January 1997
Strengthening the Patient/Physician Relationship
by Kenneth M. Culpepper
Direct Marketing Magazine, January 1997, pp.52-54
Physicians have been long time pessimists for any types of marketing technologies that appear to be anything other than a warm body communicating to their patients. However, with computer telephony products now available that are affordable, interactive, user-friendly, and able to be customized according to practice and patient needs, the once wary medical industry is now engaging this technology that has become married to patient databases.
Computer telephony is the integration of the telephone and computer systems by a written interface allowing them to work and interact together. Integration is implemented using the current phone and computer systems and is housed in a Phone Server, which is a powerful PC residing separate from the two communications technologies.
For physician practices, the primary piece of communications technology that makes computer telephony so attractive is Interactive Voice Response (IVR). IVR interfaces with patient databases allowing them to be automated for interactions between practices and patients, and also between the practice and Primary Care Physician (PCP), HMO and insurance provider.
IVR is not a new concept. In fact, some of the larger utility districts and federal banks have been using it for years. However, now because of technological advancements, IVR is affordable, able to be customized by practice needs, interactive and justifiable to all practices.
Although IVR has obvious practical applications for the larger practices and clinics, it is easily justified for those with just one physician. Terry Bradley, Business Administrator for Melissa E. Trekell, M.D., F.A.C.S. and Tennessee Breast Center, a two practice alliance in Maryville, Tenn. said, "We are eagerly embracing all the modules offered through computer telephony and IVR. Using this system frees my staff from the ever-important, yet somewhat mundane everyday tasks and allows them to focus on the critical functions of their jobs."
What Does IVR Do?
IVR delivers four interactive services to practices including appointment confirmation, pre-cert/referral number, recall notification, and patient and marketing mailbox. The justification for each IVR service depends upon the personality, type and size of the practice. Therefore, the services are packaged as four separate modules and are offered accordingly topractice and patient needs.
For example, a family physician or pediatrics practice would have everyday needs for using the patient mailbox service. This service creates a temporary patient mailbox extension allowing the patient to call back into it for test and lab results. This is great for giving the results of patients' throat cultures and where the practice has called in their prescriptions. However, this would not be appropriate for a test revealing more personal or tragic results, therefore, not fitting the needs for that type of practice.
Appointment Confirmation
Most practices confirm patient appointments or would like the personnel to do so. The appointment confirmation service allows the practice to use IVR to telephone patients to confirm appointments. Calls can be made by doctor, date and location. Phone numbers are automatically transferred to the Phone Server database and dialed during selected time frames (i.e. 6:30 - 8:00 p.m.). Over the phone, the patient is given options to confirm, cancel or reschedule the appointment. If calls are made during office hours, patients may also transfer to an operator for assistance. This service supports multiple phone lines for out-dialing.
The key to this service's success is the actual production of the initial message that the patient hears. The initial message should always communicate the purpose of the call and then lead to more interactive confirmation options. This is because of answering machine pick-ups and patients without touch-tone service or still using rotary phone service. These issues become more prevalent where practices have patients and branch offices in rural areas.
Lisa Maclay, Information Systems Manager for a 27 physician alliance in Nashville, Tenn., said this about their patient appointments, "We have approximately 675 appointments per day. We have always wanted to confirm them, but obviously because of the volume of calls we do not confirm our appointments. However, with IVR, we could afford to provide this service to our patients, collect a firm confirmation regarding who is counting on showing up and determine who needs to be immediately rescheduled; all without having to hire an additional employee."
The benefits of the appointment confirmation service are:
* Decreases in costs of postage, cards, letters and envelopes
* Extensive reduction of personnel phone time for appointment confirmation
* Ability to confirm appointments without having to hire additional employees
* Increase in revenues by decreasing costly "no-show" rates
* Personal reminders of appointments providing another communication that strengthens the patient/practice relationship
Pre-Cert/Referral Number
While health care procedures are continuously requiring more time and documentation, IVR provides a service that liberates the practice from the time required to collect pre- certification and referral numbers. Pre-cert/referral number is a service that allows a practice the ability to automate this process. The system requests and records patient information from the staff member and dials the specified HMO, PCP or insurance provider to collect the needed referral number. The retrieved number is either printed or "spoken back" to the extension which generated the call. This service carries a strong sigh of relief from all practices that currently function day-to-day while spending valuable time waiting on hold.
D. Johnson, Practice Administrator for a multi-specialists clinic in Nashville, Tenn., adds these words about their pre-cert/referral number issues, "Our staffs are spending a lot of time on the phone holding for referral numbers. Sometimes its not just with the PCP or the insurance provider, but with a PCP who is checking with an insurance provider to pre-certify the referral number. Its not only an inefficient use of our staff time, but sometimes our patients have to wait for this extra step in the process to take place."
For IVR to be efficient with this service, engaging and educating the PCP, HMO and insurance provider is necessary. This requires creation of "referral code templates" that learn the criteria of needed information from each major provider of referral numbers.
The benefits of the pre-cert/referral number service are:
* Eliminates costly time spent on hold by practice personnel
* Eliminates extra referral number steps between the PCP and insurance provider
* Strengthens the practice/insurance provider relationship
* Increases staff productivity
Recall Notification
Recall notification is a service that allows the practice to perform patient recalls using the telephone instead of costly letters or cards. The phone numbers are automatically transferred to the Phone Server database and dialed during user selected time frames. The patient is notified of their need for examination, check-up or testing with the option to be transferred to an operator for appointment scheduling. This service is also ideal for "night before surgery" and medication reminders.
The benefits to the recall notification service are:
* Decrease of postage and production costs
* Increase in revenues by recovering "lost appointment opportunities"
* Creates direct contact with the patient so the appointment can be immediately made
* Ideal research tool for the practice
Patient and Marketing Mailbox
The patient and marketing mailbox service allows a practice the ability to setup lab or exam results, patient instructions from the nurse or doctor, or other valuable information residing in patient mailboxes. The patient can call in, enter their private security code and hear lab results and any pending instructions. Additionally, this information is available 24 hours a day and many practices like the flexibility of this service for creating call in information centers that produce mail lists of new patient contacts.
Bradley also had this to say about using the patient and marketing mailbox service, "Many of our patients work outside the home, so the patient mailbox will afford them more timely results at their convenience, even after scheduled office hours. It provides them confidentiality and privacy, no physician messages at work, home or on answering machines, and it also gives them the ability to immediately respond to results by transferring to the appointment confirmation system or our message system."
The benefits to the patient mailbox and marketing service are:
* Decrease in phone time for practice personnel
* Increased communication with patients
* 24 hour communication vehicle with patients
Conclusion
IVR technology doesn't replace the necessary face-to-face meetings between practice personnel and the patient, nor is it the answer for those practices wishing to reduce communication with their patients. However, when it properly produces and communicates the practice's message to patients, it strengthens the practice/patient relationship.
IVR takes a few days to install and requires about 30-60 days for a user to develop a comfort level. For approximately $10,000, a practice can implement their needed IVR services. The price can also be quantified to fit multi-practice hospitals and clinics.
All physician practices are different. They all have different approaches for communicating with their patients, but IVR can now be customized to affordably fit them all. How they choose to communicate with patients is a perception of professionalism for the entire practice.
Ken Culpepper is president of Integrated Marketing Solutions, Inc., a
knowledge-base marketing firm that
integrates tactical marketing strategy with management of multiple contacts
of businesses to their customers, prospects and channel customers. IMS incorporates
marketing business planning, long-term corporate ROI strategies, and marries
knowledge-based marketing with e-commerce strategy and systems. IMS has
offices in Atlanta, GA (770) 390-9199 and Nashville, TN (615) 782-0461.
(Web: migmar.com/ims)