Lower No-Shows with Tech Reminder Systems
By Drew Franklin and Nicole Monti ENT and Allergy Associates® Today’s healthcare environment is marked by higher costs and dwindling reimbursement, so physicians are looking for ways to optimize their practices to achieve higher efficiencies, lower overhead, and better “throughput.” And that begins, fundamentally, with getting patients to show up for their appointments. One of the ways we have increased revenues is by maximizing and leveraging technology to drastically reduce our no-show rates. Once armed with these best practices, you will be poised to maximize the benefits that a robust reminder system offers. The Physician’s Schedule A practice’s no-show strategy actually begins with the way a doctor’s schedule is set up. Intuitively and empirically, enterprises that suffer from exaggerated wait times experience higher no-show rates based on patient dissatisfaction. Correspondingly, the number of breaks in the schedule, coupled with the number of appointments booked per hour, affect patient behavior. Each of our 35 offices schedules a one-and-a-half hour to two-hour lunch break, which not only gives the staff a much-needed respite during the day, but also mitigates any adverse effect a late-running morning might have on afternoon wait times. (For reference, our average physician has 29 to 32 clinic hours per week, excluding lunch.) Further, our physician-populated board of trustees unanimously adopted a policy that limits the number of patients seen per hour to five,with a sixth patient booking available any given hour for truly emergent visits. The policy is not intended to dictate the way a physician practices medicine as much as it is an insurance policy to guarantee the average patient an appropriate visit time, history, medical decision-making, and documentation/charting chairside. On this subject, Wayne Eisman, MD, president of ENT and Allergy Associates, said, “Our scheduling policy limiting the number of patients our doctors can see in an hour has reduced our risk exposure…reassuringly, we have not seen any reduction in practice revenues because spending more time with patients allows our physicians to do a more complete history and workup. It’s just good medical care.” This risk-reducing scheduling policy is equally important in light of our group’s newly formed self-insured company for medical malpractice. Data Capture Almost everyone has an e-mail address and mobile phone number these days, including your patients. But do you have that information? If not, you likely have a higher no-show rate than necessary. In this age of smartphones, why not communicate with patients even when they’re on the go? Your ability to communicate with that individual in a convenient, real-time way — across multiple platforms — often means you can eliminate or reduce the chance of a no-show. Over the past 24 months, we have ramped up our efforts to ensure the collection of cell phone numbers and e-mail addresses. In our quest to gather data, we have posted signage in acrylic frames at check-in and check-out to notify patients why we are asking for cell phone numbers and e-mail addresses. Signs such as, “We’re going Green” and “Get Your Appointment Reminder Electronically” are both eye-catching and compelling. When collecting patient co-pays, we use a standardized script to inform patients about our reminder systems and request e-mail addresses and cell phone numbers. We have used promotional contests to challenge (and reward) our office staffs to collect 80 percent of patient email addresses for three months. Our new patient forms explain why we are asking for these e-mail and cell phone fields. And on our online patient portal, new patients cannot complete their paperwork in advance if they do not provide an e-mail address and cell phone number. In the examination room, our medical assistants and physicians chip in if the front staff is unsuccessful in capturing this info. There are myriad database reminder software systems available, but make sure you choose one that has phoning, texting, and e-mail capabilities. Three, Two, One Use each technology to your advantage. We send HTML-rich e-mail reminder messages three days prior (except for patients booking inside of three days, who get their reminders sent the day before). These e-mail messages are constructed in such a way that if a patient hits the confirm button inside the e-mail, a subsequent reminder message will not be sent. If the patient has not clicked the confirm button on the e-mail, then he or she will receive a text message 48 hours prior to the scheduled appointment. Like the e-mail, our SMS texting system allows patients to reply with “confirm,” “cancel,” or “reschedule.” Patients also can cancel the appointment or click a button to reschedule. Once the reschedule notification is received at the front desk, someone calls the patient. Finally, 24 hours before a scheduled appointment, the patient receives an automated phone call. Patients can push “1” to confirm, “2” to cancel, or “3” to speak to a live operator who can help reschedule an appointment or help the patient navigate through his or her appointment concerns. No-show rates vary by specialty, practice type, and location, though one study shows that nearly 50 percent of practices that are not using appointment reminders have no-show rates greater than 10 percent, whereas only one in four that are using some type of appointment reminder system are experiencing no-shows above the 10 percent threshold. Our focus on reducing last-minute cancellations and no-shows has produced tangible success. In fewer than eight months, the practice’s no-show rate has been reduced by nearly 30 percent, and well below a 10 percent rate overall. This tells us that our new reminder technology is off to a healthy start. Higher efficiencies, lower overhead, and better “throughput” are already burgeoning. Implement an enhanced scheduling policy and an e-mail address/cell phone number collection program today, and reduce your no-shows tomorrow. For more information, contact nmonti@entandallergy.com or dfranklin@entandallergy.com.
By Drew Franklin and Nicole Monti
ENT and Allergy Associates®
Today’s healthcare environment is marked by higher costs and dwindling reimbursement, so physicians are looking for ways to optimize their practices to achieve higher efficiencies, lower overhead, and better “throughput.” And that begins, fundamentally, with getting patients to show up for their appointments.
One of the ways we have increased revenues is by maximizing and leveraging technology to drastically reduce our no-show rates. Once armed with these best practices, you will be poised to maximize the benefits that a robust reminder system offers.
The Physician’s Schedule
A practice’s no-show strategy actually begins with the way a doctor’s schedule is set up. Intuitively and empirically, enterprises that suffer from exaggerated wait times experience higher no-show rates based on patient dissatisfaction. Correspondingly, the number of breaks in the schedule, coupled with the number of appointments booked per hour, affect patient behavior. Each of our 35 offices schedules a one-and-a-half hour to two-hour lunch break, which not only gives the staff a much-needed respite during the day, but also mitigates any adverse effect a late-running morning might have on afternoon wait times. (For reference, our average physician has 29 to 32 clinic hours per week, excluding lunch.)
Further, our physician-populated board of trustees unanimously adopted a policy that limits the number of patients seen per hour to five,with a sixth patient booking available any given hour for truly emergent visits. The policy is not intended to dictate the way a physician practices medicine as much as it is an insurance policy to guarantee the average patient an appropriate visit time, history, medical decision-making, and documentation/charting chairside.
On this subject, Wayne Eisman, MD, president of ENT and Allergy Associates, said, “Our scheduling policy limiting the number of patients our doctors can see in an hour has reduced our risk exposure…reassuringly, we have not seen any reduction in practice revenues because spending more time with patients allows our physicians to do a more complete history and workup. It’s just good medical care.”
This risk-reducing scheduling policy is equally important in light of our group’s newly formed self-insured company for medical malpractice.
Data Capture
Almost everyone has an e-mail address and mobile phone number these days, including your patients. But do you have that information? If not, you likely have a higher no-show rate than necessary. In this age of smartphones, why not communicate with patients even when they’re on the go? Your ability to communicate with that individual in a convenient, real-time way — across multiple platforms — often means you can eliminate or reduce the chance of a no-show.
Over the past 24 months, we have ramped up our efforts to ensure the collection of cell phone numbers and e-mail addresses. In our quest to gather data, we have posted signage in acrylic frames at check-in and check-out to notify patients why we are asking for cell phone numbers and e-mail addresses. Signs such as, “We’re going Green” and “Get Your Appointment Reminder Electronically” are both eye-catching and compelling. When collecting patient co-pays, we use a standardized script to inform patients about our reminder systems and request e-mail addresses and cell phone numbers.
We have used promotional contests to challenge (and reward) our office staffs to collect 80 percent of patient email addresses for three months. Our new patient forms explain why we are asking for these e-mail and cell phone fields. And on our online patient portal, new patients cannot complete their paperwork in advance if they do not provide an e-mail address and cell phone number. In the examination room, our medical assistants and physicians chip in if the front staff is unsuccessful in capturing this info.
There are myriad database reminder software systems available, but make sure you choose one that has phoning, texting, and e-mail capabilities.
Three, Two, One
Use each technology to your advantage. We send HTML-rich e-mail reminder messages three days prior (except for patients booking inside of three days, who get their reminders sent the day before). These e-mail messages are constructed in such a way that if a patient hits the confirm button inside the e-mail, a subsequent reminder message will not be sent.
If the patient has not clicked the confirm button on the e-mail, then he or she will receive a text message 48 hours prior to the scheduled appointment. Like the e-mail, our SMS texting system allows patients to reply with “confirm,” “cancel,” or “reschedule.”
Patients also can cancel the appointment or click a button to reschedule. Once the reschedule notification is received at the front desk, someone calls the patient.
Finally, 24 hours before a scheduled appointment, the patient receives an automated phone call. Patients can push “1” to confirm, “2” to cancel, or “3” to speak to a live operator who can help reschedule an appointment or help the patient navigate through his or her appointment concerns.
No-show rates vary by specialty, practice type, and location, though one study shows that nearly 50 percent of practices that are not using appointment reminders have no-show rates greater than 10 percent, whereas only one in four that are using some type of appointment reminder system are experiencing no-shows above the 10 percent threshold.
Our focus on reducing last-minute cancellations and no-shows has produced tangible success. In fewer than eight months, the practice’s no-show rate has been reduced by nearly 30 percent, and well below a 10 percent rate overall. This tells us that our new reminder technology is off to a healthy start. Higher efficiencies, lower overhead, and better “throughput” are already burgeoning.
Implement an enhanced scheduling policy and an e-mail address/cell phone number collection program today, and reduce your no-shows tomorrow.
For more information, contact nmonti@entandallergy.com or dfranklin@entandallergy.com.
