Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

How to Improve Communication So You Can Improve Satisfaction

Posted on May 9, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

In attempts to boost revenue, practices often find themselves mired in the complex tasks of generating marketing, improving scheduling, reducing inefficiencies, and more. And while these practice management pieces are important, sometimes we make things more complicated than they really need to be. When it comes down to it, the foundation of a financially-healthy practice is simple—keeping your patients happy.

Happy patients are the patients that show up—and come back. They’re the patients that refer you to their friends. They are the ones who leave those all-important online reviews. They truly are the bread and butter of your practice’s bottom line. Research backs this up—multiple studies have found a direct correlation between revenue and patient satisfaction. In fact, one study found that those healthcare practices delivering a “superior” customer experience achieve 50 percent higher net margins than those providing just an “average” customer experience.

Use Surveys to Uncover Problems

Obviously, creating a happy patient base is key to a successful practice. But how do you know if your patients are happy? Well, you ask them—in person, in focus groups, and online. The most effective way to gather this data, however, is through surveys. Surveys are an easy and efficient way to find out where you may be falling short.

And since a study in the Journal of Medical Practice Management found that 96 percent of all patient complaints are related to customer service rather than care or expertise, every person in your practice can be involved in making improvements.

Some of the most common complaints of patients include:

  • Excessive waiting times
  • Inadequate communication
  • Disorganized operations

Last month, I discussed the importance of reducing excessive wait times. You can read that article here. In this post, we will be exploring how to avoid those communication problems that lead to low patient satisfaction.

There are two main areas where communication tends to break down within a practice—between staff members and between the practice and the patient. How can you improve?

Communication within the Office

From the front desk to nurses to doctors and even to the billing department, it is critical that everyone within the practice works as a team to support your patients. Failure to do so leads to errors, confusion, and unhappy patients. Unfortunately, experts estimate that problems take place in 30 percent of all intra-team healthcare communication. There are some ways you can combat poor intra-office communication.

  1. Daily team huddles. A daily huddle meeting is not a full staff meeting. It is a quick (10-15 minute maximum) meeting where each member of your team gives a status report. It’s a great way to align your team and know what to expect that day. Do you know an incoming patient is celebrating a birthday? Just graduated? Do you have holes in your schedule? All of these types of issues can be addressed during a quick huddle.
  2. Escalation processes. While critical care specialties have an acute need for escalation processes, every practice can improve their communication by implementing a designated process for difficult or complex situations. Decide which situations in your individual practice may warrant extra care. Lay out a plan for handling and monitoring these situations. Include the way you refer patients to other offices and communication between practices as part of this process.
  3. Use of a standardized communication tool. While your daily huddle is a great way to get everyone together each day, it is also important to have ways to communicate in real time as new issues arise. Healthcare is definitely a dynamic environment—constantly changing throughout the day. The best way to make sure everyone stays on the same page during the busy day is through the use of an instant messaging app to make communication accessible at all times.

Communication Between Provider and Patient

The vast majority of providers work hard to communicate with patients. But the sad truth remains—patients struggle to remember your instructions. One study showed that patients only recalled 40 percent of the information they were given. Even worse, around half of what they did remember was actually remembered wrong. This means that the way information is conveyed to patients is just as important as the actual information communicated. There are a few tips to improving your communication with patients.

  1. Use open-ended questions. When speaking with a patient, make sure to ask questions that leave room for patients to expound on their thoughts. Yes or no questions often leave many things undiscussed.
  2. Read non-verbal cues. Much of the communication that takes place between a patient and their provider occurs through nonverbal communication. So pay close attention to the patient’s face and their body language. After explaining something to your patient, do they look confused? Are they worried? If so, there is a good chance they will not follow your instructions. Follow up based on the body language of each patient.
  3. Use the teach-back method. One of the best ways to ensure your patients have a good grasp of the things you’ve taught them is to ask them to teach you. This may take an extra few minutes, but can have a lasting impact on patient outcomes (and satisfaction!).
  4. Continue communication between visits. Communication does not end when a patient leaves the office. Continue sending educational tips and encouragement through regular newsletters, social media, and email.

Communication is one of (if not THE) most important component of the patient-provider relationship. It is also the cornerstone of the financial success of every practice. Effective communication helps practices and patients better understand each other and develop a closer bond. It makes for not just healthy—but happy—patients.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff.

Addressing Common Patient Frustrations: Wait Times

Posted on April 11, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Experts agree that it is critically important that practices keep their finger on the pulse of patient satisfaction—and one of the best ways to do this is through patient surveys. However, the question remains: what should a practice do if a survey reveals there is a problem?

It is of utmost importance that any issue found in a survey be studied and addressed. Interestingly, the vast majority of patient irritants do not relate to the quality of care at all. In fact, a study in the Journal of Medical Practice Management found that 96 percent of all patient complaints are related to customer service rather than poor care. Some of the biggest complaints include:

  • Excessive waiting times
  • Inadequate communication
  • Disorganized operations

Over the next few months, we will be digging in to each of these topics in depth. Today we will start with the top frustration of patients: excessive wait times. These long wait times, often associated with poor time management, are also some of the major criticisms reported by respondents of the Patient Provider Relationship study. Check out some of these numbers:

  • Sixty-eight percent of patients say that the wait times in their medical office are not reasonable.
  • Sixty-six percent say that they have to wait too long to schedule an appointment.
  • Sixty-eight percent say they feel like messages are not returned in a timely manner.

The problem is only getting worse. Average practice wait times have risen by 30 percent since 2014. Unfortunately, the common patient response to long wait times is simply to change practices. Around one in three patients say they are likely to find a new medical practice in the next couple of years. So how do you reduce long wait times?

  1. Understand how long is too long. Studies have found that about 20 minutes is the maximum amount of time a patient is willing to wait before becoming frustrated. Unfortunately, it is estimated that 53 percent of physicians say patients at their practice typically wait for more than 20 minutes. If you are not sure where you stand in terms of wait time, carefully track your wait times, both in the waiting room and the exam room. There are a variety of programs and apps that can do this for you. Or if you’d prefer to go old-school, you could acquire a supply of timers. When a patient checks in or is taken to the exam room, simply press the START button. Keep an eye on the timers and recognize when a patient has waited longer than is optimal.
  2. Provide clear communication. One of the easiest fixes for long wait times is often overlooked—communication. Eighty-six percent of patients say that if they were told in advance about a long wait time that they would feel less frustrated. So make sure to let patients know if the doctor is running behind schedule. You can also consider shooting off a quick text message to incoming patients if your office is running very late. If you are tracking wait times, make sure to acknowledge the inconvenience and apologize when the wait goes longer than 20 minutes. This would minimize frustration for nearly 70 percent of patients.
  3. Improve front desk workflow. Melanie Michael, lead author of a study that looked at interventions for lowering patient wait times found that one of the critical factors in reducing wait times was the front desk management. She noted, “[At one practice], we found that these people were trying to answer phones, field questions from patients in the waiting room, check patients in, secure insurance info, and many other tasks.” Automation of these tasks enables practices to get patients seen by the physician faster and more efficiently. Appointment reminders, scheduling, and check-in are all processes that can (and should) be automated.

Wait times are directly correlated to the satisfaction of patients. If your patient survey finds that people are feeling annoyed about the wait at your office, make changes now. If you wait too long, you may find you have no patients left.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff.

Cost to Our Economy of Patients Waiting

Posted on December 8, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I must admit that I’d never really processed the economic value to society of patients spending so much time waiting in the doctor’s office. Sure, I was very familiar with the patient dissatisfaction with patient wait times, but I hadn’t ever thought about it from the economic cost perspective.

At least I hadn’t until I saw this study that tried to quantify the economic costs associated with patient wait times. They calculated that the total annual societal opportunity cost of patient wait times was $52 billion (Note: They used the number of visit data from 2010).

This video dives into some of the details of the study and how that number was calculated:

I understand many of the reasons that doctors have such horrible wait times. Some of them are preventable and some of them are not. Although, when you see the numbers from the study above, it helps you realize what a benefit telemedicine could bring not only to healthcare, but the economy in general. I also think it makes the case for why on demand health care could be such an amazing thing for all of us.

Can you imagine if we had wait times like we do in healthcare in other parts of our lives? Those companies would go out of business. As patients get more selective on how, when, and where they get their healthcare services (thank you high dedcutible plans), this is going to start mattering a lot more.

Side Note: I wonder if the opportunity cost should be lowered now that we have a cell phone in our pocket and can get more things done while we’re waiting. I guess it depends on if we use the cell phone to get work done while we wait or if we play angry birds (some might say that’s a good use of time too).

Patient Wait Time Tracking – Can We Learn Something from Fast Food?

Posted on February 19, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was recently asked by @HIMTrainer (Jennifer Della’Zanna if you prefer) if I knew where my article was that I wrote about having a “patient wait” timer in an office. I vaguely remember talking about the idea, but couldn’t find and don’t remember specifically posting about the topic. However, the idea of a timer that tracks a patient’s wait time was interesting.

I’m sure that most of you are familiar with these timers at fast food restaurants. They track how long you’re waiting for your food and they often have some promise of free food if it takes over a certain amount of time. I’ve always found these timers interesting. In fact, I can’t remember a time when I’ve been to a restaurant with one of these timers that I ever had to wait very long for my food. Is that because of the timer or is that the nature of the restaurant and this was just a marketing mechanism? The answer is that it’s likely both.

The timer is a visual display of how long you’re really waiting. Time is a funny thing. A wait time that is relatively short can feel really long. We often lie to ourselves about how long something is, but that’s our perception. A timer helps to readjust that perception to the proper perspective. Of course, on a bad day it can also illustrate how much the restaurant needs to improve.

The other value of the timer is that it encourages the staff to work faster. At first this probably means the staff will feel some anxiety over the timer. However, over time it will just be a visual indication of how quickly or slowly their working and will help to ensure a consistent speed of service from most employees.

Now I’m sure that many of you are thinking that Fast Food is an awful comparison to healthcare. Fast Food is a pretty consistent product with a consistent request. Healthcare is a pretty inconsistent product with a wild variety of requests (almost limitless). Plus, I’m sure that many people’s gut reaction will be that this is an awful idea and corrupts the practice of medicine. I can already hear the cries for “Where’s the humanity in medicine?”

Certainly an organization could take this too far. However, maybe there’s something we can learn from the wait time clock that could help healthcare improve. Plus, when people cry fowl over something, that really makes me want to dig into that idea and see how it can help.

What’s Realistic in Healthcare?
There’s no way you’re going to see an actual clock at the check in or check out window in healthcare. I can’t even imagine how that workflow and tracking would work. So, it won’t be the same as fast food, but there are certainly a number of options available to track how long a patient is waiting. In fact, in many cases you can get quite granular.

Built in EHR Status Tracking
10 years ago when I first implemented an EMR system (yes, it was EMR, not EHR at the time), we could track the patient wait times in our EMR system. It wasn’t a perfect process, but you could get a good idea of how long a patient was in the office, how long they waited to be put in a room, how long they waited from the nurse to the doctor, and then when they checked out. Of course, you can add it all together and get an idea of how long the patient was in the office.

We simply used the statuses in the EHR to track this time data. It worked out pretty well with a few exceptions. If we didn’t have something that was specifically queued off of that status, then the data would be incorrect. For example, the nurses knew to bring a patient into an exam room based on the front desk changing them to a checked in status. So, the front desk always did this. The doctor would know to go into the room based on the nurse changing the status of the patient, so the nursing staff always did this. The patient was marked as discharged when the patient was making their payment (or checking to see if they had payments) and so this final status change was always done. Nothing was queued off of the doctor changing the status, so this often failed and so that data wasn’t very accurate.

Running these reports was fascinating and we could slice and dice the data in a variety of different ways. We could see it by provider, by appointment type, etc. Seeing the data helped us analyze what was taking the most time and improve it. We were also able to exclude any outliers that would skew the data unfairly to a provider who had a crazy complex case or in case a status change was missed.

Proximity Tracking
While EHR status tracking is good, there’s an even more powerful and effective way to track patient wait times in an office. I saw this first hand at the Sanford Health clinic in Fargo, ND at the Intelligent Insite conference. The entire clinic was wired with proximity tracking and other wireless monitoring technology that could track everyone in the clinic. Every nurse, doctor, MA, etc all had this technology embedded in their badge. Patients were issued a tracking device when they checked in for their appointment.

With this technology in place, you can imagine how the workflow for my above tracking is totally automated. They would actually immediately room the patient upon the patient’s arrival. In this case, the room would automatically know that the patient was in the room and provide an indication to the nursing staff that the patient was ready and waiting. I can’t remember the exact times, but they worked to have a nurse go into the room with the patient almost immediately after the patient got in the room. No doubt that’s a unique setup, but with these tracking devices they could know how well they were doing with the goal.

I won’t dive into all the other details of this workflow, but you can imagine how all of these tracking devices can inform the flow of patients, nurses and doctors through your office. Plus, all of this data is now trackable and reportable. The nurse, doctor, or patient don’t have to remember to do anything. The proximity devices do all the tracking, status change, etc for you.

I asked them if many patients walk out of the office with their tracking device. They told me that they’ve never had that happen, but they have returning the device as part of their checkout procedures so that could be why.

Informing the Patient
I think we’re just getting started on all of this. The price of this technology will continue to come down and we’ll do a much better job of tracking what happens in a practice. Plus, it offers so many interesting workflow benefits. I wonder if one of the next steps is to inform the patient of their wait time.

If we’re tracking the wait time, it’s not that far of a stretch to share that wait time with the patient. Kick off a clock that starts counting once they check in for their appointment. Maybe that wait time is displayed in an app on the patient’s smartphone. Maybe the wait time could be integrated into the Epion Health tablets a practice gives the patient during their office visit. If it’s a fast visit, do you prompt them to do a review of the doctor on a social site like Yelp or HealthGrades? Would doctors be ready for a patient to see front and center how long they’ve been waiting?

Final Thoughts
I’m sure that many doctors and practices will be afraid of this type of transparency. Plus, I’ve seen some general medicine doctors in particular make some serious arguments for why they run behind. Maybe the app could take this into consideration and inform the patient accordingly. While there are many unreasonable patients that are going to be unreasonable regardless of the situation, many other patients will have a much better experience if they just know more details on what’s going on.

While the comparison to a fast food timer clock is a stretch, the concept of tracking a patient’s time in an office is a discussion that is just starting. As providers work to differentiate themselves from their competitors, I’ll be interested to see how all these new technologies combine to make the patient experience better.