By Dave Anderson, OD
June 19, 2019
Carefully tracking your metrics can lead to improvements that make a huge difference in patient care and practice growth.
Here’s how my practice watched our growth and profitability numbers to make changes that improved our service to patients and increased our capture rate.
I have several metrics I watch on a regular basis, and some that I will look at to ensure we are attaining a specific goal. The biggest areas that I look at are revenue per exam, new patient percentage, capture rate and percent of booked appointments. Each one has an ultimate goal of improving overall revenue and practice growth. Like anything, unless it is measured, it can’t be improved. Over the last several years, we have seen ups and downs on our glasses capture rate due mostly to competition from online retailers and other less expensive opticals.
To combat this, we looked at why our patients sometimes choose to shop elsewhere, and the two biggest factors were cost and misunderstanding of lens performance. We then focused on better educating our patients on what the lenses do for them, such as explaining digital progressives versus traditional progressives and blue light protecting anti-reflective treatments versus less advanced lens treatments. We also brought in a line of eyewear that allowed an easy conversion when cost was clearly the patient’s only deciding factor.
These efforts increased our capture rate from 45 percent to over 55 percent in less than a year.
Our optical typically generated $115,000 per month, and with the increase in capture rate, we now are over $140,000. Some of that increase can be attributed to better product mix and some to more total prescriptions (our new doctor being busier), but a significant aspect of the increase in sales is doubtless also due to the improved capture rate.
Use a Dashboard Management System
I consistently use the dashboard management system, EDGEPro, which connects directly with our EHR system. When exams are recorded, from the billing statistics to the materials purchased, everything is then brought into a dashboard for easy viewing. EDGEPro has additional features that allow comparison to national averages, to regional offices, among staff or among doctors. This allows us to quickly see areas of needed improvement and areas of excellence.
Keep Staff Up to Date on Metrics & Inspire Greater Patient Service
We do not play the Great Game of Business, but we implement several key concepts from it that help our office collectively focus on areas where we need to be successful. Our office manager and the doctors track specific areas, and key staff members are given other metrics to monitor and report.
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For example, one of our contact lens technicians tracks the percentage of direct-ship orders, which helps us better focus on the patients in our office that day as compared to in the past when we had to stop our processes to give the order to our patients. Another area we watch closely is the average frame sales price. If we see a change, or dip, we look to change our product mix, as well as retrain the sales staff to start their presentations to patients with luxury lines instead of lower-end lines.
There are two ways I involve my staff in the metrics tracking. First, we share in a weekly meeting the specific wins from the previous week or month. We point out areas where we had looked for improvement, and assess if the metric improved and what we did to make that happen. If it did not improve, we evaluate our strategy, and decide whether to continue doing the same for a longer measurement period, or adjust to see if a change will result in a different outcome. Second, we have our staff report on the specific metrics they have been assigned to monitor. This keeps us focused on every detail, and help us ensure a productive staff.
I don’t share all staff financial information, specifically salaries. I provide information so employees can gauge performance relative to other benchmarks, as well as improvement in our office, but no specifics about the performance and salary of co-workers and doctors are discussed.
Use Metrics to Incentivize High Performance
We use certain metrics to incentivize high performance, and this is mostly tailored to the associate doctors. They are tied to revenue per exam, not just the overall revenue. They reach their bonus based on total revenue, but have to maintain a high revenue per exam to attain this. The other bonuses that I offer in the office are all tailored to improved efficiency, and a better patient experience, not specifically reaching revenue marks.
One bonus we instituted was an incentive to increase and maintain our annual supply and direct ship to patients in contacts, which helped result in close to 90 percent for both, with a goal of 80 percent for each.
Put Metrics Into Context
If just dollars are discussed, the focus remains there. Any metric is only as important as the reason it needs to be measured. If the focus of a practice is solely on making the doctor more money, then the focus of staff will not be in the right direction–patient care and the vision and growth of the practice.
The key to any metric is to give the why behind it. Sharing with staff what the metric really means to a practice is important to ensuring they not only measure it, but also put effort into making needed changes.
For example, we have educated staff on why we pay close attention to the number of new patients added, including the role that patient attrition plays in weakening a practice’s profitability. We explain all the factors that lead to attrition, including patients moving and acquiring new vision insurance, and employees understand why it is important to constantly be adding new patients.
Create Plans for Improvement
Sometimes the metrics do not reach our target. It’s tough when you hear staff saying, “We all worked hard, what happened?” It’s easy to let this become a defeatist situation, and to let it interfere with what went well. Even when some metrics are not reached, there are always some that we do hit. I focus on the positives, what we did to make the good things happen and how we can keep these metrics moving in a positive direction.
For any negative, or poorly performing, area, we look at the challenges and opportunities, and work as a team to brainstorm ideas to change it. The negative metric then becomes a positive goal.
We also come up with multiple plans to make a change to a specific metric. For example, to help increase capture rate, we developed specific changes to our strategy. The first part of the plan was better patient education about what lenses do and why not all lenses are the same. Second, we added frame lines that are more affordable, and third we focused on making glasses matter to patients at every step in the process, from appointment scheduling to check-out.