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Recalls and Reactivation

Appointment reminders and patient reactivation remain the foundation of patient communication


Ensuring that patients make and keep their appointments at the appropriate interval, while simultaneously keeping practitioners’ schedules optimally filled, are among the most basic and prevalent uses for patient communication systems. Automating the old-fashioned manual system of sending out appointment reminders on postcards via snail mail, electronic systems now automatically mine a practice’s data to determine who needs to be reminded to keep an appointment and who needs to be notified that it’s time to make one.

Based on pre-determined preferences already entered into a patient’s record, these systems know whether to send out a reminder via email, text or telephone.

“Not every patient wants email or text message notifications, yet many do, and we find it tremendously valuable to provide communication in the format our patients request,” said Demandforce user April Jasper, OD, FAAO, of Advanced Eyecare Specialists in West Palm Beach, Fla.

David Golden, OD, describes his practice’s use of 4PatientCare’s ‘Intelligent Escalation’ as “increasing in the amount of touch” when recalling his patients.
“The key is getting the right message to the right patient with the modality that they respond to,” Jeffrey J. Guterman, MD, MS, chief medical officer with 4PatientCare, told Vision Monday. “We configure communication campaigns to the specific provider, location, appointment reason, insurance, age group, gender, preferred language, and patient communication preference.”

The company recently developed “Intelligent Escalation” to assure an effective and efficient outreach campaign. Dr. Guterman explained how the system works: “You can initiate communication with a low-cost modality (email or text) and escalate to more advanced methods such as automated voice, reserving the most expensive human voice and postal services only for those who do not make an appointment with the less expensive approaches. 4PatientCare automatically tracks who requires what communication, with what message, and with what modality.”

David Golden, OD, uses 4PatientCare in his Golden Optometric Group practice in Whittier, Calif. He described it as “increasing in the amount of touch” as it proceeds from email to voicemail to phone call or however you’ve customized it. “It’s a huge time saver that frees us up to focus on our patients instead of doing the mundane tasks of the day,” he said.

Not only does this illustrate the latest capabilities available when automatically connecting with patients, but it also shows the increasing availability of customization. “Our motivation for developing Intelligent Escalation came from the fact that each patient has their own desired approach to communication and each practice also has their own approach to communication,” Dr. Guterman said.

In many cases, an actual telephone call is necessary because obtaining patient’s cell numbers and email addresses remains elusive. “The most basic tenet of communication is that you have to use a modality for which there is data in the practice management system,” said Dr. Guterman. “Email and text messages are great communication modalities but the average optometric practice has only 50 percent accurate email addresses and cell phone numbers. In fact, the two most common entries in the email field are the words “refused” and the email address”

Still, even a human voice phone call can be automated. Peter Cass, OD, of Beaumont Family Eye Care in Beaumont, Texas, recently implemented Solutionreach’s SR Voice system, which combines automated phone messaging with a custom built natural voice engine. “The most important feature for us has always been the recall system,” said Cass, who installed Solutionreach when he moved to a new location in January 2011.

“There are several ways to do recall, and we prefer text based,” he said. But for those patients for whom the practice has no cell phone information, he added, “We supplement text with Solutionreach’s new SR Voice, which reaches out to patients for whom we have a phone number but no cell phone information. It can search our systems and find possible working phone numbers for those patients.”

Postcards, The Modern Way
At times, automation can even be combined with seemingly old techniques, such as postcards, for effective results. Among the early adopters of Demandforce’s system, Robert C. Janot, OD, FAAO, of Sulphur, La., participated in a beta testing group of Vision Source doctors. “I found it to be a welcome change from the traditional staff calling patients or mailing postcards for appointment reminders,” he said. “As a totally automated system, integrating directly with my practice management software (OfficeMate), Demandforce has freed up a staff person by automating my recalls and appointment confirmations via text and email. By the time we approached the Vision Source national meeting in April 2011, it had such a profound impact on my practice that I actually provided a testimonial in Demandforce’s vendor presentation.”

He’s come full circle and is back to sending out postcard recalls at times, but now he’s using Demandforce to manage them. He’s found that there’s still a portion of his patients who prefer this less technological way of staying in touch. “For those patients who do not use email or text messaging, typically our older patient population, Demandforce has recently added postcard recalls,” he explained. “Before you think how antiquated that is, these postcards are super slick, double-sided, glossy cards that are fully customizable with your practice logo, message, patient testimonials, and even promotions. They are done behind the scenes with no input necessary from the staff, pulling data from our practice management software. They are even posted for mail and sent from Demandforce.”

Reminders are not just for appointments but for eyeglasses and contact lenses as well. Some patient communication and engagement systems offer a feature that automatically notifies patients when their glasses or contacts are ready.

Drilling Deeper
There’s a new category of patient reactivation technology that drills deep into the practice’s records to catch patients who have fallen through the cracks. Brevium’s software combs through every patient record every night attempting to find patients who are overdue either because they didn’t respond to a recall or because they never got one in the first place. “It’s not about bringing back any patient,” Steve Gottfredson, Brevium’s vice president of sales and marketing, told Vision Monday. “It’s about bringing back the right patient at the right time to see the right doctor at the right location at an appropriate interval of care.”

The system works by reviewing every patient’s record to see if they are scheduled for an appointment or for a recall. If they’re not, it reviews their visit history and billing data to determine any diseases they might have and the date they were last seen. Depending on their health, Brevium (Latin for “brief”), determines when they should be contacted based on tolerances that are preset by the practice.

“It’s one thing for a practice to try to bring back patients who haven’t been in at some generic interval of care, but it’s even better to ensure patients with specific disease states are being targeted at customized care intervals,” Gottfredson told Vision Monday. “For optometric practices with a medical emphasis, Brevium software makes it easy to target patients with glaucoma at three months, diabetics at six or 12 months, etc.”

When it’s time to contact patients who need to be reactivated, a staff member opens up the Brevium caller program that lists the name of the patient, their phone number, visit history, diagnosis, the insurance plan on file, and how long they are overdue. After making the call, the staff member can indicate the results in the program, and Brevium monitors the patient’s reaction, giving credit to the caller if an appointment is made. The system gathers additional metrics including whether patients kept their appointments and how much money they spent, enabling even further analysis of the effectiveness of reactivation.

After calling patients indicated by the Brevium system, staff members can record the results in the program.
To automate the recall system, Brevium recently integrated with TeleVox, which automatically phones patients who need to be reactivated. The patient then receives an automated call with options for connecting with the office in order to make an appointment.

“AIO recently began participating in a beta test partnership between TeleVox and Brevium,” Shelby Williams of AIO Vision in West Mifflin, Penn., told Vision Monday. “This software is able to mine data from our current electronic health records, based on a number of easily adjusted settings. We are able to recall patients based on diagnosis, doctor or appointment type and make an automated or live recall that they are due, or overdue, for their care.”

Justin Everette, TeleVox’s senior marketing manager, told Vision Monday, “The integration with Brevium allows practices to use both automated calls and human calls to have the greatest impact to drive patient compliance and improve care quality. In addition, practices can bring patients back in for overdue care with a very clear picture of the return on investment from those efforts.”

According to Jessica Crooker, OD, of Dr. Gordon Price and Associates, in Scituate, Mass., her practice has reactivated almost 90 patients so far using Brevium. ■