At Health First, preregistration tech streamlines processes and boosts collections

At Health First, preregistration tech streamlines processes and boosts collections

Because of the growing number of cases in Florida earlier this year, Health First Community Health Services’ Health First Medical Group needed to create a safe environment for its patients to register for their appointments and minimize time spent waiting for their provider visit.


Health First studied a health IT system from Phreesia as a solution to its problem. The system would let patients preregister for their visits from home, wait in their car until notified their provider is ready, and then be taken directly to an exam room.

In addition, the system would provide a COVID-19 daily dashboard that correlates patients’ responses to COVID-19 questions. Health First could use the COVID-19 dashboard to move patients with symptoms to virtual visits and monitor its PPE inventory.

Health First also could implement patient completion of clinical intake forms, allowing for improved documentation and allotting more time for provider/patient interaction.

“The patient could complete a COVID-19 screening questionnaire and the entire registration process from the comfort of their home.”

Frank Letherby, Health First Community Health Services

“Phreesia proposed to alleviate all of the registration bottlenecks and pain points by fully integrating with our athenahealth electronic health record and digitizing the patient administrative and clinical intake forms, including collecting copays and balances due, and setting up payment plans – all before the patient even set foot in the clinic,” said Frank Letherby, CEO of Health First Community Health Services.

“This allowed for a zero-contact patient registration and check-in process,” he added. “The patient could complete a COVID-19 screening questionnaire and the entire registration process from the comfort of their home, or anywhere with WiFi access, using their personal mobile device.”


Health First embraced the technology and immediately pulled in resources from across the delivery network to determine how many systems could be integrated with the Phreesia system. Starting with Health First Medical Group, where the new technology already benefited from an application programming interface with athenahealth, Health First saw the largest impact within the shortest amount of time.

“In just 12 days, we brought up four Phreesia pilot sites: three primary care and one pain management specialty,” Letherby reported. “Ten days later, we were live at 72 unique clinics across multiple specialties. As the medical group is actively building the interfaces for the oncology and dermatology specialties, Health First’s hospital system already is planning its own implementation across its four hospitals and outpatient diagnostic centers.”

Primary users of Phreesia are the patient service representatives and medical assistants. Patient service representatives constantly monitor the system’s dashboard and instruct the patients via the patient chat feature, which texts the patient’s cell phone. The medical assistants monitor the dashboard to see when the patient has dropped into the “checked-in” section, then bring the patient to the exam room.

In addition to athenahealth, Health First is on track to integrate Phreesia with Unlimited Systems’ g4 application, serving as a registration and billing platform for: Aria (oncology) and EMA (dermatology); SCI Solutions, which is the scheduling platform for breast center and outpatient diagnostic imaging; McKesson’s STAR for hospital registration; and Sunrise Clinical Manager as the hospital EHR.

“The preparation and implementation tasks represent collaboration at its best,” Letherby said. “Internally, we leveraged the expertise of our revenue operations educators and analysts, optimization team, pilot site practice managers and staff, and information technology resources. Phreesia has brought on a team that has helped find solutions to any challenge.”


The benefits of the technology to encourage the pre-visit intake process via a mobile device has enabled Health First to achieve the following:

  • 44% of visits are registered by patients at home via a mobile device and an additional 12% of patients register in-office with their mobile device, for a total of 56% registrations being completed by patients.
  • More than 90% of copayments due and almost 20% of other balances are collected at the time of service.
  • Patients are completing the intake process in an average of 9 minutes, 51 seconds. The intake is routinely completed prior to the appointment time, allowing providers to maintain patient satisfaction with on-time appointments.
  • In the first half of July, Health First screened more than 14,786 patients and identified 16.5% with a broad risk of COVID-19.
  • 91% of patients are satisfied with their Phreesia experience.

“The technology is easy to use and does not require patients to set up an account,” Letherby said. “It uses demographic information known by the group to identify the patient prior to initiating the registration process.”


“One of the keys to implementing this type of technology is to embrace it and trust the results other groups are achieving,” Letherby advised. “Also, ensure the registration forms and processes are finalized prior to implementation. This will help ensure the right processes are in place to embrace the technology.”

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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