0 to 60 from a Virtual Standstill
Three orthodontists discuss getting back to practicing in the new virtual age and what it feels like when you are going from zero to sixty from a virtual standstill.Learn More
Join Allison Parks Hale of Parks Orthodontics as she discusses all the necessary steps you need to take when reopening your office during COVID-19. Learn how to use Cloud 9 + Rhinogram to easily adapt to our new environment, while ensuring that patients feel safe returning to your office.
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Video length = 0:38:14
Erika Grau (EG): All right, welcome everyone. My name is Erika Grau, Director of Marketing here at Rhinogram. Thank you for joining me today as Rhinogram and Cloud 9, present a live case study: A Guide to Relaunch your Practice During COVID-19. Let’s go ahead and mute our presenters.
All right, Lea Craycraft has more than 30 years of experience in the orthodontic industry and has filled almost every role in an orthodontic office. She is a seasoned Territory Sales Manager with Cloud 9 Software and is known for being passionate about creating success for the doctors and teams she has the privilege to work with. She brings an open mind and positive attitude wherever she goes, and her industry insights are incredibly valuable to Cloud 9. Welcome Leah. Say hi, maybe wave to everybody.
Lea Craycraft (LC): Hi.
EG: All right. I’m also joined by Allison Parks Hale of Parks Orthodontic with over an decade of experience in practice management in real time in the trenches problem solving, Allison is able to quickly and efficiently identify key areas of improvement within practice and implement practical system-based solutions. She specializes in Cloud 9 Software, rebuilding outdated systems, improving productivity and profitability, and building on the practices strong foundation to broad an excellent patient experience. Welcome Allison. Thanks for joining us.
Allison Parks Hale (APH): Hi, thank you.
EG: All right. Just a few housekeeping items before we get started. Just want to remind everyone that we will send out the recording of this live webinar via email. If you have any questions throughout the presentation, please do ask them in the go to webinar control panel. We’ve saved a few minutes at the end to answer any questions. If we don’t get to your questions during this live event, we’ll be sure to follow up via email or phone call. All right, Allison, are you ready to get in?
APH: Yes, absolutely.
EG: So let’s talk about what you were up to while your practice was closed during COVID-19. How did you offer virtual smile assessments while being closed?
APH: Well, we really saw the value in Rhinogram during our mandatory COVID closure. We used Rhinogram to develop custom templates to communicate with our scheduled new patients. Each new patient receives a text message with instructions on how to send us images for their smile assessment. Then Dr. Parks and our TC reviewed those images and provided a provisional treatment plan, which was discussed at the patient by phone. The new patient was then scheduled for a records appointment upon our reopening. We really saw at that time that using Rhinogram, we were able to see our new patients and our existing patients, including fixed appliances, Invisalign checks, retainer checks. Rhinogram really did allow us to do so much more in less time.
LC: So Allison, have you leverage teleworking and remote work capabilities to limit the amount of patients or even staff members that are in your office at one time?
APH: Absolutely. During our COVID closure, Dr. Parks was able to work from home. She screened patients there viewing images, making necessary treatment card notes the same as she would in our office. We also had several team members working from home during that time, which limited our in office contact. For example, our Financial Director and our PR Director both work at home on a regular base basis. And for myself as Chief Operations Officer, I love that I can use the full capability and functionality of Cloud 9, no matter where I am. The big joke is that if I’m ever not in the office, I always have my laptop and I pretty much work from anywhere. I’ve used Cloud 9 while on vacation in Europe and the Caribbean. I’m pretty much always available. Sort of an occupational hazard there.
EG: That is truly so impressive. Let’s kind of talk about when you guys started to reopen the office. How did you market the reopening of your office?
APH: Well, this was a big question. Unlike some other practices in our area and in our industry, we did not stop our marketing efforts during the COVID closure. We felt it was important to utilize our marketing team or public relations at that time to let everyone know what we were doing during closure, and also that we would be back. In terms of marketing it to patients. The first thing we did internally was triage our patients based on their need and also by productivity. We wanted our first days back in the practice to be productive and we wanted to address the patients with the most urgent needs. Week one was really spent seeing starts, de-bonds, our Invisalign deliveries, new patients, and our emergency repair patients. After that, we leveraged our social media outlets to spread the word that we were open.
APH: We relied very heavily on texting through Rhinogram during this time so that we could spend less. Rhinogram made it so much easier than fielding a zillion phone calls from patients who were dying for appointments.
EG: That’s awesome. I love this graphic that I took from your Facebook is absolutely just fabulous.
LC: Yeah, it, it does look awesome. Allison, how were you able to ease your patient’s anxiety?
APH: Well, it’s funny that you mentioned that infographic. This is a really great question. We feel like we did a very good job of that. We created, together with our marketing team, an infographic that illustrated the changes that our patients would come to expect when they came in for their visits. Using the Rhinogram reminder system, we broadcast this infographic to our appointment list. To limit the number of people in our office at any one time, we wanted to let our patients know that their car was going to be our new waiting room. We also developed scripts for our administrative team to use that would explain the infection control procedures that we were putting in place for this time.
APH: Rhinogram also helped us to minimize staff movements about the office during check-in and especially checkout. Once patients arrive to our office, they shoot us a text from their car. We text them back when the doctor is ready and this minimizing contact really helped show our patients that we were taking their safety and health seriously.
EG: That’s awesome. All of your marketing materials do such a good job with that kind of text first mentality. I love this need a response quickly, and it has, text us directly.
APH: We’re very blessed to partner with an amazing marketing company. They make us look good at every turn. I would love to take credit for this, unfortunately I can’t. The Virginia Creative Group makes us look like rock stars and really are the brains behind our marketing operations. We got to thank them.
LC: I would just add that as a mother that to me, puts me at ease. So good job, kudos on that. Teamwork.
EG: Woo! High five. Let’s talk about how you guys have been onboarding new patients in this digital world.
APH: Yes, this has actually been great and has produced some new workflows that we are going to be using now completely. Now that we’re back open from COVID. For new patients, I’m sure you all know there’s always a lot of paperwork between information forms, consent forms. With Rhinogram and Cloud 9. We’re able to send out that paperwork to patient’s phones ahead of time. They have a secure link to fill out their forms. We ask for their photo ID, we ask for their insurance card so we can get all that in process in advance of their appointment. It does such a good job to reduce the time that they’re spending in our office and it allows us to onboard them before they even walk in the door. It’s been amazing and we are definitely going to keep this up post COVID.
LC: Okay, so I’m curious on another note. Are you just storing those documents then in the document cabinet once you receive them?
APH: We are. So we’re able to download them as a PDF and when the doctor is ready to pull up health history, she pulls it right up from the document cabinet. Everything is named and labeled so that she can find things easily in there.
LC: Very nice. Let’s talk about… Because I know everybody is trying to get their PPE ordered and having difficulties with that. I’d like to know how you and your team address that and got enough supplies in your office? Then let’s also talk about how you manage the simple things, like taking the temperature of patients and possibly do you also take temperature of your staff members and are you tracking that within Cloud 9?
APH: Yes. Great questions. We felt like right out of the gate, the first thing we needed to do to ease anxieties among our staff was to let them know that we had thought through a PPE plan for them and protective measures for our staff. That really went a long way with helping them to come back in the office after closure feeling really confident that we had their protection in mind. We did have to order lots of PPE from many different sources other than our usual sources. My advice to reopening practices would be to start now, look outside of your regular vendors. There are lots of great vendors out there that have things, that have started making special PPE during these closures. We had to think outside of the box there.
APH: But with our team, we also do the daily temperature checks like you mentioned. We ask them a series of questions about their exposure. We do the same thing for our patients. They complete a COVID screen that we send a link through Rhinogram before their appointment and we can mark in our patient’s schedule. On the slide, you can see a little red medical symbol. That’s how we let our team know that we’ve received a COVID screen from that patient. You can see, just on a side note, the little green check mark there is to let us know that they have replied and confirmed their appointment through Rhinogram and that we love that. Then the very bottom there in tier three, you see a little pencil. We use that icon to let all the administrative team know that that patient has completed all of their contracts for starting treatment that day.
LC: Oh, I love all those good job.
APH: That’s been a nice little development, but in term… Back to PPE, we are using level two and three masks on all clinical team members. They’re wearing face shields. Launder-able isolation gowns. They had a knit cuff. They tie in the back and they have a sort of a waterproofing or protection film on them. They’re a little bit shiny. You can also get disposable ones although the price point on those are a little higher considering their disposable. We do like that we can add our temperature notes to Cloud 9 under the staff time card and we can also put the patient temperatures in their treatment card or in patient notes.
LC: So on that, I just have a couple questions for you. The first one, Rhinogram confirms the appointment, it makes it automatically apply the check mark to the schedule?
APH: Yes, because Rhinogram is integrated with Cloud 9. It does have a sort of a two-way conversation, which is nice.
LC: Very nice. And then a second question was, so your recording that just in the notes section of the time card? Is that-
APH: For the staff, as they are clocking in and out through. Cloud 9 there’s a note section where that can be recorded. And it keeps a log on the time card so we have that as a record.
EG: I have a question for you, Allison, this is kind of a tricky thing that I think practices are going to now have to learn how to manage. What do you do if a patient has a temperature that’s too high or it’s not good for them to come into the office?
APH: Well, we do have someone at the front desk, as I said, taking temperatures and doing those COVID screens. And we know that the threshold for COVID would be a temperature of 100.4. That anything above that… or 100.4 and above is going to be a cause for concern. Luckily it has not happened in our four weeks of being open, but we did develop a plan and a script that if this did happen, that the front desk would call back to my office immediately and then I personally would go around. Speak to the child or the adult and let them know that we weren’t going to be able to see them for the visit that day, advise them to go back to their vehicle, go home, take their temperature again and if necessary call their medical provider.
APH: If in the case of a child, I also would make a phone call to their parent in the car because our parents right now are staying in the vehicle while their child is treated. Unless of course they are very young or have a special need or are there for the very first time. In that case, we’re allowing those parents to come in.
LC: Scripting is so important. Is it not?
APH: It is.
LC: Questions that I’m sure everyone out there has is… Because everyone’s concerned about what their environment’s going to look like when they come back. What have you guys done, physical changes to your office, to accommodate our new normal?
APH: Well, safe distancing is obviously on everyone’s mind and we are very blessed to have an open bay clinic area. We have nine exam chairs and they are already a nice distance apart, but to add an extra layer of safety, we had our clinical team separate themselves to go to every other chair. Now we have them, the chairs are easily 6 feet or more apart. And we have two chairs for patients on the opposite end of our clinic that are semiprivate so if we do have a parent who needs to be there with their child. We will seat them back in that semi-private area so we can observe those safe distancing rules.
EG: Have you made any staffing changes post COVID?
APH: Yes, actually we have, and it’s been very interesting to see what skills your team has and what skills shine through during sort of a crisis. But we did bring on a summer intern and a new clinical team member who’s full-time to work taking patient records. We also rearranged some of our team members too. Again, areas where we felt they could be most effective. We have our PR Director who is typically a work at home position. She’s doing check-in and wellness screens at the front desk and it’s great because her upbeat personality really makes the patients feel at home and excited to come back in.
APH: We also now have a full-time Sterilization Specialist. She keeps up with sterilization, she wipes down the stations and the chairs. She handles all of our in-house laundering of scrubs and those isolation gowns and she administers our peroxide rinse chair side. Having her there has been an amazing addition. Since we reopened everyone really has had to adapt to changes very, very quickly and improve their skills.
EG: That’s awesome. How has the day to day workflow changed in your office?
APH: It’s changed a lot actually, since our parents are no longer coming into our office, we’ve eliminated our lobby. Closed down our brushing station. We converted it to a hand washing station. We don’t have our refreshment station open right now, which has been… I think our parents are disappointed. They can’t get their daily coffee, but hopefully that’s not for too much longer. We’re also using Rhinogram texting, as I said earlier for patient check-in and this helps to just eliminate the number of people moving through the practice. We’re using Rhinopay to collect patients initial payments when they begin treatment and any patients who have outstanding balances. That’s been a great way to eliminate the exchange of paper. Plus we are able to post that payment information directly into Cloud 9 and then keep track of their finances that way. We did have to add a new payment type into Cloud 9 as Rhinopay so we could keep all of our finances in a row and reconcile those payments at the end of the day, but it’s worked out really well.
LC: So on your close the day report, that makes it a lot easier?
APH: Yes, and keep that [crosstalk] all segregated into one area, you can match it up with what came in that day versus what you posted into Cloud 9 that day.
LC: Way to take advantage.
EG: So you mentioned earlier some of the templates that you guys are using. Tell me about some other templates that are in your favorites.
APH: Well, we have set up a ton of new templates in Rhinogram to meet the new communication needs of our patients and we are able to tailor it also to individual patients. So if you’re starting Invisalign treatment or you’re starting fixed appliance treatment, or you’re getting braces off. We’ve set up templates to communicate with those patients right there in Rhinogram. Also, our team has chosen their own favorites so that based on the department and their need, they have all of their most used templates right there at the top. I feel like I’m creating a new template every day, a scenario arises, and I think I’m going to have to type it out more than once. I’m going to make a template for it so not only I can use it, but somebody else on the team as well.
EG: That is awesome. I’m sure it saves a bunch of time.
APH: It does. And a lot of typing too.
LC: But like how you can customize it so it changes with you. I think that’s a good thing. But speaking of that and going forward with the way the world is and the rioting and whatever is going on. Heaven forbid we should have a spike and we would have to do more closures. Do you and your team have a plan for that? How would you handle a second closure of COVID?
APH: We feel pretty confident that if we were to experience another COVID emergency related closure or a closure related to unrest, that we would be in a pretty good place to handle it. Part of that is because Cloud 9 allows us to access patient information anywhere, anytime with any internet connection, which is huge. And Rhinogram allows us to instantly communicate with our patients right where they are at any given time. If you can imagine patients all have their cell phones right next to them, pretty much at all times so nowadays they might not pick up their phone to answer our phone call, but they’re very likely to read that text message that we sent them and respond when the time is right for them.
APH: But I do want to note that all texting apps are not created equal so if you’re out there and you’re listening to this and you think, oh yeah, I think my software might have texting, or I think my reminder system has texting. We chose Rhinogram because of their user security and customization capabilities. They are developing new features faster and better than anyone else out there. So really do your research before you choose a texting application. Rhinogram is way ahead of the pack.
EG: I have a question for you. How does Cloud 9 and Rhinogram enabled you to carry out this plan? I have this, I think this is from one of your templates maybe.
APH: Yes. We facilitated a plan to keep up with patients through Rhinogram and offer them virtual visits during our closure. Now, we’re doing retainer checks virtually. We’ll send this template of photos that shows views of the teeth that we want to see. The patient will send the photos back and we’ll reply letting them know the photos look good. The doctor wants to keep an eye on things. We also let them know that we couldn’t wait to see them once we reopened and we feel strongly that we can triage our schedule so patients will feel comfortable seeing the doctor virtually instead of in person. Their treatment is still progressing, even though they’re not coming into our office and we’re not seeing them in person. Also the fact that we can send secure messages through Rhinogram with attachments and links to video, it’s super helpful. Plus with Rhinogram it is guaranteed that we have security and HIPAA protection.
LC: With your virtual appointments, do you feel like you’re going to continue to do more virtual even though you’re getting past COVID
APH: Yes, In fact, that’s our goal. We have started to list different appointment types that we would like to remove from our schedule altogether. Unless of course there’s an urgent patient need, but doing specific Invisalign checks, retainer checks, all of that can be done virtually. We can also check phase 1 appliances, the appliances that are moving teeth very slowly. We can also use the same virtual method to check patients now. We’re also doing all of our contract and again, as I mentioned earlier, all of our paperwork virtually as well. That is definitely continuing because it saves the patients so much time in the office.
LC: I wonder if on those patients that are slow eruption patterns and they wouldn’t be seen out normally for 12 months. Do you think it be advantageous to have that six month check done virtually because there probably haven’t lost any teeth yet, but still you have that contact with them and you could retain them as patients. Do you feel that way?
APH: Absolutely. One of the things that we ever learned over the years is that sometimes 12 months is a long time to wait between visits and it’s out of sight out of mind. We’ve developed communication over the years to keep in touch with our observation patients between those visits, but what a great way to be able to get some FaceTime.
APH: With having a virtual visit. That’s amazing. Yes, something we could definitely do.
EG: That’s awesome. All right. Well, thank you guys so much for joining me. Just want to remind everyone that we are recording our session today. We will send out a copy of this recording as well as the slides if you want to look through any of that and check out Allison’s awesome marketing posts. Those are just so fabulous.
APH: Thank you.
EG: If you have any questions, please do ask them in the go to webinar control panel. Looks like we have a few questions here. For Allison, can you talk about how the reminders work with Cloud 9 and Rhinogram?
APH: Absolutely Rhinogram has an Appointment Manager that allows you to bring up a dashboard of all of the patients that are set to be seen within a different timeframe. You can customize it to today, tomorrow, next week, custom date range, and then you can either send them a one off text message. For example, if you know you’re going to have an unanticipated office closure, you could send them a custom message. Otherwise, you can send them just a static message that tells them about their upcoming appointment and anything that they need to know ahead of that appointment. Again, it does integrate directly with Cloud 9. So you’re able to go into your schedule and see what patients have confirmed their appointments and which patients have not, and maybe shoot them another text or give them a phone call and see if they’re going to come. Since I’ve been working in this practice, we’ve used four different reminder systems. This is going to be our fifth and last one. Everything is working great. We love it and our patients really have responded well.
LC: I have two questions about that. How often do you send out reminders in your office? Do you send out multiple reminders?
APH: It is based on the timeframe and the way Rhinogram works is you can set a timeframe ahead of the next appointment. We’ve done multiple different patterns where they receive multiple reminders ahead of that appointment, but we’ve found that with text messaging, we really don’t need to send out as many. They might get depending on when they make their appointment one or two reminders ahead of their appointment, but usually it’s about 24 hours. But Rhinogram allows you to customize that.
LC: Okay, so after you set up your reminder queue, if an appointment changes, is there communication between Rhinogram and Cloud 9 that will adjust that so they’re not getting a reminder if they change their appointment time?
APH: Yes, now of course there is that threshold. If a reminder has already gone out and they change it within that 24 hour period, they’ve already got that reminder out there that they’re supposed to be there. But if they make a new appointment, then a immediate reminder is generated upon making that appointment. So they should get a refreshed reminder if they change it within that 24 hour period.
APH: Erika, correct me if I’m wrong on any of that.
EG: You know your stuff. I was just going to say, it seems like you’ve had experience with other reminder softwares that may have not have been so user friendly. Do you find that it’s nice for the patient that it just not an automated, kind of text one to respond that people actually respond, “Hey, I’m five minutes late or I’m going to be… need to reschedule.” Do you get those kind of messages from your-
APH: Yes, it’s great because we can immediately then free up an appointment time that morning for someone who we know is sitting on our sooner list. Waiting to be seen sooner than their regularly scheduled appointment. We really work with Rhinogram. I mean, it is up all day, every day within our administrators’ computers, and anytime anyone’s canceling, we are… That schedule is a living thing. We are filling those appointments just as quickly as they may be rescheduled.
EG: All right. It looks like we have another question. This is a great question for you, Allison. When you guys started using Rhinogram, how do you get the team buy-in how do you get everybody using Rhinogram and loving it?
APH: I get this question a lot, especially about new things that we implement in our office. Dr. Parks and I… We were just chuckling about this the other day. We sort of were raised in a sort of a sink or swim environment with our Dad whose practice we now run. Same thing goes with our staff, when we have something new, we are just super enthusiastic about it. We say, “Hey, look guys, this is something new we’re doing. It’s great. We’re all full force, jumping in feet first into the deep end.” And the expectation is just there.
APH: All the decisions we make are what’s best for our practice and our patients, and I think our team knows that. If we are going to make a change in our communication system, I think the expectation is, “Well, we better get on this.” We’ve been really lucky to have a very, very adaptive team. They know we’re not afraid of change so it’s worked really in our favor. Especially during this time of great change that they know that we’re going to do what’s best for them, what’s best for our patients, and they’re usually on board without too much whining. So it’s nice.
EG: That’s great.
LC: Trickles down as well and just listening to you, I’m getting excited before you and your team.
APH: Well, none of this would be possible with our practice without our amazing team. We had, as you all may know, this past week was Orthodontic Staff Appreciation Week, which really came at a good time because everyone has been working very hard and hot in their PPE, which I just bless their hearts back there in the clinic with all these extra layers. But we really enjoyed having the time to thank them for all their hard work. And I told them on Wednesday, I reminded them about this webinar, and I said, “Guys, I’m going to be talking about how great you all are and how you’ve adapted to change so well.” and really it’s them who have made this possible for us in our practice. They’re just the dream team as I call them.
EG: That’s awesome. We have another question here that says, “Can you talk more about the attachments you use in Rhinogram and what those are?
APH: Okay. I’m assuming we’re talking about attachments, like where you can add a file to your message. It’s just like any attachment you might add into an email. Usually they are, unless you send it as a secure message, they’re going to be an image file. So some things I might send would be that infographic that would say, “Hey, here’s what to expect next visit.” We also send a link to our braces instructions video, and our Invisalign instructions video to every new patient that starts. We have some retainer care information that we send out to de-bonds after those appointments. I’m trying to think what else we send. Images, I feel like when I’m getting ready to start a new patient, I’ll send them an image of their treatment plans so they can go through and select the option if they haven’t already done so. It’s amazing. You can send a photo. “Hey, this is the, this is the angle we’re looking for on your intra-oral images. Hey, can you, can you snap a quick one with your iPhone?” Things like that.
EG: That’s awesome. It looks like we have just one more question. “I live in a state where we have not yet opened, but it looks like we’re going to be opening soon.”
EG: I know. Exciting. “What would be your advice on staffing? I’m so impressed that you’ve kept your same staff and even it looks like you’ve added new people. Good job.”
APH: Well, thanks. We were very lucky that everybody wanted to come back to work. If your practice has been closed and you’ve maybe had a limited crew in there. Hopefully your staff is going to be enthusiastic about coming back. I did a lot of communicating with the team over the four weeks that we were closed. Just to let them know. Keep them apprised of what we were doing, plans we were making. They really did still feel like they were part of the team, even though they weren’t in the office every day. Coming back my best advice to you is to make them feel safe. Let them know that you have thought about every possible scenario with PPE. Let them know that you have all of that in place and are ready to protect them first and foremost. Then they’re going to embrace that level of safety for your patients.
APH: I would also encourage you to practice your new workflow. This was something that we did the last couple of days before we went live and reopened with patients. We established that workflow. We talked it through, we rehearsed it a number of times, and then we figured out, “Hmm, we really don’t like the patient going that way. The patient’s coming into too much contact. Let’s switch this up.” Doing that practice is really going to help everyone feel confident on day one because the first week is going to feel so different. You want to be ready. You want to be ready for that mom who’s going to insist on coming in with her child. And how are you going to let her know that their child is safe? We developed a lot of scripts for that, and it’s made the transition a lot easier. Everyone knows what to say.
LC: Allison did you and your team do a lot of virtual meetings while you were getting ready to come back? Do you think that was helpful as well?
APH: We did. We actually had two types of meetings because as you know, during that mandatory closure, no one was going anywhere and we felt that we needed to do some work related meetings, as well as some social meetings. We held zoom meetings for our sort of social happy hours and we would do those about once a week for whoever was available. It was not mandatory, could get on and we would just talk as friends, as coworkers, and just catch up.
APH: Then one to two times a week I would get on, we have a in-office Facebook group that is just for our staff and typically that area is just used to post fun things. But during our COVID closure, I knew that was the best way to get out to everyone really quickly. I would post announcements there and I would do a Facebook live about once or twice a week where I would get on, tell them what was going on and field questions, much like we’re doing today. So that worked out really well. And I think it helped everyone feel included.
LC: That’s what I was going to say. That’s impressive because it boils down to everybody once to feel included and feel important. So again, kudos.
APH: Yeah, and they were ready to come back. So it worked out really well.
EG: Awesome. That looks like that wraps up kind of our live questions here. Allison, if anyone has any additional questions, do you have an email that they could reach you at?
APH: Absolutely. I can be reached at Allison, A-L-L-I-S-O-N at parksortho dot com. Like I said, I’m always working so if you email me, there’s a pretty good chance I’ll get back to you quickly. Thank you again for this opportunity.
EG: Awesome. It was so great to have you. Lea, thank you so much for joining me as well. We are so excited to have you guys, and anybody has any additional questions you can reach us at email@example.com.