At a Glance
- Patient engagement is important for healthcare practices to measure, as it impacts outcomes, loyalty, and retention.
- Key performance indicators (KPIs) to measure include portal enrollment and usage, website traffic, unpaid balances, visit cancellation rates, and formal complaints.
- Convenience factors heavily into patient engagement. Practices should offer digital tools like online scheduling, bill pay, and patient portals to make the patient experience seamless.
- Continuously soliciting patient feedback through surveys, monitoring social media, and speaking directly with patients helps providers understand the patient experience.
Managers of healthcare practices talk a lot about patient engagement, loyalty, and retention. Parts of their strategy might include providing patients with access to a patient portal, investing in their practice’s website, or implementing other technology that makes care more convenient. But are they actually measuring the efficacy of their efforts?
“Unfortunately, providers tend to do a fairly bad job at measuring levels of engagement,” says Jan Oldenburg, principal and patient engagement strategist at Participatory Health Consulting.
Why? Too many competing demands. Practice managers might implement one or more of these efforts but then get caught up in the day-to-day operations of running a busy practice. Their focus is primarily on revenue-generating tasks that directly affect the bottom line rather than measuring the effectiveness of customer engagement initiatives.
However, in the age of healthcare consumerism, measuring patient engagement is arguably as important as measuring a practice’s denial rate. When patients are engaged and satisfied, they return for follow-up visits. They make — and keep — preventive visits. They reach out to their provider — not an urgent care facility — when they’re sick.
When patients are engaged, they also listen to their physician and follow through with health recommendations that ultimately improve outcomes. They often refer other patients to the practice. They’re even more likely to tell you about a problem rather than just finding a different provider. All of these things are also good for the bottom line.
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5 key performance indicators for measuring patient engagement
Want to measure patient engagement but not sure where to begin? Oldenburg suggests starting with these 5 key performance indicators (KPIs) that give insight into engagement levels in your practice.
1. Portal enrollment and usage
“Practices need to pay attention to their patient portal as their digital front door,” says Oldenburg. “During the pandemic, many patients began feeling more comfortable using online tools like self-scheduling options, symptom checkers, physician messaging, virtual visits, viewing lab results, and online bill pay.”
“Patients expect their healthcare experience to be as convenient and as digital as other experiences like banking and shopping. ”
Patients expect their healthcare experience to be as convenient and as digital as other experiences like banking and shopping. Make sure your portal includes features that increase convenience for patients. Celebrate convenience as a key reason for patients to sign up.
Nationwide, the Health Information National Trends Survey (HINTS) showed that the use of patient portals increased by 50% from 2020 to 2022. The same survey found that “In 2022, most individuals who accessed their online medical records or patient portal viewed test results (90%) or clinical notes (70%).”
If portal usage isn’t increasing at your site, it could be because your practice needs to educate patients more about this tool and how to use it, or you may need to refresh the capabilities on your site to make sure they actually meet patient needs.
It is also important to make sure that capabilities built to increase convenience for patients have back-end workflows that are convenient for staff and physicians as well. Physicians and staff are unlikely to promote the use of tools for patients if they make life more difficult for themselves.
2. Website traffic
Your practice website is another way to measure and enhance engagement with your patients. Make sure the information it contains is up-to-date and that it offers accurate and complete information about how your practice works and what value you add.
Include information about billing practices and charity care. Highlight your providers or new things you’re offering or working on. Survey users about what else they’d like to see. If patients and prospective patients don’t find what they need on your website, they may choose to take their business elsewhere.
Some of the questions you should ask about your website’s effectiveness include:
- How many people visit your website monthly?
- How long do they stay?
- What information are they looking at or searching for?
- Are your numbers going up or down?
If you don’t know these answers, you’re missing an opportunity to improve the impression you make on potential or existing patients.
3. Unpaid balances
This KPI speaks to post-visit patient engagement. Many patients are facing stress and financial hardship. Even if your patients are able and willing to pay, patients want clarity and convenience in their billing process.
Practices need to make the billing and payment process as seamless as possible. Price transparency, up-front collection, accurate billing, clear and concise billing statements, and online bill pay are all critical, says Oldenburg. “We tend to think about quality of care as a metric that’s very separate from the billing experience,” she says. “But in fact, if people have a terrible billing experience, it impacts how they think about the quality of the whole experience.”
“Practices need to make the billing and payment process as seamless as possible. ”
A 2021 survey of 1,500 U.S. healthcare consumers by Cedar showed that a full 90% of patients surveyed said that the quality of the billing and financial experience impacts their likelihood of returning to the practice. A bad billing experience also negatively impacts how likely they are to recommend your practice and pay their bills in full.
To correct this, make sure you are surveying your patients about both the billing experience and the care experience. Also, pay attention to complaints and grievances related to the way your organization manages financial aspects of care.
4. Visit cancellation rates
The patient cancellation rate is a metric worth examining in the context of other data, says Oldenburg. For example, has your cancellation rate increased because there’s a 6-month wait time for an appointment — even for existing patients? Patients may simply cancel their appointment because they find another physician who can accommodate them earlier.
In that case, perhaps your practice needs to hire more providers or reevaluate workflow efficiency to increase patient access. Online scheduling can also help reduce the cancellation rate while also boosting patient engagement, says Oldenburg. That’s because patients can look at all available appointments and choose a time that’s best for their schedule.
“Make sure patients can make and reschedule appointments through your portal. ”
They can also easily conveniently reschedule appointments rather than cancel completely — all without having to wait on hold for a receptionist. To address these issues, make sure patients can make and reschedule appointments through your portal. Also, make sure that you’re actively tracking your cancellation metrics to get insight into issues that you otherwise might not hear about.
5. Formal complaints and grievances
This is a KPI that practices definitely want to monitor and address immediately, says Oldenburg. However, it’s equally important to monitor and address informal complaints, particularly those on social media sites. “Practices tend to think of social media as a broadcast mechanism, but it can also be a listening device,” she adds.
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3 additional strategies to glean patient engagement
Measuring KPIs is only one way to better understand whether and to what degree patients are engaged with your practice. Oldenburg provides these additional strategy tips:
1. Survey patients as soon after their appointment as possible
Don’t let days or weeks go by. “People want to be surveyed while the information is fresh in their minds,” she says. It's worth looking into how to design an effective patient experience survey.
2. Test various methods
This includes automated text message and email surveys as well as postcard surveys given to patients as they check out. Patients can simply complete them right there on the spot and then drop them in a secure box. Which method yields the most responses?
3. Ask these questions
- How easy was it to make an appointment?
- How would you describe the quality of care your physician provided?
- Do you feel as if we adhered to safety protocols?
- What can we do to make your care more convenient and seamless?
- Is there anything else you want us to know?
“People want convenience,” says Oldenburg. "Patients have been telling us for a long time that we often design health systems around convenience for the people who work inside of them — not for the convenience of actual patients and caregivers.” Both matter. Ask physicians to discuss the overall experience directly with patients. “Having your doctor ask you about your experience is a great loyalty builder,” says Oldenburg.
Practices that pay attention to engagement, convenience, and the quality of digital tools for patients can build a reservoir of loyalty for years to come.
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