Insider: Text-based telehealth solutions can help drive patient rosters and retention while freeing up valuable staff time

In an age where both adults and teenagers seem to communicate exclusively via text messages, why not use that popular medium to help move the needle on the acceptance and cost savings of telehealth technology?
 
Keith Dressler, DDS, MSD, chairman and CEO of Rhinogram, recently spoke to MGMA senior editor Daniel Williams on the MGMA Insider podcast to discuss his experience as a telehealth innovator – and what it takes to get both patients and providers on board.

Texting to improve patient engagement

Dressler said he started Rhinogram as a way to coordinate and simplify patient care by centralizing, simplifying and adding a layer of HIPAA-compliant security to simple text messages between patients, doctors and nurses. A second-generation physician, Dressler said three decades of work as an orthodontist revealed some issues (and some great solutions) to the world of telehealth.
 
“It all stems from the fact that communication has changed over the years,” he said. “In my practice, my nurses were being texted by patients that were friends of theirs, and my nurses were texting back. They were basically giving treatment advice, and I had no idea that this was going on. One day I asked them what they were doing, and lo and behold, every one of them was doing it — so I knew there was a big, big problem.”

Handling patient communication

In addition to his work with patients, Dr. Dressler has been a pioneering entrepreneur in the healthcare industry, founding companies including OrthoBanc LLC and Elite Physician Services, which became the Citi Health Card in 2003. He said his experience with his staff and his patients suggested a need for a coordinated and controlled way of handling patient communications — one with massive upside potential.
 
“I realized there is a big, big need to put everything in one place, and to protect it. And have it where you own the data, (instead of) it being spread all over the place on staff cell phones or even your own personal phone. So Rhinogram was created — and my staff always gets to see the first versions of everything, and tell us if it’s user friendly. We get feedback instantly from patients, as well.”

Call vs. text

Rhinogram capitalizes on the reality that old-fashioned phone calls not only have gone out of vogue, but eat up valuable staff and physician time. By providing coordinated, fast-response text messages to routine patient inquiries not requiring an office visit – plus the ability to upload lab results as attachments — Dressler says practices can save money and actually expand their patient rosters, as well as building client retention.
 
“In virtually every medical practice, it’s going to cost you $50 minimum anytime somebody walks through the door – you’ve got the gloves, you’ve got to sterilize the room, you’ve got front desk time, and you’ve got doctor and nurse time. With telehealth, you don’t have any of those expenses. We believe in meeting patients where they live, with a HIPAA-compliant text number, or you can bring Facebook Messenger in as well.”
 
Because of this, he added, “every member is given back one to two hours of time through the efficiencies created by this type of platform. We have a pediatric practice that is doing 18,000 text messages a month, which has tripled their engagement with their Medicare and Medicaid patients. Instead of spending hours and hours trying to get someone, they can reply to a text very quickly, and very easily.”
 
Those efficiencies can add up, and still pay, as well. Dressler said physicians can be remunerated for even those simplified transactions with Medicaid and Medicare patients.

Reimbursement 

“In 2019, the Centers for Medicare & Medicaid Services approved numerous codes for reimbursement for remote patient monitoring for virtual exams, checkups and visits. And that’s the biggest thing that’s going to drive it — they will continue to expand these codes because they want to keep the less acute things out of the office and spend more time with the things that need to be treated right then.”
 
Dressler said that telehealth solutions such as Rhinogram are likely to expand as the occasionally slow-to-react healthcare industry begins to embrace broader cultural change.
 
“I think our patients prefer that if they want their doctor, they want to be able to access them when and how they want to, and not really be bothered by much of anything else. If a doctor receives a test result and attaches it as a PDF or a Word document, it keeps the patient from having to text back and ask for those results. People just can’t visualize how this actually works, because nobody has it out there yet — and patients don’t realize that it’s actually available to them.”

Additional Resources:

• "Insider: Talking tech, privacy and A.I. in healthcare with Robin Farmanfarmaian" (MGMA Podcast)
• "Core tenets of effective patient engagement in medical practices" (MGMA Insight Article)
• ​"How technology can enhance patient self-management" (MGMA Stat)
• "Are portals a means to patient activation?" (MGMA Stat)