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Medical Marketing

How to increase patient appointments right from your EMR

Here’s a short guide on how to increase patient appointments. There are several ways, as you can read in our comprehensive medical marketing guide. This article will show you how to get more patients by recalls, reducing no-shows, re-appointing cancelled patients.

Here’s a short guide on how to increase patient appointments. There are several  ways, as you can read in our comprehensive medical marketing guides. This article will show you how to get more patients by recalls, reducing no-shows, re-appointing cancelled patients. 

General process to run these campaigns

  1. Decide on the return of investment you expect
  2. Identify the people, processes and technologies for your campaign
  3. Define your campaign
  4. Prepare your campaign’s data
  5. Execute your campaign
  6. Monitor your campaign and improve

Return on investment calculations

Here’s a simple way to calculate your expected return on investment.

  1. Each day, a single agent can dial about 200 patient phone numbers. They could dial a lot more if they are using the right call center software.
  2. Out of 200 patients called per day per agent, we found that about 20% (i.e. 40) patients pick up the call. So, each agent is going to talk to 40 patients a day.
  3. In our experience, out of the patients that agents talk to, about 50-70% agree to be re-appointed. So, each agent can re-appoint about 25 patients a day.
  4. Net-net, out of 200 patient calls per day per agent, you win 25 patients back, lose 15. This means that your agent is left with 160 patients per day to add to the next day’s calling workload / queue.

Using this math, you can decide how many agents you need to hire.

how to increase patient appointments

Important observations from our experiences

  1. Our experience shows that the older your patient data, the harder it is to re-appoint those patients (they seem to “forget” the provider) 
  2. The older the data, the more chances of incorrect phone numbers.

People, processes and technologies for your campaign

For each one of the patient acquisition campaigns, you are going to need to identify the right people within your medical practice. If you do not have the appropriate staff, we recommend hiring full time or outsourcing your medical marketing to an agency.

It’s not very difficult to do – you just need:

  1. One person that can prepare the data needed for the campaign and is good with a patient CRM or spreadsheets. This person should be preparing the data from your EMR, distributing it to your call center agents or whoever you choose to do the calling. At the end of each day, this staff member should be gathering all the reports from the staff that call patients, collate the data and be able to run meaningful reports/call center analytics on the data.
  2. Call center agents or staff that are comfortable dialing patients and sending patients SMS all day long (at least 6 hours of dialing per day). So, the total number of staff you need for this would vary on the total amount of patient records you have. 

Technologies

We highly recommend not running these campaigns straight out of your EMR. Instead, you should use a HIPAA compliant patient CRM that ties into your EMR.

Your staff can certainly use their desk phones to do all the calling; but our recommendation is to use a healthcare call center software for this purpose.

The productivity gains are TREMENDOUS (we have seen it ourselves). For SMS, please do not use your cell phone.

We recommend using a software for SMS texting. It gets impossible to manage the volume of SMS sent if you are using staff cell phones to send SMS.

If you want to send a bulk SMS, while still being HIPAA compliant, here’s a low tech guide on how to do so. This guide was written for handling patient cancellations.

You can modify your SMS message a little bit for each patient broadcast message you want to send. That way, you can still use the same technique.

If you have staff that are experienced in recalling and reappointing patients – you might not need scripts. However – if you are hiring brand new staff to run these campaigns, you should prepare calling scripts for these agents to use/leverage while they dial patients in bulk.

Daily Process

Define the daily process that your staff must follow. You can do it anyway you prefer. Here’s our recommendation.

  1. Start of campaign – prepare the backlog of patients to be called. 
  2. Start of the month, give the next 2 weeks’ data to the agents. This way, each agent will have 250 calls (target) per day * 10 days = 2,500 patient records to call.
  3. End of each day, each agent should hand over their daily updates to the staff member dealing with data and reports.
  4. At the start of the next day, the data person should take the previous day’s agent spreadsheets and update the EMR + the baseline spreadsheet with the agents’ dispositions.
  5. At this time, the data person would also pull all updates from the EMR (for these patients that are being called on) and rework each agents’ spreadsheets if needed.
  6. At the end of 2 weeks, the data person would hand over a new spreadsheet to each agent. This will contain the patients to call over the next 2 weeks. This spreadsheet will be prepared by shuffling the patient phone numbers randomly between all calling agents so that each agent doesn’t get into a rut of calling the same patient. This also helps because the patient sees a different phone number dialing in.

Define your campaign dispositions

At this time, also define how many attempts per patient phone number your agents are going to make. We recommend that every month, a patient will get exactly two calls from our agents.

Before you get started, just come to a consensus on how your calling agents are going to dispose of each call. 

DISPOSITIONDESCRIPTION
DONEWe break this down further
1. Patient was re-appointed
2. Patient reconfirmed – sometimes due to data errors, agents run into situations where another agent has already called and reappointed the patient.
3. Duplicate – again due to data errors, this can happen. Many times, EMRs themselves have duplicate patients that need to be cleaned up.
CBACKWe classify this further. 
1. Patient has asked for a call back at a specific date/time
2. NOANS – This means that the patient did not answer the phone. We recommend that your team calls them back in 2 weeks
3. HUP – Patient hung up 
LOSTWe classify this further and update our EMRs based on this classification
1. Wrong Number
2. Number Disconnected
3. DNC/Do not contact (as patient has asked not to)
4. Deceased

Prepare your campaign’s data

Almost every EMR allows you to get data from it. Here are a few ways:

  1. Export data as spreadsheets or CSV file – keep in mind that as soon as you download the data, it is obsolete because within 5 mins, your staff could update the EMR and one or more of the records you downloaded, would be stale. This is usually free.
  2. Connect via APIs – as per CMS mandate, each EMR is expected to have API connectivity into their data for ONC certification (typically this is free as well). Keep in mind that when you connect via APIs, you pull data as and when needed. As soon as you pull data, that data might be obsolete as well, since 5 mins after pulling the data from your EMR via APIs, someone from your staff might have updated the EMR with changes.
  3. HL7 integration – this is true, real time integration. As soon as a change happens in your EMR, the data is pushed via secure FTP as a new record so your application can act on it. This means that you always get the latest and greatest changes pushed to you. 

Here are more details on EMR integration

Understand the following logic so you can prepare your spreadsheets (or your HIPAA compliant CRM accordingly)

  1. Your EMR has patients.
  2. Each patient has appointments.
  3. If a patient shows up, that turns into an encounter. Hence, if they do not show up or cancel, this does not turn into an encounter.

This means that one patient can have 10 appointments, but 5 encounters.

Based on the understanding above, prepare your data

  1. Baseline data – where you start with a lot of data from the day your campaign begins
  2. Daily updates – where you update your EMR with the agents’ data and update your agents’ calling sheets / workload based on data changes from your EMR

Use the following columns to enhance your agent’s call sheets.

COLUMNDESCRIPTION
DISPOSITIONThe outcomes as we discussed above
APPT DATEThe appt date (if the patient was re-appointed)
REMARKSAny call notes/ remarks / patient insurance updates etc
CALL DATEThe day of today’s call
LAST CALL DATEThis is important for other agents to understand how many more calls have been made to the same patient phone number
REQUIREDTHESE COLUMNS ARE REQUIRED TO DO A GOOD JOB
LAST ENCOUNTER DATEThe last encounter date of the patient. This helps drive the campaign.
LAST APPT DATEThe last date when the agent had an appointment – doesn’t matter if they cancelled it or were a no-show. Hopefully this is the same as the last encounter date.
NEXT APPT DATEThis is very important to know because you don’t want to be trying to re-appoint a patient that already has an appointment within the upcoming 3-4 weeks
EXPECTED COLUMNEXPECTED COLUMNEXPECTED COLUMNEXPECTED COLUMN
PatientPhoneCo-payPayer
Appointment DateReferring PhysicianBalanceReferral Source
Appointment TimeChartStatusEligibility
ProviderDOBCommentsResource
LocationPolicy TypeCancellation ReasonChief Complaint
Nature of VisitMember IDCancellation Comments

How to get more patients from recalls

This is one of the easiest ones to do. You just reach out to patients that you have not seen in more than X (you decide whatever that number is) number of months. BTW, this is also a great way to start preparing for value based care where many practices will be, in one way or another, capitated.

Let’s say you want to run a “not seen in 6” campaign. Do the following in your EMR data.

  1. Pull a CSV report of all patients where the Last encounter date is > 6 months before today
  2. Note the rows of data where the last appointment date is either the same as the last encounter date or is, still, > 6 months before today (e.g last encounter was 7 months ago and last appt date where this patient was a no-show was 6 months ago). 
  3. If you are also running a no-shows campaign, be careful as you do not want to take the patients whose last appointment date is within the last 6 months
  4. Run a formula in spreadsheets (microsoft or google) and filter out the patients that have a “Next appointment date” in the future. These patients will be part of another campaign – appointment reminders.
  5. Follow the process you have defined above and hand data over to your agents
  6. Report on your data daily to measure efficiencies, efficacy of the campaign
  7. Keep in mind that you will have to run this kind of an export / report every week (or every day) and add more patients that have fallen out of care. You can very easily schedule a report every day to get fresh data from your EMR.

How to get more patients from reappointing no-show patients

We have noticed that if you call a patient back within 1 week of missing their appointment, they almost always agree to being reappointed.

Do the following in your EMR data.

  1. Pull a CSV report of all patients where the Last encounter date is less than 6 months before today. The patients with encounter dates > 6 months are already included in your reactivation campaign above
  2. Note the rows of data where the last appointment date is the same as the last encounter date. Remove these patients.
  3. Note the rows where the last encounter date is BEFORE the last appointment date(e.g last encounter was 2 months ago and last appt date where this patient was a no-show was 2 days ago). 
  4. Run a formula in spreadsheets (microsoft or google) and filter out the patients that have a “Next appointment date” in the future. These patients will be part of another campaign – appointment reminders.
  5. Follow the process you have defined above and hand data over to your agents
  6. Report on your data daily to measure efficiencies, efficacy of the campaign
  7. Keep in mind that you will have to run this kind of an export / report every week (or every day) and add more patients that have fallen out of care. You can very easily schedule a report every day to get fresh data from your EMR.

How to get more patients from reappointing patients that never showed up

We have noticed that if you call a patient back within 1 week of missing their appointment, they almost always agree to being reappointed. However, we also know for sure that you have MANY patients that were never called for being a no-show. 

If we are not, wrong, then this “no-encounter” campaign is for you. Do keep in mind that this is almost like a “cold call” and patients may or may not remember your practice or the fact that they made an appointment.

Do the following in your EMR data.

  1. Pull a CSV report of all patients where the last appointment date is not blank.
  2. Note the rows of data where the last encounter date is blank. These are the patients who you have never seen in your practice (i.e. they were a no-show for their very first appointment with you). Remove the rest of the patients.
  3. Run a formula in spreadsheets (microsoft or google) and filter out the patients that have a “Next appointment date” in the future. These patients will be part of another campaign – appointment reminders.
  4. Follow the process you have defined above and hand data over to your agents
  5. Report on your data daily to measure efficiencies, efficacy of the campaign
  6. Keep in mind that you will have to run this kind of an export / report every week (or every day) and add more patients that have fallen out of care. You can very easily schedule a report every day to get fresh data from your EMR.

How to get more patients from patient referrals

This is a simple one to do. Hopefully you are running an appointment reminder campaign in your practice. All your call center agents have to do with patients that have already been to your practice at least once are:

  1. When the agent speaks with a patient to confirm their appointment, the agent asks the patient something as simple as “As you know, we are a young practice. Can you think of anyone that you would recommend our doctors to?”. If the patient mentions names/numbers – the agent takes that information down, calls the referred patient and introduces themselves as “Hi, I am calling from <your practice name>. I was talking to <the actual patient name> about his/her upcoming appointment. They wanted to recommend their doctor <provider name> to you. Hence, I am calling”.. 
  2. When the patient confirms their appointment via SMS, the agent tries to strike up an SMS conversation with the patient by “Thanks for confirming your appointment. We will see you soon. BTW, as you know, we are a young practice. Can you think of anyone that you would recommend our doctors to?”. Same process as above

Hopefully these techniques help you. 

There’s a separate article on patient acquisition via community outreach / cold call / postcard marketing to patients around your practice locations.


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