The Secret to Patient Retention: How to Engage and Reactivate Your Patients

Announcer: Welcome to the Ignite Podcast, the only healthcare marketing podcast that digs into the digital strategies and tactics that help you accelerate growth. Each week, Cardinal’s experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Lauren: Hey everybody, welcome back to Ignite Healthcare Marketing Podcast. My name is Lauren Leone. I’m our Chief Growth Officer. I’m sitting in the host seat today because we’re going to be discussing with Jordan Parrish, our Director of Patient Retention, a fun new topic. Patient retention, patient loyalty, patient recall, reactivation, call it what you will. It all means the same thing. Are you engaging with your patients that you have already brought in the door to ensure that they are coming back?

Jordan, thanks for joining. I’m so excited. We’ve been working on this new service offering for a few months together now, and it’s time to bring it to the world. I think most importantly, it’s important to establish why people should care. Why should people care about this? Why is just driving new patients not enough?

Jordan: Yes, I think that so much of this people strategy, since people have realized that digital is the way to go, it’s all been about acquisition. You can continue to focus on your acquisition strategy and you’re bringing in more and more patients. Then what happens after they book? you have them in your system and then it’s up to them to reschedule. Maybe you have an appointment reminder in place and then they’re just lost in the abyss. That is what we are trying to prevent.

Once you bring them back, you truly want someone to, not that you want a patient to always be seeking medical services of some sort, but if they are looking for a certain service, you want them to come to you and you don’t want them to have to go out of the way to do the work schedule. You want to help them out.

Lauren: You say something that now I’ve started to weave into my conversations. Your patients are your competitor’s prospects. If you are not doing anything to keep them engaged, even if they don’t need you right now, right? There’s different types of recall. There’s, “I canceled my appointment and I never came back in.” We need to recall them. “I’m on a 12 physical therapy care plan and I only came in for eight and I dropped off.” Why?

Then there is, ‘ I’m not technically scheduled for care right now, but maybe I need to go to the dentist twice a year.” “I need to go to my primary care doctor every year.” “I need to get my skin checks every year.” Those people need to be reminded why your brand is important, what you have to offer, and that they should come back. I think you have a stat about the difference in if you have an open appointment, the cost to fill that with a new patient versus the cost to bring in a patient who’s lapsed and already aware of you.

Jordan: Yes. It is five times more expensive to acquire a new patient than just retain an existing one. I like how you brought that up because if you are that person who’s got a 12-step physical therapy plan and you’ve only made it through part of it, or let’s just say you are not scheduled for your next appointment at the dentist. That patient is in your ecosystem and they’re just floating here waiting for their next appointment. Like you said, your competitor, they’re targeting them with ads. They are receiving all of this new sort of fresh marketing from your competitor. How do that their next appointment is not just going to be booked with them? You’ve got to make sure that you are retaining them.

Lauren: Yes. If a marketer is listening to this and, or an ops person, because this really does straddle the line. We see that retention sometimes lives in an operational capacity in an organization. Sometimes it lives on the marketing P&L and sometimes it’s a blend. Regardless of what point of view you’re listening from, you’re going to recognize these common challenges. Jordan, what are the challenges that we’ve been hearing in these conversations? What is the problem? Then we can talk about the solution.

Jordan: Sure. The way that we’ve gone about sort of analyzing where we’re seeing these major pain points in this patient experience, you’ve got it sort of as the patient journey in the beginning, you acquire them, they’re on your site, they’re on your landing page that you’ve worked so hard to get them there. Now they give you their info, they’re ready to schedule their first appointment. What happens between then and their first appointment? I think it’s something 40% of people, either no-show or they cancel their first appointment.

That’s one of the major solutions that we’re tackling is that first iteration of pre-appointment automation. Even if it’s something as simple as an appointment reminder or something a little more specific saying, “Hey, we’re in this office building, but this is where to park.” A lot of people have anxiety about that stuff and just being able to ease someone’s mind or just, “Hey Lauren, your appointment’s tomorrow at 9:20.” “Oh, okay. Good. I’m glad I saw that. I thought it was at 9:00.” I think that sort of focus on just getting someone in the door for their first appointment seems simple, but it’s really not. That 40% is a huge drop-off.

Lauren: I think as an agency who spent so many years refining new patient acquisition, we would love to see the lifetime. That essentially extends the value of the dollar that we have to spend to invest, right? We got them to book. Let’s get them to show up. I think the cancellation no-show isn’t just applicable to new though, right? Because you have someone coming in, they’ve been, at your practice for five years coming up for their biannual visits to the dentist.

They may not need to know where to park, but in order to ensure they retain that appointment, there’s other things we could be saying to them, “Hey, we need to update your insurance information.” Or, “Hey, did you know our check-in has changed? It’s now all virtual” “We have an app. Did you know you could download the app and get better appointment reminders?” There’s a lot we could be doing to make sure [unintelligible 00:05:49] miss.

Jordan: Yes. Absolutely. We all need to be reminded that it’s not just that first appointment showing up. This is pre-appointment automation that you’re going to cycle back for when you have an appointment booked. Even if it’s something as simple as this is the 10th time I’ve ever been in, but I’m going to get that text with the reminder. It is astonishing to me. A lot of people don’t even have that in place because it’s pretty advanced automation to be able to set up, but the strategy and maintaining it is really just a no-brainer that is worth it.

Lauren: One more note on this, Jordan loves that I always harp on this cool video I saw, speaking of AI, we’ve seen a brand go as far as to a video of the doctor saying, “Hey Jordan, I’m excited to have you in the office tomorrow. Look forward to meeting you and getting to know more about your situation.” Whatever they’re saying. Then they use AI to replace the name. The doctor’s mouth like, [unintelligible 00:06:48]

Jordan: Oh, Lauren [unintelligible 00:06:49]

Lauren: You can go quite far in how you choose to engage. You can really make it personalized. Like you said, we can set up the basic triggers of your appointment is at this time at this place. Click C to confirm. We can go further than that. What you should be doing, even if you have automation set up is now AB testing. How do I continue to get my no-show rate down, my cancellation rate down and make sure that people are really feeling like this experience was tailored for them?

Jordan: Yes. It’s tough because I know that, internally in-house within these practices, you’ve got a lot of people doing a ton of different things in terms of marketing initiatives. Sometimes this one does fall through the cracks. If you do have it set up, maybe you aren’t doing AB testing. I think what we want to do is be able to jump into whether it’s the solution that you’re already using or we’re bringing on something else. I think that we want to be able to not just put this in place, but really be able to optimize it through testing and just constant optimization there.

Lauren: What we’ve seen probably 80% or 90% of the time, your patient management system will have these capabilities. This is such an easy win. There’s not a big tech investment. You don’t have to be building it out. There are awesome technologies to do this in a more sophisticated way for brands that want to. We can have a discussion with you about that, but for the most part, this exists in your ecosystem already. Pretty low barrier.

All right. Let’s get into the next big problem that we’re solving. This is probably where the biggest revenue sitting on the table lives. Let’s talk about what we’re going to call patient retention, patient recall, reactivation. You can really use those three Rs interchangeably.

Jordan: Yes, absolutely. What’s so important about patient reactivation is this is where, when you have that drop-off and you can define lapsed, however best fits the situation, we’ll use that physical therapy 12 step as an example. If somebody has not completed their treatment, this is where you’re going to send them these automated reminders via text, via phone call, which is an auto call, postcard, email, which we are going to test all these different solutions and you’re reminding them to come back in. We are not putting it on the patient to do the work, to remember to call. This is where you are doing this full-service patient experience, reminding them to make their next appointment.

Lauren: Some other, I like to always bring it to reality in some examples. We’ve seen it where in our optometry, for example, you’ve got patients who are diagnosed. You said we can decide what lapsed means for any given practice and it could look different. There could be multiple definitions.

Jordan: Specialty, even.

Lauren: For specialty. Yes. In optometry, there’s a huge population of people that are diagnosed with cataracts that haven’t acted on that diagnosis yet. Sending them SMS, auto call, asking them if they’re ready to schedule a procedure to remove the cataracts. We see it in dermatology a lot. You can use this a little bit from a cross-selling perspective. Maybe they had a skin check and they had a dark spot and you’d like them to come in for some further testing on that. Or dermatology, a lot of times you’re using it to move people through a funnel from

skin cancer screenings into a Mohs surgery, which is a big ticket item in dermatology. Other examples, primary care, just these healthcare engagements where people are supposed to come in every so often, once a year, twice a year, and they just simply haven’t booked that appointment. Those are the easiest patients to retain and win.

Jordan: Yes, absolutely. This is where I think a lot of people get intimidated by the idea of how heavy of a lift this could be. That’s where I feel really confident in the way that we at Cardinal are presenting the solution here because it really is just, “We are going to set up this integration and we are going to go through and do this for you. Continual AB testing is going to make sure that you’re optimized.” I’m a big data person. I think the ROI that we’ve seen within this patient reactivation program is just-

Lauren: It’s in the thousands of percentages, right? [crosstalk]

Jordan: I had to double-check to make sure I was reading it correctly.

Lauren: Yes, there’s multiple models. In few cases, your tech stack may already contain this capability and you may not be using it. In most cases, we’re talking about bringing on tech into the stack, something that is designed specifically for recall flows. It’ll plug right into your patient management or your EHR and we’ll create all the perimeters. It’ll query from your EHR on a regular basis, like daily, hourly, checking if someone is lapsed. Are they on the schedule in a forward-facing capacity? No, they fit the parameter, they drop into a flow, but we’re talking $11, $14, $18 to recall a patient. Some of the models are paid for performance. It’s really nice to know it’s guaranteed to work to drive an ROI.

Jordan: Yes, absolutely. Then when we’re going into those different flows, that definition of your lapsed patient can be different per flow. Your definition of your time delay in between messages can be different per specialty or provider. There’s so much customization in here and I think that is where the intimidation lies internally and that’s what we can just be able to provide peace of mind because we’re familiar with this and we can jump in there, make it definitely specialized to each practice and go through. Like I said, I’m a big data person, and being able to go through and analyze your tests that you’ve got running and just really maximize what you’re seeing from there.

Lauren: Yes. If you guys haven’t, I keep throwing this out there. Shout out to Luna Physical Therapy, if you’re listening.

Jordan: [unintelligible 00:12:29]

Lauren: Someday I’m going to get them as a client. If you want to see an example of a really good flow, I’m not encouraging everyone to fake sign up for appointments, but like half went through their booking flow in an attempt to understand their experience and how they communicate like fantastic email and SMS attempts at booking and rebooking. They’re using multiple channels to try to understand. Not everybody responds well to SMS. I have 58,000 unread emails in my Gmail, so you better reach me via SMS.

Jordan: Ooh.

Lauren: Those are the types of tests that you can do based on different segments. There’s a lot of nuance and you can set it up and forget it, but you can also set it up and continually refine it and just get more and more out of it.

Jordan: What I liked a lot about the Luna experience was their time delays. I think that sometimes a lot of this automated email marketing and SMS marketing started in the e-commerce world where you’re getting, abandoned cart messages and it’s back to back to back to back. Something where you are having more of a consideration process like physical therapy, you don’t want to be inundated immediately with all of this. I really appreciated within their flow, having this consideration for that time where it’s not going to always be immediate.

Lauren: All right, Jordan. Then the last, I don’t want to call this one so much an issue. This is true marketing. This is, do you have a way to retain loyalty with your patient base and to get them to come back, but to refer and to speak highly of your practice? This is the one piece that we see doesn’t usually straddle operations at all. This is your true email automation, email campaigns, SMS, your drip, your welcome sequences, your birthday messages, your use it or lose it benefits. There’s so much you can do in the world of what we would call patient loyalty and patient experience. Talk a little bit about what we’re solving for there. If people are listening, what’s a sign that this could be a good fit for them?

Jordan: Yes, absolutely. This is where you’re also going to associate having a full-scale email or SMS program. This is where to your very beginning point about your patients are now your competitor’s prospects. I think that this is establishing that loyalty and knowing that if you are going to come in for physical therapy, then yes, I’m going to come into the person who is emailing me about different ways to address your back issues at work or, giving you solutions for allergy season. Whether it’s educational content like those or you’re receiving happy birthday emails and you’re in an automated flow with a win back or a welcome series or some sort of form abandonment. A lot of people forget as well, these HIPAA compliance that we always aim for. These solutions that provide email and SMS, a lot of them have integrated web forms. Whether you are halfway through scheduling something or if you abandon, you capture your email, you’re talking via live chat and you abandon, we can set up this automation in place that reminds them to continue. Whether it’s that, or you’re receiving SMS reminders or you have been fed into a full nurture campaign of educational content regarding the specific specialty you’re being seen for. Kind of the sky’s the limit within the ability to get really granular within these flows and the messaging. You can get personalized in– we were talking about the saying your name or I like doing things by geolocation. If we’re talking about seasonal allergies, that’s a tough thing to be able just to say for the entire country. It’s not going to be the same everywhere. It’s impressive how you can blend marketing efforts with true data behind everything in this sort of automated in-campaign messaging space.

Lauren: Yes. This is like bidding on your brand terms and search guys. This is, you have all of this rich information on your patients, and in a relatively simple, it can get very nuanced and you’re going to need a dedicated person or a dedicated agency sitting in that seat, but creating flows. Flows live. Then you just push people into them and then you can have one-off campaigns that are specific to maybe what you have going on. A big one that we see is when brands launch online scheduling, it’s a great way to notify your patients of that new technology and make sure that they have the easiest way to schedule an appointment.

Or another brand I always like to look at for really great post-patient marketing, meaning I’m already a patient there would be [unintelligible 00:17:03] I get this message. They probably have me in a group of people that use electronic toothbrush because I maybe like checked that box on my form and I get these reminders, like, “It’s time to replace your toothbrush head,” simple things. I’m literally like, “Oh my God, you’re right. I need to replace it, once every couple of months.” Those little things go a long way to me wanting to stay with that brand, feeling like they understand me, and making it really easy for me. It’s a no-brainer. They’re giving me all this great information. They care about my health and I wouldn’t go somewhere else.

Jordan: I think that’s a great example of personalization in more of a complex way, rather than, we’re just going to put in a dynamic field and pull in someone’s name for hello Lauren, providing that experience to where you are getting that reminder at the right time and it’s being helpful to you. A big thing with email and SMS, but particularly email is you want to feel like you are someone’s friend in their inbox. You don’t want someone to receive your email and say, “Oh my gosh, I’m still subscribed. Or have 60,000 unread emails [crosstalk]

Lauren: 50 emails [unintelligible 00:18:08] A lot of people are doing really bad email marketing.

Jordan: You’re opening 10. You know what I mean?

Lauren: Yes.

Jordan: You want to be able to provide something helpful. If nothing else, they’re seeing your name and they’re associating it with education. You want to always be seen. This is a reiteration that you’re an expert in your field. It is just that sort of recall. It’s reminding them that you’re there. You’re there when they’re ready. Even something as simple as focusing on particular KPIs like click rate. If you’re looking at come in to reschedule your appointment or we have new providers, welcome them to the group. We’ve opened these locations. Whatever your goal is and having them click through to the site, we’re able to measure across the board and what we’re going to define as success within this sort of program.

Lauren: Jordan, I think that really brings us full circle on the capabilities. I would encourage everyone listening to assess your efficacy or what you’re doing in those three areas. Do you have high cancellation and no-show rates? Are you doing anything about it? Do you have a large population of lapsed patients? Are there people in your EHR who should have come in that have not? Are you doing anything about it? Are you doing it well? Are the rates coming down?

Lastly, do you have a way to maintain loyalty with your patients? Are you proactively communicating with them about your practice, about what’s going on in the space, and keeping them from becoming your competitor’s prospects? Thank you guys so much for listening. Jordan, it was great to have you on. This is just the beginning of a whole series because this is really important to Cardinal. This is going to be the counterpart to new patient acquisition over the next couple of years for all of you PE-backed groups. Thank you guys for listening. Please like, subscribe, comment, wherever it is that you’re listening and we hope to see you next time.

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