Is your CRM doing more than storing patient data?
Too many practices invest in powerful CRM systems only to use them as little more than digital Rolodexes. The truth is, a CRM can (and should) be one of the hardest-working tools in your practice—if you know where to start.
In this webinar, learn how to move beyond basic data storage to the automations that actually capture more leads, improve conversions, and strengthen patient retention.
Webinar Transcript:
Ryan Miller: I’m Ryan Miller, I’m the founder and CEO of Etna Interactive. For the last 20 years, we’ve been one of the leading marketing agencies in the elective healthcare space.
Today, though, is about our three panelists. We’re very, very lucky, because we’re joined today by Sean Mahoney. Sean’s the VP of Sales of 4D EMR. With more than 25 years of experience in medical sales and marketing, I’m really excited to have Sean here because he not only has the viewpoint of software and CRM, but he also has extensive experience in the medical device space and understands what’s happening in your practice from that lens as well.
Ryan Lehrl is joining us from Red Spot Interactive, where for more than 15 years he’s helped over 200 practices, both with their online marketing and with their CRM deployments. And rounding out our panel, Robin Ntoh. Robin is the VP of Aesthetics for Nextech.
Congratulations, Robin, I understand that you were recently named one of the top 50 female leaders in healthcare technology.
We are stoked to have all of you, and I think specifically not because of those differences, but what you guys all have in common.
Your jobs today are all devoted to helping elective healthcare practices optimize workflow and practice operations, driving patient engagement, and supporting really meaningful practice growth through the work that you do as leaders in CRM. That’s important for those of you that are attending today in our audience.
You know, the reality is these are 3 competitors who are giving freely of their time, and they made a promise to me. They’re not going to pitch their software until I give them the space to do that at the very end.
What they’re here to do is to share all of this combined experience responding to a specific challenge that we observe with our client partners, which is they make a big investment in CRM, and for a lot of their practices, it sort of ends up working like a really sophisticated Excel table, where it’s storing information.
But they’re just not sure where and how to prioritize deploying automations to actually use the software to its full potential and the biggest effect for the practice. So, first I want to thank everyone on the panel for joining and being here today and being so generous of spirit to sit together and just share your best advice.
Sean, why don’t you start us off? Because my question for all three of you is this:
What are your top 3 recommendations for building automations on top of a CRM.
And, Sean, in our prep meeting, you talked about actually starting at the very beginning, so why don’t you lead us off?
Sean Mahoney: Yeah, first of all, thanks, Ryan and Etna, for putting this on. I’m really excited to be a part of it. When you talk about automations and CRM I think people have a tendency to get really complicated with it, or they oversimplify it, one or the other. And, you know, every automation should either move the patient forward or add value. If that isn’t happening, then it’s just noise, and it just adds to the complexity. So, you know, when you’re talking about building, your CRM and your first 3 automations…
Ryan Lehrl: I like to focus.
Sean Mahoney: Focus on 3 things.
Ryan Lehrl: Capturing the warm lead.
Sean Mahoney: Nurturing the lead and closing the decision loop after the consult. So, starting with the first one, capturing the lead.
I like to say the fastest practice, wins. Because replying within your first 2 minutes does change outcomes. When you’ve got somebody out there shopping and looking around, speed is a priority.
Within 2 minutes is really important, and so then what do you do with that? You can send a short SMS message, plus an email. You want to send that email, but you want to send an SMS message letting them know that that’s been sent. And the idea is you want to ask them a clear question, not just some sort of an auto-reply. Your standard auto-reply is not going to work.
You want to address them. “Hi, Mary, thanks for your breast aug inquiry. Dr. Beauty consults Tuesdays, Thursdays, and Fridays. What works for you? You want to generate a response, actually prompt a response, instead of making the mistake of saying, “Hey, thanks for reaching out. Here are the 5 ways that you can reach out to us.”
Then you put it back on the patient, and you don’t want to do that.
Ryan Miller: But I know one initial challenge that a lot of practices face is actually just getting the data into the system.
What does that look like in terms of CRM? If I think of all the ways our typical client gets form-based inquiries from their website, they have calls that can originate from a variety of sources, they may have responses coming from past email-threaded conversations, they may get DMs on social media, they probably have messages coming in from platforms like RealSelf that are filtered through third-party directories.
As a business leader, I know I would be concerned, do I even have visibility to what’s happening in terms of all of the inquiries coming into my business?
How do you guys in the CRM world… how do you even approach getting all of that data into the CRM? What’s automated versus manual?
Sean Mahoney: Yeah, I think you can automate a lot. In terms of demographic capture, the CRM and EMR relationship is key. You want to be able to automate the capture of that into the CRM itself, but you also want to be able to automate feeding that into the EMR, so there’s a lot you can do. I know this is about automations, which is a little bit different, but there… there are automations within the lead capture sequence within the CRM, which I know Ryan can definitely speak to.
That can take a lot of that off your plate and provide you with the visibility to see that coming in, the notifications you’ve received a new lead. How do you want to receive that lead? Do you want to receive that lead in the CRM? Do you want to receive that lead in the EMR? There are a lot of options now.
Ryan Miller: And Ryan or Robin, do you want to build on that with me? Does a DM on social media have a place? When is the place? When do you graduate from having that be a conversation you’re having with somebody on Instagram to an actual lead record that gets created in CRM?
Ryan Lehrl: Sure, well, when we set up our systems to capture inquiries, you nailed all the entry points that patients, or potential patients, generally have, right? Phone calls are one of them, form submissions are one of them.
You have online booked appointments today, which blur between a lead and an actual appointment, because they are scheduling. And then you have direct messaging platforms. I think, definitionally, it ultimately comes down to the practice and their own workflows. For example, a lead in most cases has to have very specific criteria for it to be identified as a lead, right? And what I mean by that is if you look at phone calls….all phone calls are not leads, right? And therefore, that data does need to be captured. It is the responsibility of the practice to set up those definitions of what generates, or what really categorizes a phone call as a phone lead, meaning first, last, phone number, procedure of interest.
Ultimately, setting up the triggers to capture all of those entry points into the system, setting up your own definitions of what a lead is, is really the first data point that becomes critical in all of this. It’s the top of the funnel information. And you need to set those definitions for yourself in many cases, because everyone’s got a different definition of a lead. Me, Robin, Sean, Ryan, and Etna could all have a very different definition of a lead. In my opinion, it comes down to the practice setting that standard and using that as their first data point to understand top-of-the-funnel activity as it flows through.
Ryan Miller: And I think for me, it’s important, Robin, before you jump on, just for Praxis to leave this call knowing, let’s say, hypothetically, you’re very active on a third-party platform like RealSelf, where that email’s not running, an inquiry isn’t running necessarily through your website forms, but it just arrives in your inbox. Is there tooling, like a Zapier integration, things like that, that can parse email and automatically get it into your CRM.
Because I think that’s an area where, when we talk with our clients who are post-CRM deployments, and they didn’t have that conversation about what is a lead, we often find when we look at the body of records created in the CRM, there are big holes where the practice didn’t stop and think about, “Oh, wait, I have these inquiries coming in from over here, I better get them in.” Robin, what did you want to add on that topic?
Robin Ntoh: Well, I was just going to add, I think that Sean and Ryan have really captured what the essence of a lead is, and that you need to capture it. The problem a lot of times practices don’t have a single platform that really recognizes all those leads coming in, and so their tech stack just continues to grow. And with that, then practices just don’t take the time. Think about it, you may not even have a full-time person that’s really managing this.
And so you’re expecting, perhaps, your front desk person to really just manage all of those leads, or maybe it’s a marketing person, and they just don’t have one central place. So if you think about it from a simplistic standpoint, just aligning everything to come into one place
really starts to set the stage for what you can do with it. And that really starts the beginning of centralizing all that data so that you can not just use the data and understand your business better, but to just manage those leads as they’re coming in.
Ryan Miller: Yeah, and I know we have a bunch of practice owners and leaders registered, and a lot will watch the recording after the fact.
And I think that’s one of the first and biggest messages to take away is, are you confident all of your inquiries are making it into a place that you can observe how your staff is responding and handling those needs? Because to Sean’s point, at the very beginning, you know, we’ve studied this, it’s something that’s been talked about for years and years and years. It’s been studied by major organizations as well, like MIT.
Optimal response time is often sub-30 seconds, not even 2 minutes, and the winning businesses are often the fastest to reconnect with the person, because that was the moment in time that they were thinking about this purchase. Minutes later, their life has moved on, right? They’ve got to go shopping, they’ve got to get a good school, they’re checking out at the grocery store, and they just… they’re not available to you anymore.
Let’s assume now we’ve got them into the system the practice has run an initiative, they’ve worked across the spectrum, they’re confident all the data’s there. Robin, what’s the next thing that you recommend in terms of focusing on automation for lead nurture?
Robin Ntoh: It’s a really important thing to think about this from the perspective of the leads. And again, your staff have a full-time job a lot of times, and so this is just putting in front of them an opportunity to shove it into a corner, because you’re going to focus on the hot lead, which is the phone call.
Ryan Miller: And so, how do you get them to focus on them?
Robin Ntoh: Fact of the matter is, is you’re not really going to get them to do it, because it’s going to be an afterthought. So this is where technology, I think, really leans in. I mean, I think about AI in so many ways that we think about where it’s optimizing our efficiencies with our practices.
But one of the things that we’ve thought about intentionally is, is there opportunity for there to be more nurturing in a more specific drip campaign format?
So, for example: If a lead comes in and you’re putting it into a drip campaign, does it need to go into a drip campaign that’s specific for injectables, or specific for facelifts? And that gives you that refinement, probably some more personalization. We also think about the generational impacts on how people want to be communicated with, and so that right there…
Ryan Miller: I’m realizing as I’m listening to your answer, I think there might be a part of our audience that doesn’t know what a drip campaign is. Could you give me two sentences and explain what that is?
Robin Ntoh: Well, in the simplest form, it’s basically providing information in small increments to nurture or bring someone along, cultivating their experience, to hopefully get them to the point of converting.
Ryan Miller: It’s a sequence series of messages. The actual delivery format is open. You can have a drip that’s email, or that’s SMS, or a combination of email, SMS, or outbound calls. Often, there’s a lot of very sophisticated organizations that have AI call agents that an AI operator, an agent, will call the person and have a conversation, so there’s lots of things that can happen there.
That sets the stage. And I think you posed the question, should it be procedure-specific?
And how deep do you need to go into personalization? And so I’m going to frame a very specific and pointed question for you, Let’s say I’m a plastic surgery practice with a medical spa, so I have both things going on inside my business. I have just deployed a campaign. I’m thin on the staff that I can devote to this activity.
What should I prioritize? Let’s say drips specifically for post-initial inquiry? So, we don’t know if they’ve booked or not booked a consultation or a service yet. What should I do?
Robin Ntoh: The moment that you get that inquiry and it goes into some sort of response, automatic response, if it can be built in its simplistic format, just separating surgical and non-surgical, that’s baseline. Bu it’s no different than what we’ve trained practices to do over the years. Before we even got into lead management and nurturing.
A patient would come in, and you would not communicate or cultivate that relationship the same way if it was for a breast procedure versus a face procedure. It would be different. So it’s really no different than how you would think about the way that you would want to build those drip campaigns.
Ryan Miller: How many pieces of creative, at a bare minimum? So you’ve established first baseline is, if you have a surgical or non-surgical component, the grossest division of those two service lines, is it 2 messages, 3 messages, 10 messages that I have to craft in each of those two channels?
Robin Ntoh: Well, I think that’s one of the things that we’ve thought about. You want to take the work out of it, and you want a system that actually launches with those baselines in place for you.
And then the work is kind of already created for you, so that… or, I’m sorry, not the work, but basically the baseline is there.
Ryan Miller: It’s kind of the templates.
Robin Ntoh: The template is there, the snapshot is there, because we know what we need to do. This isn’t something that Ryan, or Sean have… this isn’t foreign to us. I mean, we’ve done this for years. Now it’s just a matter of if we can put it in front of a customer so that they can launch day one with what they need and they don’t feel like they have to build it? They shouldn’t have to recreate what’s already known and available.
Ryan Miller: So that’s that minimum performance. Like, major classes of customers, a couple of messages, maybe it sounds like 3 to 7 templates are built in. I’ve seen data that says 11 touchpoints is really what’s recommended to maximize conversion. But…
that’s a… that’s, like, like, your worst case scenario. What’s the ideal?
I think I hear you saying the ideal is, for every one of your core procedures, you have a specific series of messages that are carefully considered, unique to your brand, and, you know, timed and going out in a way that is thoughtful of that person’s journey that is very procedure-specific.
Robin Ntoh: The more specific you can become, the higher you’re probably going to see that conversion, and that automation should support it. But it varies. It varies based upon the generation, it varies based upon the procedure. If you want to average it out, it’s generally around 7, but it just varies.
Ryan Miller: I know, Sean, you had some thoughts on… on cadence and drip. Can you build on this conversation for us?
Sean Mahoney: Yeah, and I think, you know, in terms of the whole nurturing journey, it also is broken into parts. So, we’re not talking about 7 touchpoints on average for each sub-component of the nurture. You know, you’re ideally hoping to accomplish that within the whole process, so again, first we talked about capturing with the goal of starting that two-way conversation immediately with the patient, and then you’re into nurture.
And what you want to be able to do in that pre-consult phase between the call and actually getting that consult, I think is… someone mentioned it, somewhere around 3. 1 to 3 touches.
Keep the topic short, and provide one clear action on the part of the patient, is kind of key. And so I think some examples of that would be something like, you know, and again, the goal here is to reduce anxiety, increase the show rate and answer all of their top questions as early as you can. So, first you can send an FAQ-type email, with a quick SMS, just to kind of, kind of break the ice.
And then maybe they’re interested… they’re interested in financing at some point. So, if that comes up, you can send a financing link to give them an overview of what that process looks like and what their options are. Also, something that I think is really, really good, and I’ve seen some practices do this and do it really well, is a 60 to 90 second tour of the practice because that can really go a long way to building familiarity with the patient and the practice before they ever even set foot in the door. They feel like they’ve been there.
I think that can be really powerful. Video’s huge, and that sort of personalized tour where they kind of walk through each office, hey, this is Mary, hi, this is Doctor, and, you know, you can kind of just keep going through the practice, and when they get there, they’ve been there already.
Ryan Miller: That’s great. I think the thing for me that stands out, especially, you know, as I think for most of our clients, the smallest of them, their menu of service is 20 procedures, probably 10 that they really care about, 10 that are maybe a little ancillary. Our largest is maybe in the 70-procedure range.
And if I’m going to do messages for 70 procedures, that’s… that’s 49 pieces. It’s a lot of creative that I’m investing in when I start getting customers. That’s not going to come out of the box. That’s not going to be something that’s, on everybody’s standard deployment or build.
Sean Mahoney: Definitely not.
Ryan Miller: And so, if I’m a business leader, and if I’m going to do it in-house, if I have a staff member to do it, or if I’m going to hire an agency or a consultancy that’s going to help me with it, Ryan, let me bring you in on this conversation, because I think a lot of my interactions with you and your organization have been around the power of reporting.
What do leaders need to be looking at, and what should they expect to be able to pull out of their CRM deployments to understand the impacts of some of the early automations?
Can you talk a little bit around just leadership reporting expectations? Like, which, for the people on the call, presumably they’re somehow responsible for the practice, the CRM deployment, or its efficacy. What do they need to be looking at to know that it’s working?
Ryan Lehrl: Yeah, sure. I’ll, I’ll try to narrow this down a little bit, because, you know, one of the things that I, come across with our practices all the time, especially in aesthetics and cosmetics, you go to sites, you see that they do… you said 20 and 70. I’ve got practices that have, like, 200 things they could do if you asked them to, and if they felt like it was appropriate to deliver that care. And they put it all on their website.
And so, if you think about this, the way that we’re talking about it, it’s, well, that means we could have 200 inquiries at any given time, with 200 unique requests for information that we have to nurture, right? And this becomes a burden on the staff, right? To the point where you get, you know, integration or deployment fatigue, and that creates problems, it frustrates everyone.
You know, be it the company you’re working with to do this, as well as your own internal operations team.
So the first thing that I always talk to practices about is starting small, right? Meaning, you can start by invasive and non-invasive. You can start measuring these, and I’ll talk a few minutes about the measurement of it.
You can start with creative, sure, and this may not win a ton of people over from a marketing perspective, but as Google and Apple continue to make changes to email efficacy and the way they’re auto-inboxing things. we’ve seen the open rates drop. Some people may argue that with me, but we’ve got groups that were running 20, 30%, are now at 10%, and you’re lucky to get higher. And so, I would say maybe don’t concern yourself so much about creative because SMS delivery to the most recent people is much more impactful.
When you have a site built by someone like Etna, it’s generally got the FAQs, the design there, you’ve already approved it, so don’t do something new if you’ve already checked the box on design content that you’re satisfied with. A lot of that can be done via text.
When it gets to the actual tracking of this there’s very specific data points that we look at, and it may be different than what other people do, but a lead comes into your system, whether it’s a phone call, whether it’s a form fill or anything. If you’ve got your system set up the right way, you can automatically take the demographic data from the lead and bounce it across the PM system. Nextech, ModMed, whatever it is, to identify, did that patient that was delivered something actually have an appointment that was created, and then follow that through to profit.
That should give you a very clear indication of whether these are actually turning patients into appointments. And once you know that, you can start to expand it, but I wouldn’t go 100 types of nurtures deep just for the sake of saying, I have 100 nurtures for my system. If you have 5 that work, then 5 could be a good number for you.
Right? You don’t have to think about volume in this. It’s not about volume of work that you did. It’s about what’s actually producing results, and that’s how I would track that, at least at the top level.
Ryan Miller: Yeah, can I steal that phrase, by the way, deployment fatigue? I’m 2 years in, in our… inside of Etna to a Microsoft Dynamics deployment, and there are definitely days where I feel deployment fatigue, still trying to get the value out of that big investment in CRM.
Ryan Lehrl: It’s very real, and everyone should know… everyone should be mindful of that going into it, right?
Ryan Miller: Yeah, so I think starting small is a really smart idea, and as leaders, being able to, look at benchmarks, and I think importantly, in a lot of the clinics that we’re working with, I think, maybe Sean or Robin, you said this in the beginning, a lot of clinics don’t have a point person who owns the deployment, and then its maturation after that deployment begins.
So starting small, you know, the challenge there, and I think the inspiration for business leaders, is if you can see and you can prove to yourself that it’s paying off, it might justify additional headcount or carving out space in someone’s role, to importantly ask questions, develop a hypothesis, and say, is this doing as well as it could?
I think if we change the messaging, or if we shifted from 2 drips post-inquiry to 3 drips post-inquiry, we can lift our conversion rate. Maybe, Sean, to your point, by adding a third drip that talks about affordability and financing. Let’s try that, and then look at conversion for the leads that receive this drip versus the one, the inquiries that receive the other.
That kind of hypothesis is something that’s commonly missing inside of clinics to be able to develop the wherewithal and the time to structure the test and to follow those results. But the ability is there to do the reporting in all of your systems to be able to support that.
Robin, let’s…
Ryan Lehrl: I mean, I think just one thing to add to that.
Ryan Miller: Please.
Ryan Lehrl: I just want to be mindful for everyone, but that type of reporting is top-down, right? It’s not the front desk person coming to you as the CEO or the owner of the business saying, hey, here’s how they’re doing, right?
You know, corporate alignment starts at the top, and you have to own that as a leader of your organization and drive it down, not expect a front desk person or someone wearing 10 hats, like Robin mentioned, to bring you the data that drives your business.
Ryan Miller: Yeah, and I think for a lot of businesses, whether it’s part of an annual planning process or a biannual planning process to say, hey, we’re making these big investments in technology, what do we want to do with it next? And, you know, we often coach our clients who are feeling they should be doing more with this, to go back to your team’s reps directly and say, hey, can you look at my deployment with me? Advice on where do I go next so I can be engaged and loyal and excited about my use of your platform.
Robin, let’s pivot for a second and let’s talk about some of the other features that are emergent inside of platforms that are really helping to drive and support more rapid conversion, because we’ve been talking about the importance of timely connection with clients.
And interestingly, we just had… I think that ties in this, we just had a question from someone about what do you guys all recommend about CRM’s interface with after-hour inquiries? So, could you talk to us a little bit about some of the cool features that are present in many of today’s CRMs?
Robin Ntoh: Yeah, I think one of my favorites is the missed call text back. You know, people call, they, you know, people step out of a meeting, and we’re… we go through meeting fatigue all day long these days, and they’ve got a short window, and they’re like, okay, I need to call and follow up on this inquiry, or they call me back, or maybe I want to schedule something, and they make that phone call, and then there’s no response.
And so people are apt to just pick up the phone and keep calling the next person down the line. And so I think that a lot of time the tools are being enhanced and developed to help, and so this feature actually is one of my favorites because it gives that initial texting conversation lift, because someone calls and immediately can text them back from your practice and say, hey, I am so sorry I missed your call, what can I do for you, or what can we do to initiate a conversation right now, when we know texting is definitely a viable way of people communicating. And so it just introduces that safe, more convenient way for people to communicate.
And in the aesthetics market, people are all about convenience. Practices that deliver convenience definitely deliver differentiation. So that’s one of those components that I think is one of my must-haves.
Ryan Miller: I apologize, because I’m about to hit you guys all with a left hook on this one. I didn’t prepare you in advance for this question, but David’s bringing it up, and it’s interesting, it’s something we’re struggling with right now in terms of formulating a response.
Texas, I think, many of you will know, just passed a law about essentially really, really burdensome regulations to be able to send business-to-consumer SMS communications into the state.
It is okay, because I know that you don’t deal with all of the operational side of your deployments, but do any of you have perspectives on how you’re approaching SMS messaging in the wake of Texas’ new regulations?
Robin Ntoh: I would say that it still goes back to you have to have permission from the patient, and so that has to be the first thing that you do, which a lot of people don’t like that component, but it is relevant.
Ryan Miller: Yeah, for those that don’t know, it doesn’t matter where your business is located, according to the new Texas law. I’m just going off of memory here, because we had a conversation about this last week.
You have to register your business officially in advance so that you can be identified when you’re texting into any consumer that lives in the state of Texas.
I think the legislation’s supposed to work, that you’re supposed to be able to discern that based on their phone number.
Second, you actually have to carry special insurance to protect against, essentially, to pay off in the event that you’re found guilty of misusing things. You basically have to carry a $10,000 bond inside of the state. And then you have to go through, essentially, a tortuous process of documenting the consumer’s consent to receive both customer service and marketing communications in the message in their state.
There are some exemptions that you can get based on the type of your business and the number of employees you have. It’s a very strange law. Are any of you intersecting with this yet? It’s a… for us, it’s a little bit vexing, because it’s… it’s a pain in the butt.
Sean Mahoney: We were only notified, very recently, by our COO that this is going to become a thing, and, you know, so we haven’t only had one initial announcement so far about it.
Ryan Lehrl: I always just find it interesting because the, the majority of my text abuse comes from politicians, not business.
Ryan Miller: That’s exactly…
Ryan Lehrl: That’s a sidebar. The way we, you know, each state has… I haven’t heard of this yet. I mean, we’ve usually managed it on a state-by-state basis, and divert the team’s legal counsel on this. You know, there’s a lot of nuance to it, so I’d rather not comment yet.
Robin Ntoh: Well, it’s 50 states, and we’ve got 50 different ways to slice it up and think about it. I mean, California just launched a new law about AI and medical decision making, and it’s just this ongoing chasing factor that it’s quite honestly frustrating for practices to have to keep up with it. I think there’s an expectation to some degree for the technology companies to help inform them and keep them informed, so…
Ryan Miller: That’s true.
Ryan Lehrl: My only thought there, too, is, you know, with the number of deployments we have is most practices focus on the basics, because most still have a lot of room on just doing the basics appropriately.
You know, I think there’s a lot to shake out with all technology. There’s, you know, there’s early adopters. Who knows what this will look like in a year or two with AI and what’ll happen, but I can assure you most clients still have the basic fundamentals to get right first before worrying about the next new thing.
Ryan Miller: Yeah.
Robin Ntoh: Yes, I think people definitely need to learn the basics, because I would say if you were to put a bell curve in place, that’s probably the majority of people, but I applaud the people that are actually listening to this webinar, because I think they want to go to the next level, and this is probably one of those two levers that are going to provide differentiation in a practice in the future, plus efficiency.
Sean Mahoney: And to the point that was made earlier about keeping it simple, yet differentiating where it’s absolutely necessary. You know, when you’ve got a practice and you’re like, okay, let’s differentiate our creative, but let’s be really specific about it. Okay, we’re gonna do face, we’re going to do med spa, and we’re gonna do breast and body. Boom, we’re done. You know, you could really start with something like that, even.
Ryan Miller: Agreed. Robin, sticking with what you were talking about with that tech spec feature, the hypothetical thing here is during business hours, someone calls… surprising for us, a lot of our clients, all triage is done by one patient coordinator, and if that person is on the phone, then they’re out of luck in terms of connecting with that patient opportunity. This is specifically triggered when the practice is unable to answer, to connect to the call. Maybe they closed for a lunch hour, all of their lines are occupied, which we actually see during peak times.
You know, very often, immediately following lunch, we’ll see this spike in activity, and in our call tracking, we can see holes. We’re like, oh, there’s… every day, you’re missing 3 or 4 calls on this, maybe we need to adjust staffing in that window, or whatever it happens. This sends a message to that person saying, sorry, we couldn’t answer your call, maybe that person left a voicemail, is that the idea?
Robin Ntoh: Yes.
And then…
Ryan Miller: And then somebody could, in theory, then continue to engage them. Often, they’re just trying to get a basic question answered, or they’re gonna schedule an appointment, and you could… you could take care of the entire interaction and text past that point.
Robin Ntoh: Yeah, but I think this is where AI is going to come into play as well, when you think about the chatbots, and that’s gonna basically extend your office hours.
Practices have learned that having online products and services extends their sales opportunities 24-7. Now they’re learning that they can extend beyond their communication with potential customers to 24-7 with, you know, with AI and all the nuances of where that’s advancing this.
Ryan Miller: And actually, Robin, I think that’s a beautiful segue, Ryan, back to you to talk a little bit about, the integration with self-service booking, and the benefits that can offer for practices. I might top you off with some risks that we’ve seen, not with any of your platforms, but with others that are out there. But can you talk a little bit about power integration? I know you had a story, too, to share that.
Ryan Lehrl: Yeah, we’ve, obviously, you know, Robin, or we’ve all mentioned online booking, and how powerful that’s become, right? And, you know, what we’ve seen practices do is they’re pushing how often and frequently online booking is presented to the patient. And so when you have these links, things like a missed call or text, even a lead form that gets submitted, right, automatically delivering and reminding the patient that convenient booking is available to the practice, or to the patient, has really extended the opportunity for patients to use those bookings, those booking tools.
We see that in operations throughout the process as well, right? If the patient no-showed their appointment, drive them back to re-booking that appointment. If they cancel their appointment, we appreciate the cancellation, here’s a link, go ahead and rebook.
So, I think that making sure you’re leveraging these technologies, like self-booking, throughout all of your automations is really important. Going back to the commentary we were having around very specific automations by procedure, right, you should be doing the same thing with your automations and your online booking. If you’re trying to get someone booked for Botox, present them links automatically for the providers within your office that offer that, right? So it’s not just about convenient reminders to call the office, right? Make it convenient to actually book the appointment, and you can really extend the value of these tools you have available to you.
Ryan Miller: Yeah, and I’ll have a moment here as an aside, because I’ve had interactions in the last 30 days with accounts who’ve moved to self-service booking platforms. Full disclosure, none of yours.
Where it’s effectively a black box, and we become very tuned into it as an agency because we’re very, very focused on data, and the moment self-service booking goes away, depending on the nature of deployment, we see a carve-out in terms of the number of inquiries that were previously captured on form, or would have called the practice. Those numbers all fall.
And then we’ve got to adjust our monitoring and reporting the conversations we have with our client partners to see that.
And interestingly, when we look at the back end, because for a lot of online booking engines, it’s kind of a black box. The patient enters, and then a number comes out on the back end, and most of our clients, what we found is they weren’t even looking at the number going in, they were just looking at the bookings coming out.
And what we’ve seen with a lot of the booking engines that are out there is the fail rate, the drop-off rate for booking is often in the range of about 70%. So 7 out of 10 people go in with an intention to book, or at least they’re interested in what the system is going to do, but don’t complete.
And, there are some really simple things that we find, and I challenge our practices, if you’re gonna do booking, go try it yourself. Go through the process, because there are a lot of points in the process where you will stumble, you’ll run into really obvious things. I’ll share an example that I discussed with a client yesterday, where that particular tooling has a button to find next available appointment.
But the entire capability is to look out 2 weeks in the future, and this is a practice whose medical spa is booked 6 to 7 weeks into the future, and all it returns is a blank screen, and it looks like it’s either broken, or there are no appointments available ever.
And, it can’t be fixed, it’s just a limitation of the system.
And, you know, with our nudging, they’re engaged in the conversation to try to get the user interface modified, so recognize that for all the good of self-service booking, there’s also some risk factors in there as well, and to be really interested about what your consumer is going to experience when they get in there, in case there’s a need for improvement.
Sean.
Ryan Lehrl: I got a question about that for you, actually, Ryan.
Ryan Miller: Yeah.
Ryan Lehrl: We’re turning the panel back on the host, but I’m curious. So, let’s say you have online bookings like that, and you say 100 people enter online booking, and 70 people go into it but don’t complete. It sounds pretty… it sounds not too dissimilar to, you know, the same… if you looked at online forms, right? 100 people might submit, and 70 of them you never even get on the phone, right? You’re chasing these forms.
So, I don’t know if it’s so much a question, but it would be interesting to compare those data sets to form submissions versus online bookings, and the throughput from them.
Ryan Miller: Well, it’s a… I’m gonna… so I’ll say, I have visits because of, you know, we work with hundreds of practices across North America, and I can see ones where… two different factors. Inside the exact same platform, who have availability inside the two-week window, and inside different platforms that don’t have this sort of buggy behavior around finding the next appointment.
And what we see is that drop-off rates were between 22% and 35%, so it’s twice the drop-off rate, and the only thing I can point out as a consulting partner with our clients is the fact, like, this behavior is horrible.
Ryan Lehrl: 70%, you’re saying 70% of that particular product, so the point was, be mindful of your solutions, make sure they’re working for you, not against you.
Ryan Miller: Totally. 100%. It’s a great synopsis, Ryan.
Let’s take it back, Sean, to you for a second, because, you know, I think, you know, at this point, if we’ve done everything right, we’ve got everybody in our system, we’ve nurtured them, we’ve got some decent bookings and consults. What happens then? Like, is there room for automation after a consult happens, and does it matter? Should I do something different if that person books or doesn’t book at the consult?
Sean Mahoney: Yes, definitely. I want to just make a quick comment on the previous discussion, because it pertains to this. In speaking with some really busy practices who have experienced that, that loaded calendar, and the frustration with online booking.
A lot of them are beginning to convert that process away from booking online consults to booking pre-consult phone calls to do a better job of pre-screening those patients, because there is dual complexity with booking online consults. You end up bringing in patients that should have had that pre-consult phone call. So then, it really helps to eliminate that. Also, the process is much shorter. The form is much shorter.
And you eliminate steps to that first conversation. Barriers to the first conversation. So, just a little, tidbit there, just spoke with a practice the other day about that.
So, post-consult, are we talking about, moving… Ryan, can you, can you cue that for me again?
Ryan Miller: So, we’ve got to the place where a consult has been scheduled and or has happened. Obviously, there’s a couple possible outcomes. They no-show, they show and book, they show and don’t book. Where’s the room for automations after or around the consultation?
Sean Mahoney: Yeah, so when you’ve got the post-consult, you’re sort of in that post-consult decision support phase, is what I call it. That’s where, you know, from a marketing standpoint, they’re gonna say, it’s time to kill top funnel, you know, which means stop sending entry-level messages.
Don’t repeat yourself, don’t send the messages that they’ve already seen before. Let’s send something more appropriate to this stage of the process. And also, still, you know, you want to send something that feels different than it did before, but you also want it to be something else that moves them toward the next step.
There’s got to be an action involved. So, instead of sending short messages that are generic, you can send something that supports the decision, like a thank you video from the surgeon themselves.
Those can be very successful. I see a lot of that happening now. You could also send a recap of the visit, you could send an estimate with one clear next step, which is to either book surgery or make a deposit. It depends on where they are in that journey, but you can be very specific at that point, if you’ve done the other… other parts right. And what it does is it… the goal there is to make the decision feel personal and give clarity to that process, so it’s got to feel personal and be very clear at that point, I think.
Ryan Miller: Yeah, and I think for a lot of our attendees today who are aspiring to provide leadership inside their practice, some things that were important that you were talking about there is stopping earlier were automations and workflows, so you talked about killing it, and it occurred to me, like, maybe our audience doesn’t understand there are triggers that when somebody changes stage, and they have either scheduled or completed a consultation, that that can be a digital signal that tells earlier automations, like, okay, your job is done, don’t send them any more of those earlier messages, they’re now in a different place with us.
Then it starts new automations of different kinds. An automation, I think, you know, Ryan, you talked to, or Robin, you were talking about, like, if they no-showed, or they canceled the appointment, automatic… the link that you would send them, Ryan, in your example, to rebook.
You know, if they visited and didn’t schedule a procedure with you through consultation, one automation that helps explore things that are common barriers to making the decision to move them closer to help them make the decision that’s right for them. And if they definitely booked, locking it in and making sure that they feel supported and they get all the things that your staff might otherwise have to send to them manually to prepare them for the journey that they’re about to undertake.
Ryan Lehrl: And that’s the importance of these connections to groups like 4D and EMR, right? Like, if you’re using a tool that doesn’t integrate with them, I would say that’s problematic, because, you know, part of your funnel is in one system, the other part’s in their system. You really need that complete linear understanding of what the patient’s doing to kill automations and shut them down.
Ryan Miller: Yeah, Ryan, I think building on it, what we talk about when we’re advising our clients who are trying to shop for the right CRM for them, assuring full bi-directional communication between your CRM software and your practice management software, so that state changes did they have a procedure? You know, if so, has that procedure elapsed? Knowledge of associated revenue, the future purchases can all make it back to the CRM, so that you can do really smart communications things, automated communications things, over here in the CRM software. That bi-directional communication is essential.
For sure.
Ryan Lehrl: But I think it goes a bit further than that, too, in terms of, you know, payment platforms, right? All the EMRs have payments platforms, you want those integrated, you want all of the data, right? You either have the FHIR API or the data marts, if you need that level of information, because not every API endpoint that you need to use is available, so you need to connect there. And then upstream, other solutions like your phone systems, right?
We’re talking about phone calls repeatedly, it’s been mentioned several times. You know, the majority of bookings occur over the phone. As much as forms are great, online appointment tools are great, the majority of things occur on the phone call in a small business setting, or even a group with a call and contact center. So, if you’ve got no visibility there, too, that creates a pretty big hole for you.
Ryan Miller: So, we’re getting closer to, kind of, the last few topics here. For those of you that are on the call, you’re thinking about questions that are percolating, remember, you can click the Q&A in the bottom of your screen, open that up, and pass some questions to me. I’ve got a bunch here I’m going to try to get through in a second, but it’s time to start loading me up, because we’re getting near the end. I know, Ryan, you were going to talk a little bit about reactivation, you know, recall protocols. Could you go there with us and just talk a little bit about it. A lot of our practices have kind of annuity-driven services, things where patients might come back over and over again.
They have situations where if somebody no-shows, cancels last minute, there’s a lot of things that automation can do to make the practice more efficient there. So can you talk about those things?
Ryan Lehrl: Sure, I’ll start with those operational points. The no-show or missed appointments are very straightforward. You should have automations that if a patient cancels that appointment last minute, you want something immediately, and I would say you start there in most cases with automation. Lead nurturing’s great, but think inside-out, right? These are a captive audience. This is a patient that went through the process to book.
Automation should start there and build to the outside. Inside to outside. I also think, there’s other things that you should be considering. For example, let’s say someone had a Botox treatment from you, you see the bills, the charges, they got the procedure. It’s not just waiting for them to call back in 90 days, but what about reminding them in 2 days that they should be back here in 90 days?
Right? Getting them on the books in advance.
And keeping them prepared. Not every time do they book that next 90, 120-day appointment with your front desk when they’re leaving the office. So, those are a few simple examples of operational automations you could run. When it comes to recall, it’s using that same set of data based off criteria that you have within your practice, right? Using Botox again. 90-day, 120-day reminders are really helpful. We find 210 is helpful, too, because if at 210 they didn’t come back to you, there’s a good chance they went somewhere else, and maybe you’ll catch them in your net versus them going back to that practice that they probably went to.
You know, we find using that history and that appointment data is really beneficial, to be able to set up those automations. You’ve got to have a system connected with your PM solution to even get and ascertain that data.
And then one other thing that I think is valuable to think about that a lot of aesthetic practices don’t, is that cross-sell opportunity, right? If I’ve been getting fillers for 10, 12 years, and I all of a sudden hit a trigger of 55 years old, then maybe I need to start learning about a facelift, right? Because eventually, the volume of fillers doesn’t support the work that you as a surgeon can do, right?
The people that are surgeons will agree with me on the meeting. Those that aren’t might think they can do it better, but you want to be able to think cross-sells as well. There are triggers based off historical purchase data that would allow you to start cross-marketing new procedures or opportunities, laser, surgery, etc, for a patient at the right time.
Ryan Miller: Robin, why don’t you wrap us up, and I think this is very where we all may have something to say, is just reflecting on the rise of AI in terms of how and where we interface with our data, and how and where we interface with our patients, and what that means from a CRM perspective.
Robin Ntoh: So just kind of leading off where Ryan just, you know, captured the essence of reactivation and retention. I think that one of the misses in the industry is thinking of a lead management tool as just being… or cultivating, collecting new leads. It’s… it should be every bit of a reactivation retention tool as well, because that’s a component that’s really important in practices, because it’s just… it’s just so much more expensive to work a new lead.
But the other tools are AI. I mean, when we think about AI, one of the things that’s… that is out there for us to kind of think about in the essence of optimization in our businesses is AI and CRM is very relevant. I mean, we’re seeing AI in just the chatbots. I mean, that’s not new. We’re seeing where that has big relevance in that 24-7 type of concept. Going back to that tool that texting missed calls, that’s where AI is coming into play to help manage those text messages, such that, you know, you can flip that on so that after hours, that becomes a different type of text that starts to generate and cultivate that relationship.
We think about the content in your social media and what you’re trying to do there, where AI can support and, you know, help facilitate on ideas that help generate some differentiation.
Ai is definitely in place for the different workflows. We talked about all these different drip campaigns that we want to build. Where does AI have a place in that?
It definitely has a place in the CRM tools that are available. We also think about just managing the reviews. You’ve got the Google reviews, the Facebook reviews, you’ve got all of those things where AI can help as well. And so a powerful CRM should be able to help facilitate and work through those things, because if you’re going to use a tool that’s really meant to support across all of your interactions with your potential customers, you want it to be able to be efficient. You want it to be able to be something that doesn’t incur more costs or create a bigger lift on you and your practice.
And so we have to lean into AI, but we have to think about it from a safe perspective. And that’s where, you know, I mean, I mentioned it earlier, where California has this new law about medical decision making, and where chatbots can potentially have some foul areas there where they’re generating content that’s learned, because that’s what AI is, but once that bias comes into play and it generates content that is insinuating medical decision making.
Then we have to pause there and think about what is the governance around the AI in these products? And that’s something that, from a technology perspective, we’re very focused on, and we have to lean into it, because we recognize that no longer as a technology company are we just beholden to what we produce and create for our practices, but we also have to think about that’s now becoming patient-facing as well. And so, there’s a lot of responsibility. We shouldn’t run from it or be afraid of it, but we should be cautiously optimistic about it as well.
Ryan Miller: Yeah, I think about one of our clients that had deployed a chatbot over the beginning of the first two quarters of this year, and one member of their staff spent almost two and a half months training the AI to sound like their practice, to answer correctly, to add guide rails when the bot was suggesting things that were not appropriate, given the context of that, you know, the chatbot communication platform.
And I, like, full, full props to them. They always… they’re one of our client partners that tend to do everything well.
But they have the staff for it, and they have someone who was willing and able to dive in and to learn, and we don’t see that quite as often. And, you know, I’ll test out clients’ bots and really quickly run into hallucinations or very scary things that are being said. They can learn, but they’re like one of the most foolish employees you can ever hire. If there is a pile of dew, they will step in it, until you train them not to. So, you know, I think that that’s going to be pretty common there. We’ve got some really good questions coming up in the audience. First of all, thank you guys again so much.
Before I get into Q&A, just remind everybody again, your platform, your CRM platform, and give me the one-sentence pitch. This is the sales moment I promised each of you for being so generous with your time, that why you would like people on this call who are shopping for a CRM solution to call you after this event.
Robin, take it away.
Robin Ntoh: So NexTech does have NexTech CRM, and it is being launched with those templates that I talked about that do provide that snapshot by specialty that’s going to give you those 70-plus different types of responses that you are looking for, so that we can help practices launch quickly and efficiently.
Ryan Miller: Awesome. Ryan, give us the RSI pitch.
Ryan Lehrl: Sure, our system’s a very comprehensive healthcare-specific CRM. You know, practices want to look at our solution if they’re looking for, in my opinion, the most, you know, complete and comprehensive solution from a data, patient acquisition, and patient retention perspective.
Ryan Miller: Awesome. Sean, this is your pitch, man, take it away.
Sean Mahoney: Yeah, so 40EMR was created by Dr. Robert Pollack. He’s a plastic surgeon, and he really wanted to create something that was, from an EMR perspective, simple, all cloud and aesthetic-specific. So, and he’s simplified a lot of the doing business as components when it comes to the EMR-doctor relationship. On the CRM side of the equation, one of our focuses has always been an open API. We integrate with many, many platforms, including Red Spot Interactive. We integrate with other CRMs. A lot of times, practices will come to us, and they’ve already got a CRM relationship, but they want to plug it into their EMR, so we’re able to do that.
And lastly, we’re in the process of building out our own very deeply integrated CRM called the 4D Zone. It’s a go-high-level based, CRM that we’re really excited about, so that practices who, you know, are looking for that type of an option will have that as well. So we’re… we’re super excited about that, and again, I learned a lot today, from the others on the panel, and I really appreciate the opportunity. Thanks.
Ryan Miller: Awesome. So let’s get some of those less questions in there really quickly. So we’ve got a question coming in from Mandy about, self-service booking and requirements there. For a lot of our clients, they have a credit card option, they have, like, a pre-qual form that are required. Do any of you address any of those, those needs where you’re getting payment and maybe a few qualifying questions before patients are allowed to self-service book?
Ryan Lehrl: Yeah, that can…
Sean Mahoney: Sorry, go ahead, Ryan.
Ryan Lehrl: Yeah, I was just gonna say, I’ll speak to that. We do that with, you know, with both the two systems on the call today, Nextech and 4D. We allow for credit card capture, to save on file that gets stored in the ledger of the systems, or you can charge a consult fee. We find that to be pretty beneficial. It opened up a lot for plastic and cosmetic surgeons that wanted to take booking, with great success, versus just having, you know, free consults.
Ryan Miller: Yeah, Sean or Robin?
Robin Ntoh: Yeah, they were.
Sean Mahoney: Head rub.
Robin Ntoh: I would agree with Ryan. I think that, and even going down to the type of appointment, and even to the… at the provider level, do you need to require a credit card? I think that those different types of preferences are important, and so those are things that we’ve put in place.
Sean Mahoney: Yeah, and the practices can customize that, too, you know, depending on what level of information they want to collect in advance, or how… or if they want to simplify that process, you know. There are different options to kind of set that up within the EMR, if you’re doing it within the EMR, or in the case of, you know, Red Spot, you could customize that process there, too.
Ryan Miller: So, the next question comes from Mandy, it’s about setup, and I’m gonna… Mandy, I apologize, I’m going to twist your question a little bit, I think, to be kind of egalitarian and fair to everyone, and it’s about, given your expertise and your platforms, what do you recommend that a practice budget for, plan for in terms of staff need for successful deployment.
And kind of that immediate post-deployment customization and, you know, internal training for their team.
You need a champion for the entire initiative who’s going to own it. It might be for several months their full-time job. You need to plan for things like, you know, the migration of some amount of old data into new system, or some amount of manually captured data that you have today into new system for it to be meaningful.
You’re going to have to play a role in, Ryan, like what you said, defining what is and is not a lead, defining initial automations that you want to deploy, but let me pass it back to you.
I’m a practice, I’m about to shop with you, you’re… you’re being a good advisor to me and say, look, you need to have this, like, this amount of human resource, this kind of expertise ready to do this well.
Ryan, why don’t you start us off, then Sean, then Robin.
Ryan Lehrl: Sure, you know, most of our clients have, have stood up their medical record system before they adopt our solution. I err on the side that standing up your, you know, CRM is the same amount of work.
Right? When you do it the way that we believe to be right, you’re integrating multiple platforms into your CRM, inclusive of your medical record system, meaning phones, you’re working with marketing agencies to deploy, ingestion methods, and you’re going through a process of, you know, you’re going through a process of change agent, if you will, right?
You’re adopting a solution to change the course of your business, not to just put a tool in place that keeps a few people happy and gives them something to maybe do their job better, right? And so to do that, it’s a… it is a significant investment in time.
You know, on the short term, over a period of, you know, 3 to 6 months to get it set up appropriately, we usually see 1 to 2 hours of time a week invested from an individual. Depending on your size, you’re going to have different departments in it, so it can’t just be one person. If you’ve got revenue cycle management, marketing, operations, call center, so…long-winded answer, but it’s not a small task. None of our clients would tell you that. That’s where I think we revert back to eat the elephant one bite at a time. You’ve got to identify what’s most important for you, get those items up to a degree you’re going to be satisfied with, but then realize this is ongoing maintenance, and it doesn’t go away. And it shouldn’t go away if you’re going to deploy it the right way.
Ryan Miller: John or Robin, do you guys have a different answer?
Sean Mahoney: Yeah, you know, I was… well, the same answer to start. You took my analogy, Ryan. I was literally going to say, how do you eat an elephant?
Ryan Lehrl: That’s close.
Sean Mahoney: How do you climb a mountain, right? It’s one step at a time. So, it comes back to that deployment fatigue conversation that we had, and keeping it as simple as you can, and doing the necessary amount of setup for the size of your practice, you know, what does it absolutely require to get you launched? Because getting… getting a practice launched with any software, there’s a huge level of satisfaction there.
So if you can just focus on distilling things down to the basics initially, and get launched quickly, I think that that’s how you can grow it. You know, I think that’s your best-case scenario for growing the power of your CRM, is to get it launched with something really simple and really effective to start.
Ryan Miller: Yeah, Robin, any final thoughts on there?
Robin Ntoh: Recognize there’s change management, and look for as much out of the box as you can get, because there is going to be a lift, but the goal is to get yourself up and running as quick as possible. Recognizing, though, there will always be the updates and things that you need to finesse as you go along.
Ryan Miller: Excellent. We have gone over on time, there’s some other great questions there. I might send some follow-up to you guys to do a follow-on article or piece about it inspired by some of these questions.
Again, Sean, Ryan, Robin, my thanks to you personally and to your organizations for allowing you the time to participate and being so generous with your knowledge and experience. I know it’s been really, really valuable to our attendees today, and again, just from the bottom of my heart, thanks you guys. It’s… the generosity is inspiring.
Ryan Lehrl: Thank you.
Sean Mahoney: Thank you.
Ryan Miller: Bye-bye.
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