Patient Engagement is Patient Management and Customer Conversion

How often do you openly engage with a patient, particularly when you have a busy dispensing schedule under way and the order in your day is rapidly becoming “disorder”.
Eyes averted, you bend your head to avoid eye contact, because that would extend patient engagement, and with that, your day suddenly just deteriorated a shade further.

I was particularly thinking about patient engagement and customer relations management directly involving pharmacists, as an interesting topic to write about, particularly for intending clinical service pharmacists.
For inspiration, I looked up my marketing “bible” as written by marketing guru Seth Godin.
As usual he had the right words, even though they are in a different context, and as you read them, they plainly refer to YOU!

Please, go away

What if you had a big blue phone on your desk, and whenever you needed to, you could pick it up and instantly be connected with a smart and caring tech support expert (from your internet provider, your web host, the airline you use the most…)?

What are the chances you’d ever consider switching to a competitor that didn’t offer similar service just to save a few bucks?

The current model of big company support is to throw undervalued, undertrained, underpowered human beings at perplexed customers, frustrating and disrespecting them enough that they shrug and give up.

These are the chat rooms staffed by people who merely repeat what’s on the website.

The phone trees that bury ‘talk to a human’ at the very bottom of the options (or hide it altogether).

The reps who are rewarded for a short call and punished for escalating you to someone who can help.

And yes, the email correspondents who send notes from addresses to which you cannot reply.

In industries with drive-by customers, people you’ll never see again, customer churn is no big deal. But in businesses where the lifetime value of a customer exceeds $15,000 (I’m thinking cable, phones, travel, banking), it’s insane to blow someone off so you can save $17 in customer support isn’t it?

How to execute this shift? Start with this: Use the conference call functionality built into every phone to create a team of customer advocates. They can even work from home with a cell phone you provide. Your best customers call an advocate, and then the advocate’s job is to start calling internal resources until the problem is solved. Reward advocates not for short calls, but for delighted customers.

Start with six advocates and 600 customers and see what happens. The advocates will get smart, fast, about who to talk with and what to say, they’ll start to see what works and what’s broken, and they’ll work to change the organization into one that keeps score of the right things.

Any customer that walks away, disrespected and defeated, represents tens of thousands of dollars out the door, in addition to the failure of a promise the brand made in the first place. You can’t see it but it’s happening, daily.

I wonder how these companies would act if every day, someone piled $100,000 in cash in the parking lot and lit it on fire. For many companies, the ‘please go away’ strategy is more expensive than that.

This is representative of pharmacy today, so it’s very obvious that in today’s climate of cutting costs, pharmacists are being deleted from the payroll.
Even worse, those that are left are having their penalty rates attacked by the PGA!
Not much incentive for taking an interest in that pharmacy, particularly their patients.
Personal professionalism prevents an immediate deterioration in patient relationships – but long term, what will happen?

Recently, the Australian Self Medication Industry association held a conference to deliver a range of papers involving pharmacy.
Our editor attended and he brought back s few interesting stories for i2P writers.
He told the story of Virginia Trioli, the very professional ABC presenter who led the program for the day.
She described how she felt uncomfortable asking to see a pharmacist because every time she entered “her” pharmacy, the pharmacist was always “flat out”.

It was embarrassing to interrupt someone who was obviously under stress even though the pharmacist eventually appeared and was quite helpful.
As a patient, Virginia felt uncomfortable with her pharmacist experience because she did not feel fully engaged.
She decided to visit what appeared to be a “less busy” pharmacy so as “not to be a disturbance” for her original pharmacist.
She described her new experience as “cheerful” and “unhurried”.

Most importantly, she described her return experience as “fulfilling” because as soon as she entered the pharmacy she was greeted with a “Hi Virginia, let’s have a quick look at that blood pressure of yours” and before she knew it she was completely engaged in a seamless manner, being serviced for something that was a concern to her (elevated blood pressure) and everything conversational in a friendly delivery that was non-threatening.

She still attends that pharmacy after years of being with her former pharmacy and each time she enters she is greeted by her first name and is engaged in a manner that she finds very satisfying.
As she commented: “Being swept off your feet is better than waiting around for someone to appear from a stressful “inner sanctum”.”

The end result of a professional patient engagement is the Seth Godin “pile of cash in a parking area” migrating to that pharmacy and gainfully employing more professional pharmacists and support staff along with investment in infrastructure.

In all of this I am reminded of what pharmacists did during earlier models of pharmacy that really worked.
Control of pharmacy since those days has passed to the payer – the PBS system.
In this I am also reminded of the old story of the roadside pie vendor selling a quality product cheaply and deliciously by the kerb of a busy road.
The product was good and sold well, and the pie-man was able to save money towards his son’s university education.
Years passed and the pie-man still prospered and his son graduated from university with a master of business administration degree.
The son immediately applied his knowledge for his father.
“Dad”, he said, “Your product is too cheap. Why don’t we increase your price and cut out some ingredients?”
“That way you will be able to weather the recession we are about to have.”
So the pie-man did exactly that. After all, his son was now a business expert!
Time went by and six months later the pie-man said to his son: “You were right son! Pie sales are declining – we must be in a recession. And if it keeps going I will have to sell the pie cart or close down.”
Substitute the PBS for the son of the pie-man and join the dots.

The same ASMI conference also produced an interesting speaker in the form of Dr Alison Roberts who had just completed a trial involving “forward pharmacists” in a range of community pharmacies for the PSA.
Alison proved conclusively that a “forward pharmacist” dramatically improved the bottom line of a pharmacy and that the pharmacists paid their way and were not a burden to pharmacy profitability.
Quite the opposite.

So what constitutes the requisites of a customer/patient management relationship?

Well, obviously the starting point is a pharmacist not involved in dispensing and having a work station well away from the dispensary.
A dispensing pharmacist is left with that responsibility.

i2P has done its own research in this regard and recommend a specialised work bench called “Health Station Central (HSC)”, which is simply a sit-down work bench located near the front door of the pharmacy.
The pharmacist stationed there is intended to greet and engage with every customer/patient entering the pharmacy, helped by other clinical assistants who have trained to a level to earn a spot on the HSC.
Alison Robert’s study noted that pharmacists not completely segregated from the dispensary tended to migrate back there because they had no “home”.

The HSC must be developed to be a communications base and the range of equipment and software is distinctly different.
iPads become the primary tool to further patient engagement and deliver services.
A laptop computer may also be necessary because some computer tablets will not link in with printers or access the dispensing software without some form of intermediate software that may have to be developed.

Customer Relationship Management (CRM) software is well-developed in commerce and is at the stage where it is “off the shelf” if you wish to purchase a quality system.
Many of these systems are now evolved as “cloud” systems where you start with basic modules, pay a monthly “rent” and build in additional modules as the business grows.
Many of these systems can be adapted to handle patients, but most would be incomplete.

So it may be necessary to build your own system with each segment being managed by a different system, but with the future prospect of commissioning your own system to incorporate all the segments.
Or maybe an enterprising pharmacy software developer will come up with a useful system to embrace all the “segments”.

The problem for a developer is that no recognised work flow exists in a range of community pharmacies as yet.
So, budding clinical pharmacists need to cobble together a system to embrace as many as the following segments as possible.

1. Knowledge Management – a system that can access knowledge databases and be able to deliver excerpts for patient reports.
I would personally recommend Evernote, a system where you are able to “clip” data from an Internet page and store it as a “note” in the Evernote system.
Evernote comes complete with a chat system to link in with patients or other people you communicate with.
You can store templates for patient reports e.g. HMR’s, retrieve them and insert data from an HMR interview.
You can share documents from Evernote or print them from Evernote.

The software can be installed on more than one computer and synchronisation between computers is automatic.
It is a good and flexible starting system which is also secure.
You can store patient reports within their own designated folder and you can retrieve patient information or knowledge notes through an internal search engine.
It’s free until you begin to use a bit of storage, but the annual charge is modest for quite a large amount of storage.
Go to and download your own free copy.

Evernote also couples with other useful software such as Livescribe, which can convert hand written notes to pdf files and store them in Evernote seamlessly and electronically.

In conjunction with Evernote I also use a form of transport software called Dropbox.
Dropbox is useful if you want to transfer “heavy” files such as X-Ray and MRI images.
This is also free software to a reasonable level of storage before a modest monthly fee kicks in.
You can allocate individual patient folders and share information privately with those patients.

Dropbox files can be imported into Evernote creating a higher level of patient profile.
Get your own free copy from .
Dropbox duplicates some of the activities of Evernote, but it is useful for file sharing and transfer, because it is almost instantaneous.
To keep storage size and cost to a minimum, all files can permanently migrate to Google docs and be managed or archived in that area. Google docs comes complete with a calendar, office software and a storage system that can retrieve via a search engine. Also, Internet access through the Google search engine can be performed if more knowledge sites need to be accessed.

Google docs functions as both an archive and a backup to all systems mentioned.

The second major segment system is one for contacts and most email systems satisfy this function.
The system can be used for patients and customers, current or potential patients/customers
You can operate at a B2C level (patients and customers) or as a B2B business.
The major function will be to maintain pharmacy customers for conversion to patients.
The list could also double as per Seth Godin’s suggestion for a team of telephone advocates to create “conversions”,
The people being contacted will listen to your advocates because they know and listen to you.
Appointments can also be sold remotely using Skype as the interface and these types of appointments can be scheduled for transmission from your home to their home, or any other comfortable location (but still includes a pharmacy).

B2B may be an alternate source of patients e.g. if you offer to provide a Medscheck for patients held by chiropractors, naturopaths, exercise physiologists, physiotherapists etc. you may find this group of health professionals a new source of patient referrals to you.
You may also want to refer some of your patients to them as well.

The third major segment will be supplier B2B businesses that provide say, stationery or equipment like blood pressure monitors, or practice items like stethoscopes.
As a clinical practice grows, so do its requirements and appropriate sources can form up into a valuable database.

The fourth segment is used to track potential sales through customer to patient conversion or through a new health practitioner relationship.
One of the primary functions of the HSC desk is to provide information packs to potential patients that promote the services you provide.
The objective is to create an appointment with possibly the first appointment offered free of charge to get the process started.
For this you need software to list tasks and make appointments as part of those tasks.
The links below will take you to suitable software for organising tasks.
The second software item automates patient appointments by sending SMS reminder messages the day prior to the appointment as a reminder.

As you can see from all the above, possibly the most important activity within a pharmacy to support clinical services is a support system that involves all of the above in as simplified format as possible.
The recruitment of patients is an ongoing process, the most important sources being existing customers and other health professionals.
An email newsletter directed to customers and patients may also be a valuable addition to develop and grow your patient list, and generate appointments.

Why sell toilet paper and toothpaste if your customer sources them next time from a supermarket – because you cannot sustain the price long term.
Certainly use those items to attract new customers.
But convert them to patients and you immediately build core business and goodwill that the supermarket cannot compete with.

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