Follow-up Appointments

Patient Checks In

  • Receptionist marks the patient as “Arrived” in Cerner to notify nurses and providers.
  • During check-in at a Memorial Care facility, staff asks the patient if they would like to register for the portal.
  • Patient provides their email address, confirms their identity with a photo ID, and sets up a challenge question for future identity verification.
  • Receptionist enters information such as name, date of birth, address, insurance provider, and guarantor details directly into Cerner.
  • A unique FIN is generated to track the patient’s visit.
  • Staff verifies in real-time that the email address is accurate and a photo ID is on file to minimize errors during account setup.

Sets Up Portal

  • Activation links are manually sent to patients during the registration process, enabling them to create an account in the FollowMyHealth portal.
  • Emails contain unique activation links for account setup.
  • Patients can also set up a portal account by requesting a “connection” with Memorial Care.
  • If needed, patients can self-enroll in the Cerner HealtheLife portal once an appointment is created.
  • Patients can reach out for assistance if they encounter problems during activation.
  • The portal provides visibility into results, after-visit summaries, and upcoming appointments, and also offers the ability to message providers.

Troubleshoots Registration Errors

  • Staff monitor data flows between Cerner and TouchWorks to ensure accurate transfer.
  • If activation fails, staff investigate and resolve issues, such as mismatched patient records or failed activation attempts.
  • Staff resolve interface errors that prevent data synchronization.
  • Staff trace and correct errors, such as missing patient charts, to ensure clinicians can access accurate information.
  • Staff investigate issues flagged during data review.
  • Staff identify root causes, such as incorrect provider selection or reused FINs, and implement fixes.
  • Staff collaborate with other departments to resolve errors.
  • Teams, including HIM, billing, and coders, are contacted to finalize corrections when receptionist cannot resolve issues.

Visits Primary
Care Doctor

  • PCP assesses the patient by collecting symptoms, reviewing medical history, and conducting an examination.
  • PCP identifies a need for follow-up appointment, and the time frame and location in which it should occur.

Patient Schedules a Follow-up Appointment

  • For provider-initiated scheduling, scheduling teams receive a work list, contact patients to arrange appointments, and ensure alignment with the provider’s availability.
  • If the patient does not coordinate the follow-up appointment in the provider’s office or by calling the office directly, they can schedule an appointment via the My Memorial app.
  • The patient logs into the app and navigates to “Primary Care” to look at their doctor’s availability.
  • The patient uses the app to submit appointment requests, which are added to a tracking board for clinic staff to review.
  • The patient can send messages within FollowMyHealth to the provider’s office to request an appointment. Providers can respond here too.
  • Patients are notified via email or phone if their appointment request is still pending manual confirmation.
  • Staff use Cerner’s scheduling interface to view providers’ schedules and identify and reserve available appointment times in Cerner.
  • If an appointment slot is no longer available, clinic staff contact the patient to propose alternative options.
  • Staff inform the patient of the confirmed appointment details, including date, time, and provider information.
  • Scheduling staff update Cerner to reflect confirmed appointments, making them accessible through the portal.

Patient Reviews Visit Updates in Portal

  • Staff ensure eligible records (e.g., lab results, visit summaries) are instantly released to the portal.
  • Patients receive notifications when records or results are available in the portal.
  • Patient logs into the portal (e.g., Cerner HealtheLife or FollowMyHealth) and navigates to the “Medical Records” section to view diagnostic results, medications, and visit summaries.
  • If records are incomplete, patient can message their provider through FollowMyHealth or contact staff directly.
  • Using Chart to PDF, staff process patient requests for specific documents not integrated into the portal.
  • Instructions for accessing records and troubleshooting issues are provided via email or during follow-up interactions with staff.

Follow-up Appointment Reminder

  • External systems like Mutare extract appointment data from Cerner to generate email or SMS reminders 48 hours prior to the appointment.
  • Notifications include the appointment date, time, and location.
  • Patient reviews reminders and confirms attendance by replying to emails or contacting the facility directly.
  • If the patient wishes to reschedule, they must call the facility, and staff manually update Cerner.
View Technology Map

Step

Technology/Touchpoints
Patient Checks In
  • TouchWorks (FollowMyHealth)
  • Cerner Identity Verification System
  • FollowMyHealth
  • Cerner Check-in Module
  • Workplace, Teams, Email (internal updates around portal)
Sets Up Portal
  • FollowMyHealth
  • Cerner
  • TouchWorks
  • HealtheLife after Cerner
Troubleshoots Registration Errors
  • Cerner Error Logs
  • FollowMyHealth
  • TouchWorks
  • PowerChart
  • Memorial Central
  • Experian
  • Interface Logic for Data Transfer
Visits Primary
Care Doctor
  • Touchworks
Patient Schedules a Follow-up Appointment
  • Memorial App
  • Cerner Scheduling Interface
  • FollowMyHealth
  • Phone
Patient Reviews Visit Updates in Portal
  • TouchWorks
  • PowerChart
  • Chart to PDF
  • FollowMyHealth
  • Symplr
Follow-up Appointment Reminder
  • Mutare
  • Cerner

Step

Pain Points
Patient Checks In
  • Receptionists struggle to ensure that the status of patients marked as “arrived” is updated correctly across systems. If an appointment fails to sync correctly, nurses and providers might not be notified, requiring manual intervention to adjust records and notify staff.
  • Patients at competing health systems can complete preregistration online, reducing their wait times and administrative burden. Memorial Health has no equivalent system, forcing manual input at check-in.
  • Registration errors, such as incorrect demographics or insurance details, are common during initial patient intake.
  • If a patient successfully self-enrolls to an app/portal prior to an in-person appointment, check-in access is limited.
  • Encouraging sign-ups for portals requires operational staff to promote and enable portal registration, ultimately adding to their current workload.
  • Changes in tools such as app enhancements are not fully communicated, are missed among the various communication channels, or are not understood by staff, creating missed opportunities for staff to educate patients or promote these tools.
  • Follow My Health is only available for primary care and specialty care patients (including weight loss and wellness services, and behavioral health), but does not include wound clinics, pain clinics, or hospital-based services.
Sets Up Portal
  • When a patient tries to make a connection with Memorial Care through the portal, the dashboard tries to enroll them into Springfield and Jacksonville hospitals, which are no longer accessible via FollowMyHealth. The dashboard would need to be rebuilt to fix this, which would delete past patient data.
  • Some patients try to reuse an activation link to access the portal, which is not its intended use.
  • No portal is all-encompassing; each has limitations on access and functionality.
  • Activation links often expire, causing registration issues.
  • Activation links fail to function when patient records in back-end systems do not align.
  • Errors in the registration or scheduling process within Cerner can prevent TouchWorks from recognizing patient data, causing validation to fail.
  • Patients receive no real-time feedback during enrollment in the portal, so it is not clear or easy to troubleshoot getting access without staff assistance.
Troubleshoots Registration Errors
  • Staff occasionally reuse old FINs during registration, which can cause downstream mismatches in patient records and disrupt data flow to other systems.
  • Interfaces rely on predefined logic, which often breaks due to mismatched data (e.g., reused FINs or incorrect provider assignments). Breakdowns can prevent patient records from appearing in TouchWorks, delaying access for clinicians.
  • Mismatched emails can cause a portal registration to fail.
  • Staff must manually correct errors in patient registration or demographic information.
  • Communication for resolving registration errors is slow and manual. Staff must manually copy information from email messages into Cerner or TouchWorks.
  • When multiple organizations use TouchWorks, changes made by one (e.g., SIU) can unintentionally overwrite Memorial’s patient records.
Visits Primary
Care Doctor No Pain Points
Patient Schedules a Follow-up Appointment
  • Providers maintain separate, disconnected schedules, preventing a unified scheduling database.
  • Appointment requests in FollowMyHealth are not automatically scheduled in Cerner.
  • When patients request appointments through the app, staff must manually retrieve requests from the app’s tracking board and input them into Cerner.
  • Appointment slots may become unavailable before requests are processed.
  • Lack of synchronization between provider schedules creates delays and potential double-bookings.
  • While Cerner supports viewing appointments and records, it lacks self-service features for managing appointments, and patients cannot schedule or cancel appointments.
Patient Reviews Visit Updates in Portal
  • Patients frequently encounter issues accessing the portal.
  • Due to privacy regulations, certain types of sensitive information, such as mental health notes, are not shared via FollowMyHealth. Patients must request these records through additional processes.
  • Orders transmitted through Cerner and TouchWorks may not transfer to FollowMyHealth, requiring staff to manually retrieve and upload missing records.
  • Automated notifications rely on back-end data synchronization, which can fail due to errors in data integration or system updates.
  • A lack of integration with messaging tools delays information from being available in the portal.
  • FollowMyHealth uses a pull mechanism to synchronize data from Cerner, but only after the patient logs in, leading to delays in accessing real-time updates.
  • Cerner HealtheLife displays more detailed inpatient data, while FollowMyHealth provides broader access across outpatient services.
  • The interfaces of tools like FollowMyHealth are not intuitive for patients or staff.
  • Automated systems send lab results directly to patients without provider context, prompting patients to call with questions. Providers struggle to keep up, creating delays and confusion.
  • Providers often make quick follow-up calls to discuss test results, prescriptions or additional steps, but these interactions are not converted into billable telehealth visits. This results in lost revenue despite staff performing the necessary work.
  • While chatbot and portal functionalities exist for follow-up communications, most interactions revert to manual processes due to system limitations or lack of adoption.
Follow-up Appointment Reminder
  • Mutare and Cerner Email Notification System both send reminders, creating confusion for patients.
  • Different tools are used for appointment reminders, results notifications, and patient messaging, requiring manual intervention to consolidate data.
  • Urgent Care, Primary Care, and other departments develop their own chatbot functionalities, leading to inconsistent messaging and experiences.
  • Tools like Mutare and paper-based reports require staff to manually handle appointment confirmations, cancellations, and follow-ups.

Step

Thinking

Feeling

Quotes
Patient Checks In

“This process will help me access my medical records and appointments more easily.”

Reassured

Frustrated

 N/A
Sets Up Portal

“I thought I’d have more functionality by downloading the portal.”

“Which portal do I need to go to for what?”

“I’m not sure why I can’t log in.”

Confused

Frustrated

 N/A
Troubleshoots Registration Errors

“I wish this wasn’t so difficult.”

“This will take awhile for me to troubleshoot.”

Busy

Stressed

 N/A
Visits Primary
Care Doctor

“I’m not looking forward to finding time in my schedule to come back.”

“Glad they addressed my concerns and we have a plan.”

Relieved

Apprehensive

 N/A
Patient Schedules a Follow-up Appointment

“Why does scheduling an appointment have to be so difficult?”

“I thought I had already secured an appointment.”

Frustrated

“Several patients have had issues where they request an appointment through the app and assume it’s confirmed, when in reality, it’s just a request. I haven’t seen the exact message they receive, so I’m not sure if it’s a misunderstanding or if the system isn’t clear enough.”

“20+ min on hold trying to call your primary doctor. 3+ months to be seen by a specialist. Not getting calls back from primary doctors after leaving multiple messages.”
Patient Reviews Visit Updates in Portal

“I wonder when I will get my results?”

“Great, looks like I can view them on the portal.”

“Where is the rest of my visit information?”

Anxious

Confused

Impatient

 N/A
Follow-up Appointment Reminder

“Why did I get two reminders?”

“I forgot about that appointment.”

Confused

“Patients receive reminders from multiple sources—text, email, and sometimes personal calls from staff. Some appreciate it, but others get confused about why they’re receiving duplicate notifications.”

“If a patient doesn’t confirm their appointment, we have no way of knowing if they plan to show up. A more centralized reminder system could help reduce no-shows and improve scheduling efficiency.”

Step

Opportunities
Patient Checks In
  • Enable portal self-enrollment to eliminate the need for in-person steps at registration.
  • Implement a unified platform that integrates appointment reminders, real-time updates, and patient-arrival notifications across all locations and services.
  • Identify other promotional opportunities to help build awareness around the portals/apps and encourage utilization.
  • Implement pre-registration through FollowMyHealth or My Memorial app, so patients can input demographic and insurance details before arrival.
  • Use the My Memorial app’s “On My Way” feature to feed arrival data directly into Cerner, reducing the need for manual reconciliation.
  • Use AI algorithms to validate patient demographic and insurance information in real-time during registration.
  • Add an alert system in Cerner to notify staff when an appointment fails to sync correctly during check-in.
  • Use short, post-check-in surveys for receptionists to identify workflow challenges.
  • Provide a short training session to familiarize staff with existing digital tools like FollowMyHealth and appointment chatbots.
  • Add physical displays in waiting rooms with clear instructions on downloading the patient app.
Sets Up Portal
  • Extend the expiration period of activation links sent to patients.
  • Implement a simple validation script in Cerner to ensure the accuracy of patient data before activation links are sent.
  • Send automated email reminders to patients who do not complete their activation within 24 hours.
  • Develop a one-page, step-by-step guide for patients to complete FollowMyHealth registration.
  • Replace the multi-step invitation and verification process with a single email or text link that immediately activates accounts.
Troubleshoots Registration Errors
  • Add a validation step in Cerner to ensure that a new, unique FIN is generated for every patient visit.
  • Add real-time validation during self-enrollment to flag discrepancies in the email address entered and provide corrective guidance before submission.
  • Deploy an AI-powered middleware that monitors data transfer between Cerner and TouchWorks for inconsistencies.
  • Use an AI bot to triage and resolve common registration and scheduling errors across departments.
  • Enable a live chat feature on the portal login page to help patients resolve common access issues.
  • Develop a virtual simulation model (digital twin) of the registration and scheduling process to identify bottlenecks and test process changes.
  • Provide a focused training module with step-by-step guides on unique FIN generation during patient registration.
  • Provide new patients with a digital welcome kit highlighting all available tools and services.
Visits Primary
Care Doctor N/A
Patient Schedules a Follow-up Appointment
  • Modify the My Memorial app to reserve appointment slots in real-time while the patient is scheduling.
  • When requested slots are unavailable, the system will automatically suggest the next closest times.
  • Create real-time confirmations for patients to understand where their appointment stands.
Patient Reviews Visit Updates in Portal

• Add hyperlinks in each portal that navigate to the other for complete record access.
• Implement automatic alerts for providers to sign off on records required for portal updates.
• Enable staff to upload multiple records simultaneously using a batch upload tool.
• A “Request Records” feature within the portal could route requests directly to the appropriate staff for processing.
• Implement AI to automate indexing and categorizing patient records for upload.
• Implement a pull mechanism that automatically refreshes data in FollowMyHealth whenever new updates are made in Cerner. Notify patients of these updates via email.
• A middleware solution could ensure that any updates to patient data in one system are immediately reflected in the others.
• Ensure consistent messaging by aligning chatbot templates for Urgent Care, Primary Care, and test results notifications.
Follow-up Appointment Reminder
  • Use a centralized notification system that combines Mutare and Cerner email reminders into a single communication, clearly labeling details like appointment type and preparation requirements.
  • Use Mutare’s capabilities to send automated texts confirming scheduled appointments and follow-up reminders. To reduce confusion, these messages should include the date, time, and type of appointment (in-person or virtual).
  • Update patient intake forms to include a pre-checked option that enables chatbot notifications for results, reminders, and follow-ups.
  • Use APIs to integrate communication tools like Mutare and LifeLink into a single messaging hub.
  • Develop a centralized hub for overseeing chatbot implementations across all departments.
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