An automated practice-based patient survey Goal: to demonstrate the feasibility and acceptability of an automated practice-based patient survey

Automating patient outreach Survey based on existing technology, already adopted by primary care practices, to send automated patient phone, email, text message reminders for appointments, practice notifications, etc.

Patient survey Short survey sent by email or automated phone call within 72 hours of visit to a practice Phone up to 4 retries Email sent once with link to on-line survey

Survey questions in English or French At your last visit with your family doctor or nurse practitioner, how good was the doctor or nurse at giving you enough time on a scale from 1 to 5? Thinking about the care you received from ALL the persons you saw in ALL the places you received care over the past 12 months, were there times when the person you were seeing did not know about changes in your treatment plan that another person recommended on a scale from 1 to 3, where 1 is never or rarely and 3 is often or very often?

Mode preference by age Mode Preference Age 18-24 n=29 Age 25-64 n=553 Total N-851 Email % 89.7% 75.9% 57.8% 69.6% Phone % 10.3% 24.1% 42.2% 30.4%

Mode preference by income <$20K n=113 $20K-40K n=165 $40K-60K n=162 $60K-100K n=206 100k+ n=136 Total n = 782 Email (%) 55.7% 61.2% 71.0% 79.1% 83.1% 70.9% Phone (%) 44.2% 38.8% 29.0% 20.9% 16.9%

Mode preference by chronic condition   Mode Preference 0-1 chronic condition n=234 2 chronic conditions n=130 3 > chronic conditions n=479 Total n =843 Email % 84.6% 70.8% 64.1% 69.6% Phone % 19.2% 29.2% 35.9% 30.2%

Response rates by mode and income <$20K n=113 $20K-40K n=165 $40K-60K n=162 $60K-100K n=206 100k+ n=136 Total n = 782 Email %(n) 46.0% 29/63 57.4% 58/101 64.3% 74/115 66.3% 108/163 64.6% 73/113 61.6% 342/555 Phone 23/50 35.9% 23/64 38.3% 18/47 37.2% 16/43 43.5% 10/2 39.6% 90/227

Lessons learned Automated survey is feasible Language preference easy to incorporate Email response rates appear significantly better than phone Age and income differences in email vs phone preference as well as response rates.

Cost Cost of current commercial patient survey services Cost of tailored EMR linked “premium” survey $35/100 surveys

Future directions- direct from EMR As part of QI or CPD, deploy survey directly from EMR like appointment reminder systems: deployed by preset parameters at specified times and intervals, eg: random selection within age group If not seen in two years After visit for PHE

Future directions- link to patient service APS linked to routine automated patient outreach: CPD update flu shot clinics notices appointment reminders preventive care information change of clinic hours notices, etc. Increase patient buy-in Justify cost with added service