AutoMed targets patient experience as well as practice efficiency
It was four years ago that Burwood HealthCare in Melbourne decided to build its own in-house system to allow patients to check themselves in using kiosks that were then new-fangled but are now commonplace, not just in general practice but in hospitals too.
For Burwood, the driving force was a need to increase patient numbers without adding extra reception staff, as the practice couldn't physically fit another person in. Since then, practice owner Peter Demaio and his team have built extra functionality into their system and about two years ago decided to commercialise it, setting up AutoMed Systems and offering the technology to other practices while still using Burwood as the guinea pig.
Back then, Burwood was seeing about 600 patients a day with the help of five somewhat overworked reception/admin staff. Now, the practice sees about 750 and 800 patients a day with the help of three. The practice is also seeing saving no one had even considered, such as the $20,000 a year it is saving on appointment cards.
It has also seen a massive decline in bad debts due to some pretty nifty financial technology that comes built into the system, along with a big improvement in data quality, such as the correct spelling of names and the right address. It is fully integrated with Best Practice and MedicalDirector.
AutoMed also features something that other kiosk check-in systems don't, which is real-time rebates from Medicare. With the swipe or tap of a card, patients have paid the doctor and received their Medicare rebate within seconds. The system also includes online appointment booking, SMS and MMS reminders and a concierge element for new patients to register their details on an iPad.
For Dr Demaio, the idea was not just to provide a solution to a particular problem like online appointments or how to self-arrive, but to improve the whole patient experience from the decision to see a doctor to making an appointment, self-arrival, payment, booking a follow-up and receiving a reminder.
Patients cottoned on pretty quickly and about 55 per cent of patients now make online appointments and 65 per cent self-arrive using the kiosks, which has seen the amount of work at the front desk decline. However, the practice was still getting about three or four hundred calls a day, however, so attention moved to how this could be automated as well.
That's when the idea of caller ID came in, which Dr Demaio says has hugely improved the efficiency of reception staff. This feature matches the caller's number with their details so receptionists don't have to search the database – useful for patients with common surnames or if they use a diminutive, or have a difficult accent – and it will also tell the receptionist if the patient isn't registered.
“If you are a patient it will automatically match your number with any patient in the PMS that is attached to that phone number,” Dr Demaio said. “It might be you and your children, so all you need to ask is date of birth and along with the phone number and full name that’s displayed, your three points of ID is taken care of.
“Instead of taking five minutes to book an appointment – which can happen with common names like Nguyen – you can cut it down significantly, with an automatic MMS appointment confirmation included.
“So now we are seeing 750 or 800 patients a day with three reception staff. That then got me thinking that if we got this system working, maybe we could make a difference to the viability of general practice. Fees are fixed, costs are going up, patients are more demanding – we need to be more efficient and we need to engage the patient more in their own management.”
Other features added over time include MMS rather than SMS reminders, which allows the practice to send extra information like patient information sheets, links to websites or informing diabetic patient that a new dietitian has joined the practice. “It becomes a powerful marketing tool that is starting to really value add to the experience,” Dr Demaio said.
Payment has also been automated using the Paywave payment gateway that allows the patient to walk out of the consulting room and swipe or tap their card, pay their $65 and get $35 back simultaneously, and get a receipt that says so. Dr Demaio says AutoMed is the only system on the market that is integrated in real time with Medicare.
The system uses the practice's own website as the portal for online appointments rather than a third-party app or booking service, which Dr Demaio says has the benefit of reducing duplication of files if the patient books under a slightly different name from what is recorded in the PMS.
It also caters for 100 different languages, allowing patients to arrive in their own. This is important for Burwood, a large practice of over 25 doctors with a patient population that is about 30 per cent Chinese, 20 per cent Sri Lankan and with a large Vietnamese profile as well.
It also allows practices to automate the coordination of health care plans, finding a doctor that provides that service and booking an appointment with a nurse concurrently. And for practices that take walk-ins, it has an in-built algorithm that scores each doctor with an efficiency factor.
“If one doctor sees a patient every half an hour and he's got one patient waiting, while the other doctor sees patients every 10 minutes and she's got two patients waiting, if you come in as a walk-in, we allocate you to the doctor who has more patients waiting but we know she will see you first,” he said.
“It arrives you, it checks your demographics, it checks your date of birth and your phone number, it upgrades your Medicare card number if it's out of date, it also in the background checks to see if you have any outstanding accounts and it makes sure you arrive on the right day. We have 135 functions in all.”
There is also the iPad concierge service that allows patients to enter their data and their patient questionnaire. That data is then entered automatically into Best Practice in document form and in Medical Director in the appropriate fields.
But apart from the kiosk and the concierge, the rest of AutoMed's services are virtual. Practices can choose from 10 different modules and only pay for the ones they use.
There is a $1000 upfront fee to install and remove the kiosk, and then there is a weekly charge to use it, depending on the modules. There are no lengthy contracts and you only pay for what you use, Dr Demaio says.
“We are trying to improve the patient experience rather than just provide solutions. 65 per cent of patients will self-arrive in our practice, and we find that older people will use it more than younger people because they don't want to stand in line or they can't hear the receptionist or the receptionist can't hear them.”
It is also useful for patients who don't want to draw attention to themselves or give their details in public. And for the 20 per cent or so of Medicare cards that don't actually work when swiped, the phone identification system allows the receptionist to print out a barcode so the patient can self-arrive that way.
“We'll get to the point where almost every patient who is under Medicare can use the kiosk to arrive,” he said.
Despite tight margins in general practice from the Medicare freeze and rising costs, Dr Demaio says getting practices to use the system isn't a hard sell.
“The biggest difficulty is practices that are just getting into the IT space,” he says. “There's so much you can do with this stuff that is incredible. Imagine you have a measles case that comes into your clinic, you don't get the result until the next day and you have to go into the previous day and look at the waiting room and contact all of those people.
“With this system anyone who came in between two o'clock and five o'clock would get an SMS. That takes a full day of ringing around with humans.”
Posted in Australian eHealth