Community Intervention Services (CIS) provides care to over 40,000 people in seven East Coast states every year. From in-home care to clinical services spanning birth to adulthood, CIS helps patients through therapy, school-based services, medication management, and family services. The network of behavioral and mental health companies offers critical support to communities during an average year; during the COVID-19 pandemic, these services have become all the more vital. Yet the pandemic brought an immediate need for changes in how services were provided, with no time to test new processes.
Leveraging Historic Insight to Pivot Successfully
Chief Clinical Officer Ed Neuhaus says over 90% of CIS’s 1,500 clinicians had to move to a full telehealth model in just 10 days, a complicated move involving compliance standards and consent from patients. Many of CIS’s patients access services through Medicaid which follows Medicare regulations that pre-pandemic did not allow providers to use telehealth to deliver services, instead requiring in-person visits. With changes to the regulations in March 2020, plus a major pivot within CIS to provide the devices and new processes for telehealth, CIS has been able to get back to full operation rather quickly, pursuing the same level of excellent care the clinicians offered at in-person visits. Ed and his team were already using SurveyMonkey for twice-annual surveys and to gauge both employee and patient satisfaction. A self-proclaimed “data guy,” Ed relies on feedback and the Net Promoter Score tracked through SurveyMonkey to ensure quality care for every patient.
“We are an evidence-based practice…and ground our decisions in data whenever we can,” he says.
When the time came for the first patient satisfaction survey of 2020, Ed knew the survey itself and the results would need to be leveraged differently to reflect the current era. He turned to the baseline set by CIS’ years of partnership with SurveyMonkey to collect insight that could guide the organization through a changed world.
Understanding How Delivery Methods Affect Patient Satisfaction
Priority No. 1 for Ed and his team was to understand whether the quality of care had been maintained during the shift to telehealth. Beyond ensuring the health and well-being of CIS’ patients, Ed wanted to uncover proof of telehealth’s viability over the long-term. The virtual option, now and projecting to the post-pandemic world, would increase access for many patients, especially the poor and underserved communities. Furthermore, the aim was to demonstrate to Medicaid and other payers that telehealth must remain as a method of delivering services into the future, and not revert back to pre-pandemic restrictions. The way to do that was to conduct a survey, using SurveyMonkey, to show that services delivered via telehealth are comparable in quality and patient satisfaction to in-person services. Ed leaned on the biannual survey already in use for making this comparison.
Specifically, “we didn’t want patients to be unintentionally led to consider recent appointments inferior with questions like ‘Do you like telehealth?’ because it’s not a different service, just a different method of delivery,” he says.
This approach allowed the team to compare results from the Spring 2020 survey to benchmark data from the previous biannual surveys dating back to 2018. CIS did add one question to the survey at the beginning to filter respondents who had not been accessing telehealth services. Those who said “no” were led to a different survey to get feedback on why they chose to not take advantage of the service. Ed notes that this filter system functioned “a bit like a randomized control factor.” The satisfaction survey was sent out to patients in each of CIS’ branches in early summer and quickly yielded encouraging results.
Proving the Value of Telehealth Services
As results came in, Ed’s team was able to discern that CIS’s expanded telehealth services were very much on the right track.
“Everything was comparable in terms of satisfaction with services—patients were equally satisfied with services delivered via telehealth compared to in-person services, which is huge when you consider the pivot we had to make in March,” Ed says. “This was exactly what we hoped to find, as delivery methods should be equal, not better or worse.”
Across each of the subsidiaries within CIS, satisfaction levels remained stable compared to pre-pandemic levels and were in some instances slightly higher. Perceived respect from providers and hopefulness after receiving care are always high for CIS, but the organization saw a slight bump after the move to telehealth.
Net Promoter Score (NPS) was of most interest to Ed. There was a significant jump in Net Promoter Score, which increased 30%-50% depending on the subsidiary. Ed emphasized, “NPS in combination with the responses to other survey questions really showed that our clinical staff stepped up and served their patients while they themselves navigated their own life challenges through the pandemic.”
“This gives us a strong argument that telehealth should be a permanent, reimbursable option,” Ed says. “It’s equal in terms of care quality and satisfaction.”
Ed hopes the conversation about implementing telehealth permanently across the behavioral health world will continue. In addition to continuing to track customer satisfaction and Net Promoter Score, Ed and his team are considering how to use SurveyMonkey to improve their diversity, equity and inclusion efforts.
“We are aiming to understand the experiences of all our employees and the perception of our policies and implementation. SurveyMonkey is a powerful tool to engage employees.”