For many in the veterinary field, the COVID-19 pandemic has greatly accelerated burnout and staffing shortages as volume and, in effect, wait times and phone calls have increased. It’s no surprise that pet ownership increased during the pandemic, with many finding themselves stuck at home with newly found free time and/or flexible work-from-home schedules – around 1 in 5 American households ended up getting a pet during the pandemic⁽¹⁾. With this increase in pet ownership, the average number of appointments booked at veterinary practices increased 4.5% in 2020 and went up to 6.5% in 2021⁽²⁾. Wait times at veterinary practices also increased, but not necessarily because of more sick pets. Instead, safety measures put in place such as curbside visits that require extra back and forth phone calls, which increased wait times from an average of an 11 minutes in 2019 to 20 minutes in 2020⁽³⁾ and decreased productivity by about 25%⁽⁴⁾. For an animal emergency clinic, the wait time increase and case load was accelerated further by an uptick in referrals and overflow from vet practices that modified their hours due to staffing shortages, were completely booked up for weeks, and/or limited the types of cases they saw. As a result, animal emergency hospitals have started to see more routine cases, which, combined with the fact that they take the most critical cases first and don’t offer appointments, has meant hours-long waits for clients. As a result, many frustrated clients are spending hours waiting in the parking lot calling in and asking ‘how much longer?’ to overworked and under-staffed clinics just trying to hold down the fort⁽⁵⁾.

Because of this strain on the animal healthcare industry, accelerated by the pandemic, the turnover rate for veterinary staff, which already wasn’t great pre-pandemic, has only increased especially with veterinary technicians who have the highest turnover rate of all health care positions ^(6,7). Burnout and high staff turnover can be caused by a number of factors, besides the difficulties imposed by COVID-19, but with the increase in volume and the decrease in efficiency that many animal hospitals have recently experienced, the obvious reaction may be to just hire more people. Unfortunately this solution is expensive and not quickly or easily solved by just hiring more people. Here’s a better way to not only lift some of the burden of your staff’s workload but to also satisfy your clients: turn to technology to automate some of the workload, ease communication, and improve efficiency.

Create a virtual queuing system
Checking clients in can be time consuming and the burden of that task falls on veterinary staff. With a curbside process up in place, check-in has become even more of a headache with the increase of back and forth phone calls from the parking lot to the front desk. Instead, let your clients complete this task themselves by allowing them to check in from your website ahead of their visit, or when they arrive by texting a short code or scanning a QR code with their phone. Once they submit their information, they will automatically show up in a queue that staff manage. Meanwhile pet owners can wait from home, from your parking lot, your lobby, or wherever they prefer because this allows for automated communication as well. Moving pets from queue to queue, based on your specific workflow, can trigger customized SMS alerts letting your clients know what the next step is. This wi

ll greatly reduce the back-and-forth from the parking lot to the office that takes up staff time, while giving you immediate insight into the caseload and eliminating manual entry.

Digitize your intake process
While you’re at it, you might as well eliminate the paperwork and back-and-forth that comes with getting your clients registered. Turn your clipboards into digital forms that clients can receive as soon as they get checked in. Whether you need to gather signatures for consent forms or you need to serve up specific questions based on the answers they provide, this can easily be done using a mobile intake form, which allows for electronic signatures, conditional logic, image or file uploads and more. As soon as the forms are submitted they can attach to each client’s listing in your queue so the work is done for you without having to leave the building or worst yet, manually fill in forms while talking with the client over the phone.

Utilize two-way texting
By far one of the most difficult and frustrating aspects of the curbside process is the sheer volume of phone calls it creates. Meanwhile, you only have so many staff members that can take the phone calls, calls that range from simple questions about pet care to time-consuming registration questions and discussion of the DVM’s findings. This results in overloaded phone lines and long hold times which makes your clients frustrated and your staff members stressed and unable to devote as much of their time to other important tasks. The best way to clear up your phone lines is to use the automated SMS messages from the virtual queuing process, and in addition, utilize two-way texting. Two-way texting gives your staff the ability to send personalized or templated messages out to multiple clients at a time, while receiving their responses, which they can address more quickly and efficiently than dealing with a game of phone tag. This process works well because 85% of Americans own smart phones, including 61% of people over the age of 65⁽⁸⁾ and better yet they’re much more likely to check and respond to those text messages than they would a phone call, email, or voicemail. In fact, texts have a 99% open rate⁽⁹⁾ and 45% of texts receive a response⁽¹⁰⁾. Your clients are more than likely going to be pleased with having the ability to text your business back, about 78% of people in fact⁽¹¹⁾.

By embracing technology, you can drastically decrease the strain on veterinary staff members and as a bonus, make your clients happier as well. The key lies in automating the processes that are sucking up much of your staff’s time – manual entry and client communication. By giving some of the workload to your clients through the smartphone in their pocket, you’ll find that your staff will have more time and be less stressed. There are no promises that automating your check-in and intake process will completely eliminate burnout and staff turnover, but it’s a big step in the right direction and one that doesn’t require much time or effort to get set up. The majority of our clients are able to implement this new process within 2-4 weeks and many consider it a “lifesaver”.

Start here to learn more about creating a mobile check-in and digital intake process for your veterinary clinic or animal emergency hospital or schedule a demo to see if it’s the right fit for your veterinary business.

Contactless patient intake digitizes the workflow that enables patients to check in for scheduled and walk-in visits at veterinary ERs, urgent care clinics, and hospital emergency centers using their own device from their home, their car or any other location.

The COVID-19 pandemic changed patient check-in from a matter of convenience to one of safety.  Safety protocols combined with multiple surges in transmission rates have heightened the need to collect patients’ signatures, demographic information, ID and insurance images via digital devices instead of pre-pandemic norms that often relied on manual, in-person workflows.  In addition to reducing potential virus exposure for both patients and staff, staff need ways to quickly collect this information without relying on phone calls.

As provider settings and veterinary hospitals deal with a rapidly changing healthcare environment, here are three reasons to implement contactless patient intake:

1.     Reduce call volume
2.     See patients faster
3.     Focus staff on more valuable activities

First, what defines “intake?”

Intake encompasses everything that staff need to collect before the visit, including:

·       Appointment book / hold your place in line
·       Visit confirmation / reminders
·       Pre-visit registration
·       In office, lobby, or curbside check-in system
·       Chief complaint / visit reason
·       Demographic information
·       Consent forms
·       ID card capture
·       Insurance card capture
·       e-signature
·       Payment options
·       Payment collection
·       Review of systems

#1: Reduce call volume

Each time a community experiences a surge in COVID-19 rates, its on-demand healthcare settings also see a spike in patient visits.  Typically, call volume spikes as patients call for information about hours, appointment availability, test results and wait times.  However, the largest driver of call volume comes from the need to remotely collect intake information, via phone call.  Each patient typically triggers one to two inbound calls, plus two to three outbound calls.  Each of these calls last five to seven minutes on average, with some urgent care clinics receiving 30 inbound registration calls in the first 10 minutes of the day.

Digital contactless patient intake immediately reduces this call volume by enabling patients to submit all of their intake information from their mobile device or in-office tablet or kiosk.  Many clinics push this process further upstream to have patients complete their intake at home.

One animal hospital eliminated five phone calls per visit.

#2: See patients faster

Picture this: an urgent care clinic opens at 8:00 am and has twenty patients already at the door.  Signage directs them to call the front desk to register.  The clinic staffs two phone lines and can register a patient in five minutes on average.  Guess what time the 20^th patient gets registered?  Probably not until almost 9:00 am!  This phenomenon, sometimes dubbed “a line just to get in line,” can add 30% to the average length of staff.

However, contactless patient intake vastly reduces the intake time because it enables almost unlimited simultaneous, parallel registration.  Reimagine the above scenario: twenty patients all start filling in their intake information from their phones.  While some patients will complete it faster than others (depending on whether they have visited before, need to update their insurance, etc.), all 20 will get registered by 8:10 am.  Staff can review, triage, and prioritize all twenty patients.  They can spot the patient presenting with shortness of breath or the dog that ate chocolate immediately.

One urgent care clinic measured 30% shorter throughput times after it implemented contactless patient intake.

#3: Focus staff on more valuable activities

Manual intake consumes front office staff efforts on data entry related activities – verbally getting information from the patient, typing it into the practice management system, scanning insurance cards and then uploading those images, etc.  Additionally, they spend time answering the same set of questions related to managing patients’ expectations, most often around wait times.

By contrast, contactless patient intake removes 80-90% of the data entry.  Staff can re-allocate their time toward more valuable activities such as verifying eligibility insurance, collecting payment, or helping patients with unique circumstances (out-of-towners, out-of-network benefits, etc.).  In addition, contactless intake can include text message updates that give patients answers about why they can expect to wait longer than normal as well as how many patients have signed in ahead of them.

Virtual queuing and automated texts, as part of contactless patient intake, delivers all these benefits without the challenges of posting wait times.

Learn more about how ER Express supports contactless check-in workflows, including at-home and car check-in.

^{Kaufman Hall reports that the pandemic accelerated demand for more consumer-friendly healthcare services such as mobile check-in: https://www.healthcaredive.com/news/pandemic-spurs-consumer-friendly-healthcare-services/589023/}

A quick Google Search will show an overwhelming number of articles (“hospital wait times” showed 1.4 billion results) on healthcare wait times, how to reduce them, publish them, and/or use them as part of a marketing strategy. It’s no wonder then that as most emergency departments, urgent cares and other walk-in clinics see their competitors advertising their wait times via billboard, website or SMS message, they feel a strong impetus to follow suite.

This impetus assumes that by posting wait times, patients will choose the facility that offers this degree of transparency over another that does not. While this may be true, let’s take a step back and consider what posting wait times online really accomplishes.

Varying definitions of wait time rarely match what patients expect

First of all, what do patients think “wait time” means?  The definitions of wait time vary widely from one health system to another. Consider for example, these common definitions:

1. The time spent from arrival to triage
2. The total time spent from arrival to the exam room
3. The total time spent until the patient sees the doctor (including time spent waiting in the exam room)
4. The time from check-in to discharge

Definition #1 would likely result in very short wait times. Under this definition, staff immediately triage patients but send them back out to the waiting room again until a bed is available, making it look like the wait time is quite short but really, patients will still wait longer than they anticipated. On the extreme end, definition #4 most likely presents a much longer wait than what patients have in mind.

Wait times suffer from low accuracy

Many health systems use completely different methods for updating the wait times, such as taking an average over several hours and posting once every half hour or so, while another facility may just post yesterday’s average or a historical average. There are also plenty of health system websites that rely on staff updating the wait time – staff who are busy and are more likely to inflate the number to decrease their workload.

Wait times change rapidly

Consider that even real-time wait times posted online are not the same as the wait times a patient will experience once they arrive. A patient who sees a posted wait time of 15 minutes may head over straight away only to find out that by the time they get there the wait time has increased. The opposite situation may also be true. Patients may pass over the facility with a wait time they perceive as being too long, even though the busyness could clear up by the time they get there.

Wait times can make you look bad in comparison

On that note, in some cases patients will pass up the busiest location if you have more than one where wait times are posted and choose a location with more capacity to treat them. However, they may just decide to skip it altogether and pick a competitor with lower advertised wait times. That competitor may have a completely different definition of wait times that is more easily kept low, even if the actual throughput time is longer. Your posted wait times still can make you look bad in comparison.

A better alternative to posting wait times

What’s a better way to manage expectations while increasing transparency and patient satisfaction? Create a virtual queuing process. Allow patients to get in line ahead of time through your website using online check-in and wait from the comfort of home. Online check-in allows staff to offer up time slots during times of the day when they are historically less busy. If there is a sudden surge in volume, it’s easy to quickly turn it off or temper it down to fewer time slots.

In addition, all walk-in patients can sign-in via kiosk or their own mobile device, while a smart queuing algorithm automatically gives them an estimated treatment time slot that takes into account online time slots and the real-time volume. Both walk-in and online check-in patients can opt to wait from home, their car, or the lobby while staff have the ability to communicate with them via two-way text messaging to keep them informed while they wait.

To make the wait more transparent, virtual queuing has multiple tools that give patients a sense of their place in line – an API that can be added to the health system website that publishes the real-time number of patients already in line, an automated text sent upon sign-in that lets patients know what their place in line is, and the ability to text back a number to receive an update about the number of patients ahead of them.

Here’s what makes this a better solution than simply posting wait times online:

• Increases operational efficiency – Automating the check-in process reduces phone calls and paperwork and streamlines communication with patients.
• Optimizes throughput – The virtual queuing algorithm uses historical and real-time throughput to calculate and assign treatment times.
• Reduces staff workload – Allowing patients to essentially check themselves in and receive automated updates about the wait, reduces the amount of time your staff spends on the phone.
• Manages patient expectations – Patients are assigned treatment times instead of being told how long the wait may be based on an inaccurate average. Patients care more about their individual wait time than the average for all patients, so knowing what their specific wait time will be (or choosing their own treatment time via online check-in), while receiving updates on their phone, offers a much higher degree of transparency.
• Attracts new patients – Providing the convenience and transparency patients want turns first-time visitors into loyal patients. Providing the option to check in online and wait from home is a differentiator from the competition who still only post wait times.

While posting wait times online or through various marketing initiatives may seem compelling because everyone else is doing it, there is a better way to solve the issues that would make an urgent care or ED consider posting wait times in the first place. If you’re trying to increase patient satisfaction, then it makes more sense to give patients more control over their experience. If you need to increase efficiency, don’t stress your staff out by having to adhere to a posted wait time, automate the wait time process instead. If you want to better manage patient expectations, keep in touch with them without having to pick up a phone. Using these digital tools to your advantage checks off all the boxes that wait times do not and benefits both patients AND staff.