The 5 Key Steps to Re-opening Your Practice in the Age of COVID-19: Lessons from the Houston Thyroid and Endocrinology Specialists
Tashfeen Ekram, MD
As states across the nation begin to slowly re-open stores and services, many medical practices are still trying to figure out how they can do so safely, for the sake of their patients, staff and medical practitioners. And for many care providers, re-opening is absolutely essential for the health of their practice: according to Dr. Medhavi Jogi of the Houston Thyroid and Endocrinology Specialists (HTES), some providers have seen a decline in visit volumes of up to 70%. Given that the vast majority of medical office visits are billed on a fee-for-service model, getting visit volumes back up to near pre-COVID levels is critical if existing practices are going to survive through this pandemic.
But, as with all things, easier said than done. Providers are struggling to figure out how to navigate new public health requirements, which change on a near-daily basis. The good news is, entrepreneuring practices like Dr. Jogi’s have blazed a trail for successful re-opening, and he’s shared with us the 5 key steps that he took to get HTES back up and running to preserve his practice.
Read on to find out how he did it, and how you can leverage the same key steps when re-opening your practice.
1. Plan for the Future Like the Present is Here to Stay
With so many things changing so quickly, it’s easy to get paralyzed by uncertainty. While many states are beginning to open back up, murmurs about a potential “second peak” mean that practices must become flexible and able to roll with the punches to maintain continuity.
For Dr. Jogi, that means embracing televisits: “For the next two years, I’m moving to a model where required in-office visits, like for biopsies and ultrasounds, will only happen several days per month. The rest of the time, I’ll offer televisits that I can do from any location. What I’ve seen is that my patients are happy with the televisits, as they no longer have to drive into my office and can stay home; and the ability to practice medicine from anywhere, most of the time, is a big lifestyle benefit for me.”
2. Embrace the Technology that Allows Your Practice to be Flexible
Telehealth visits aren’t going away; but you will still have patients who will need to come in now that you’ve re-opened your doors, or who will change their mind about their in-office appointments as the COVID-19 situation continues to unfold. Having the flexibility for patients to change their appointment type on-the-fly without impacting your business practices is key.
How? Well, implement a pre-payment and pre-screening model so that your patients pay any fees the day prior to their appointment like Dr. Jogi did. “Since we’ve moved to collecting fees and completing pre-screenings through Luma Health, in advance of the appointment, we just need to have someone at the office to direct the patients to their exam room. We’ve essentially eliminated the need to check-in at a kiosk or hand over a credit card; and if patients decide they don’t want to come into the office, they can just let us know and one of our doctors will take the appointment from one of our dedicated televisit exam rooms. It makes no difference whether or not they’re here in person or sitting at home, because we’ve taken care of all the appointment administration in advance.”
With the systems in place to handle both office visits and televisits and the flexibility to move back and forth between the two appointment types, HTES can pivot as required. The practice can accommodate more office visits if needed, or move back to a fully remote telehealth model if required, without having to cancel patient appointments.
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3. Expand Your Waiting Room
You’re planning for the future, you’ve implemented new processes to reduce interactions between staff and patients, and have limited in-office visits. All of these things allow you to maintain or regain visit volume, which is essential for your fee-for-service practice. But if you’re only in the office a few days a month and you have people coming in to see you, you will need to figure out how to keep people six feet apart without spacing appointments prohibitively far apart.
“Everyone knows that doctor’s waiting rooms are full, so the real issue to opening back up for in-office visits was the waiting room. But once we started thinking about how to utilize our space better and came up with the infinite waiting room concept, everything got easier,” said Dr. Jogi.
Essentially, Dr. Jogi took inspiration from the world of restaurants. Once a patient checks in, if the waiting room and exam rooms are already full, they are sent away and a Luma workflow is used to notify the patient when to return to the office, much like a pager at a restaurant where all the tables are full. The patients can then go wait in their cars, go for a walk, or wait outside until they receive the notification, so local regulations around social distancing can be met without whittling down the appointment roster.
Implementing complicated rules or sending out complex instructions for patients, even if they’re intended to keep everyone healthy and safe, will make it more likely that patients won’t bother with their appointments or go down the street to another provider who isn’t as rigorous about following the recommended procedures.
“The more rules and regulations you put in place, the harder it will be to manage and enforce. There are too many variables right now and patients are feeling overloaded. Identifying our bottlenecks – like the waiting room, pre-screening, payments – and solving for those was essential,” noted Dr. Jogi. “Once you think through your set-up, from your patients’ perspective, the need to explain processes and set rules virtually disappears because they just get it and adapt.”
5. Don’t Forget Your Doctors and Staff
Making sure your doctors and staff are comfortable prior to re-opening is equally important.
All the prior steps have focused on the patient experience, and for good reason: you need to make everything as easy as possible when re-opening for your patients so they keep making appointments with your practice. But making sure your doctors and staff are comfortable is equally important. Some doctors in your practice may want to take a more conservative approach to in-office visits, where others may be more eager for their resumption. Let them take the lead, and make sure that your technology can be customized to support each provider in their preferred processes.
For more insights from Dr. Jogi, read this FierceHealthcare article. And, remember, investing the time to work through all the re-opening obstacles with a patient-centric focus is key to getting your practice back to (the new) normal. Our COVID-19 Data Report is a good place to start to learn more about the myriad ways that this global pandemic has served as an accelerator for healthcare innovation, including patient communication trends and expectations around telehealth.