centers would be well-served to put in place a streamlined patient survey process that is repeatable, flexible, consistent, and reliable while also being affordable.

Health Centers Face Challenges Gathering Patient Feedback

“Before we adopted an automated process, it was a nightmare to plan and administer annual patient surveys!” says Katherine Derby, Communications and Marketing Director at Lamprey Health Care. They were using a paper-based and manual process which entailed printing the survey questionnaire, printing mailing addresses of patients on envelopes, mailing out the surveys, waiting for responses, entering the responses in a spreadsheet, merging demographic data, analyzing the data, and finally reporting.

Often-cited challenges with manual survey processes are:

  • High Cost: Costs related to paper, ink/toner, and labor. Each ensuing survey will incur most of these costs again.
  • Significant Delay: Sending surveys and receiving responses via snail mail takes time. Needing staff to perform data entry into spreadsheets adds further delays. Often, it takes months before the health center gathers actionable insights.
  • Low Patient Participation: Patients must check their mail, fill out paper-based surveys, and mail them back. Not many patients will have the time or motivation to do so. Therefore, patient participation is often low. This leads to insufficient sample size as well as underrepresentation of some patient populations.
  • Lack of Actionable Insights: Because of delayed and sparse data and insights, the health center cannot be nimble and proactive about addressing current and future needs of the organization and its patient base. This puts it in a reactive mode.
  • Inflexible: If the health center wants to initially tweak and fine-tune the survey by performing quick dry runs on smaller sets of patients, it cannot easily do so due to the onerous nature of the manual process.

Automating the Patient Feedback Process

Lamprey Health Care implemented an automated Annual Survey Process using Simple Interact. Here are some key learnings related to their new process:

  • Solution implementation time (including fine tuning): less than 4 weeks.
  • Survey instrument: Mobile-friendly online survey form with 18 questions.
  • Mode of communication: SMS or Email Survey request.
  • Multi-language support: Patient can view the survey questions in preferred language.
  • Targeted patient population: Appointments that occurred in March 2021.
  • It literally took less than 1 minute to select the target patient population and trigger the survey request.
  • 100% of the desired survey sample size obtained within 3 days! 200% of it obtained within 10 days, and 300% within 30 days.
  • Overall patient participation rate was 7%.
  • Staff was able to immediately export the survey data in .csv (comma separated values) format and merge it with demographic data as per HRSA’s specific reporting needs. It was possible to use the same data to satisfy the reporting needs of other grant sources or certification entities.

The transition from a manual survey process to an automated survey process was a success for Lamprey Health Care. The large sample size of the survey data increases the confidence in the insights drawn from the data. The health center can proactively use these insights to understand current and future needs of the organization and its patient base. The speed with which the health center can now plan and administer surveys, and turn around reports to grants/funding sources, is a game changer. Meeting their requirements enables continued consideration for future grant allotments. Katherine says, “Incorporating an automated survey process like this is an absolute necessity from a fiduciary responsibility perspective.”

Lessons for Acquiring Patient Feedback

Katherine felt we should share the following take-aways with other health centers:

  • Survey your organization before surveying your patients: A health center typically has multiple departments with different needs. It also has multiple grant sources with different reporting needs. Rather than firing off numerous surveys and exhausting your patients, it makes sense to get all your stake holders together to come up with a common survey that addresses a broad set of needs.
  • Design a survey that is succinct and simple: While it may be tempting to create a super long survey, that approach is self-defeating because it will result in low patient participation. Spend some time on word smithing questions to make them easy to understand. Where appropriate, provide answers that patients can select from vs. having to type each answer. Avoid leading questions to avoid skewed data.
  • Embrace technology, automation, and change: Don’t assume your organization is a unicorn, or that your patients are very different, so therefore technology will not work for you. Change can be good, and automation when applied correctly can be a game changer.

Patient Feedback Software: Before and After

Stacy Allard, Business Analyst & System Developer at Lamprey Health Care, was the point person and helped plan and coordinate this effort.

Stacy says, “Lamprey’s annual patient survey has always been a huge burden for both patients and staff. Over the years, we have tried various methods with limited degrees of success. As survey time neared this year, we dreaded the whole upcoming process. We had limited in-person visits and with a decrease in staffing, we were not sure if we could get the survey out to patients, let alone how to process the results. We had seen Simple Interact transform our appointment reminders system and thought similar streamlining possibilities might exist for our survey. The process we developed with them was completely transformative. It was easy to plan, implement, execute, and report results. The new survey process is a total win across the board for patients and staff as we embrace smart, simple technology that moves us forward in leaps and bounds!”

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