Reduced no-shows, fewer late cancellations and improved prep quality while using Manage My Surgery

Duke Health Gastroenterology

Key Results

60%

Decrease in No-Shows

16%

Adequate Prep

1 FTE

Save Up to 1 Full-Time Employee

Introduction

Duke Gastroenterology performs about 25,000 procedures yearly, such as colonoscopies, upper endoscopies, and endoscopic ultrasounds. With such high volumes of procedures, a stringent workflow is necessary to ensure patients arrive at their appointment adequately prepped. For example, Duke GI staff assistants call all patients before their procedure to confirm that they will come to their appointment and that they have all the appropriate materials to “prep” their bodies for these procedures. Often, this still leaves many appointment times with empty procedure beds because of late cancellations or bowels that are inadequately prepared for the procedure. 

Challenges

  • High procedure volumes

  • Limited opportunity to educate and engage patients, often requiring investment in significant human capital

  • High no-show/late cancellation rates, sometimes as high as 15%. Significant lost revenue opportunity

Solution

In collaboration with the team at Duke GI, the team at Higgs Boson built a clinically seamless workflow in Manage My Surgery to address the challenges noted above. For one, because of the high procedure volumes, we built an interface with Epic via HL7 and FHIR that automatically invites patients to Manage My Surgery when their procedure is scheduled in Epic.

To enhance patient engagement and education, the team built modules for multiple high-volume GI procedures, including Colonoscopy, Upper Endoscopy, Endoscopic Ultrasound, ERCP, Flexible Sigmoidoscopy, Capsule Endoscopy, and Device Assisted Enteroscopy. Each module has an extensive set of frequently asked questions and timed notifications that help guide the patient in the pre and post-op period. Another feature that has been very well received by clinic staff is the ability of patients to confirm their procedure appointment on the software platform. When this occurs, the staff assistants no longer need to call the patient, saving 10-15 minutes per patient on the procedure schedule, allowing them to do their jobs more efficiently.​

Impact

Duke GI has implemented Manage My Surgery at one hospital-based procedural site. To date, Duke GI has invited over 26,000 patients to Manage My Surgery. Patients that logged in to the app had a 60% decrease in no-show/late cancellation rate (13.1% vs 5.3%) and a 16% improvement (73.4% vs 85.5%) inadequate colonoscopy prep. The staff assistants are very pleased to avoid approximately 20 patient calls per month, saving them hours. At scale, we anticipate saving a full FTE of staff assistant effort with MMS per site. 84% of patients using Manage My Surgery reported that the application was helpful in preparing for their procedure and 84% would recommend Manage My Surgery to a friend or family member undergoing a similar procedure.

Conclusion

The Manage My Surgery implementation at Duke GI provides a clinically seamless virtual patient navigator that has improved prep quality and no-show rates while also saving staff effort. Patient satisfaction is high. As a result of these successes, Duke has decided to expand Manage My Surgery, enterprise-wide, to all of its GI procedural sites.