The challenge:

COVID-19 effects on care delivery in community oncology

New York Cancer & Blood Specialists (NYCBS), a multi-specialty practice with over 25 sites of care across Long Island and New York City, felt the swift and significant impact on care delivery and practice operations due to the novel coronavirus (COVID-19).

By the end of March, their weekly average cancellation rate increased by 80 percent as they served patients in the epicenter of the pandemic.

NYCBS decided they needed to quickly implement solutions to effectively and safely treat their patients, while also keeping their clinicians and staff safe. The practice also knew it was likely to face financial pressures soon given the sudden decrease in patient volumes.

The solution:

Implement remote visits, remote waiting rooms and drive-thru services for patients

Initial implementation and learnings

NYCBS moved quickly to implement remote visits for patients as the pandemic escalated in the greater New York City area. Partnering with the Flatiron Revenue Cycle Management (RCM) team, NYCBS implemented best practice workflows in Flatiron’s electronic health record (EHR), OncoEMR®️, to make it easy to schedule appointments, enter orders, and bill for remote visits一ensuring that the practice maximized their revenue for these services.

Meanwhile, the Flatiron RCM team defined and tracked new key performance indicators (KPIs) to report on how remote services were being adopted on a daily basis. Initial results from these efforts indicated a 51.2 percent acceptance rate for remote visits. NYCBS recognized a need to change their approach to increase adoption to reach more patients.

Expanded remote services

Together with their staff and the Flatiron team, they focused on creating solutions to support the 40.6 percent of patients who declined a remote visit because they did not have access to technology or needed in-person services一including labs, shots, injections and consults.

NYCBS wanted to find ways to limit their patients’ contact with each other and staff to minimize the risk of exposure and infection while receiving those services. The practice decided to implement drive-thru labs and shot services. Additionally, they created a remote waiting room workflow that enabled patients to check in remotely and wait outside of the clinic until their provider was ready for their in-person appointments.

My top priority as a physician and CEO when COVID-19 hit our region was to make sure our patients could safely receive care when they needed it. Our operational teams partnered closely with the Flatiron RCM team to rapidly implement remote care solutions and track their success so patient care wouldn’t be interrupted and our clinical teams could remain focused on their treating patients.

— Jeff Vacirca, MD, Chief Executive Officer at NYCBS

The outcome:

Increased patient adoption of remote services

After implementing these additional remote care options for patients, the practice saw higher adoption rates of 70 percent for drive-thru services and 77 percent for remote waiting rooms. Meanwhile, NYCBS’ cancellation rate decreased and stabilized close to the 2020 weekly average prior to COVID-19.

Leveraging the Flatiron RCM team’s technology and process expertise, NYCBS was able to focus their time and energy on treating their patients during the challenging and unprecedented COVID-19 pandemic. Offering new remote services also helped quickly stabilize their cancellation volume and reduce negative downstream financial effects.

The Flatiron team helped us quickly implement processes and technology to support remote visits, waiting rooms, lab, and injection services. They built detailed analytics to help us understand where there were opportunities to reach out to patients who missed appointments and increase adoption of remote services. Working together, we have been able to maintain the same level of care we provided prior to the COVID-19 pandemic.

— Nicole Gregory, Chief Administrative Officer at NYCBS

Remote care: results to date

3,500+ telemedicine services delivered in the first three weeks of April

77% acceptance rate of remote waiting room option to enable in-person care

70% acceptance rate of drive-thru services (injections, shots, labs)

About NYCBS

New York Cancer & Blood Specialists is located in New York and has over 100 providers serving patients across over 100 clinical sites of care. NYCBS provides multiple specialty services including medical oncology, radiation, breast surgery, urology, and nephrology. They use Flatiron’s technology and services including OncoEMR®️ and Flatiron Revenue Cycle Management and are a founding practice of OneOncology.

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COVID-19 impact across the Flatiron network

Starting March 16, 2020 through April 15, 2020, practices across the Flatiron network have experienced a notable drop in visits when compared to the previous six months. On average, our practices have seen these trends:

13 percent drop in daily visits during which a chemotherapy infusion was administered

33 percent drop in daily non-infusion visits

60 percent increase in appointment cancellations

50 percent decrease in new patient visits

Learn more on our COVID-19 support page.

Note: This data is sourced from over 270 community oncology practices that use Flatiron’s OncoEMR® platform. The data may not be fully representative of Flatiron’s research-grade datasets and should only be considered directional.