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Paying by card?

£58 billion!

That’s the total spend on all credit and debit cards in the UK in April 2017, the most recent figures available at the time of writing. Credit cards accounted for just short of £17 billion, whilst the debit card spend was boosted by the growing acceptance of contactless payments.

Overall our growing love affair with the card as a form of payment has resulted in a 6.8% year-on-year rise in card spending. Partially thanks to the contactless element, this translates into a 12% increase in transaction numbers.

What does this mean for business? Well for a start it makes it far easier for businesses to move away from cheques and cash and towards card payments. The old arguments about cards and businesses which accept cards being the preserve of the few now simply don’t hold sway. So much so, that this writer was surprised recently to be asked for a cheque in payment. Luckily the request came in advance, saving a round-trip to retrieve the cheque book from its secure drawer.

 Quite simply, card payments are convenient for both customers and businesses. More importantly, they speed up the receipt of funds for the business. Particularly so in businesses which have traditionally relied on the service/ invoice/ cheque payment route. Simply sending out the invoice and waiting for the cheque to arrive in return could easily take up a couple of weeks; and by the time bank clearing has taken place and funds are available for use the original service is a distant memory. Secure card processing generally delivers cleared funds approximately one week after the appointment.

The growing acceptance of cards as a means of payment has also brought further benefits, particularly for those businesses such as health providers which rely on an appointment system. Taking card details at the time of booking, whether on the phone or online, tends to concentrate the mind and that means that clients are far more likely to turn up for their appointments. Particularly so if the health practice operates a ‘no-show fee’ system, charging clients who fail to turn up a percentage of the overall fee.

Adding a further service such as sending out SMS text messaging or email to remind clients of the appointment also helps to ensure that clients either turn up to their appointment or cancel well in advance. It can be all too easy in a busy life to forget the date or time of an appointment so scheduling reminders acts as a handy aid memoire.

When it comes to health services, anything which can boost attendance numbers is welcome. Both in the public and private sectors time is of the essence and resources are stretched. Those who fail to turn up to appointments not only jeopardise their own treatment plan, they also block or delay the chances of treatment for others. So the hidden cost is far higher than simply having a team of health professionals sitting and waiting for a client who has either forgotten or has no intention of turning up.



The Rise in Health Literacy

Once upon a time the pronouncements of health professionals were treated as absolute. We attended their clinics and surgeries, described our symptoms and took whatever treatment was prescribed. Whilst in some ways unquestioning faith may have been easier for the health practitioners, it also meant that the level of health knowledge within the general population was fairly poor.

The result of this was that many diseases went undiagnosed until it was too late and ‘old wives tales’ were as likely as not to determine health levels in some districts. What was needed was a good dose of education; a way of helping the general population to be better informed about health issues.

Fast forward to the internet generation and we are all far more likely to be health aware. We can look up symptoms, check healthy diets and delve into treatment options for illnesses. In fact the only challenge facing us nowadays is to distinguish between the reputable sites and those which rely rather more on rumour and gossip than is good for us. Oh yes and having the strength of mind to work through the list of diseases associated with symptoms and be realistic rather than just plumping for the one at the top of the page or which looks most alarming. But in general being more aware of the course of illness and disease helps us to work with health professionals in designing a treatment plan which is appropriate for us.

And surfing our symptoms is not confined to the young. The rise of the silver surfer has resulted in the elderly also being more aware of what treatments are better for them. So much so that a recent BBC report revealed that regular internet use in older people was associated with good health literacy. In other words, the more familiar we are with surfing the more likely we are to research symptoms, ask for help in a timely manner, and engage with treatment.

But our increasing familiarity with the internet and associated technologies also has other benefits for health practitioners. Those who are used to surfing the web are more likely to accept time saving options such as online booking allied with pre-payment by card. This not only saves health practitioners time, it also is more likely to result in patients who show up for treatments. Additional reassurance can be gained by adding a SMS text reminder to the online booking system, prompting patients to attend appointments or to cancel in time for the slot to be refilled.

Linking in a pre-payment by card module to the booking system also enables practices to easily take a cancellation fee in the event of no-shows, bringing the added benefit of smoothing out cash flow. There are those who say that the ability to look up symptoms online can result in a generation of hypochondriacs but there have always been those who take their symptoms too seriously. What internet surfing does do is help practitioners and patients to work together to create the optimum solution and that can only be good for the health of the nation.

Streamlining payments

The days of making manual payments are numbered if a report by Juniper Research is anything to go by. According to the report’s press release the number of household bill payments made via PC, mobile or tablet is expected to top 20 billion this year (2014) with the UK having 16% of the global market.

Driven by Generation Y users, the growing acceptance of mobile payments is only expected to expand further as fears over security are lessened and additional mobile devices come onto the marketplace. Interestingly, when it comes to larger payments, users still seem to prefer the security of a larger screen with PCs and tablets leading the way.

Whilst this report concentrated on household bills, the acceptance of online payments generally is also on the increase. Shopping or booking events or holidays via the internet is also on the up and this means that consumers are far more accepting of the idea of providing credit card details whilst online. And the more accepting we become, the more that online payments becomes part of the mainstream.

That creates tremendous opportunities for health professionals who are looking to streamline administration and payments.  With a ready acceptance in providing card details; when someone makes an appointment to see a physiotherapist or other health professional the next logical step is for them to confirm the appointment by providing payment card details.

Having an appointment confirmed in this way has two benefits for the health professional.  Firstly, the act of providing card details tends to fix the appointment in the patient’s eyes, making it far more likely that they will turn up for their treatment. This not only helps to ensure a full treatment schedule it also makes it more likely that the patient will receive a full course of treatment at the time when it is most needed. Secondly, with card details to hand, it is simple for the health practice to process payments, either in full once the patient has attended or to take a payment on the card in line with the practice’s stated cancellation policy.

Payment card details can be taken at the time of booking an appointment either online or via the telephone. At that stage the payment amount is simply pre-authorised which means that the payment amount is ‘reserved’ against the card. Once the appointment has taken place, should the patient choose to pay by other means the reservation can simply be cancelled.Otherwise the payment is taken at the time of the appointment; speeding up receipt of funds and saving the invoice/cheque/bank clearance cycle.

With time at a premium, anything which helps to reduce administration and speed up payments is a winner in today’s health practice. Pre-authorisation of cards means no delay in payment collection and no need to spend precious time in sending out and chasing bills on a regular basis. And with pre-authorising reducing no-shows and therefore increasing the likelihood of patients receiving the treatment they need when they need it, pre-authorising is a win-win solution for patient and health practitioner alike.

Optimising Sporting Performances with help from your dentist

What does it take to help an elite athlete to stay at the top of their game?  Good nutrition, a balanced training regime, access to the best physiotherapists and osteopaths?  Well if a recent (April 2014) conference in London is anything to go by the need for good oral hygiene and a trip to the dentist should be added to the list.

In September 2013 a study published in the British Journal of Sports Medicine revealed low levels of oral health among London 2012 athletes, with 40% being bothered by oral health problems and 18% reporting that dental problems impacted on training and performance.  The study was carried out on a cross-section of athletes competing at the games.

Now the oral health and performance in sport conference in London has backed up those findings with a series of discussions and presentations on the impact of oral hygiene on sporting performances.  Whilst good dental hygiene won’t turn a novice into an elite athlete, for those at the pinnacle of sport where the slightest edge can make the difference between Olympic Gold and also-ran, it seems as though dental hygiene is a contributing factor.  And the effect is not just confined to those who seek to be ‘the fastest’.  The British boxing team have already noticed a difference since regular dental checks were introduced as part of the training regime.

But good dental hygiene is not just for athletes.  Type 2 diabetes and heart problems have also been linked to poor oral health, making a visit to the dentist a potentially life-saving activity.  Plaque can lead to gum inflammation and studies have shown that inflammation anywhere in the body, including in mouth and gums, can have a detrimental effect on arterial health.  So studies have concluded that regular brushing and attention to oral hygiene including trips to the dentist can help to protect heart health.

But as the British boxing team managers found, a visit to the dentist is not on many people’s priority list.  It is important therefore to ensure that making appointments and contact with the dental surgery is made as easy as possible.   Systems such as online booking and automated appointment reminders can make a huge difference to attendance rates.

Whilst a nagging toothache is a strong enough reminder that something needs to be done, without pain our impulses to make a check up appointment are fleeting at best.   Being able to log in via PC or smart phone and book on the spot enhances the chances of capturing that fleeting idea.  And for surgeries which operate a ‘book your next appointment now’ system for those who do visit, an automated appointment reminder will help to decrease no-shows from those who forget the appointment that they made six months ago.

Talking about the boxing experience, Dr Mike Loosemore said of the enforced dental checkups: “They may not appreciate it now, but hopefully they’ll appreciate when they’ve got a gold medal round their neck in Rio.” For non-athletes the reward may well be a lessening of the chances of heart or diabetes problems in later life.

Reaching out

A study in the USA has revealed the benefits of automated telephone calls for patients with hypertension.  Taking a sample of 64,773 hypertension patients, half were sent a recorded phone message inviting them to have their blood pressure monitored at a clinic whilst the rest received no such invitation.

After four weeks it was found that 32.5% of those who had received a call had controlled their blood pressure against a base of 23.7% for those who had not received a call.  Although researchers did not collect data on measures taken by patients to control blood pressure it is believed the calls played an important part in raising patient awareness.

Certainly this study mirrors the findings of other surveys in the way in which patient care can be improved by a simple call.  Whether by encouraging patients to have a check up or replacing costly health visits with a simple call, the telephone is increasingly playing its part in enhancing health care.

One particularly successful way in which phone calls are being brought into the front line is in reminding patients about their appointments.  Whether issued via automated phone message or by text, a simple reminder can make a substantial contribution towards reducing the number of “no shows.”

This has two benefits.  Firstly it encourages patients to attend booked appointments and secondly it encourages them to notify the health practice should they be unable to attend for any reason.  With an early warning of a cancelled appointment the practice has the chance to book in another patient; thus benefitting the practice, the patient and boosting the overall level of patient care.

In our ever busier lives, it is inevitable that we will forget appointments from time to time and an automated phone or text message can be that vital memory jogger which we all need.  Health care practitioners from opticians to physiotherapists and even vets are using messaging for everything from a reminder to pick up some new medication or book a check up to reminders about appointments which have been made.  For example this writer received a text from their vet recently reminding them to pick up a fresh batch of worming medicine for a pet.

In summary, phone reminders can save “no shows, they can ensure patients receive the treatment which they need and they can help to keep health practitioners busy at all times.

Fit for the future?

The 2012 Hospital guide from Dr Foster makes very interesting reading.  The headline statistics about hospital occupancy rates alone paints a picture of an NHS which is full to bursting.  Against an ideal occupancy rate of 85%, the report shows that for 48 weeks a year most hospital trusts have a bed occupancy rate in excess of 90%.

This not only puts pressure on trust staff on a day to day basis, high occupancy levels mean that when a crisis hits there is little spare capacity to meet it.  So, the current Norovirus outbreak which according to the HPA is already 72% up on last year is bad news indeed.

Unfortunately for NHS managers the Dr Foster report highlights one major bed blocker that could easily be avoided.  Apparently 29% of beds are taken up by “patients whose admission might have been avoided if their care was better managed.”  This includes patients who are readmitted shortly after discharge, patients who would have been better treated in the community and patients who could have been seen as day cases.

The report does conclude that efficient hospitals can deliver good quality care but that areas such as missed hospital appointments, unnecessary admissions,  a lack of weekend care and keeping patients in too long (or conversely discharging them too soon) all need addressing.  The report also highlights the number of follow up appointments which could easily have been replaced by a quick phone call or visit to a GP.

When looking at outpatient appointments the report also says that “both primary and secondary care providers can take measures to improve the proportion of patients who attend hospital outpatient appointments.”  We have previously highlighted ways in which some providers are taking steps to address this issue, using simple methods such as sending appointment reminders by phone or text.

Patients failing to show up for appointments is an issue for everyone working in the healthcare field.  For health practitioners who charge their patients direct, a no-show not only prevents another patient from being treated, it also costs the practitioner in lost revenue.  That is one reason why an appointment reminder service can pay for itself in reducing no-shows and keeping treatment rates high.  Allied to a virtual receptionist service which can take calls, make appointments and even manage patient records, a health practitioner can concentrate on treating the maximum number of patients and providing good quality care.

Proactive phoning

A trial of a new telephone system has found that contacting patients by telephone can help to spot early warning signs as well as cut down on unnecessary hospital appointments.  The study into patients with Chronic Obstructive Pulmonary Disease required patients to input answers to a series of questions using their key pads with the results being analysed by doctors.

This regular contact not only alerted doctors to patients who needed urgent attention it also eliminated the need for some three hundred unnecessary hospital appointments, saving both time and money.  Regular contact also resulted in patients being more aware of their condition, enabling them to be more proactive in self-management.

In a way this trial is another step forward in the growth in understanding of how health professionals can use telephone services to improve patient interaction and fill appointment books.  Simple measures such as sending out SMS appointment reminders can not only improve the client attendance rate but will also prompt clients who cannot attend appointments to cancel in good time.  This enables practitioners to re-fill appointment slots and maximise time spent on treatment.

Similarly, taking steps to ensure that calls are answered helps to foster the client relationship.  We all lead busy lives and tend to steal moments from our day to carry out tasks such as making appointments.  If the call is not answered the chances are that the need to phone will slip from our minds for some time or that we will simply telephone elsewhere.  This is where a virtual receptionist service can be so valuable.  With the virtual receptionist ensuring that the call is answered on behalf of the health practitioner there will be no chance that the client will phone elsewhere or that an urgently needed treatment will be postponed.

Whether they be osteopaths or chiropractors, beauticians or physiotherapists, the one thing all health practitioners have in common is the need to maximise time spent with patients.  Interrupting treatments to answer the phone or blocking out diary time to remind patients of impending appointments is simply not a viable option if the practice is to run to its potential.  Calling on the services of a virtual receptionist service means that calls are answered, appointments made and reminders sent without taking up practice time.  And with easy to use diary software which is visible 24/7 the use of a virtual receptionist doesn’t preclude the practice making follow up appointments at the end of a treatment session.

Reducing “no shows”

A recent NHS report revealed that 1 in 10 hospital appointments in 2011 resulted in “no shows”.    This adds up to a staggering 5.5 million missed appointments and costs the NHS £millions each year.  Even if each patient has a genuine reason for missing the appointment, missed appointments have a knock on effect across the NHS.

In announcing the “no show” figures, the then health minister, Simon Burns, said “It is important that people realise that not turning up for their agreed appointments means other patients’ care might be delayed.”  Although the figures were down by 250,000 on the previous year they still have a significant impact on NHS services.

Hospitals are starting to employ a variety of methods in a bid to reduce the number of those who fail to turn up for appointments.   One project in Bedfordshire cut missed appointments by 30% simply by asking patients themselves to write down the appointment time and repeat it back to the receptionist.  Other health providers have started sending reminders to patients by text or e-mail whilst Newham University Hospital doctors now check up on their diabetes patients via Skype.

The problem of missed appointments also affects those in the private healthcare sector.  However with many services such as osteopathy and physiotherapy operating as via comparatively small practices, health practitioners can be torn between the options of treating patients or spending time in administration.  This means that inevitably patient appointment reminders are not sent, raising the chance of missed appointments.

Whilst some private health practices have a policy of charging patients for missed appointments these fees can prove hard to collect and may endanger the patient/practitioner relationship.   There is no point in trying to collect a missed appointment fee if that means missing several other fees in the future.

This is where a virtual receptionist service comes into its own.  Answering the phone, making appointments and sending reminders via text or email, the virtual receptionist service takes the appointment strain, leaving the clinician free to maximise patient time.  Interestingly a study in 2008 showed that those in the 20-24 age group are the most likely to miss appointments followed by the 25-29 and 15-19 age groups. The most tech savvy groups are therefore the worst offenders and a reminder system which takes advantage of text or e-mail could therefore have a significant effect.

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