2. Effects of TeleVox on DNKA Rates and Customer Service

4. Study of Community Health Clinics Data collected for five clinics: ► Diamond Hill ► Northeast ► South Campus ► Stop Six ► Viola Pitts Data collected for five clinics: ► Diamond Hill ► Northeast ► South Campus ► Stop Six ► Viola Pitts

5. CHC Fiscal Year 2003-2004 Dashboards No-Show (DNKA) Rates Prior to TeleVox The following table shows that the average no-show rate ranged from about 23% to 24% in the two years prior to the implementation of TeleVox. These rates are based on a total of 222,440 patient visits for all five clinics. The following table shows that the average no-show rate ranged from about 23% to 24% in the two years prior to the implementation of TeleVox. These rates are based on a total of 222,440 patient visits for all five clinics.

6. CHC Fiscal Year 2005-2006 Dashboards 2005 – 2006 DNKA Rates In the two years since the rollout of TeleVox the average no-show rate has dropped from a high of 24% to 19%. The 2005-2006 rates are based on a total of 263,165 patient visits for all five clinics. In the two years since the rollout of TeleVox the average no-show rate has dropped from a high of 24% to 19%. The 2005-2006 rates are based on a total of 263,165 patient visits for all five clinics.

7. 2003 – 2006 DNKA Rates 2003200420052006 Stop Six26.3%31.3%38.2%24.7% Viola Pitts27.1%26.7%23.0%22.0% Diamond Hill26.4%21.3%20.0%18.0% Northeast22.4%17.8%16.0%15.0% South Campus17.5%16.0%16.3%16.0% Average DNKA23.9%22.6%22.7%19.1%

8. CHC Consolidated 40/50Report FY 2003-2005 Average DNKA Rate 2003 - 2006

9. Declining DNKA The minimal difference in the DNKA rate between 2004 and 2005 may indicate that patients had some trouble adjusting to the new system, which is typical for any new technology rollout. However, the rate dropped 3% in the second year, which is a significant improvement. The minimal difference in the DNKA rate between 2004 and 2005 may indicate that patients had some trouble adjusting to the new system, which is typical for any new technology rollout. However, the rate dropped 3% in the second year, which is a significant improvement.

11. Cost of Calls by TeleVox

12. Cost of TeleVox The pricing model for TeleVox is based on units of service. The price per unit changes based on the number of units used (the number of calls made). The pricing model for TeleVox is based on units of service. The price per unit changes based on the number of units used (the number of calls made).

13. Usage and pricing provided by Kay Melugin TeleVox Usage Oct 06 – Mar 07 Oct 06Nov 06Dec 06Jan 07Feb 07Mar 07 #Items606925069637842547385431853899 Unit Cost$0.16 $0.17$0.16 Total Cost$9,710.72$8,111.36$6,433.14$8,758.08$8,690.88$8,623.84

14. TeleVox Productivity 312,185

15. Did you know… TeleVox speaks nine languages Can a reg rep do that? TeleVox speaks nine languages Can a reg rep do that? Bonjour??

16. Cost of Calls by Employees

17. Registration Rep Salary Salary - $10.25/hr Add 15% for benefits - $11.79/hr Diamond Hill had 2.37 reg reps in March 2007 Salary - $10.25/hr Add 15% for benefits - $11.79/hr Diamond Hill had 2.37 reg reps in March 2007

18. Example: Diamond Hill, March 2007 # CallsAverage DurationTotal Time Incoming Calls38341:1378 hours 9 minutes Outgoing Calls24781:0645 hours 7 minutes 6312 TOTAL123.27 hours 1,121

19. Example: Diamond Hill, March 2007 TeleVox Calls3749 Failed Calls486 3263 1:13Reg Rep Average Duration 66 hoursAdditional call time

20. Example: Diamond Hill, March 2007 123.27 hours x $11.79 per hour = $1453.32 $1453.32 / 6312 = $0.23 per call

21. Cost Comparison TeleVox cost per call $0.16 – $0.17 Reg Rep cost per call $0.23 60,692 calls made by TeleVox in October 2006 for $9,710.72 $0.23 x 60,692 = $13,959.16 TeleVox cost per call $0.16 – $0.17 Reg Rep cost per call $0.23 60,692 calls made by TeleVox in October 2006 for $9,710.72 $0.23 x 60,692 = $13,959.16

22. Cost of DNKA

23. Cost Per DNKA Average Cost per Visit…… $90.00 $62.50 Doctor Salary $250/hr x.25 $152.50 ( 15 minutes downtime per DNKA)

24. 2006 DNKA Cost* Total Patient Visits135,128 DNKA Rate19% # DNKAs25, 674 Cost per DNKA$152.50 Total DNKA Cost$3,915,334 *Diamond Hill, Northeast, South Campus, Stop Six, Viola Pitts

25. 2006 Visits/Revenue Gained* *Diamond Hill, Northeast, South Campus, Stop Six, Viola Pitts Total Patient Visits135,128 DNKA Rate19% DNKA Reduction4% Visits gained5,405 Revenue gained$486,450

26. Additional Benefits of Shrinking DNKAs Improved efficiency for busy registration staff Better service Decreased wait time for patients Improved efficiency for busy registration staff Better service Decreased wait time for patients

27. 2005 - 2006 Press Ganey Reports Patient Satisfaction Scores 2005 - 2006

28. 2005 - 2006 Press Ganey Reports Question2005 Mean2006 MeanNet Change Access to Care77.178.11.0 Ease of scheduling appointments78.981.02.1 Courtesy of person scheduling appt85.085.30.3 Speed of registration process76.576.0-0.5* Courtesy of registration staff81.882.20.4 Waiting area comfort/pleasantness76.177.61.5 Wait before going to exam room67.369.32.0 Cheerfulness of practice82.283.21.0 Likelihood of recommending practice84.886.51.7 Press Ganey 2005-2006 2005 n = 475 2006 n = 1300 *Net Access

29. Benefits of Decreased DNKA DNKA Continuity of Care

30. The Internet Journal of Medical Simulation and Technology Jan 2005 v1 i1 pNA Benefits of Continuity of Care Decrease in emergency department visits A decrease in the likelihood of future hospitalizations An increase in patient satisfaction and the use of preventive health services Decrease the cost of health care Decrease in emergency department visits A decrease in the likelihood of future hospitalizations An increase in patient satisfaction and the use of preventive health services Decrease the cost of health care

31. Recommendations Consider revising Spanish language script, get feedback from Spanish speaking patients Have the Caller ID name display as something other than JPS so that patients don’t assume a bill collector is calling Consider revising Spanish language script, get feedback from Spanish speaking patients Have the Caller ID name display as something other than JPS so that patients don’t assume a bill collector is calling

32. Recommendations Make sure that clinic staffs are using the TeleVox reports to ► adjust staffing/scheduling ► Identify trends and repeat offenders Remind patients when scheduling appointments that they will receive a phone call two days prior to their next appointment, and stress the importance of canceling appointments they cannot attend Make sure that clinic staffs are using the TeleVox reports to ► adjust staffing/scheduling ► Identify trends and repeat offenders Remind patients when scheduling appointments that they will receive a phone call two days prior to their next appointment, and stress the importance of canceling appointments they cannot attend

33. Special Thanks Pat Mohler Martha Melanson Linda Hicks Mayra Urbina Pat Mohler Martha Melanson Linda Hicks Mayra Urbina