VITAS Healthcare Partners with DocuSign to Improve the Patient Experience through Digitization

Creating a seamless customer experience and reducing turnaround times—major goals in almost any industry—take on a completely new meaning when your customers are terminally ill patients with only days left to live. “When you only have two weeks, every second counts,” said Patrick Hale, Chief Information Officer for VITAS Healthcare, the largest provider of hospice services in the United States. “Our job really is to get them home, stabilize their pain and make sure they can live every moment that's left to the fullest.”

With roots going back to 1976, VITAS Healthcare was one of the nation’s first hospice care providers. In the early 1980s, the company led the successful, bipartisan effort to add end-of-life care to Medicare coverage. Still a pioneer over four decades later, VITAS is extending its lead by digitally transforming to improve the patient experience.

That dedication to technological leadership proved vital when the Centers for Medicare and Medicaid Services (CMS) instituted a new regulation amid the COVID-19 pandemic. Under the new rule, hospice care providers were required to provide—upon request—an addendum notifying patients of all items, services and medications not covered by the Medicare hospice benefit. For patients who opt in to receive the document, providers must acquire a signed receipt verifying delivery.

Announced at a time when capturing a wet signature was more challenging than ever, the new rule sent shockwaves through the industry. “We literally had to have a solution up and running within 90 days,” said Steven Smith, Senior VP and Chief Technology Officer. “DocuSign stepped up in a way we didn't even expect.”

Seamlessly integrating DocuSign into the onboarding experience

With loved ones’ emotions frayed and patients struggling with the gravity of their rapidly changing situation, making the transition from curative care to hospice care as seamless as possible is crucial. As part of the onboarding process, VITAS clinicians typically make several bedside visits to counsel the patient and family on what to expect, answer any questions they may have and get the required forms signed via an iPad.

“They’re already being given a stack of information and signing multiple consents,” said Smith. Adding yet another form to the mix at a time when strict social distancing guidelines limited face-to-face interactions presented a big challenge. 

Utilizing DocuSign’s Fast Start API service, VITAS rapidly integrated eSignature with its homegrown electronic medical records system—designing a streamlined workflow for patients who elect to receive the form during the admissions process. “It starts with a simple yes or no: Do you want this information or not?” Smith described. “DocuSign manages the process from there.” 

1. If the patient (or caregiver) elects to receive the Notification of Non-Covered Items, Services and Drugs, the EMR kicks off a workflow in DocuSign.
2. DocuSign sends an encrypted email with the election addendum—as well as automated reminders to acknowledge receipt.
3. Once signed, the document is uploaded to the patient record and an audit report is created.

“We don't need to have a clinician touch it; no one is keeping spreadsheets, stuffing envelopes or emailing anybody,” said Smith. “It’s all automated.”

In addition to increased speed and reduced effort, automating the process with DocuSign yielded other benefits: transparency and measurability. When Hale and Smith learned that over 40% of VITAS patients were requesting the optional documentation—versus an industry average of about 5%—DocuSign’s trackability enabled them to quickly see that a few admissions nurses were driving the high numbers. They followed up, found out that the nurses mistakenly thought the documentation was a mandatory check-off, and were able to retrain them in short order.

While the industry went into panic mode, VITAS turned to DocuSign Customer Success

“Although we were forced into it under duress and really unrealistic time frames, we found a solution that meets all of the requirements and includes an automated workflow that doesn’t require human intervention,” said Hale. “Super exciting.”

Throughout the process, the DocuSign Customer Success team was instrumental in keeping the mission-critical project on schedule. With DocuSign’s support, VITAS deployed the new addendum-request process in about 60 days—well ahead of the CMS-imposed deadline. Overly optimistic vendor promises of quick project turnarounds aren’t uncommon, but Hale was impressed by DocuSign’s ability to actually deliver. “In IT, we hear a lot of very aggressive timeframes that we know aren’t going to be anywhere close to what’s being promised,” said Hale. “But the DocuSign team never faltered.”

Partnering to transform healthcare

VITAS sees an opportunity to further improve the patient experience and increase speed to bedside by bringing DocuSign into another important part of the admissions process. “Consents are the next phase,” said Smith.

Both Smith and Hale are driven by a vision of a digitally transformed healthcare ecosystem where resources are carefully managed, costs are brought under control, processes are more efficient—and organizations can react instantaneously to a changing and dynamic care environment. “We want to take the lead and change the way things are,” added Hale. “We have a handful of partners that are helping us achieve this in a very big way—and we count DocuSign among them.”