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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 devices from their homes, cars, 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 needed ways to quickly collect this information without relying on phone calls.
Though we are now largely living in a post-pandemic world, many of these features have remained fixtures in medical facilities. For example, wearing a face mask in urgent cares and ERs is still commonplace and many patients continue to appreciate the convenience of cutting down time spent in the waiting room and filling out digital intake forms from a more comfortable location.
On a practical level, this makes sense for medical organizations. By continuing some of the safety measures introduced during COVID-19’s peak, you can also potentially help prevent the transmission of other airborne illnesses and place less administrative burden on your staff by having them manage intake paperwork manually.
Today, there are still three primary benefits that providers can enjoy from continuing to use contactless patient intake, including:
Intake encompasses everything that staff needs to collect before the visit, including:
Anytime a community experiences a common health condition, like during flu season, call volumes and demand for services also increase. 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. In turn, time spent fielding calls means more time away from other aspects of your operations and serving patients presently at your facility.
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-lobby tablet or kiosk. Many clinics push this process further upstream to have patients complete their intake at home.
You don’t have to take what we’re saying at face-value, though. Learn more about how an animal hospital was able to successfully eliminate five phone calls per visit using ER Express.
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 20th 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.
As a result, patients with more urgent medical needs can be treated more quickly than others who may just be visiting for a minor complaint. By prioritizing patients based on need, you can more efficiently move them through treatment and more accurately allocate the appropriate resources to do so.
This isn’t just a hypothetical scenario. With the right solutions in place, it’s achievable. One urgent care clinic measured 30% shorter throughput times after it implemented contactless patient intake.
Manual intake consumes front office staff efforts on data entry related activities. This can include tasks such as 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. With a contactless, digital system, you can proactively provide answers to these frequently asked questions and set accurate expectations for patients that are considering visiting your practice.
As an added benefit, contactless patient intake removes 80-90% of the data entry. Staff can reallocate 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. This transparency enables them to make more-informed decisions about when to plan their visit so that they can have a more enjoyable experience that better suits their preferences.
Virtual queuing and automated texts, as part of contactless patient intake, delivers all these benefits without the challenges of posting wait times. Your staff will not have to manage any of the communication directly, enabling them to spend more of their time focused on more impactful aspects of their roles at your animal emergency department, urgent care, or ER.
At ER Express, we support animal health practices, urgent cares, and emergency departments with innovative patient engagement and digital intake software, enabling you to offload many recurring administrative tasks and simultaneously manage patient expectations. Learn more about how ER Express supports contactless check-in workflows, including at-home and car check-in.
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 suit.
One significant concern that arises from this trend is the potential stress and anxiety it could cause among patients. When individuals are unwell, they’re already in a vulnerable state.
Adding the unpredictability of wait times could exacerbate their stress levels, particularly if there is a long wait ahead. This emotional strain, in turn, might even negatively impact their overall recovery and perception of care.
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.
Before implementing any strategy, understanding patient concerns and expectations is crucial. This doesn’t mean they necessarily want them posted online, but they want some form of communication about it. By understanding this need, healthcare systems can address it more effectively.
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:
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.
Moreover, the focus on wait times might shift the attention away from the quality of care provided. Patients could make choices based solely on waiting, potentially compromising the medical attention they receive. It could lead to an environment where medical facilities are seen as ‘fast food’ establishments rather than places of professional healthcare.
The psychological impact of waiting
Another dimension to consider is the psychological impact of waiting. Uncertainty and unpredictability can lead to stress and anxiety.
When patients are uncertain about how long they will have to wait, it can escalate their anxiety levels, especially if they’re in pain or distress. By offering a clearer picture through virtual queuing and real-time updates, you reduce this anxiety and provide a more patient-centric experience.
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.
Here are some reasons you should use a virtual queuing process at your facility:
Patient experience
A virtual queuing process acknowledges the human aspect of healthcare. It recognizes that patients are not just numbers but individuals who appreciate comfort and communication. When patients are informed and feel considered, their subjective experience improves, potentially elevating the perception of your organization’s brand as a healthcare leader in their local market.
The implementation of virtual queuing also signals a progressive, patient-first approach. It shows adaptiveness in meeting contemporary healthcare expectations, which could also enhance the facility’s reputation.
Less burden on staff
Online check-in also 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.
Integration with other common technologies
Modern healthcare systems already employ Electronic Health Records (EHR), patient portals, and telehealth services. Incorporating a virtual queuing mechanism can dovetail into these services, ensuring a holistic and integrated approach to patient care.
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.
Cost-effectiveness
The cost-effectiveness of virtual queuing cannot be overstated. By reducing the need for your staff to manage queues and handle frustrated patients, resources can be allocated more efficiently. These savings could then be redirected to improve healthcare services, upskill staff, and invest in other advanced technologies, making a positive impact on operational capacities.
Beyond pure monetary savings, the time saved through these tools also increases the value of the time your staff spends during their shifts. Less time spent on administrative tasks creates more time to spend directly with patients and providing excellent in-person service.
More engagement, less phone calls
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.
In turn, this can help to reduce the number of phone calls that urgent cares and emergency departments receive. Patients are less likely to call and ask about wait times if they are able to obtain a transparent view of the real-time foot traffic so they can decide when to plan their visits to your facility.
Here’s what makes this a better solution than simply posting wait times online:
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.
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.
Expanding on this, it’s important to recognize that online patient scheduling, may initially seem incompatible with the acuity-based nature of the ER. Despite initial hesitations, we consistently find that the benefits far outweigh any perceived drawbacks. In fact, many of the reservations expressed by clients stem from common misconceptions about online check-in. We’re here to debunk these myths and demonstrate how online check-in can significantly enhance the functioning of your emergency department.
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. So, this online check-in isn’t just a feature; it’s a smart move in the world of healthcare. It’s a way to make things easier for patients and helps your Emergency Department stand out. It’s like a director in a play, making sure everything goes smoothly and leaving a positive impression long after the wait is over.
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[1].
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 [2] 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 [3]. 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. Think about it this way: without online check-in, you might face sudden rushes of patients, leaving some frustrated due to long waits. By spreading the word about your online check-in service, you’re not just being smart – you’re making it clear you care about your patient’s comfort. This approach helps things run more smoothly for everyone, creating a reliable and trustworthy environment for both patients and staff.
4. Our patients won’t 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:[4]
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.
Additionally, embracing online check-in demonstrates a commitment to embracing modern technology in the healthcare industry. In an era where convenience is valued more than ever, providing patients with the option to check in from the comfort of their homes or while on the go is a game-changer. It shows that your healthcare facility is attuned to the evolving needs and preferences of the community you serve.
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.
Moreover, an efficient online check-in system can significantly improve the overall patient experience. It minimizes the time spent in crowded waiting rooms, allowing individuals to have more control over their schedules.
Patients will appreciate the convenience and the respect for their time, which can lead to higher levels of patient satisfaction and loyalty. This positive experience can have a ripple effect, as satisfied patients are more likely to recommend your facility to others, contributing to a growing and thriving patient base.
Furthermore, implementing an online check-in service sets a precedent for a culture of innovation and adaptability within your healthcare practice. It shows that you are willing to explore new avenues to enhance the quality of care you provide.
This forward-thinking approach not only benefits patients but also boosts staff morale and productivity. When employees see that their workplace is invested in streamlining processes and prioritizing patient comfort, it fosters a positive and motivated work environment, ultimately leading to better outcomes for everyone involved.
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.
[1] Patient Engagement Hit, July 2018
[2] Google Blog, February 2015.
[3] Penn Medicine News, February 2019.
[4] Pew Research Center, data collected in January – February 2019.
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