Earlier this week, Dr. Heidi Jannenga, PT, DPT, ATC/L, the president and co-founder of WebPT, teamed up with Charlotte Bohnett, WebPT’s director of demand generation, to host a webinar on common barriers to patient progress—and strategies for overcoming them. During the question-and-answer portion of the presentation, we received quite a few audience questions on the nuances of fostering patient engagement and moving patients toward their therapy goals as efficiently as possible. We’ve compiled the most frequently asked questions—and answers—below. Don’t see the information you’re looking for? Let us know in the comment section at the bottom of this post, and we’ll do our best to get it for you.

We get a lot of referral patients. What can we do to get more support and buy-in from physicians so they will help reinforce the importance of therapy treatment and home exercise?

Start by building rapport and developing positive working relationships with your referring physicians. Also, make sure you’re tracking patient outcomes. That way, you can present your physicians with tangible evidence that your treatment is effective. Furthermore, encourage your patients to share their progress with their physicians—thereby improving those physicians’ perception of you and your services and keeping your name top of mind. Finally, share research. You and your referring physicians have a common interest in evidence-based practice. So, send them any interesting articles you find that cover the latest research from your specialty. This is one more way for you to demonstrate your expertise as a specialized healthcare provider.

We work with a lot of older patients who aren’t super comfortable with technology. Are they really going to use a digital HEP?

It’s tempting to assume that older patients are less inclined to adopt new technology. But more and more, the older population is embracing digitized tools and engagement platforms. In fact, a recent study found that 48% of people aged 65 to 74 have a social media profile, and 41% of people over the age of 75 are on social media. So, it’s beneficial to provide your patients with multiple options to keep them engaged and actively involved in their therapy care. Also, digital HEPs make completing at-home exercises interactive and fun at any age, whether patients are completing them on their own or making a game of it with their grandkids.

When will WebPT’s new home exercise program (HEP) software be available?

We plan to launch and roll out this product later this month. (To learn more about the new WebPT HEP, check out our HEP product page.) However, it is currently available for pre-purchase. Simply ask your WebPT representative and he or she can get you signed up.

Can I bill for home exercises if I’m using a software that allows me to interact with patients?

Unfortunately, PTs, OTs, and SLPs still aren’t widely considered eligible providers for telehealth, which means they typically cannot bill for telehealth services—although there are some exceptions. This is why it’s crucial that therapists continue to advocate for legislation that will expand their ability to leverage—and receive payment for—such services. That said, helping your patients adhere to their HEPs shouldn’t be about how much you can bill. At the end of the day, it’s about helping patients achieve their therapy goals, and having an easy-to-use, accessible application that engages patients at home is crucial to improving therapy outcomes and preventing patients from dropping out of therapy early. And while providers don’t typically receive reimbursement for time spent creating and managing at-home exercise programs, those improved outcomes increase patient retention and satisfaction—not to mention help drive more referrals—and that positively impacts practice revenue.

Is there a way to reach patients who are searching for free stretching/exercise videos on YouTube?

While there’s no way for you to go into YouTube and see who’s accessing those particular videos, there are things you can include on your website to attract some of the same people. For starters, put yourself in the patient’s shoes and optimize your site for the keywords they may be using (e.g., “back pain exercises” or “bicep stretches”). Typically, these phrases will be significantly less clinical than those that a healthcare provider would use. Then, develop content based on those keywords, including an FAQ page with answers to frequently searched questions. It’s important to incorporate such keywords in an organic fashion—in other words, avoid keyword-stuffing—so you can attract potential patients who are broadly searching for help online. You’ll also want to generate online reviews that are relevant to some of the same topics. That way, when potential patients search for those keywords, they are more likely to see a listing for your clinic—as well as a slew of positive testimonials from happy patients. To learn more about not only optimizing your search strategy, but also setting a digital marketing budget and implementing paid keyword ads, download your free copy of our rehab therapy marketing guide today.

What’s the difference between patient satisfaction and NPS?

Net Promoter ScoreⓇ (NPSⓇ) is actually a measurement of patient loyalty. And according to Strive Labs co-founder Ryan Klepps, measuring patient satisfaction isn’t nearly as meaningful as measuring patient loyalty. Why? For starters, many satisfaction surveys aren’t sensitive enough to capture actionable patient data, so many providers are left with artificially high scores and no meaningful feedback to drive improvement. Additionally, you’ll need to do more than simply satisfy your patients for them to feel comfortable recommending your services to a friend; you’ll need to exceed their expectations, and customer loyalty is a better metric to gauge whether or not you’ve accomplished that.

To begin tracking your practice’s NPS score, you’ll need to ask your patients one simple question at specific intervals throughout their course of care: on a scale of zero to ten, “how likely are you to recommend [practice name] to a friend?” We like NPS because it’s measurable and standardized. Plus, it’ll help you segment your patients so you can:

  1. immediately identify unhappy patients and remedy the problem in order to keep them engaged in their care, and
  2. tap your happy, loyal patients to serve as brand ambassadors and evangelists, thereby increasing word-of-mouth referrals.

What would you suggest for a cancellation/no-show policy that won’t anger patients?

Every clinic is different; there’s no single “right” way to structure a cancellation/no-show policy. That being said, Jannenga is a big proponent of cancellation/no-show fees. When she was a clinic director, she implemented a $25 fee for patients who no-showed or cancelled without providing adequate notice. While she didn’t always charge patients the fee, she had it as an option for patients who chronically missed appointments. Most of the time, her patients were understanding of the policy, especially because she and her team always clearly communicated attendance expectations and repercussions upfront. She also made it a point to explain the reasoning behind the fee (i.e., we hold your appointment time for you, and if you do not provide us with enough cancellation notice, we can’t fill that spot with another patient).

You cited a few studies during the presentation. Could you provide links for those?

Here are the various studies we cited in the webinar, along with direct links:

  • According to a 2014 study from HIMSS, patient engagement in health care leads to improved health outcomes, “and information technologies can support engagement.”
  • A 2011 whitepaper from the Beryl Institute found that facilities that used interactive technology saw a 10% increase in general satisfaction. It also found that satisfaction with educational materials—like HEPs—increased by more than 40% when they were delivered in an interactive digital format.
  • A whitepaper from Press Ganey points out that patient experience is not a gauge of happiness; it’s a gauge of value. That same whitepaper included a review of 55 patient satisfaction studies revealing a link between patient experience and the safety and quality of care. Patient satisfaction levels also correlated to the amount of time a patient spent with his or her provider.
  • A study published in Medical Care found a definitive correlation between a positive, teamwork-centric culture among hospital staff and an increase in patient satisfaction.
  • According to a study published in the journal of Health Services Research, “patients who feel their [providers] treat them with respect and fairness, communicate well, and engage with them outside of the office setting are more active in their own care.”
  • According to research cited in a Health Behavior News Service article, “a one unit increase in the measurement of the quality of interpersonal exchanges [between the provider and the patient] led to an almost 10-unit increase in the level of activation by the patient.”
  • One study conducted at the University of Missouri found that:
    • Medicaid recipients had a higher rate of no-shows than any other insurance beneficiary type. Additionally, Medicaid patients who had appointment times outside of the public transportation schedule never showed.
    • Patients who lived five to 10 miles away from the practice were the most likely to make their appointments, whereas patients who lived 19 to 60 miles away were more likely not to show. Patients who lived more than 60 miles away almost always made their appointments.
    • Young, single men had the highest no-show rates. However, attendance for this group was better for mid-morning appointments on Tuesday, Wednesday, or Thursday.
    • Patients were more likely to show up for an appointment at a time of their choosing. The study noted that many traditional schedulers tend to book “the first caller for Monday at 8:00 AM, the second for Monday at 8:30,” and so on. But, the schedulers who had fewer cancellations and no-shows asked patients which date and time they preferred.
  • According to a study from the American Journal of Medicine, patients are significantly more likely to keep an appointment when they receive a phone call reminder.
  • A 2014 Kyruus survey of providers across 11 different specialties found that more than 25% of referrals are misdirected. Specifically, respondents noted that about half of those mismatches happened because patients were sent to the wrong specialist or subspecialist.

Hungry for more information on patient satisfaction, retention, and exercise program adherence? Be sure to check out the full webinar recording here—or take a look at this blog post on patient engagement best practices, this one on the cost associated with patient dropout, and this one on the importance of HEP software.