The year of the optometrist proved to be challenging for our schedules and, as we have seen, that having a good plan for patient recall is critical. A simple but effective recall to allow communication — even when we are not able to go to our clinic — can increase practice health and, specifically, patient retention.

Many systems can be implemented in our offices to make patient recall an easy process that also ensures patients are being seen in the time frame we have recommended.

Let’s explore these and put a plan in place for our teams to ensure those patients are returning to the practice.

FOSTER PARTNERSHIP

Next year’s recall starts during this year’s eye exam. I tell my patients during the exam what eye health concerns I have noted and when I want to see them back for follow up. I do this because I want to make sure patients fully understand the importance of returning when designated. Helping the patient understand the “why” of the follow up lets the patient know they are an active partner in maintaining the health of their eyes.

Before leaving the exam room, I address the finding of the exam: “Mrs. Jones, today we talked about the cataracts that are forming and causing mild changes in your vision. We have adjusted the glasses to help you with night driving, but we want to see you again in a year to monitor the cataracts. We will set up your appointment before you leave today.”

SET UP A RECALL SYSTEM

The first steps are deciding what will work most efficiently for the practice situation and how much the budget will be:

• Practitioners not using an EHR system. Recall systems can be as simple as a color-coded filing system in which, for example, green files indicating patients with diabetes and blue files indicating glaucoma suspect patients are sent reminders every six months to monitor their eyesight, whereas a pink tab indicates no medical concerns and annual exam recall is sufficient.
  Another traditional method many optometrists who are not using an EHR system use: Postcards filled out at the day of the exam and placed in the appropriate bundle to be mailed out the month prior to the expected exam date.
  In either of these systems, or one like it, a staff member will be needed to manage these potentially labor-intensive, tasks. With paper systems, it can be quite difficult to see how many of the recalls are scheduled for exams and how many of the recalls need to generate a second notice. Spreadsheets can be used by doctors, using paper charts, to make a second recall easier to manage. The spreadsheet would need to be updated as patients return for their exams to reflect the new recall date.
• Practitioners using an EHR system. In such cases, the internal recall system or a partnership with an external system that can integrate and automate the process once the proper recall triggers are established makes sense. For example, a glaucoma patient is recalled every six months.
  At my practice, we have created a system in our EHR so that we add office visits, specialty testing and comprehensive exam triggers before signing off on the patient encounter. These alert the checkout staff to schedule the needed appointment before the patient leaves. For those patients who are not able to commit to scheduling the needed visit at check out, we have an EHR-integrated patient communication partner who sends a text or email asking the patient to schedule their next visit.
  Additionally, we have assigned a staff member to run reports with our patient communication partner to see how many patients have outstanding recalls. We can run reports on special testing visits, dry eye disease follow-ups and comprehensive exams. Our staff then follows up after the prompts, via automated call, text or email, have not resulted in the patient making an appointment to return. Staff members call patients who require special testing (glaucoma, AMD, etc.) every four to six months and patients who have not had a comprehensive exam in two years. If your staff is too busy to handle these phone calls, services can make the calls on your behalf.
• When identifying your budget. Looking to external systems requires knowing your budget. To arrive at this number, calculate what your staff’s time is costing the practice for recall to see whether an external system would be cost effective. Specifically, ask the staff member to track the number of hours in a month she works on the task. Multiply this number by her hourly rate, and you’ll find the amount of time per month that the labor of the activity costs the business. (To find the annual rate, multiply this by 12.) Consider this number, along with any other associated costs, such as the paper postcards and postage, and weigh this against quotes from external service providers.

According to Optometric Management’s 2020 Q&A survey, patient scheduling is one of the top glaucoma-related business challenges.

 

 

MONITOR RECALL SYSTEM EFFECTIVENESS

Finally, partner with your office manager to monitor the effectiveness of your recall system. My office manager runs the recall reports monthly to see how many patients have not been scheduled for their next visit, and we discuss how to improve the retention rates. For example, two areas in which you may see trouble: the charts, which should be checked that the proper triggers are set before it’s signed, and staff buy in, ensuring a clear understanding of how the system works by all the doctors at your practice. We’ve also found that having our integrated partner and collecting all the proper patient data (cell phone and email) has greatly improved our patient retention.

CREATE A SMOOTH PROCESS

With just a little planning, ensuring patients return for their follow-ups can be a smooth process for your practice. (For additional information on optometrists’ responsibility to follow-up with patients, see this month’s “Legal”.) OM

DR. GREENE is an optometrist practicing in Asheville, N.C. for more than 25 years. She is a speaker for Alcon, a member of the AOA and the Ocular Wellness and Nutrition Society. You can contact her at lmgreene2020@gmail.com.