In the days before COVID-19, Northeast Valley Health Corporation (NEVHC) struggled to get its patients to complete patient experience surveys after appointments. The waiting room kiosk, where patients could answer 10 questions about their doctor’s visit, wasn’t very inviting. Clinic staff had to coax folks to use it, remind them, and even physically walk some over to the touchscreen to get any feedback.

Today, a simple automated text message yields slightly more patient responses than the kiosk — but it doesn’t require any cajoling from staff.

Just as coronavirus compelled health centers to quickly pivot from in-person visits to telehealth, in-person surveys have moved to the virtual realm. As the pandemic spread, NEVHC quickly piloted Feedtrail, a digital tool that allows people to complete short surveys via text message, to start engaging its telehealth patients and avoid the infection risk of the touchscreen kiosk for patients continuing in-person appointments. Now every day at noon, Feedtrail sends a text message to all patients who have completed a visit the day before, asking about their experience at NEVHC.

“Nobody has to do anything — we just wait for the patients to answer the survey. We’re now getting a lot more feedback than we ever did through the kiosk,” said Debra Rosen, director of quality and health education at NEVHC.

The health care organization had actually been in discussion with Feedtrail about its survey tools for both patients and employees months before the pandemic. But COVID-19 and a three-month free trial was the push NEVHC needed to get started.

“This has been moving so fast,” said Debra Rosen, director of quality and health education at NEVHC. “That’s a good thing because we’ve been able to implement this unlike any other product. It quickly went from, ‘What’s your idea? What questions do you want to ask?’ to ‘Let’s go and do it.’”

In April, Rosen launched the first patient experience survey at Newhall Health Center in Santa Clarita, Calif. It took a little more than a day to create the questions, and then the text messages started flying. Soon after, NEVHC spread Feedtrail to Pacoima Health Center.

Of course, none of this replaces the annual CAHPS patient experience surveys, which have validated, standardized questions with years of benchmarks. But these small, pulse surveys help Rosen read and analyze the patient experience in real time. And when patients type out a response — beyond just clicking on the rating — Rosen has been responding to individual comments herself.

Boosting Pediatric Appointments

In May, NEVHC launched its second text message campaign focusing on increasing the number of pediatric appointments. NEVHC had been seeing 100 percent of its scheduled adult patients, but pediatrics was closer to 65 percent. So, it decided to drum up business in a series of two text messages 48 hours apart.

The first text message tells parents to click to open an important COVID-19 message. This link takes them to a webpage where Dr. Gina Johnson, the medical director for children’s health, stresses the importance of bringing your children in for well-child exams and vaccinations.

• English: We are open. Click to hear an important COVID-19 message from Dr. Johnson, Pediatric Medical Director bit.ly/35Y27fp
• Spanish: Estamos abiertos. Haga clic para escuchar un mensaje importante de COVID 19 del Dr. Johnson, Director Médico Pediátrico bit.ly/35Y27fp

The second text message ensures parents that NEVHC is taking extra steps to protect the safety and health of families during COVID-19. And it encourages them to click on a link, which connects the parent to a call center operator who can schedule that appointment.

• English: NEVHC has taken extra steps to ensure the safety of you and your children. We are open for in-person, phone, or video visits. Call now 818-270-9719 for appt.
• Spanish: NEVHC ha tomado medidas extra para cuidar su salud. Estamos atendiendo en persona, por teléfono o por video. Llame ahora al 818-270-9719 para una cita.

What’s unique about this campaign is that NEVHC’s chief information officer can count how many people click on that call center link and measure the effectiveness of the text message. At the same time, the director of public relations can monitor clicks as well; if no one clicks on the Spanish-language link, for instance, NEVHC can troubleshoot the content and framing of the text message to make it more engaging.

During the test, NEVHC sent out about 31,800 text messages with a link to the call center. From those messages, 184 patients clicked on the link and 87 of these calls lasted 54 seconds or longer. (The assumption was that this was enough time to make an appointment.)

“The numbers aren’t high, but this accounts for a robust outreach effort informing our patients that we are open for services and providing a safe environment,” said Rosen. “Many will likely call for an appointment at a later time when a visit is needed.”

Next Steps

The three-month free trial ends next week, but NEVHC has already signed a one-year agreement with Feedtrail. Meanwhile, since 2020 has been such an unusual year, NEVHC has decided to pause the CAHPS survey. It would be difficult to analyze the CAHPS data, given the pandemic, and NEVHC is focusing on reviewing patient feedback in real time.

Soon Rosen intends on launching an internal employee survey so NEVHC can get a pulse on morale and satisfaction in real time. “It’s a great opportunity to hear from the providers how the heck things are going out there. Things are changing so rapidly, it’s hard to get a handle on how everyone is doing,” she said.