Simplifying the New Patient Experience

Hi, everyone, welcome to this episode of Catch Up with ChiroTouch. Thank you for tuning in. I'm your host, Dr. Brian Blask.

Today's topic revolves around the new patient experience in your office. We're going to talk about intake forms and patient engagement. With me today is Dr. Naota Hashimoto from Hashimoto Chiropractic in La Quinta, California.

Dr. Hashimoto is a ChiroTouch client and has been in practice for 14 years, running both an integrated practice and a chiropractic only practice. Welcome, Doc. Thank you for joining me.

Thanks for having me.

So Dr. Hashimoto and I have been colleagues for quite some time now. And after a few conversations, I thought to myself, this guy knows what he's doing. All right.

I realized he runs a pretty smooth practice when it comes to operations. So can you tell me and our audience a little bit about your evolution as a chiropractor?

Well, I've always been like kind of more of a process person. And then I ended up marrying my lab partner who used to be a financial analyst is a high process person. So like just we're always trying to do that.

Like Kaizen, that 1% improvement. I was just trying to see how you could continue improving the practice. But as far as with new patients, we always focus on that new patient experience.

Like a lot of people focus on the ROF, but that ROF, the close really happens on the first day. And you can look at RAN studies and like there's these big studies where they've looked at like what people don't like about health care. And like the biggest complaints are people wait too long.

They feel unheard, scheduling difficulties, not getting enough time with the doctor, confusion about pricing, fees, insurance. So like we're always trying to kind of improve on those different areas. And, you know, as we added in more providers into the office, like physical therapists, chiropractors, and especially the medical providers, because they don't see them as many visits, we kind of had to feed the machine.

So from like probably 2014 up until COVID, we had a run of 100 to 160 new patients a month, 12 months a year, year in, year out. And then obviously March of 2020 was the first month that it actually dropped. It's picked back up, but it was, you know, it was a little dicey there for a couple of months.

That's a ton of new patients in a month. Like you said, feed the machine. You have to have a well-oiled machine.

We're talking about this all the time, where you have to have systems in place. Like that's what ChiroTouch is as a software, right? You have to have a system in order to scale, which clearly you guys did and you continue to tweak it and improve it, correct?

Yep, absolutely. It's dialed in pretty tight right now. So you know, right now it's kind of like on autopilot.

That's great. So let's start there with the intake, right? You mentioned a few things about making sure people have that engagement, right?

They have that first visit experience where they feel like they're part of the practice or that you care about them, right? And I feel like you do that it starts at intake.

Yeah, like it starts there. It starts like obviously with like your marketing ahead of time. And then like, you know, obviously they got to answer the phone.

You got to answer the phone correctly. But yeah, the CT intake was huge because like before that we were doing fillable PDF because something that a lot of people don't realize is that the patient starts counting the time in your office as soon as they get there. They take 45 minutes to fill out the paperwork, and the office visit was 45 minutes.

They're counting that as an hour and a half. So that's just the way patients think. And then they get to the second visit and the doc saying, hey, we need to see you three times a week for the next eight weeks.

They're thinking, it's like, holy crap, I don't have enough time to do that. So that's why the CT intake, as soon as you guys offered that, that was kind of a no brainer, is like, it's almost free. Like, I don't even know how much that costs.

How much is that?

It's $35.95, so about $36 a month.

Yeah, it's pretty much nothing. And I have, some people say they want it super custom, but we just put the minimal stuff in there, and if you really have to ask super specific questions, you could send them another form, or you could have them fill out those two, three, or four questions in the office. But it's huge.

And another thing that CT Intake is actually done is our data entry errors have almost been eliminated because patients know what their own phone numbers are. So now when you're trying to do texts for appointments and things like that, there's no errors. It goes to the right phone number because they know what their cell phone number is.

So CT Intake's been a nice piece because we just text them the link or email them the link. They fill it out. We tell them to text us back or email us back when it's complete, and then we just kind of get them scheduled.

But we actually schedule them as an event to begin with. So a lot of these offices will complain about no shows, and we have about 100 percent of our patients call or show up for their appointment. It's usually between 90 and 92 percent for a show rate, and about eight to 10 percent of the people will call to say that they can't make it and they'll reschedule.

But those no call no shows are non-existent if you're using CT intake. So we just send it to them, they text us back, and then we turn that event into an appointment.

Okay, so explain to the audience, for those that aren't using CT intake, what then happens?

It's super easy. You just go into the front desk thing, you just import it, and you link it up with the patient record, and then it just maps all the different fields in there, and it just fills it out. Another cool thing about it is it starts off your subjective in your note, and then it does part of your vitals for you in your objective.

Yeah, so it's taking that time that you would be spending in the office, reading through with that patient, just put on a paper form or on a digital form, and instead ChiroTouch is writing it out into the system for you to help streamline.

It's not just saving time though, it's working on that patient experience, right? So now it's less time in the office filling out paperwork. So when they get to our, when they come in the door, we already know their name, we greet them, we take a picture, we attach that to their patient chart, they get brought back for vitals probably within about a minute, then they watch a four-minute video which tells them what to expect on their first visit.

And so they're in the exam room immediately within like a couple of minutes, and then we have the case manager going in there just kind of reviewing the history with them four minutes after they've kind of walked in the door.

You bring up such a good point earlier that I didn't touch on and you speak about it right now is that time starts when they start filling out the paperwork mentally for the patient, right? Like you just mentioned, when that patient comes in the door, they're already in your office in the back within two minutes. That's phenomenal.

It's phenomenal. It really is. Because now that patient thinks, holy cow, these people know who I am, they care about me and my health, and I'm not just sitting as a number in the waiting room.

Then guess what? Since you have a predictability of your schedule, and you know that the people are going to show up, you're not rushing anymore. Now they feel like they're being heard.

Now they feel like they're getting, even though you may not spend a ton of time with the patient, like the doctor's time with the patient, with that first visit and the exam, it's probably less than 10 minutes. They're just asking a couple of key questions, doing a couple of key orthopedics and taking the x-ray, pointing out a couple of things and then they get started into treatment time. But like that initial part, you don't need to do a 45-minute history.

So you just streamline the entire process, again, by having a system in place, by having those operations dialed in. Then you said you guys do use patient engagement tools to be able to send text messages and emails, which is again part of ChiroTouch, use CT and Touch, that works as well.

Yeah.

It's easy.

A lot of people do things by text. So yeah, we just text it to them. Some people fill out in their smartphone.

Some people prefer to fill it on their tablet or their computer. We do that. Then as an absolute backup, we have it where they could fill it out on the iPad, where we import it with CT forms in the office.

So if for some reason someone didn't confirm that they were going to come in and they just show up or we get like a walk in, they could fill it out there. Then as an absolute backup for like a curmudgeon that refuses to fill it out on an iPad and we don't have a staff member that's available to type in the answers, we do have it printed out on a piece of paper. So that's pretty rare.

But like a couple of weeks ago, we had someone that just refused to do that and they didn't want help with that. They just wanted to fill out on a piece of paper, so we just said fine.

It happens. We're all going to come across patients and humans like that, that's fine.

Yeah, but the first visit is really where the close happens. So if you do a good first visit, they get impressed and then on the second visit, they see that they knew my name was a fish and I went back there. If you treat on the first visit, treat them if you don't treat on the first visit, they still think it's an efficient visit.

Then when you tell them to come in X amount of times for X amount of weeks, they're not thinking it's going to take them forever.

We don't want to think about this, but you still have to sell them on Chiropractic in your office, right? You still want to make sure that this person understands and you communicate to them what you're doing as a chiropractor in your office as opposed to somebody else on the street. So you want to take care of that patient and that you're right, it happens right there from as soon as they walk in your door.

You're selling what your service is right away and you're being efficient about it.

Yeah. And like the thing is like when all these little things happen, it just whittles away at like, you know, like their confidence in you. So, you know, like we're big on all these little things.

We like to keep our waiting room tidy. We make sure there's no cigarette butts in the parking lot in front of our building. All these little things, they just kind of whittle away at the confidence.

Make sure that you're, you know, when you're doing your consultation, your clothes, like it's sales choreography, like you have a closing room. The exam room is a closing room. So we have a dedicated room.

We're not sitting there in a stall, in a busy office, trying to go over a treatment plan. So we have a process and it's the same. So we have two closing rooms with just a set process and we have a case manager that knows how to do it very well.

But you've worked at it. It was time and time I'm actually doing it.

Yeah, and then you got to train at it, right? And then that's the one thing that I do with the case manager. It's like there's head trash in their head all the time.

So things happen. So you're just debugging in if they had a bad day, going over it, going over the objection handling and things like that. But it's just if you want to get good at it, you have to practice it.

If you want to get good at doing free throws in basketball, you couldn't just show up in game time and expect to do it. You look at these professional basketball players, they're shooting in practice, they're shooting in the morning, and even before the game, they're shooting. You have to practice it to make it permanent.

Totally agree. And a perfect basketball analogy as we head into March Madness, which I love. I want to mention that you created a backend CRM.

So you work with a lot of ChiroTouch users as part of your software that you've created as well. So you work with those offices. I'm curious, what common mistakes do you see people doing in practice that we can use a couple of minutes here to help rectify and shed some light on?

I think a lot of people are just using ChiroTouch the way that it shouldn't be used. They don't have their fee schedule set up correctly, or they have case types set up as insurance companies, as opposed to a case type. There's a chiro case type, a personal injury case type, a medical case type.

There's a medical DME case type, because like with Medicare, when you're sending back braces, it's not going to the regular Medicare, it goes to a different pair, so we don't feel like changing the different fee schedule. I don't do any of the billing, so I don't want to pretend like I know how to do all the billing stuff in there. I just know enough about it.

But we took some time in it, and with just any of our inventory items and stuff like that, just thinking of a consistent nomenclature, and then some of the people just go bananas with their appointment purposes, or like, another thing I see people messing up is, they don't use the care packages. I think the care packages work great, but not everyone uses care packages. Another mistake that I see happen all the time is, they're complaining that the texts aren't going through, and then we take a look and there's no cell phone in the cell phone slot and ChiroTouched.

So our system can't find that cell phone, nor can any other system because the cell phone is not in the cell phone slot. And there's a cell phone slot in each case type. So if they're trying to do an appointment reminder for a specific case type, and there's no cell phone number in that cell phone slot, then that would be a typical mistake right there.

So a lot of these things, like we mentioned before, the data entry errors, little things like that, that you beat your head against all the time, can be rectified by using CT intake like you mentioned before.

Yep, our data entry errors have kind of been cleaned up a lot, but yeah, it's virtually free. You can make your own custom form and ask your perfect questions, but the problem is now you have to take that and you have to put it in. You run the risk of making a mistake, and then you're wasting staff time.

And another thing that we always try to focus on is kind of like our team. And each one of these little things, like it whittles away at your team. And you know, our front desk loves CT intake because now they don't have to copy and paste everything over or type everything over.

It just comes in, it's easy. And another thing that the staff hated is they hated the no call no shows. And another thing they hated is like, you know, like is like, I just say is like, okay, let's overbook the schedule then.

Now all of a sudden we get triple booked with new patients. And that now it gets a little hectic and you know, patients get like a little nasty with them. So, you know, the CT intake is kind of solved that no show issue and it's solved the data entry issue and it's like 30 something bucks.

So I would say it's a very good value add for the service and the case manager likes it because it starts her note too.

It writes that information right out into the documentation for the case manager. Or if you're doing it all yourself, you can do it as a chiropractor as well.

Yeah, or you can make your own custom note. And for the people that want to have it super custom, get CT intake, get the, you don't have to check all the boxes where you ask all the questions. And for the three to five or eight questions that you want to ask for your medical practice or your functional medicine practice, you could do that as well.

You could ask in the office or you could have a separate fillable PDF. And there's other things out there like JotForm is pretty easy as a fillable PDF. They have a HIPAA compliant version with that.

And then the neat thing about that is a patient doesn't have to email you back. You actually get notified that they filled it out and you have all their answers right in there. You can download it right there.

So it saves an extra step.

Beautiful. What you're doing right now and sharing for other users is, it's phenomenal. I mean, what you've been able to create and like I said, your years of experience.

You're such a huge help. So I really appreciate you taking time out of your busy day to kind of go through your processes and help others. I really appreciate that.

It's a great profession. Like I started out going into dental school and then got in a car accident because someone decided that they get to work a little faster by running through intersection, hit me head on. I started out as a head on car accident victim, and chiropractic is the thing that really saved my life after six months of failed medical treatments.

So that's how I started. My wife's grandpa was a chiropractor way back in the 40s, back when they were put in jail, and she started out as a financial analyst, and wasn't really her calling or passion, and she wanted to do what her grandpa did, and so passion about the profession, and I think it's one of the most noble best jobs out there. It's like we have miracles every day of the week, and it's a pretty cool thing to go to work to do.

Yeah, that's amazing. Keep up the good work. I really appreciate your time.

Thank you for helping out not only ChiroTouch users, but also the profession.

Thank you for having me, Brian. And you know, if anyone's curious about finding me, they could find me on trackstat.org.

Do you have a website for the practice as well?

lakintachiropractor.com. Surprisingly, that wasn't taken, so I took it.

Well, perfect. Well, thank you again so much. And thank you to our listeners for tuning in to Catch Up with ChiroTouch.

You can find more episodes of Catch Up with ChiroTouch on Spotify, iTunes and chirotouch.com/podcast. Again, I'm your host, Dr. Brian Blask, and I wish everyone listening a well adjusted day.

‍