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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.

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.

Changing the UK’s Health

Sometimes for change to happen it requires a seismic shift in technology or actions, but on other occasions a series of small individual acts can come together to create something special.  That was the idea behind NHS Change day; a time when individuals can make small pledges which could result in significant change for the NHS.

At the time of writing over 450,000 people have made their pledges and with the last pledge date for 2014 still some weeks away the final total is expected to be far higher.  Some pledges are designed to support and strengthen local campaigns whilst others have been made on a far more individual basis.

One national campaign which the NHS is promoting through NHS Change Day is the idea of reducing no-shows.  With 12 million GP and 6.9 million hospital appointments missed in the last year costing a total of £270m, every person who makes an individual pledge not to miss an appointment in future will be saving the NHS money and improving treatment for themselves and others.

In an attempt to cut down on no-shows NHS practices are adopting a range of measures from reminder calls and texts to encouraging direct booking online.  But it is not just health practitioners within the NHS who suffer from missed appointments.  Health practitioners across the board from chiropractors to physiotherapists and from beauticians to counsellors all suffer if a patient fails to attend an appointment.  And in many of these cases it is not just the taxpayer who loses out but the health practitioner themselves, not to mention other patients who could have taken that vacant slot.

So for health practices everywhere, anything which can be done to cut down on no-shows should be done.  Appointment reminders, online booking services, ensuring continuity of telephone answering; all can play their part in working towards a full diary and effective treatments.

The pledges being made for NHS Change day are not just confined to reducing missed appointments.  Challenging culture, enhancing leadership, patient safety, improving skills, the list goes on.  Some of the pledges are from patients, others from those on the front line or back office who are working to improve the NHS from within and without.  From individual pledges to walk more or eat healthily to sharing knowledge and experience with others, the pledges may individually not be earth shattering.  But if enough people see the pledges and join in then health care for all could be the winner.

Telephone reminders

We’ve written before about the way in which telephone reminders can help to cut down the number of no-shows but it is always a pleasure to be able to report on a practical example.  Earlier this year the Great Western Hospitals NHS Foundation Trust introduced a reminder service for those with outpatient appointments.

Since the reminder service started the trust reports that no-shows have reduced by a third and the trust is therefore expanding the service to its physiotherapy departments.  Using a mixture of texts and automated calls the trust decided to adopt the appointment reminder service as a way of cutting down on the 39,871 appointments missed in 2012.

In announcing the extension of the service the trust’s deputy general manager responsible for outpatients told the Wiltshire Times: “The reminders seem to making a real difference. I hope that patients find the service helpful and it makes it easier to cancel or rearrange. If we know a patient won’t be attending, we can offer the appointment to someone else. By making sure all of our appointments are used, we can see more patients and patients will be seen sooner.”

Patients who fail to show up for appointments are not just a problem for NHS trusts.  Health practitioners everywhere from osteopaths to physiotherapists and from beauticians to specialised health clinicians all need to run with as full a schedule as possible if they are to remain competitive.  Not only can missed appointments lead to delays in treatment times for the patients concerned and others, for those who rely on the appointment to generate income, every gap is a loss.  The Wiltshire trust estimated that for them each missed appointment cost some £108 and the opportunity cost charge can easily be higher for those in private practice.

It is hardly surprising therefore that telephone appointment reminders are increasingly becoming a necessary feature of health practice.  This writer has received reminders within the past few months from their optician, dentist and doctor, all of whom have adopted versions of the reminder system.  Set alongside a virtual assistant service which can also take calls and arrange bookings, even the smallest of health practices can move towards a fuller diary with fewer no-shows.  This in turn means that health practitioners can keep their prices competitive whilst maximising both their income and patient treatment times.

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.

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.

The rise of sports science

One element which has emerged very clearly from the Olympic Games is the extent to which sports science has grown up. Competitor after competitor has talked about getting a massage or having some treatment.  We already knew that sport had moved on but the unmistakeable message is that  sporting prowess is now inextricably linked with science and medicine; with psychologists, food nutritionists and physiotherapists all playing their part.

In fact it’s not just the Olympic athletes who will benefit from physiotherapy.  A team of veterinary physiotherapists has also been drafted in to look after the needs of the 180 or so horses taking part in the Olympic and Paralympic games.

Whilst the top teams travel with their own support staff, the Olympic organisers have also drafted in a range of medical practitioners to help look after the athletes.  One such, physiotherapist Sian Vaughan-Evans, has even postponed her honeymoon in favour of helping out this summer.  Mrs Vaughan-Evans told the London Evening Standard that she was looking forward to meeting “athletes from around the world and sharing their Olympic experience, and doing what I can to aid recovery, prevent and treat injuries.”

This dedication to providing treatment is something which we see time and time again in the health practitioners that we come into contact with via Clinic Appointments.  Perhaps it is because those who take advantage of our virtual receptionist service are constantly seeking ways to improve patient service and maximise treatment times.  Using the Clinic Appointments service means that whilst patients are being treated, our reception team are booking appointments, answering simple queries and sending out appointment reminders.  This means that patient treatment time is not taken up in answering the phone or administration and prospective patients are not lost due to unanswered calls.

When it comes to providing treatment it doesn’t really matter if the patient is a top athlete or someone who has twisted their ankle getting off a bus.  The important thing is to provide the right treatment as quickly as possible to aid speedy recovery.  Maximising the time available for treatment is one way to ensure that patients are not kept waiting for days to receive an appointment.

As an added bonus, taking advantage of the Clinic Appointment practice management and patient record services just might free up some time in the evening.  This enables practitioners to watch or take part in their favourite sporting activities in free time which would otherwise be spent sending invoices or filing records.

Maximising business through texts

The UK’s love affair with texting continues.  A recent Ofcom report revealed that for the first time ever the volume of mobile calls has declined, whilst on the other side of the equation the average consumer now sends over fifty texts every week.

Admittedly many of these texts are sent by the 16-24 year age group.  Interestingly this group say they prefer talking face to face.  However, with 90% texting family and friends on a daily basis compared with only 63% talking face to face it is clear that sending texts has become a way of life.  Luckily for businesses, this love affair with texts presents a fresh marketing opportunity.

Perhaps because text messages have taken their place as an intrinsic part of our daily lives, we are far more likely to open text messages from businesses than mail or e-mails.  Surveys show that we read over 90% of text messages from businesses.  This percentage increases still further when the text is from a known and trusted business source.

This means that businesses which want to attract the attention of their clients can use texting with a fairly high certainty that the text will be read.  For businesses in the health or beauty sector which need to minimise “no-shows” the use of text reminders can prove invaluable.

The Clinic Appointments Diary Management service includes a text service.  This means that we can send appointment reminders by text, or e-mail, as well as send out marketing SMS text messages.  Reminding clients of their appointments not only increases attendance rates, if for some reason clients are unable to make the appointment the text message prompts them to cancel, giving the business time to re-book the appointment slot.

Using texts to send out marketing messages is also an effective way of attracting clients’ attention.  So, you can quickly and simply let your clients know if a new treatment is available or a new product has arrived.  Add an invitation to book with the text alert and your client can call you via the Clinic Appointments Diary service and book their appointment on the spot.  Better still, while they are booking via Clinic Appointments, you can concentrate on maximising your time with patients.

Yes, texting has arrived as a force in our lives.  Using texts as appointment reminders or as marketing channels means that the text savvy business can make texting a force for their business good as well as providing an enhanced service to clients.

Contact us today to discover how Clinic Appointments can help your clinic. Book your free demo call now to learn more.