When a sizable packet of new patient registration paperwork shows up in a patient's mailbox before his first appointment, he is far from engaged. He's overwhelmed by the burden of filling out the paper forms and remembering to bring them to his appointment. He's also bothered by the inefficiency and a bit frustrated with the inconvenience.

Even in this age of never-ending technological advancements, countless healthcare facilities still interact with new patients in this manner. But Indiana Health Group (IHG) found a better way.

Dr. Chris Bojrab, 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 workplace through use of online forms and an electronic health record. A key component of handling patients' electronic protected health information (ePHI) is HIPAA compliance. When the original online form tool the practice was using failed to meet IHG's needs in this regard, Dr. Bojrab turned to Formstack.

Since implementing Formstack, Indiana Health Group has processed thousands of new patients through the system, and 90% of patients have opted to complete their paperwork online. With Formstack's help, IHG has created a secure and seamless patient onboarding process that engages and empowers patients.

Challenge

Before moving to Formstack, Indiana Health Group was using another online form tool for patient forms. However, with more recent changes in HIPAA guidelines, the practice was forced to implement several workarounds to continue using that tool in a way that was HIPAA compliant. The company behind the tool eventually rolled out a HIPAA compliant version of the service, but it involved a nearly tenfold increase in the cost compared to what IHG was paying.

"The HIPAA compliance piece is just becoming more and more at the forefront of everybody's mind," Dr. 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."

Dr. Bojrab was familiar with Formstack because he had used it for several years in his work as vice president of Professional Development Associates, a medical society management company. When he learned of Formstack's HIPAA compliant offering, he was thrilled. The timing was perfect, and the price point was much better—thousands of dollars less—than others he had seen.

Formstack is flexible and easy for everyone at IHG to use. And best of all, Dr. Bojrab no longer has to fret about employees inadvertently collecting patient information in a non-compliant way.

"We're all under increasing regulatory challenges—not only from HIPAA, but from a lot of other things that are going on in medicine right now—so it's nice to have one less thing to worry about," Dr. Bojrab said. "With Formstack's HIPAA compliant forms, there's a whole set of headaches that I simply no longer have."

Solution

Indiana Health Group uses Formstack first and foremost for efficient patient onboarding. Before moving to online forms, IHG would typically mail out a bulky set of patient registration forms, hoping for one of two outcomes:

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

This left a lot of room for error and opened the door to patient flow problems.

"We see in excess of 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," Dr. Bojrab said.

Now, new patients can access and submit referral and registration paperwork via a link on the Indiana Health Group website. While not required, 90% of patients use the electronic forms. When they submit their registration form online, the information automatically goes to those in the billing department, and the required pre-authorization begins. The information then goes to the scheduling staff, and the patient is contacted to schedule an appointment.

"Using Formstack really reduces the number of potential points for failure when bringing new patients in," Dr. Bojrab said. "It increases the speed and efficiency and cuts down on the duplication of data entry for both patients and staff members."

Indiana Health Group 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. Empowering patients to complete this complex information through an efficient online patient onboarding process helps keep the practice running smoothly and allows clinicians to prepare for appointments.

Outcome

Getting patients off to a good start is not the only way Formstack helps Indiana Health Group engage patients and create a positive experience. The behavioral health facility also uses Formstack 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 communication, with the added benefit of providing an audit trail in case of any miscommunication.

Indiana Health Group also uses Formstack 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 from work.

"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," Dr. Bojrab said. "In our case, I think it often makes for a more comfortable experience since 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."

The flexibility and intuitiveness of Formstack's design allows anyone at Indiana Health Group to craft an efficient, user-friendly form to securely collect information. Additionally, features like Conditional Logic enhance the patient experience by turning irrelevant questions or checklists off based on prior responses, which keeps forms (and their output) from looking too busy.

Indiana Health Group is committed to modernizing its healthcare processes, and Formstack's HIPAA compliant online forms have played a big role. Dr. Bojrab continues to innovate with Formstack. Most recently, he created a form that is intended to function like a web app, with easy access via a shortened URL or QR code. It's a simplified referral form that allows healthcare providers to make a patient referral from the bedside in 30–45 seconds.