Business, Feature, Practice management, Report

Call to action: Patient reminders

String tied around finger as a reminder

How a practice approaches patient recalls can determine their success from both a clinical and business perspective. It is also a field that’s ripe for innovation, writes RHIANNON BOWMAN.

Reminding patients they are due for their next eye health visit – and ensuring it results in an appointment – has become its own science, bridging the gap between data management and psychology.

Many factors can influence a patient’s decision to re-visit the practice, with more businesses adopting personalised reminders to motivate their clientele to take control of their eye health and vision. Discussing the benefits of attending a health-related appointment can be more effective than simply providing basic information like the date, time and location of their next appointment.

With the modern-day practice also demanding innovations that eliminate manual processes which take valuable time away from patients, technology providers are responding with automated systems and data collection methods to help measure the effectiveness of their communications.

What do optometry practices need to consider when inviting patients to confirm and attend their next eye health appointment, and how do they cut-through to keep existing patients returning?

Fostering the relationship

Ms Paula Sadler is general manager of marketing and managed services with relative newcomer, National Optical Care. She brings with her five years’ experience in the same role serving more than 100 practices in the veterinary industry.

“Although I’ve recently come across to the optical space, the same discipline and methodology in patient recalls and reminders works across all sectors.”

The reason for that, she says, is because patient communication is data-driven.

“Data is everything in 2021. Regardless of the size of a practice, the lead person responsible for marketing needs to; one, understand patient lifestyle; and two, understand performance of communication activities, knowing what works and what doesn’t.”

Paula Sadler National Optical Care
Paula Sadler, National Optical Care

Sadler says being agile and flexible to adapt communications to patients is essential. Keeping a finger on the pulse of trends in the ‘patient recall’ space and shifts in patient behaviours are also vital.

“Patients of a certain age are still attached to receiving hardcopy notices, and don’t have the ability to connect digitally, so recall letters for certain patient demographics, like those over 75, is still essential but there are outliers,” she explains.

“You need to have an understanding of the type of person who is comfortable with digital communication. There has been a shift in the ability of those in their 50s and 60s to connect via digital channels like SMS, and they are becoming more engaged.”

While email, SMS and letters are the mainstays of direct-to-patient communication, a practice’s social media channels and websites can also be utilised to keep existing and prospective patients abreast of information.

Sadler recommends using a multi-channel approach to communicate with patients.

“But don’t stop there – measure the results. Look at the open rate of communications and what happens off the back of that. Look at the practice’s online bookings, the call volume/rate, and specs sales,” she says.

“Maximise email and SMS because of their inherent speed of delivery and cost-effectiveness but don’t disregard patients who rely on, and expect, a letter in the post. You need to take a selective approach.”

Despite the conveniences of fast, low-cost modern text-based communication technology, Sadler says there is still a need to simply call patients at times, which can offer an efficient, personalised resolution to communication black holes.

“We take a segmented approach via a smart CRM (customer relationship management) system, segmenting by life-stage, tailoring communications to those in their 20s to those in their 40s. We rely on the strong capture of data to tailor our patient communications,” Sadler explains.

How frequently patients need to visit their optometrist depends on their individual needs and their age, with some needing to return every two to three months, while others only every two to three years, which is why fostering the relationship between appointments is important, to guide them through their eyecare journey. Patient communications can go beyond simply stating the date, time and place of their next appointment, to showcasing new frames in the practice, or new equipment and its clinical applications, Sadler explains.

“If you understand the patient, what they’ve been in for (the purpose of their visit/appointment), and what they’ve purchased, you can tailor communications to be eyecare-led without being retail-focused.

“If you’re not engaging with patients outside of the face-to-face consultation, you’re losing the opportunity to be their local eye health care expert and owning that space. That’s why you need to have a strong capture of the patient’s contact details, so you’re in touch outside of their one, two or three visits a year.”

According to Deloitte’s 2021 global healthcare outlook, consumers are helping to accelerate the pace of change in healthcare, showing greater activity and engagement, using virtual visits more than before (not yet mainstream in eyecare in Australia), and using technology for health monitoring.

Sadler says research shows what modern patients are looking for, pointing to the 2019 Healthcare Consumer Trends Report from US-based NRC Health. It found patients don’t just want excellent care, but are seeking excellent service, too, which means care delivered with more ease, convenience, and choice.

“We need to understand what people want in 2021, which is different even to 2020. We know consumers are becoming more sophisticated, engaging pro-actively,” she says. “People look for convenience – it trumps everything else. Once you have a patient, retaining them is easier than attracting new patients.”

Technology is absolutely key, Sadler says.

“Understanding your data and patient behaviour is essential. You need to engage your patient database more frequently than issuing a recall every two to three years. It’s about nurturing the relationship in between recalls to trigger their engagement.”

National Optical Care announced in April this year it was launching Optical Growth Partners, a new division of its business that offers independent optometry practices new subscription-based buying group and managed services opportunities.

Sadler says it has the capability to offer a more sophisticated patient journey, tailoring multiple patient communications based on life-stage. “It’s about how we communicate pre-appointment, what do we do during an appointment, and how we communicate post-appointment. The service includes internal processes to follow-up with patients who miss appointments, to understand the why, and keep the door open.”

Rather than issuing cancellation fees for missed appointments, Sadler says it’s more valuable for patients to understand they’re always welcome.

A nimble plan regardless of business size

Mr Aaron Kangisser, general manager of The Optical Company and its 42-store portfolio, says technology and automation have made a significant difference to the recall process for both store teams and customers.

“Now it is all about customised messaging, set recall times, frequency and delivery method,” Kangisser says.

Beyond SMS, email and letter, he says more sophisticated advances in tailored recalls are imminent. Outside the automation, he says the industry has seen examples of customer-journey mapping to schedule a communications calendar to the individual based on the type of recall. The value of accurate data and a scientific approach to planning also lends itself to an area of engagement that focuses on the customer and their needs.

From a purely business perspective, Kangisser says patient recalls are critical.

Aaron Kangisser The Optical Company
Aaron Kangisser, The Optical Company

“Recalls are a reminder for patients to have their eyes checked and form a key part in their eye health journey. The response to a recall and subsequent visit in-store is an opportunity for store teams to engage with that patient and deliver them with a great experience supporting retention.”

Conversely, recalls are equally important for patients leading busy lives.

“Life is busy, so offering the ability to remind them rather than rely on people just remembering is a benefit. Many consider vision the most important of their five senses – so the optometry industry’s contribution to the management and improvement of vision is important,” he says.

Kangisser believes a few different factors might influence the future of patient recalls.

“With the increasing rate of myopia and more people entering the optical market, establishing a nimble plan to respond to customer demands for the ways they wish to be managed or contacted has never been more important,” he says.

“This is equally essential for a single-location business and groups. A recall strategy and platform to store data prompts important health reminders and rely less on busy optometrists and store teams to be across every detail, delivers results and supports important store tasks accordingly.”

The road to AI-activated recall

Specsavers director of professional communications across Australia and New Zealand Mr Charles Hornor says traditionally, the optometry sector has always been strong across the board with regards to patient recall.

“Early detection is key to avoiding vision loss and blindness for so many eye health conditions, so it has always been imperative to ensure patients are reminded to attend regular eye checks,” he says.

While SMS, postal letters and email reminders are staples of modern recall programs, other forms are also playing a vital role.

“The biggest difference in recall now is the mix of channels used to communicate with patients. Whereas letters and telephone calls used to be the primary mode of communication, the advance and adoption of technology means electronic channels such as eDMs (electronic direct mail) and SMS’ play a far greater role in recall,” Hornor says.

Charles Horner, Specsavers
Charles Horner, Specsavers

“There will always be a percentage of patients who do not action a recall reminder, therefore follow-up eDMs provide a gentle reminder of the importance of regular engagement with optometry. When a patient does book an appointment, SMS is a very effective and efficient channel for confirming appointments and subsequent information.”

The bottom line, Hornor says, is that the most effective response to recall will always occur when it is a channel and mode that complements the patient’s lifestyle. Looking ahead, he is in no doubt we’re yet to see the best in patient recall technology, especially given AI is often talked about as a game-changer in so many areas of patient care.

“However, no matter what advances are made, the core element of a successful recall program is the quality of the data. Ensuring patient data is up-to-date, appropriate, and managed properly will ensure the right communications can be shared with the patient at the right time and place for them,” he says. “Get the data right and the recall not only becomes more effective in managing patient care but will be the foundation for building the road to valuable AI linked recall.”

From an eye health perspective, patient recalls are vital for early detection of structural changes in the eye and the presence of eye diseases, as well as preventing avoidable blindness caused by eye conditions.

“With Medicare funding a comprehensive eye test every one to three years depending on age, it is critically important patients are reminded to attend eye checks so a comprehensive history can be tracked, monitored, managed and, if needed, treated,” Hornor says.

“It is just as important to remind a healthy 30-year-old patient to attend regular eye checks as it is a patient with diabetes, as there’s every chance that visit may be the time an optometrist picks something up they weren’t aware of on their last visit. It could be the difference in saving sight.”

While AI might bring the next revolution in patient recalls, tailoring messages to individuals will remain paramount.

Patients with, for example, glaucoma and diabetes receive specific recall communications that are relevant to those conditions and are reminded of the need to make their next appointment on a timely basis.

A combination of email, SMS and letters are used based on patient preference, available contact details and appropriateness. The personalised messaging clearly identifies the reason for the recall and, as the notices continue, whether the patient’s assessment is due or overdue. This personalised, condition-specific messaging continues to be a point of focus for Specsavers, which has found through ongoing testing that there is more effective engagement when the messaging is specific to a patient’s needs, as compared to standardised communications.

“As we understand more about eye conditions and clinical technology and processes improve patient outcomes with early detection, so the focus will be on personalising and tailoring recalls to a patient’s specific eye health status,” Hornor says.

“This is much like the KeepSight program that is targeted at encouraging and reminding patients with diabetes to attend regular eye checks due to the nature of the disease and its impact on vision. This personal touch will help recall messages cut through patients’ busy lives and ensure eye health is a priority.”

All in the timing

Independent practice Canterbury Eyecare sits among a vibrant local commercial centre on Maling Road in the inner Melbourne suburb of Canterbury. Established in 1996 with one optometrist and one consulting room, the business has expanded into the neighbouring shopfront and now employs 10 staff – and has secured a strong patient base.

When optometrist and business partner Ms Genevieve Hastings spoke with Insight, Victoria had entered a seven-day lockdown in June, and Canterbury Eyecare was limited to providing emergency and essential care only, in line with government restrictions. Lockdown, Hastings says, makes for an “interesting time” for patient recall processes.

“We can’t issue normal recalls during lockdown – we have to dissuade people from making routine appointments, triaging only emergency and essential care.”

Genevieve Hastings, Canterbury Eyecare
Genevieve Hastings, Canterbury Eyecare

Canterbury Eyecare takes a unique approach to patient recalls, mostly sending messages directly to patient’s mobile phones, and it doesn’t measure responses.

“We send out recalls, and although we don’t specifically measure how patients respond, our recalls are certainly effective because our appointment book is full – it’s a busy practice,” Hastings says.

“We use SMS mostly, because it’s cost effective, it’s easy to activate with a bulk number of recalls at any one time, and it’s extremely effective because patients can book directly online through MyHealth1st. Our SMS messages include an activation link, making it handy and convenient for patients to book.”

Hastings says there is a small percentage of patients, particularly older patients, who prefer a letter or phone call.

“We don’t use email for patient recall at all – our preference is SMS. We seek the patient’s permission to send SMS for future patient reminders,” she says.

During an appointment, the optometrist selects when and why they want the patient recalled in Canterbury Eyecare’s practice management software.

Hastings says the practice usually batch-processes recalls.

“We normally send out recall reminders monthly. However, when we were exceedingly busy at the end of last year – after the lengthy COVID lockdown in metro Melbourne – we processed recalls weekly because of the large volume of patients requiring appointments,” she says.

During the most recent lockdown, the practice has phoned patients directly to reschedule appointments.

“We’ve called patients because it’s more personalised, rather than sending batch SMSs, but it’s also because we want to discuss with them whether we need to triage their appointment or reschedule it. We have their patient record on hand for that conversation, allowing us to pre-empt the desire for an appointment.”

Hastings says Canterbury Eyecare has no plans to change its recall processes, as all indicators point to a successful, seamless operation. But the practice is selective about exactly when recalls are sent.

“We try to send SMS recalls at a specific day and time when we are not overrun. Not first thing Monday morning, for example.”

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