MedNow, a 7-location urgent care + primary care practice led by Mark Newton, M.D., deployed the MedChat triage bot combined with ER Express’ online scheduling solution to screen and book patients for telehealth visits and COVID-19 testing.
“We have long made it a top priority to deliver high-quality, timely, and efficient care. MedChat along with ER Express allows MedNow Urgent Care to stay at the forefront of respecting our patients’ valuable time,” said Newton, practicing ER physician and founder & CEO of MedNow.
“When the county asked us to provide COVID-19 testing, we needed a way to screen and prioritize patients,” said Newton. “Our scheduling partner ER Express brought the MedChat triage bot to our attention. In just a few hours, we launched the triage bot tailored to our telehealth workflow.”
The triage bot screens patients to determine their individual level of risk based on Centers for Disease Control criteria. Medium- and high-risk patients are routed to schedule a telehealth screening through ER Express’ queueing software and, if appropriate, prioritized for testing. Patients with severe symptoms are triaged to nearby emergency departments. All patients can opt for a telehealth visit no matter their risk.
“Members of our communities want a way to know if they should be concerned for their health,” added Dr. Newton. “Offering the triage bot assessment reassures low risk individuals. The full protocol of triage bot, telehealth encounter and in-person testing maximizes the number of patients we can serve. As the protocol evolves, MedChat’s platform makes it very easy to change the bot’s screening criteria. We can now better deliver care to the patients who most need to talk to a provider and get tested. Like almost all counties, the demand for testing exceeds our capacity to test them all at once.”
In the first week, more than 600 patients screened themselves – many during off-hours. In the first weekend, more than 60% of high-risk patients scheduled a telehealth consult.
MedChat helps physician practices and other providers screen and triage patients quickly. Prior to the COVID-19 outbreak, practices primarily deployed MedChat to improve call response times, simplify scheduling, respond to billing questions, and handle other common patient inquiries. The chatbot and live chat platform became immediately useful for COVID-19 response because screening criteria and triage rules can be quickly adjusted as clinical guidance changes.
“We were already working with MedChat to deploy Schedule Bots for urgent care and emergency departments,” said Sahil Patel, founder & CEO of ER Express. “When COVID-19 hit, our clients asked for ways to assess patients, facilitate telehealth workflows and handle growing call volume, we immediately thought of MedChat. We are now deploying MedChat with several clients to triage patients, enable staff to work from home and alleviate the flood of inbound phone calls.”
“Won’t patients in my lobby get mad when someone checks in at home and then shows up in the lobby?”
Many health systems face a psychological barrier to offering online check-in: “I know the patients who use it will love the convenience. But I’m afraid it will make all of my other patients mad because they think someone skipped the line.”
Our display board technology, which shows all patients in the lobby their place in line, now comes pre-loaded with a promotional ad that rotates in every 10 seconds.
This pre-installed ad:
This ad educates your patients on where they can find the online check-in option, helping to spread the word on its convenience. It also helps reduce the anxiety that walk-in patients may feel when they hear or see a patient enter the waiting room and announce “I made an online reservation.” It helps manage patient expectations and reduce the perception that other patients “skipped the line.”
Missouri-based Freeman Health recently implemented online check-in and digital patient queuing in two of their urgent care clinics. Freeman’s ‘Save My Spot’ strategy aimed to reduce wait times and bring in new patient volume. The queuing system automates patient expectations and gives staff much better control over influencing patient arrival patterns by throttling down time slots during their busiest hours and opening up slots during typically slower parts of the day.
Delivering new patient volume
Freeman Urgent Care Director Kayla Martinez summarizes the appeal of Save My Spot for her patients as something akin to “…call ahead seating at a restaurant, you can get your name in line and then do your waiting at home or in your office.”* Patients can plan out their visit at the time of day most convenient for them and avoid sitting in a waiting room when they’re not feeling well with other patients who may have contagious illnesses such as flu.
Patients immediately caught on to this idea. In the first two months:
Doubling the % of 5-star Google reviews
Freeman has also seen an immediate uptick in positive Google reviews. Patients consistently praised the convenience of the service. ER Express’ reputation management feature elicits patient feedback via SMS text and then prompts the happiest patients to share their feedback on Google. Good reviews based on the convenience of the service, as well as the use of our built-in text survey which prompts the happiest patients to leave their feedback on the Google for the facility they visited, have started rolling in as well. Case in point, Freeman Urgent Care at Webb City received three new 5-star Google reviews in a 24-hour period following the online check-in go-live. Summary of the stats**:
Here’s a preview of the good things patients had to say:
Getting the word out: digital marketing + local news + traditional signage
Freeman’s marketing team launched a very effective campaign to publicize Save My Spot in its community by combining digital promotion, local news reach and street side signage.
The full embrace by Freeman’s operational and clinical leaders combined with a savvy marketing campaign points to future increases in new patient volume, 5-star Google reviews, and overall usage of the online check-in service.
*Source: Koam News Now
**As of 2/19/2020; based n patient reviews posted for Freeman’s Webb City clinic
Today’s world is increasingly mobile and fast-paced so keeping up with the competition, delivering a better patient experience, and expanding an online services are often at or near the top of the list for many health systems. One of the best ways to hit all three marks is to offer patients the convenience of online scheduling, but most often walk-in facilities, especially emergency departments, are often overlooked.
We get it. Online patient scheduling (aka online check-in) seems at odds with the acuity-based nature of the ER. In fact we regularly hear four excuses from clients as to why online check-in won’t work for them. We’re out to prove that these excuses are just misconceptions and that online check-in is actually ideal for addressing many of the issues your emergency department faces on a regular basis.
1. The emergency room is for emergencies. If patients aren’t sick enough that they can check in online and wait at home, then they shouldn’t be going to the ER.
We agree! Unnecessary and avoidable ER utilization is a costly problem.
However, consider the percent of overall patient volume in your ED today that comprises of non-emergent, “fast-track” type of patients:
An online scheduling program is not designed to encourage more ED visits. Rather, it is a tool that gives the ED more control over patient arrival times and can reduce length of stay (LOS).
These low-acuity patients are likely to consider several different options via mobile device before deciding where to go. If it is after 5:00 pm, the choices are likely going to be limited visiting the emergency room or waiting until the next day. Having the convenience of online check-in on your website can help persuade these patients to choose your ED over a competitor’s ED while decongesting your waiting room because they will be able to do most of their waiting from home.
If you have more than one location or even an urgent care facility you’d prefer to direct these patients to use, online scheduling can also help redirect patients to the facility that has more capacity to treat them. Your staff can simply block out times during your busiest hours and open up time slots when you are less busy to encourage more staggered arrival patterns.
2. Our IT department says our EMR already has online scheduling built-in. Why should we spend money on an outside vendor?
Many EMRs offer some form of patient scheduling, and while some offer a lot of useful features, many are tacked-on offerings with limited usefulness.
First, let’s unpack what “our EMR already does scheduling” means.
Does IT mean the patient portal (MyChart, etc.) can do “appointments?” Patient portals work well for patient-provider messaging and getting lab results (85% of patients who use the portal use it for getting lab results). The GAO cites that patient portal actual use tops at 30% of patients.
They have two big limitations: first, they usually require a username / password sign-in, which prevents new patients from using it. In other words, they do not do much for patient acquisition.
Second, they give your patients a clunky scheduling experience, especially on mobile devices (where 70%+ of your patients will want to book). Ask yourself: what percent of patients are using the portal regularly from a mobile device? Can MyChart even report this metric?
Other EMRs (such as Epic’s On My Way product) offer an actual walk-in scheduling tool. However, you are getting its first-generation product, while specialized vendors offer their 4th, 5th, or 6th generation product based on 5-10 years of focus on the scheduling category. The EMRs focus on what pays their bills – clinical charting, coding, and charge capture.
Specialty vendors focus on what pays their bills – an outstanding online scheduling system. If your EMR vendor fails to meet your online booking goals, you probably will not change EMRs. However, the specialty vendors know that their survival depends 100% on meeting your online booking goals.
ER Express will deliver a better product than your EMR for three big reasons:
3. Online check-in seems to be a good marketing tool but why do we need to market our ER – everyone knows us right?
Here’s something to consider: about 5% of all Google searches are healthcare related  and in the week leading up to a patient’s visit to the ER, their Google search history for health information doubles. About 15% of those patients end up searching for logistical information for nearby ERs . If your ER is not showing up at the top of the Google search results page or you have a decent amount of competition in your area, it’s very likely that patients will choose a competing hospital.
Marketing the convenience of online check-in on your website, through Google Ads, display ads, etc. is not only going to help your emergency department to stand out, it’s going to make for a better patient experience overall. Instead of pushing for the popular option of advertising wait times, you have an actual benefit to advertise that can give patients more control over their time and comfort, while helping your staff redirect low-acuity visits to less busy times. It’s definitely better to get the word out about your online check-in service than to deal with unpredictable volume surges and unhappy patients who end up waiting longer than they expected.
4. Our patients wont use it. They are too old / poor / rural / old / uneducated (Based on actual comments we have heard from our customers).
This issue boils down to one simple fact: Do your patients have a phone?
The answer is almost certainly yes. If they have a mobile device, then they will be more likely use this service. Let’s look at the stats:
Myth # 1: Our patients are too old to consider using this service.
Smartphone ownership by age indicates that phone ownership is still quite high.
Myth # 2: Lower-income patients will not use this kind of service
Smartphone ownership by income bracket shows that even at the lower-end socioeconomic status bracket (based on household income), the vast majority of your patients have some kind of mobile device.
Myth # 3: We are based in a rural area, and our patients don’t have smartphones. Or, flip side of the same coin: we are based in the inner city.
Smartphone ownership by location indicates that phone ownership does not vary as much as you might expect:
Myth # 4: We do not have a highly-educated patient population, so they are unlikely to use service that requires a phone.
Smartphone ownership by education level also indicates that across all education levels, your patients are quite likely to have a smart phone:
5. We’re low on staff. Adding this service will require too much training and effort to implement right now.
It may seem like adding a new initiative should wait until you have a full staffing. However, our program can actually reduce your workload and help your staff get more done.
The online check-in program staggers patient arrival times, which in turn reduces bottlenecks. Staff work tends to increase with bottlenecks, and likewise, decrease when you take away bottlenecks.
Yes, this new service does require some initial training, but we make it as painless as possible by actually spending time on-site training your staff, understanding your specific needs and then customizing a workflow that works best for you.
 Patient Engagement Hit, July 2018
 Google Blog, February 2015.
 Penn Medicine News, February 2019.
 Pew Research Center, data collected in January – February 2019.
We’re pleased to announce our latest EHR integration with the Aprima practice management system at MedNow, a multi-facility urgent care / primary care based in the Augusta, GA. After piloting Check-in Express + Walk-in Express at one location, MedNow is expanding its rollout to help increase patient volume, reduce manual data entry for registration staff and smooth out patient flow.
Aprima bi-directional integration
MedNow’s implementation features a fully automated bi-directional integration with their EMR, Aprima (recently acquired by eMDs). As a result, the program has:
The bi-directional integration automatically writes patient arrivals into Aprima and matches existing patients to their medical record number. It also reads workflow updates, (for example, how many patients are in the lobby, at triage, ready to discharge, etc.) to automatically space apart treatment times based on surges in the real-time census.
ER Express worked closely with Aprima’s technical team and Redox Engine, our integration partner.
A well-rounded marketing effort
MedNow’s third-party marketing agency took most of the marketing efforts into their own hands with the advice and assistance of the ER Express marketing team to create a robust campaign and website integration that has already had up to 15% of patients checking in online in the first month of go-live. Among the many avenues they used to get the word out, including social media posts, in-lobby standing posters and tent cards, they also created a commercial for the online check-in service.
MedNow followed many of our best practice recommendations for their website, making it a great example for future clients. Not only is the online check-in service uniquely branded as MedNow Express and extremely visible on the home page with more than one point of access, but their landing page for the service features a helpful interactive map that displays the relative locations of all the participating facilities and their first available check-in times. In keeping with our best practices, the landing page also features the what, why, and how of online check-in so patients are well educated about the service before checking in.
All-in-all an excellent start with a great client! Stay tuned for our integration with MedNow’s Virtual Visit scheduling – a first for us.