Competing for Patients in a Digitally Connected World

Urgent message: In today’s tech-driven, digital-everything society, industry-leading consumer companies all leverage technology to reducing friction—ie, steps, obstacles, and unnecessary effort—in making their products and services fast, convenient, and accessible. The urgent care operation that can align with this growing trend and leverage technology to root out friction will win loyalty and patronage from today’s digitally native healthcare consumer.

Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine.

Friction might be the most oft-repeated buzzword in business and tech today, and for good reason. Consumer giants like Uber and Airbnb (along with countless others) are disrupting industries and driving billions in revenue by reducing the steps and effort required to perform traditionally time-consuming tasks such as renting rooms, hailing rides, ordering meals, and making reservations. Apple—long a trailblazer in reducing friction—for example, allows shoppers in its Apple stores to grab items right from the shelves, scan them with the free Apple app (linked to the customer’s Apple account with billing/credit card information digitally stored) on their iPhone, and walk right out, bypassing the crowd without needing to interact with an employee beyond the store greeter. The purchase is billed directly to their Apple account. Talk about reducing friction!

Although the Apple example is exceptional and obviously one of a global tech giant that spends billions on R&D, you can find examples of consumer companies leveraging technology to reduce friction everywhere you look—many of them in your day-to-day life. Mostly through apps, digital tools, and online technology, businesses not only endeavor to reduce the friction between their product/service and the consumer purchase, but also to encourage and influence desired behaviors. At every turn, companies are looking for cost-efficient ways to eliminate unnecessary steps between the consumer deciding they want something, and the few taps and swipes necessary to make it happen.

So how can urgent care—a multibillion-dollar industry in its own right that delivers on-demand healthcare in a retail fashion—capitalize on the revenue and loyalty opportunities that follow from a mindset of reducing friction at every patient touchpoint? Can a visit to the urgent care center really be as “frictionless” as, say, ordering ahead and paying for a breakfast sandwich from Dunkin Donuts through the app, then arriving at the store to simply grab your hot, ready, and waiting order? Receiving treatment for injury and illness by a medical professional is a bit more meaningful and complicated than that, of course. However, there exist ample opportunities to explore the current tech and digital landscape for ready solutions which, if implemented strategically, can reduce friction toward making your urgent care the path of least resistance to patients looking to receive low-acuity healthcare in a fast, efficient, and seamless fashion.

To that end, the following sections will explore four key areas of the urgent care customer journey:

• Brand exposure (through marketing)
• Utilization decision (deciding to go to urgent care)
• Patient financial experience
• Post visit follow-up and support

Then identify opportunities to not only reduce friction at these important customer touchpoints, but to implement digital/technology solutions for streamlining the entire urgent operation on the backend—all with an eye toward reducing employees’ administrative burden, allowing them to recapture the time and effort needed for throughput and patient care.

Brand Exposure

Experience is that, on average, an urgent care patient utilizes an urgent care center only about 1.7 times a year. And that utilization occurs only when—aside from ancillary services like sports physicals and employer drug testing—there’s an unexpected injury or illness. There’s typically no “direct response” marketing opportunity (especially with traditional methods) where the customer is exposed to some marketing tactic, and then immediately decides to visit the center. Urgent care, therefore, would usually market ahead of the actual need so the center is top of mind when an injury/illness episode does occur. Traditional urgent care top of mind marketing tactics include:

• High-visibility locations (especially endcap space in shopping centers featuring food/drug/mass retailers) that have lots of traffic and prominent signage
• Grassroots and community marketing—schools, sports leagues, YMCA, community and chamber of commerce events—positioning the urgent care brand as a ubiquitous presence in the community
• Mass media advertising—TV, radio, billboard ads, direct mail, newspaper ads

While these tactics are effective and do raise awareness for a later need, they can be expensive, especially for smaller, independent urgent care operations with tight marketing budgets. Additionally, a consumer needs to be exposed to a brand message several times before it’s cemented as top of mind, so the marketing must be ongoing. Today’s technology, though, allows for more of a direct response-type approach to marketing that allows the urgent care to be front and center right as the need for care arises—in real time.

Have a Modern Website

At this juncture, the friction point—anything that slows or impedes the customer journey—for the urgent care consumer lies in the decision-making process when there’s an immediate injury or illness:

• Which center is open? What are their hours?
• How close is the center? Where’s the center located?
• Does this center take my insurance?
• How fast can I be in and out?
• Can I “get in line” ahead of time so that I’m seen by a physician as soon as I arrive?

This is where technology can be employed to reduce the friction inherent in this decision-making process. The first step? A modern, professional website.

Consumer research shows that nearly 90% of patients go online first when they’re looking for a healthcare solution.¹ This means your website may be their first exposure to your brand. You don’t need to spend thousands on a fancy urgent care website, but it should have a modern design, easy navigation, up-to-date information, and above all, a mobile-friendly design. Google statistics reveal that around 5 million urgent care-related keywords are searched every month—with 74% of those searches occurring on a mobile device.² So, what information should your website be able to quickly provide?

• Center location and hours
• Clear, current contact information
• Participating insurance plans and payment types accepted
• Services provided (as opposed to those that require a prior ED or primary care visit)
• Map widget that shows the center location on a map with major cross streets, nearby stores, and major landmarks
• Useful information on common illnesses (ie, a blog with valuable information that’s optimized to get picked up by search engines when people search for terms like “flu” and “strep”)
• Billing and insurance FAQs

In addition, you should invest in quality hosting so your website pages load fast. Slow-loading websites—a major source of friction—will cause nearly half of online users to abandon the site within 3 seconds. And your website should be designed by an expert who knows how to structure the content, layout, and navigation to be search engine-friendly.

Online SEO

While having a modern website is a key first step, ensuring that people find it when an online search takes place is critical. To rank near the top of search engine results for keywords like “closest urgent care” or “urgent care near me” (a trending keyword) or “urgent care that’s open 24 hrs” you’ll need to employ paid advertising and search engine optimization (SEO) services. The monthly SEO and ad budget can be tracked and tweaked in correlation with captured analytics data to achieve the desired number of “hits” to your site when local consumers search urgent care keywords.

Local Directory and Review Sites

Savvy urgent care operators understand just how many local consumers use directory and review sites when searching online for a clinic. Yelp!, Google, and Glassdoor are examples of sites that feature short reviews and star ratings from one (worst) to five (best). Ensure that your urgent care is registered with these services, and diligently monitor the reviews. One bad review from an angry patient has an outsized impact on clinic perceptions and can negatively influence thousands, so always have a staff member follow up immediately with any patient who leaves a negative review.

Social Media

Especially with Facebook, where many people already spend time online, a well-designed urgent care business page can convey important information to consumers making a quick decision. People who visit your page will see the familiar menu links to the left of the page where they can quickly click Hours, Locations (with a map widget right on the page), Reviews, About and Posts links from one place. The urgent care Facebook page should also be linked from the main website and optimized to show up in Facebook “urgent care near me” searches.

Takeaway: By employing the aforementioned digital marketing strategies, urgent care marketing can not only be employed for top-of-mind” awareness for later, but a quasi-“direct response” for real-time illness and injury. With an SEO-optimized, mobile-friendly website along with a Yelp! business account featuring positive reviews working in conjunction with an optimized Facebook page, a mom with a sick kid can go from tapping into her phone, “urgent care near me,” to picking your center literally within seconds.

Utilization Decision

Even after the decision to patronize your urgent care is made, obstacles (friction) may still be present that, if inconvenient enough, can lead the consumer to consider other providers. Consumer questions at this point might be:

• Can I reserve my spot online so I don’t have to wait in the lobby?
• Can I preregister online to cut down on paperwork when I arrive?
• Will I be notified via text when my spot in line is approaching so I can head to the clinic?
• Will the clinic text me if there are unexpected delays?
• How easy/difficult is it to navigate to the correct location via GPS?

Many of these concerns center on wait time and reaching the clinic when their spot is ready. Again, technology is available—as you’ll see as you read on—that the urgent care can employ to reduce friction at this stage and simplify the process.

Online Reservation System

Technology companies that service the healthcare industry have developed high-quality online reservation systems that urgent cares can easily integrate into their pre-existing platforms. Generally accessible from the urgent care website, an online reservation allows patients to shift the bulk of their wait from the urgent care lobby to their office, vehicle, or living room couch. These systems also send text communication when the patient’s spot in line is approaching, allowing patients to time their arrival with minimal wait. As many patients view a wait (real or perceived) in a crowded lobby with other sick patients as a major aggravation, online reservation systems are a huge convenience and thus an effective friction eliminator. As a bonus, the ability to anticipate patient flow aids the clinical staff, as it helps maximize efficiency in staff coverage and planning.

Preregistration/E-registration

In addition to the online reservation system, urgent cares should provide online or in-clinic lobby kiosk preregistration for patients. The urgent care staff will double-check the registration information, of course, but from the patient perspective, this becomes an additional digital tool to speed up the visit and reduce wait time, while the urgent care gets to shift some of the administrative work away from the paid front office staff to the “free labor” of the patient.

GPS Apps

As most people use some sort of navigation/GPS app on their phone when driving, urgent care centers would be wise to create accounts with popular apps like Waze and set the direction and location details to their center within the Waze Map Editor. Especially in big cities with heavy traffic, this makes it easier for patients to find the urgent care center, time their trips, and even discover alternate routes amid obstacles like traffic delays and construction closures. Additionally, by paying a small daily fee for Waze ads, your center can target nearby drivers with a custom ad promoting your business and services (and later get reporting as to which drivers ended up in your parking lot).

Takeaway: Many of the major disruptive technologies we enjoy today eliminate friction by saving us time and reducing waits. By thus implementing technologies such as online reservation and e-registration systems, and GPS navigation, you’re reducing friction by eliminating many of the obstacles and speed bumps that could prevent, deter, or delay patients from showing up at your clinic when they have an urgent care need.

Patient Financial Experience

Going back decades, the financial experience in healthcare was a major source of friction for patients. Confusing bills, a lack of price transparency, and difficulty paying bills was long the norm, yet patients accepted it as passive receivers of their healthcare. That was, of course, before the proliferation of high-deductible health plans (HDHPs), which altered the landscape and spurred the growth of an empowered, discerning healthcare consumer. So even if you’ve reduced the friction inherent to getting them to your front door, today’s patients have options and are quick to vote with their pocketbooks when providers don’t offer what they’ve grown accustomed to: straightforward pricing, clear explanation of charges, and multiple ways to pay for services.

With that in mind, urgent care must ensure that their entire financial experience features the following benefits toward delighting patients and avoiding reputation-damaging negative encounters.

Flat, Clear Pricing

Today’s patient will not tolerate guesswork or uncertainty in this area; there must be clear, flat pricing for every service and procedure the urgent care offers. A prominent menu board that shows each price for comparison with other providers should be placed in the lobby. Additionally, pricing for common services and procedures should be displayed on the urgent care website and other relevant marketing touchpoints.

Clear, Consolidating Billing

Experience and anecdote suggest this is a critical touchpoint in the financial experience, given its potential for creating friction. Even if a patient was satisfied with the clinical outcome, a poor experience here will cause them to label the entire encounter as a negative one. Therefore, the urgent care must ensure that there is a single, consolidated bill at the time of service—no separate bills for labs and imaging, etc. The bill must also be easy to understand, have each billable service and procedure itemized, and be payable in a single transaction. Financial counseling should be provided when necessary so a patient never leaves a center confused about their bill or payment options. There must also never be “surprise” bills after the fact; sending one to a patient almost always guarantees a negative review on Yelp! or social media.

Integrated, Seamless Transaction

The actual financial transaction should not consist of several fragmented steps. Rather, it should flow as a seamless transaction consisting of the following sequence of processes:

• Confirm the patient’s information
• Verify insurance eligibility in real-time
• Identify self-pay, correct copays and deductibles to be collected in real time
• Collect payment
• Registration quality assurance (staff double-checking and verifying each other’s entry)

Credit Card Preauthorization

When insurance coverage is undetermined, prior claims are in process, or the policy has a high deductible, credit card preauthorization can be an effective safety net for the urgent care center. This entails authorization of the visit’s total anticipated charge, and is released when insurance is verified. It is not a hold and doesn’t entail storing credit card information; rather, it enables a third-party processor to charge a preapproved amount once the insurance claim adjudicates. This method has the added benefit of saving the urgent care the time and expense of statement rendering, bill mailing, and payment posting costs.

Takeaway: Simply put, patients who are aggrieved due to a poor financial experience will not return to the center and will almost certainly post a negative review online. Indeed, friction in the financial transaction is no longer tolerated by today’s healthcare consumer; hence, it behooves the urgent care staff to get this part right.

Postvisit Follow-Up and Support

When today’s consumers choose products and services, the postpurchase support experience factors heavily in the decision-making process. How easy is it to get a live human for technical support? How much of a hassle is it to get a quick refund or exchange? What digital channels (ie, email, live chat, text) are available for support? Will someone follow up with the patient after purchase? Inadequate support in this area produces friction even after the purchase, and can hurt word-of-mouth, online reviews, and customer loyalty. Urgent care should therefore consider the certain digital tools to cultivate the after-visit patience experience:

Online patient portal

Healthcare technology vendors have created full-featured online patient portals that enable patients to view their HIPPA-protected personal health information remotely, and communicate with your center via secure login credentials. Patients can use these online portals for postvisit support, including:

• View their private health records and patient history
• View lab and diagnostic test results
• View their medication list
• Request medication refills
• View and print their chart
• Two-way messaging for follow-up questions and concerns with the provider
• Receive email and text notifications for account updates and appointment reminders

Online bill pay

When a patient does receive a statement indicating a balance due, the ability to go to a website and enter their credit card information not only expedites payment for the urgent care, but is a tremendous convenience to consumers who don’t have to write out a paper check, address and stamp an envelope, or go to the post office.

Postvisit text survey

Urgent cares should have a system that texts patients a link to an online survey, which could include links to common review sites where the urgent care business is registered (ie, Google, Yelp!). Postvisit survey texting must occur immediately after the visit to give the clinic a remediation opportunity well ahead of an angry patient heading to a review site. The follow-up must also be immediate, as consumer research has shown time and again that fast, prompt service remediation can in many cases transform a disgruntled patient to a loyal supporter.

Takeaway: The patient journey doesn’t end when they leave the clinic, given that the relationship is always in the process of being built (or damaged). Friction in the postvisit, follow-up phase is therefore just as problematic as it is before and during utilization and must be identified and addressed in order to be rooted out.

back-office technology

Most of us have had at least one service experience where although there were multiple steps involved, everything just flowed in a synchronized, coordinated, and fluid fashion. There were probably few long delays and several attentive, nonharried staff members on hand to answer questions, patiently explain the process, and provide updates. Perhaps an experience that might have occurred at a five-star hotel?

In an urgent care operation, this level of coordinated, frictionless service can only be delivered if administrative burdens are shifted or reduced, freeing up staff and providers to focus more time and energy on patient care and throughput. Having quality IT solutions and back-office technology is key here to streamline the operation, and indirectly reduce friction in the service delivery. Following are several examples:

• Full-feature EMR. A robust EMR will have the following features (including add-ons) that streamline operations, remove human error, and reduce administrative tasks:
• Documentation templates – To facilitate flow and promote quick handling of common conditions. As the 10 most common presentations make up 80% of all urgent care visits, templates reduce repetition. Further, a template-driven process with mandatory fields requires the provider to document everything that needs to be documented so nothing that is billable will be omitted—and additional revenue that may have been missed is recaptured.
• Coding engine – Assures all services are correctly captured without human error, and augments automated charge entry and electronic claims submission—which assures the insurance company gets complete information to process payment without delay.
• Schedule and coordinate referrals – Assure continuity care for patients who require surgery, imaging, physical therapy, primary care. Having the urgent care send all the relevant health information to the next provider in the process is a welcomed convenience for patients and eliminates a potentially friction-laden part of the process.

• Automation technology. This comprises various technologies to automate routine tasks and allow staff to reclaim training, coaching, and patient care time. Automation tools can include:
• Barcoding systems to scan, track, and order medical supplies
• Automated scheduling system to assure appropriate staffing levels during hours of operation and peak patient times / lulls
• Payroll and timecard automation to simplify time and attendance tracking, increase accuracy, and eliminate human error

Takeaway: Creating an in-clinic experience where the patient “flows” from one station to the next without unnecessary delays, gets in and out faster, and still receives an appropriate amount of patient care time from staff and providers means time-consuming and repetitive administrative tasks must be shifted. EMR technology and automation tools help accomplish this and more, and has a notable albeit indirect impact on reducing friction in the service delivery phase.

Frictionless Business: Not the Future, But the Present

Several major hotel chains now allow customers to compare rates and make reservations from their devices, select their specific room and check-in directly from the app, then use the app as their room key—bypassing the front desk altogether. Amazon has “1-click purchasing” and will soon offer 1-day shipping to Prime members. Companies like Starbucks invite customers to store their payment information in the app, paving the way for fast purchases without cash or cards. Frictionless commerce is here, and the companies that find ways to remove effort and steps between customers and their products/services will surge ahead of the competition.

Not every business, however, has the deep pockets necessary to splurge on technology platforms, app development, and complicated infrastructures. For urgent care, the amount of cash available for marketing and technology depends largely on the size of operation; smaller organizations may be limited to, say, grassroots efforts and some basic digital tactics, whereas larger operators and hospitals can leverage more capital toward in-house digital marketing teams, better technology, and mass media campaigns.

No matter the size or sophistication of the operation, though, every urgent care operator must grasp that even when planning a visit for something as simple as a sore throat, consumers have been conditioned to expect little to no friction, and will actively seek out providers who make the process the most convenient. This new reality requires a thorough examination of the status quo, and the recognition that actively seeking cost-efficient ways to eliminate friction from the various touchpoints along the patient journey will pay off in the form of revenue and patient loyalty, and position you as the provider of choice.

Conclusion

Technology has allowed urgent care to lessen its reliance on “top of mind” marketing to capture a patient’s one or two utilizations a year, and employ more of a direct response-style approach that leverages digital tools and mobile technology to place the urgent care right in front of the consumer as soon as they realize a need. To take full advantage of this opportunity, extra steps and obstacles must be eliminated at every touchpoint, especially during the service delivery and the financial transaction. Because in the new “frictionless” business world, the urgent care that makes an injury/illness visit as simple and pain-free as possible will emerge as the winner in their market.

References

1. Fox S, Rainie L. The online health care revolution: how the web helps Americans take better care of themselves. Washington, DC: Pew Charitable Trusts; 2000.
2. Google Trends. Interest over time. March 3, 2019. Available at: https://trends.google.com/trends/. Accessed August 28, 2019.

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