Appointment Reminder Intelligence

A practice can reach out to patients via phone, e-mail, SMS, and snail mail. Each communication media serves its own purpose. Let’s review available options for serving appointment reminders to practice patients.

Snail mail can be used to remind a patient only if appointment was scheduled long in advance. For recently added appointments, there is simply no time to deliver mail on time, so that it can remind of upcoming appointment. Another disadvantage of snail mail is cost. Printing, packing, and stamping a reminder will cost between $0.50-1.00 per reminder. With an average 400 patients a month, practice will have to spend $200-$400 just on reminders.

SMS is definitely a viable option for reminding patients. Most patients are expected to own SMS capable phone. SMS is easy to deliver and read. The disadvantage of SMS is that it can carry a limited amount of information. It is just 96 characters long, so adding web page links and long instructions is not an options. It is also impossible to deliver a calendar event via SMS. Calendar events can be imported directly into smart phone calendar and set to remind the owner of incoming appointment at pre-determined time. Another minor disadvantage of SMS is cost. Text messages cost around $0.10 per message. This is nowhere close to snail mail, but still adds up to a measurable amount for a busy practice.

E-mail is by far the richest media to deliver appointment reminders. It can include long instructions, patient forms as attachments, calendar items, links to web forms and documents to fill, links to confirm or reschedule appointment online. E-mails are also cost effective. Being virtually free, there are no budget concerns even for a busy practice. The disadvantage of e-mail is that Medicare patients might not be as acceptable to this media as the rest of patient population. Practice should evaluate what percentage of older patients might be impacted and ensure this population is covered by a voice call.

Voice call is not as rich as e-mail. Its main advantage is that this is a universal way to reach patients across all socioeconomic groups. Voice call is much less likely to be ignored compared to e-mail or SMS. When used with pre-recorded practice messages, voice call delivers personal touch. It sounds like a doctor or front desk that patient knows personally has called and spoke to the patient or left voicemail. This creates and strengthens existing connections and makes patient less likely to miss an appointment.

What is the best way to remind

When a practice is identifying best fit for notifying its patients, a table below can provide a general guidance. There are several ways to build practice appointment reminders. This depends on how much time is available and return of investment on time spent. The simplest way is to ask patients of preferred way. If patient preference is not available, practice can choose to implement universal approach with preference order based on most common scenario, see Unknown and Seniors in the table below. A practice may also choose to analyze patient panel in order to determine a category where most of the patients fit.

Patient group	Preferred Media in order of preference
Young adults	SMS, E-mail, Voice
Working adults	E-mail, SMS, Voice
Seniors	Voice, E-mail SMS
Unknown	Voice, E-mail SMS

A good appointment reminder system should enable practice to either pre-select reminder categories or even better let the system intelligently determine the order based on patient age and other cues available from patient demographics.

 

Happy reminding!

Appointment Reminders and Practice Workflow

Any automated system is as good as it blends into the workflow. Appointment Reminders is no exception. Its impact can be compared to switch from paper to Electronic Health Records. In order to understand how appointment reminders fit into typical practice workflow, let’s review the manual reminders workflow. There are several scenarios:

1.       No reminders – plain and simple. This usually translates to high no show rate, 8% and higher and low adherence, e.g. having a meal before a procedure that requires fasting

2.       Random reminders – practice identifies high risk patients and high impact appointments and selectively calls them ahead of time to remind. This is a “low hanging fruit” approach that gives very good return of investment, but still leaves room for improvement

3.       ‘Total Remind’ – practice personnel prints appointment report 2 days before the appointment date and calls each patient throughout a day whenever they get available minute. This approach provides a good coverage, but is time consuming and makes high impact on personnel. Our surveys demonstrate that practice personnel feel overwhelmed whenever they have to manage several tasks in parallel, not to mention that each call takes 2 minutes on average, adding up to 40 min a day or 200 min a week for a 20-visit/day provider

Automated appointment reminders provide benefits of the ‘Total Remind’ approach at cost close to ‘No Reminders’. Sounds too good? Let’s dive into details…
Automated appointment reminders may be fully integrated into practice management system, so once appointment is scheduled, there are no other steps to be performed by practice personnel, except managing cancelations or reschedules.
Unfortunately not all EHR providers enable direct appointment reminder integration. In this scenario, practice personnel needs to add a small task of exporting appointment schedule into automated appointment reminders service. This is a 5-minute task that needs to be performed daily for appointments that are 2-3 days ahead. Once completed, appointment reminder service takes the task of reminding patients and notifying practice of any changes requested to the schedule.
Practice workflow integration comes down to eliminating manual reminder calls during the day and in case of indirect integration, a 5 minute task of exporting schedule to the service. In most cases even this task can be automated depending on specific EHR used by the practice.

All in all, implementation of an automated appointment reminders system frees up practice personnel from 200+ minutes per week per provider.

As for benefits of no show elimination, please see the “Why would a medical practice want to implement an automated appointment reminder system?” article.

www.GoToClinic.com

Medical Appointment Reminders – SMS, E-mail, Voice. What works the best?

Technology adoption varies by patient age group. Younger patients are more open to the ‘coolness’ of SMS as communication media. Older patients are less likely to rely on SMS or e-mail, preferring a more traditional approach.

When a practice needs to reach out to patients, choice of media varies by availability, price and effectiveness. Something is better than Nothing is the major principle behind selections made by practices when it comes to reminding or notifying patients. And it makes perfect sense. The difference between having patients notified one way or another vs. not having notified at all is really big. The difference is similar to Paper Charts vs. Electronic Health Records. It is a huge leap, even though choice of the EHR may be not as optimal as it could be.

Once appointment reminder media selection process passes first stage, practices should start looking into what would be a better choice.

E-mail is a good way to communicate with the younger and middle age generations. It is the most effective way to communicate. E-mail also enables 2-way communication, sot that patients may reply and notify the practice in case they can’t keep up an appointment. On a negative side, e-mail is more likely to go unnoticed lost in the flood of other e-mails in patients’ mailboxes.

SMS is a good way of staying on touch with the younger generation. Its main disadvantage is that there is no feedback unless patient calls the clinic back and notifies of being unable to keep the scheduled appointment.

Voice call is the most traditional way of reaching out to patients and it has highest chances of actually ‘being heard’. Whether it reaches the patient directly or left on the answering machine, chances are the patient will listen to the instructions. For older Medicare generation, voice call is the most reliable way of getting practice message to the patients. It carries warmth of the practice voice and is as personal as communication can get. Same as e-mail, voice call enables interactive communication, so that patient can notify the practice of change of plans by making selection through the Interactive Voice Response system (IVR). The practice gets notified immediately and is able to utilize appointment slot that would have gone unfilled otherwise.

The main disadvantage of voice reminders is that they require office personnel to call patients individually. However, use of an automated appointment reminder system makes voice calls not more expensive than sending an SMS.

 Setting up automated appointment reminders has become as simple as setting up e-mail notification system. Hosted in the cloud, the system enables practices reach out patients in the most effective yet personalized manner.

www.GoToClinic.com

Medical Appointment Reminders most important features

When a medical practice is looking for an appointment reminder system to be integrated with the practice Electronic Health Records Management, practice manager needs to identify a set of features to evaluate. While medical appointment reminders may come in a huge variety of flavors, it is important to pick ones that satisfy practice requirements. A reminder system that has tons of bells and whistles, but does not address practice workflow scenario, is not going to do any good for the practice.
With this in mind, let’s first identify main scenario(s) common across most practices.

Scenario 1 – No Shows: Patient no show rate is above 3% and practice is looking how to minimize losses cause by patients not showing up for their appointments

Scenario 2 – Non-adherence: Patients come for a procedure not prepared. E.g. patient had breakfast while procedure requires fasting. This creates both health and liability risk. In addition, this leads to lost appointment slot that otherwise would have been taken by another patient

Scenario 3 – Health Maintenance: Patients need to be reminded to take their medications or schedule follow up appointments as necessary.

Scenario 4 – Billing and Collections: Patients that have outstanding balances need to be reminded to pay

In all scenarios, practice manager wants to ensure that patients are aware of upcoming appointments as well as are instructed on appointment prerequisites. Practice manager also requires a tool to reach out to selected patients and remind them of health maintenance issues, available immunizations and in some cases outstanding balances.

These tasks can be accomplished via:

1.       Office Manager making direct call to patient

2.       Automated appointment reminder system sending e-mail to selected patients

3.       Automated appointment reminder system sending SMS to selected patients

4.       Automated appointment reminder system calling selected patients

Out of options listed above, direct patient call is the most effective way of reaching out to patient whether to remind of upcoming appointment or collect the balance. A warm human touch makes a world of difference when getting in touch with the patient. However, calling every single patient would require a dedicated call center that would not be feasible for most practices whether small or large.

Automated appointment reminder e-mails and SMS would be a good choice since they do not require dedicated personnel to be sent out. However, the down side of automated e-mail and SMS reminders is media disconnect. E-mail is much less personal than a phone call. In many cases it might get ignored or sent to Spam folder.

Automated reminders performed via phone calls are proven to be the most effective way to bring reminders to the patients. It is important that the phone call shows on patient caller ID as a call from the practice, so that patient is not hesitant to pick up the phone knowing that this is not a telemarketer on the other end of the line.

Automated voice reminder should be able to greet patient by name using pre-recorded message featuring doctors or receptionist voice. This makes patient at ease that this is his doctor’s office calling.

And finally, the automated reminder system should be able to clearly communicate information about upcoming appointment date, time, location as well as any instructions, e.g. “Please come 15 minutes before scheduled time to fill in all the necessary paperwork”.

When evaluating a medical appointment reminder system, practice manager should consider applicability of the four major scenarios listed above and evaluate how the automated appointment reminder system is going to satisfy each scenario.

Appointment Reminder Provider Ranking:

http://www.nuesoft.com/news-events/video/appointment-reminder-calls.html

http://www.GoToClinic.com
http://www.reremind.com/
http://www.physicianspractice.com/articles/tech-doctor-appointment-reminders
https://www.appointmentreminder.org/
http://www.talksoftonline.com/doctor-appointment-reminders.shtml

Appointment Reminders in depth analysis

What makes a difference between good and great medical appointment reminder system? Two things consistently come on top of customer satisfaction surveys are Ease of Use and Vendor Support. Are you not surprised that feature set was not mentioned? You should be, because many practices do not realize how much appointment reminder system used by a practice could be missing in terms of minimizing no show impact on practice financial results.

Technology

Most of not all appointment reminder systems can be bucketed in one of two major categories – on premise or cloud based. Each technology has its pros and cons.

On Premise Appointment Reminders

For enterprise-scale customers, such as large hospital systems and I mean really large with 5-10 hospitals and thousands providers, an on-premise system might be a better choice. It would run the system for several hundred thousand on a yearly basis and minimize system integrator or IT provider related risks.

Cloud based appointment reminders

A cloud based system would be a choice for smaller hospital systems and definitely the only cost effective choice for groups and individual practices. There is no need to talk much about benefits of cloud based appointment reminder system. Most practices have already gone through the process of getting their Electronic Health Records systems in place and cloud adoption is really high. The main advantage for the practices is no need to keep, support and maintain all the infrastructure required for an appointment reminder system to function, e.g. computers, phone lines or IP trunks, monitoring software, and support personnel. It is much more cost effective to pay a relatively low monthly fee, which ranges from $50 to $300 per provider.

Hybrid or private cloud appointment reminders

There is a third option available for Medium to large size hospitals – a private cloud. This is an equivalent of outsourced cloud, but hosted in house. This usually entails licensing fee paid to provider, but enables the hospital to have full control over access and maintenance to the in house appointment reminders system.

As of time of this article, the only known private cloud medical appointment reminders provider was www.GoToClinic.com provided by IMG Residency. As the technology has started making traction, more and more hospital CIO’s are looking into private cloud appointment reminders systems. It provides same cost effective cloud approach, but at the same time minimizes hospital exposure to the risks of accidental information disclosure.

Medical Appointment Reminders integration with Practice Electronic Health Records

Medical Appointment Reminders EHR integration 

For the average medical practice, about 7 percent of patients are missing their appointments. These appointment no shows result in $50,000-$500,000 lost revenue per medical provider.

Is there anything that a medical office can do to minimize impact of no shows to how the doctors practice medicine? Fortunately yes. There is an array of choices when it comes to selecting a medical appointment reminder system.

Many Electronic Health Records (EHR) and Practice Management (PM) Systems come with some form of appointment reminders available out of the box. These appointment reminders vary by features, price, and technologies. But they all have one thing in common – tight integration with appointment scheduling software. This is one of the greatest advantages that a fully integrated appointment reminder system has over a stand-alone one.

Some stand-alone providers such as reremind.com or GoToClinic.com have realized the gap and provide seamless appointment reminders integration with practice appointment scheduling software. How do they do it?

Appointment scheduling software is on premise or cloud based. Appointment reminders software providers enable full integration via an integration agent that is installed on one of practice computers and periodically pulls appointment data from the scheduling system and updates scheduling system with appointment cancelations received from the appointment reminders calls.

So, what’s the difference between fully integrated appointment reminders and custom integration? There should be no difference if vendor implementation accounts for all nuances. Data flows between practice EHR and Appointment Reminder system, effectively providing a seamless integration.

Some appointment reminder systems, however do rely on standard interfaces enabled by practice EHR or Practice Management software. Unfortunately this is not something a practice can rely on. When comparing and selecting automated medical appointment reminder systems, practice manager should take into consideration EHR integration aspect of the system

Automated Medical Appointment Reminders - Is there a value?

Why would a medical practice want to implement an automated appointment reminder system?

Medical appointment reminder software is aimed at minimizing doctors’ no show rate and optimizing physician time allocation. When a patient misses her appointment, time that could have been re-allocated to another patient is lost. Well, to be fair, at a busy clinic, doctor always has something to do, but missed appointment time will likely to be dedicated on administrative task. One might say, so what, this saves doc’s admin time that he can later dedicate to seeing another patient. But this is not really how time allocation works. Time fragmentation and task hoping impacts efficiency and hurts practice bottom line.

Doctors have a whole arsenal of tools aimed at improving productivity and minimizing lost time. An automated appointment reminder system should be considered as a single most effective tool that costs a small fraction of benefits it brings.

So, what makes use of an automated appointment reminder system is a big game changer in the doctor’s office set up? There are several factors.

Firstly, it minimizes chances for patient  not showing for her scheduled appointment. No show has a measurable impact on practice revenue and is easy to assess. Typical outpatient medical office no show rate varies between 7 and 15%. Even best case scenario hurts the practice. 7% no show rate translates to about 500 patients a year. Depending on physician specialty, this could be from $50,000 in Primary Care (Family Medicine, Pediatrics) to $500,000 in procedures, e.g. minor surgeries. If the rate drops by just 1%, practice is making $5,000-$50,000 more a year!

Secondly, if medical office has no automated appointment reminder system in place, an employee should be calling patients with reminders and pre-procedure instructions. This is a cumbersome task that makes one bored in a minute. This is also a task difficult to supervise and control, so quite often an individual responsible for reminding patients does not complete the task 100%, leaving some patients uncovered.

Finally, an employee that is calling patients with appointment reminders gets paid salary and fringe benefits that add up to about $5,000 a year.

Add up One, Two and Three and see if you can afford not to use an automated medical appointment reminder system.

When it comes to selecting a reliable Automated Medical Appointment Reminders system, there is a large array of choices. They span from on-premise to cloud hosted solutions and vary by feature set. Naturally, the following features come as most important while selecting an automated appointment reminder software:

- EMR/EHR integration

- Practice Management integration

- Cloud vs. on-prem based

- Ability to pre-record templates in a warm human voice

- Ability to combine text-to-speach with pre-recorded voices

You can quickly get an idea on what's available on the market:

www.GoToClinic.com

www.Reremind.com

www.televox.com

Decide for yourself. Good luck!