A Look at Patient Engagement Amidst COVID-19 with Luma Health CEO Adnan Iqbal

The following is an interview with Adnan Iqbal, Co-Founder and CEO of Luma Health.

Tell us a little bit about yourself and Luma Health.

My co-founder, Dr. Tashfeen Ekram and I started Luma Health five years ago, starting with a super simple problem that we both experienced first hand, him as a doctor, me as a patient — patients are waiting weeks to months to be able to access healthcare in the US, and yet doctor’s have 15-30% of their schedule become open and remain underutilized, all due to communication breakdowns between the patient and the clinic/hospital.

Years ago, I tore my ACL and the earliest available MRI appointment was 3+ weeks out. I was incredibly persistent – calling my clinic 10 times in one day – and secured an opening that was the result of a last-minute cancellation. I called the clinic on Monday, my MRI appointment was on Tuesday, and I had a successful knee surgery procedure on Friday. Most patients aren’t as persistent nor have the time for that kind of follow up (I was a student at the time, so could make 10 calls in one day, in between classes).

At the same time, at Tashfeen’s clinic, he would have a full schedule of patients on Tuesday when he left the office Monday afternoon; by the time Tuesday morning came, there were several openings due to last-minute cancellations. But patients were waiting 6 weeks to make an appointment! That just didn’t add up for him.

Tashfeen and I reconnected in graduate school and started talking about this problem — we were college roommates, so knew each other well – and Luma Health was born.

Today, our platform serves more than 12 million patients, 450+ clinics and health systems, and drives real results for providers: 79% reduction in no-shows / 1.7x referral conversion rate (above industry average) / 89 average NPS score / >6x increased ROI.

And, as you can imagine, the platform has played a critical role in connecting patients and providers during the pandemic.

How did COVID-19 impact your business? What did you see your clients doing?

COVID-19 has accelerated our business. Pre-COVID, a patient engagement and communications platform was a nice-to-have for many clinics and health systems, once the pandemic hit and doors closed overnight, it became a necessity.

At the onset of the pandemic, clinics and health systems were leveraging our platform to communicate en masse with their patients — about office closures, appointment cancellations, telehealth options and general COVID education. Many also drilled down further and used it to connect with and engage patients with certain conditions that put them at a higher risk for contracting the virus. For example, all patients with diabetes would receive tailored information. As the months went on and the country started to open up, clinics and health systems used the platform to inform patients of changes to office hours, new safety protocols in place, and what they can expect during their next visit. It became about getting the patients back in for needed care, which includes assurance that it’s safe to do so.

Based on this new way of delivering care, we have continued to evolve our platform by adding: A one-click telehealth solution (no-app, no-login, no-portal) and zero-contact solution suite (waiting room and check-in).

What are some of the keys you’ve learned to be able to engage the patient effectively? What doesn’t work?

When it comes to building a patient communications strategy, there are three core pillars that are important for a clinic to design around: Educate, identify and treat. These pillars provide a structure for ensuring every patient is a part of your clinic’s engagement process – even if each is not relevant to them right now. For example, a patient may not currently require treatment, but they do need to be educated about COVID-19 prevention and best practices for healthy behaviors.

Education: It’s critical to connect with all patients – to share best practices, keep patients healthy, and address any misconceptions – even if they haven’t been seen by the provider’s office in a while. One example is to send a text message that targets patients with a specific condition that puts them at higher risk of complications from COVID-19 (e.g., diabetes) with information about the virus, how to prevent it and signs & symptoms to watch out for. A text message campaign for this group could include tips for staying healthy as the weather changes, which could include a one-push link to schedule a flu shot appointment.

Identification: Taking a proactive approach to identify patients who may be infected with COVID-19 is essential, as this is the most effective way to slow the spread of COVID-19. Screening recommendations include: General screening, targeted screening, screening of scheduled patients, screening of patients being scheduled. Adding a sentence to appointment reminders for already-scheduled patients can reduce the unnecessary spread of infection. To minimize incoming phone calls from patients, practices can digitize the screening process for those patients by providing them a link to an online survey with screener questions.

Treatment: Patients with a lab-confirmed diagnosis of COVID-19 not requiring hospitalization need to be quarantined. However, keeping a close eye on these patients can be a challenge. To aid in coordinating care, clinics should use a telehealth solution that allows patients to reach out via SMS when they have questions, need prescriptions, or have worsening symptoms that require next-level care.

Here’s a snapshot of effective engagement activities:

  • Clear up confusion and misinformation: As healthcare providers, we should take a proactive approach in dispelling myths and keeping patients safe. The message you send to patients should contain references and links to reliable resources and advice on prevention.
  • Convey extended healthcare services: If a clinic is offering special services, such as a dedicated nursing line, telehealth visits, or in-person evaluations for patients who are potentially infected, it’s essential to communicate the services to patients.
  • Communicate preventive care to high-risk patients: High-risk patients need to be made aware of the fact that they are at greater risk should they become infected with COVID-19 as well as the additional precautions required of them during the outbreak.
  • Educate scheduled patients: Patients are still fearful of going back to doctors’ offices, so it is up to providers to educate them about the policies and procedures in place to reduce their risk.

In terms of what doesn’t work:

  • Requiring too much effort from the patient. A patient should be able to reschedule or cancel an appointment within the reminder message they received. They shouldn’t have to log-in or call the office.
  • Lack of outreach/communication. We recently conducted research that shows 38% of patients are nervous about going back to the doctor because of exposure risks. The onus is on providers to assure patients it is safe, and outline the things they are doing to make it so.

How do you respond to doctors who say that they don’t get paid to secure text with patients?

Great question — there is still a lot of uncertainty around the physician reimbursement/payment rules and guidelines. On the flip side, what is clear is that patients are demanding more digital touchpoints to access healthcare — texting with their clinic, one-click launching into a tele/virtual health visit, being able to self-schedule on-line, completing intake questionnaires (goodbye annoying clipboards), etc. all from their mobile device. The COVID-19 pandemic has only accelerated and amplified this trend. Doctors, clinics, and health systems must all adapt to healthcare’s new normal — clinics and health systems are redesigning the way they deliver patient access and effective patient communication, and patients are changing the way they interact with healthcare.

“Ok, but I still don’t get paid to secure text with patients” — this is where Luma Health’s platform helps clinics and health systems truly automate the entire patient journey. Our real-time, SMS-first, intelligent bots (multilingual, active NLP) are able to drive automated conversations with patients at any given point along a patient’s unique healthcare journey. Doctors don’t have to lift a finger, all while these automated conversations drive the patients to more easily access healthcare and to get to the desired health outcome — both of which drive real payments and revenue for doctors, clinics, and health systems.

On average, our clinics and health systems see a 10x ROI that sustains year-over-year.

In your new telehealth solution, what makes it unique compared to the hundreds of solutions out there?

There is no app, login or portal required, and providers do not need to have an existing video conference platform in place. Our solution includes Twilio video conferencing, and supports integration with video conferencing platforms Zoom and Cisco Webex.

How it works:

  • A patient schedules a telehealth appointment in the clinic’s EHR or directly in Luma Health;
  • The patient receives a text or email with a link to one-click join the virtual session 30 minutes prior to the appointment; an additional reminder can be sent 5 minutes prior and when the session starts (reminder cadences can be custom configured);
  • The provider joins and completes the virtual session without a separate app;
  • Clinics capture pertinent and critical patient info prior to visit through appointment reminders, such as insurance info, intake forms, telehealth consents, and more.

What standards or approaches are you using to integrate with 70+ EHR vendors?

We use open standards, such as FHIR, proprietary standards that are specific to an EHR, and do custom development work with our EHR partners in order to enable things that are not necessarily supported out of the box that our clinics and health systems need to achieve true automation.

What data are you getting from the EHR and what data are you sharing back with the EHR in these integrations?

It’s always about patient access. We get information from – and share information with – the EHR that’s needed about the patient, such as their schedule, appointment(s), phone number, when a provider is free or busy, diagnoses data, and prescription history so we can help with refills. There is a large variety of data we need; it all depends on the specific customer and what they’re looking to achieve.

Our most common customer use case requires patient demographic, diagnosis, and scheduling data: What to talk to patients about (diagnosis, scheduling) and how to talk to them (demographics).

Which EHR data or API/Interoperability functionality would you love to have access to in order to better serve patients and clinicians, but it is still not really available?

I think there’s a big gap around billing and insurance. It seems to be underserviced in terms of how billing systems and third-parties can innovate in that area. The broader picture around the different parts of their case and health – how to make patient financial access part of their journey itself. We’re focused on unifying and simplifying the entire patient journey, the patient’s financial experience is an important component of this — there’s a lot lacking here still.

What’s next for Luma Health?

One of the big pieces we’re looking towards is moving the broader idea of telehealth forward. What I mean by that is the term “telehealth” in today’s vernacular generally refers to a video call between a provider and a patient. But, telehealth is so much bigger; it’s about healthcare being delivered virtually.

At Luma Health, we want to be able to use data to move an individual along their patient journey – through messaging, campaigns and targeted information. Right now, engagement efforts are mostly around acute points of care or very generalized information. But there’s so much in between those points of care. Providers should be able to deliver more personalized care without having to see the patient in their office. For example, the system should know if a patient with advanced diabetes has access to transportation, and, if not, automatically schedules a video visit for their next annual foot exam.

It’s population health meets telehealth (really, it’s virtual health) — and we have the data and technology to not only start paving that path, but to deliver impactful solutions.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.