Indiana Health Group Patients Turn to Online Registration Forms

Almost all patients have opted to complete their paperwork online.

When a sizable packet of new patient registration paperwork shows up in patients’ mailboxes before their first appointments, they are far from engaged. They are overwhelmed by the burden of filling out the paper forms and remembering to bring them to their appointments. They are also bothered by the inefficiency and a bit frustrated with the inconvenience.

Even in this age of technological advancements, many healthcare facilities still interact with new patients in this manner. But Indiana Health Group (IHG) has found a better way.

Established in 1987, IHG is a multidisciplinary mental health facility located in Carmel, Ind. With roughly 55 clinical staff comprising psychiatrists, psychologists, and social workers with master’s degrees and 15 support staff members, it is the largest behavioral health private practice in the state. As such, the facility logs 65,000 to 70,000 patient visits every year.

Chris Bojrab, MD, a board-certified psychiatrist, joined the IHG practice in 1997 and has served as president since 2003. In recent years, his focus has been on creating a more efficient and compliant patient access process through use of online forms and an electronic health record (EHR). A key component of handling patients’ electronic protected health information (ePHI) is HIPAA compliance.

“The HIPAA compliance piece is increasingly at the forefront of everybody’s mind,” Bojrab said. “It’s getting to be too much of a liability to do anything that might put you or your practice in harm’s way when it comes to HIPAA violations.”

Since implementing a HIPAA-compliant online form, IHG has processed thousands of new patients through the system, and 90 percent of patients have opted to complete their paperwork online.

Smooth Patient Onboarding

Before moving to online forms, IHG would typically mail patients registration forms, hoping for one of two outcomes, leaving a lot of room for errors and patient-flow problems:

• Patients would fill out and return the forms ahead of their appointments.
• Patients would bring the forms to their appointments and arrive early enough for support staff to get some of the pertinent information entered into the system before appointments.

“We see more than 300 patients a day, so it doesn’t take too many people having questions or problems with the paper forms they are bringing in to really bog down the whole check-in and check-out process,” Bojrab said.

Now, new patients can access and submit referral and registration paperwork via a link on the IHG website. While not required, 90 percent of patients use the electronic forms. IHG staff encourage patients to use the online forms by explaining how to access them when they are on the phone with patients or by providing a link to the forms in a patient-authorized welcome e-mail. In addition, referring physicians often provide patients with a link to the IHG website, which has a welcome page that directs them to the registration forms and questionnaire.

Once patients submit their registration forms online, the information automatically goes to those in the billing department, and the required preauthorization of treatments and prescriptions begins. Online forms streamline the prior authorization process considerably by requiring patients to complete certain portions of the form before they can submit them, says Bojrab. This cuts down on back-and-forth phone calls between staff and patients as IHG tries to track down information patients may have left off a paper form.

After preauthorizations are complete, the information goes to the scheduling staff, who contact patients to schedule appointments. This process saves the practice—and patients—a lot of time. IHG staff members have readily accepted the transition away from paper because it has freed them up in many ways. For example, the electronic patient forms can be imported into IHG’s EHR system for quick availability and easy accessibility.

There is an added benefit to the online form process. IHG sees between 6,000 and 8,000 new patients per year, and each is required to complete a detailed patient history questionnaire that covers general medical history as well as mental health history. When patients share this complex information through an online patient onboarding process, clinicians can prepare more thoroughly for appointments.

Delightful Patient Experience

In addition to getting patients off to a good start, IHG uses online forms as its primary route of communication between patients and clinicians. Using a link on IHG’s “Contact Us” page, patients can reach out to a specific healthcare provider with any questions or concerns. This provides a quick and easy way for the practice to manage patient communications, with the added benefits of providing audit trails in case of miscommunications.

IHG also uses online forms to gauge patients’ mental health status through rating scales, such as a depressive symptom rating scale, as well as to gather information related to disability or medical leaves.

“I think patients like the experience of filling out the forms online. There’s even some data to suggest that people are willing to be a little bit more honest or forthright in the information they provide if they can do so from the perceived anonymity of the screen,” Bojrab says. “In our case, I think it often makes for a more comfortable experience because patients can be sharing some things that might be a little uncomfortable to talk about or that they might feel some degree of guilt or embarrassment about.”

In addition, online forms offer a more flexible design than paper forms, which allows IHG to craft customized forms to securely collect information. For example, IHG can design a form so irrelevant questions or checklists remain hidden until they become relevant, which keeps forms (and their output) from looking too busy.

IHG is committed to modernizing its healthcare processes, and HIPAA compliant online forms have played a big role. These forms save IHG staff a significant amount of time because they allow the practice to collect patient information in an accurate and efficient manner while honoring patient privacy.

Interviewed for this article:

Chris Bojrab, MD, is president, Indiana Health Group, Carmel, Ind.