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Digital Media Management

Posted By Administration, Sunday, June 23, 2019

Most practices are spending more time and money on marketing activities than they used to keep their practices growing and keep clients bonded to the hospital. Digital media can be time-consuming to manage, and the practices who do it most successfully have clearly assigned team roles and a detailed digital marketing plan that keeps everyone on schedule and moving towards the same goal. This month's Insiders’ Insight survey takes a look at how practices do this.


When asked “Who created your practice website?” about 23% of the practices did this all themselves; for 45% of the practices, it was a combined effort between the practice team and an outside marketing company. About 1/3 of the respondents said that an outside marketing group did essentially all of the work.


When asked, “Who manages or maintains the content on your practice website?”. A little over 50% of the practices indicated this work is done by various members of the practice team with practice managers having the primary responsibility. In 38% of the practices, it is a joint effort between the practice team and the outside marketing company.


Most practices use digital media beyond a website, and this question asked: “Who manages your practice’s social media programs?”. In 80% of the practices, this is done by the practice team. In about 19% of the practices, an outside marketing firm works with the practice to manage the social media programs.


Online reviews are of big interest and concern to practices, and there, of course, needs to be a process in place to address these comments. 60% of the respondents indicated this is the practice manager’s responsibility, and in another 32% of the practices, other team members do this job. Very few practices use an outside marketing company to deal with online reviews.


Some practices have blogs and/or online newsletters. 40% of the respondents indicated that the practice manager performs this task. Other team members have the primary responsibility in about 36% of the practices. About ¼ of the responding practices involve their outside marketing company in managing their blogs and newsletters.


Video content is a part of many practice’s digital marketing; therefore, survey respondents were asked: “Who creates your practice’s video marketing content?”. About 60% of the practices do this in-house, and a wide variety of team members are involved. About 20% of the practices outsource this task to an outside marketing company, and about 20% of the practices work together with their outside marketing company to create this content. Responses were similar when asked, who manages the video marketing program.


About 50% of the respondents said their practices don’t use Google Ads. Of the 50% who do, a little over ½ of them create the ads in-house, about 1/3 outsource this task, and the rest create them jointly with their outside marketing firm.


About 29% of the respondents said their practice doesn’t have a mobile app. 51% of the practices outsourced the creation of the app to an outside marketing firm, and the others were split fairly evenly between creating the app totally in-house and sharing the creation with their outside marketing firm. About 27% leave the content management to their outside marketing firm while 26% do this in-house and 19% share the responsibility jointly between their practice team and outside marketing firm.


Digital marketing is, of course, just one component of a practice’s overall marketing plan, and it is critical that a practice look at the big picture before diving into the use of specific marketing tactics. Read the full report for big picture marketing tips.


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Practice Purchasing

Posted By Administration, Saturday, May 25, 2019

Many factors are essential to the practice of quality medicine and surgery including having an appropriate range of high-quality equipment for both diagnostics and treatment and the right medications, supplies, and food to use in-house or send home with clients. The process for purchasing and replenishing these items varies from practice to practice, and May’s Monthly Management Survey asks about that process.


No surprise, the practice owner (typically a veterinarian) makes the final decision in 75% of the purchases of medical equipment and about 55%-60% of computer hardware and software purchases. This makes sense due to the higher cost of equipment and the long-lasting impact of the decision on practice finances and medical care. The practice manager and practice team are more involved in the drugs, supplies, and food purchase decisions. Those respondents who answered “other” typically said that a combination of these team members were involved in the final decision or that others not listed here (associate DVMs, inventory manager, IT person, corporate office) were involved.


Peers are the most common initial go-to resource for all purchase categories, although practices use many resources to gather information before making a purchase. Resources listed in the “other” answers included company sales reps, VIN, VMG groups, VHMA boards, the Internet, corporate headquarters (if a corporately owned hospital), and the veterinarians in the practice. The almost unanimous resource for IT purchases was the practice’s IT consultant.


Purchases are made for different reasons, and it must first be understood what the goal of the acquisition is before gathering information and making a decision. Will the new equipment, supplies, food, or medications improve patient care? For example, the purchase of an ultrasound machine may allow for more accurate diagnoses. Will the new equipment lower the operating costs related to the provision of services? A new blood chemistry unit may lower the direct costs incurred in running a blood profile because less maintenance is required for the unit. Will the new equipment, food, or medications increase revenue? Or will it allow the practice to offer a more affordable diagnostic or treatment alternative? Often, more than one of these goals is met with the acquisition of a single piece of equipment or change in medication protocols. For example, an IV fluid pump will often reduce staff costs related to monitoring fluid administration as well as improve patient care by more accurately insuring patients receive the volume of fluids needed. Purchases aren’t usually made just to increase revenue; the revenue is a happy consequence of providing better patient care.


There is a broad range in how much financial authority managers have in purchasing. About 50% of the respondents can spend up to $1,500 without owner approval.


When asked: “What factors go into your decision making when you consider new products and services (rank the factors in order of priority)? The two factors that are ranked as 1 and 2 over 50% of the time are “User experience” and “Return on investment and value.” “Affordability” is included in the first three rankings 38% of the time and “Product support” and “Customer service” are included about 1/3 of the time.


For more details including tips on how to evaluate a new equipment purchase see the full report, VHMA’s Insiders’ Insight May 2019.


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Posted By Administration, Monday, April 29, 2019
Telemedicine is a hot topic right now and has generated a lot of controversy over whether it should be part of how veterinary medicine is practiced. Some of this controversy is due to confusion over what all the “tele-terms” really mean; however, some of the controversy is also over real issues related to whether pets can be appropriately diagnosed and treated using some of these modalities.
Telehealth, the umbrella term, is defined as follows: “all uses of technology to deliver health information, education, or care remotely.” Telehealth can include both services that require a VCPR (veterinary-client-patient relationship) and those that don’t. The definitions of the telehealth services shown below are based on the 2018 AVMA-AAHA document entitled “The Real-Life Rewards of Virtual Care.”
  • Telemedicine—the practice of veterinary medicine using technology as a communication tool (requires a VCPR)
    Teleconsulting—the use of telehealth tools by a general practice veterinarian to communicate with a veterinary specialist about the care of a patient
  • Telemonitoring—the remote monitoring of patients who are not at the same location as the healthcare provider
  • Teletriage—safe, appropriate and timely assessment and management of animal patients via electronic communication with their owners under conditions of uncertainty and urgency and where a diagnosis is not rendered
  • Electronic prescribing—the digital-based electronic generation, transmission, and filling of a medical prescription
  • Teleadvice—providing health information that does not require a VCPR to pet owners or other parties using technology

To find out where practices stand on telehealth, VHMA asked managers as part of their April 2019 Insiders’ Insight Management Survey to identify their current and future practices.

When asked “What types of telehealth services does your practice currently provide? (Electronic communication can be via the telephone, email, fax, text, video conferencing, mobile app, web-based chats, wearable monitoring devices, etc.).” Not surprisingly, the most used services are teleconsulting with specialists and electronic prescribing. Telemonitoring is not used extensively at this time, and only about 1/3 of practices are providing true telemedicine services which require a VCPR. 
When asked “What technologies does your practice use in telehealth communication?” Telephone, email and messaging lead the pack, but it is worth noting that 100% of practices didn’t select the phone as an option. That indicates some practices are very strict about the kind of information they will discuss even when a VCPR isn’t required.
A big question that comes up when discussing telehealth is can these services be charged for and how to do it? The VHMA survey asked, “Does your practice charge for the following types of telehealth services?”
Answers are all over the board, but in summary, most practices are not offering many of these telehealth services and, of those that do, few are charging for all or most of the services provided.
When asked if practices have discussed telemedicine as a business strategy, not quite 40% of the practices surveyed have discussed telemedicine as a business strategy; the majority of practices have not. However, the majority of practices have indicated they are at least thinking about telemedicine as a potential service to be offered or expanded in their hospital.
The next question asked: “In what ways is your practice thinking about expanding your telemedicine services?” Telemonitoring via pet wearable devices generated the least interest while almost 50% of the respondents indicated interest in live virtual appointments and asynchronous electronic consultations. 2/3 of the “other” comments stated their practice was not looking at using any of these options. Several others said their practices are considering telemedicine and exploring options but not yet sure how it can best be utilized.
Most managers think their team members have concerns about the legal liabilities of telemedicine. They also think their clients would appreciate the additional access to the professional staff.
Telehealth and telemedicine are in their early days in veterinary medicine, and very few practices are comfortable jumping into all aspects of it. There is a lot to be worked out. Telemedicine is becoming increasingly popular in human medicine, and it is likely the veterinary profession will feel ongoing pressure to participate. Ignoring the issue or just saying no won’t make it go away. Veterinary professionals need to shape telemedicine and telehealth in a way that works for the business side of the practice and provides quality care to our patients (does not harm).


Read the full report - VHMA Insiders' Insight April 2019


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Devaluing the Role of Inventory Management Devaluates the Bottom Line

Posted By Administration, Thursday, March 28, 2019
In the veterinary industry---more so than other medical fields---practices maintain large amounts of inventory. Delivering quality veterinary care requires practices to respond to a vast array of need and manage inventory for the laboratory, surgery, OTC sales, preventive care, food sales, ancillary services, and the veterinary pharmacy. Not surprisingly, inventory costs account for the second largest expense category. When inventory management is treated as an ordering and stocking task, practices are doing a disservice to the bottom. To have a positive impact on profitability and practice value, inventory management must be dealt with for what it is---a sophisticated and complex office function.

According to Melissa Mauldin, CVPM, SHRM-SCP, instructor for Patterson Veterinary University, many practices have not formulated an effective strategy for managing inventory. Lacking a cogent strategy, these practices are likely to be challenged with inventory glut, inventory shortages and expired inventory, all of which impact the practice financially. A casual attitude toward inventory can have other implications. For example, managing controlled substances without proper documentation, reporting, and disposal procedures in place can pose threats to health and wellbeing.

Mauldin advises managers to be proactive rather than reactive when managing inventory and suggests that the key to improving inventory management starts with an attitude shift about its importance, a commitment to exploring effective inventory management techniques and a conscious and critical review of the practice’s current management strategies.

Gaining control over inventory management: Getting started

Managing inventories effectively and efficiently can be challenging since there are so many moving parts. Encouraging feedback about current inventory management practices is a reasonable starting point. Assessing current inventory management processes and systems and discussing how they can be improved is another vital step. By combining observations and impressions with available inventory metrics, a picture will emerge. Every practice’s assessment will be different. These efforts will lay the foundation for identifying and implementing more effective inventory management control.

Finding the sweet spot between too much and too little inventory can be arduous and the steps outlined above are a shorthand version of the effort involved. Furthermore, because there are a number of systems and strategies for managing the inventory, managers can benefit by familiarizing themselves with what is available and creating a unique strategy that best address the needs of the practice by culling from various sources and creating an effective hybrid.

Resources to improve inventory management

The Veterinary Hospital Managers Association (VHMA) and Patterson Veterinary University (PVU) recently launched a co-branded series of educational certificate programs to enhance and expand learning opportunities for veterinary management professionals. The series, VHMA/PVU Management Essentials: Strengthening Core Competencies to Advance Management Skills, focuses on several topics, including inventory management.

“Identifying veterinary industry-specific inventory management strategies can be a bit of a challenge. The VHMA/PVU Management Essentials - Inventory Management certificate program outlines a number of strategies in detail that participants can familiarize themselves with. Each practice is unique and there is not one approach that works for all. After delving into the strategies, participants may find that one approach fits their situation or that a hybrid approach that melds aspects of different strategies works best,” said Mauldin.

Continuing education credit is available for these courses and can be used to satisfy CVPM program requirements. For more information on the VHMA/PVU Management Essentials: Strengthening Core Competencies to Advance Management Skills certificate series visit the VHMA website.

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Fee Changes in 2019

Posted By Administration, Thursday, March 28, 2019

Each year the VHMA asks practices about fee increases for the year; either those planned or already implemented. As with past years, the majority of the 180 practices participating in this survey, 53%, said yes to the question: “Have you or will you raise your professional service fees in 2019?” Twenty-seven percent in 2019, said they would be increasing fees on only non-shopped services compared to 2018.

When asked the average amount of increase for shopped services responses were fairly spread out amongst the categories with about 41% of the hospitals saying the average increase on shopped services would be 3% and a surprising 32% increasing shopped fees by 5% or more.

Hospitals planned on increasing the fees on non-shopped services by a greater amount, the majority of hospitals said their non-shopped service increase would be between 4-6% with about 35% of hospitals increasing these fees just 1-3%.

When asked what factors or strategies were considered in deciding how much to increase either the shopped or non-shopped services in the practice. The most commonly mentioned factors or strategies for shopped services included:

  • Overall cost of doing business and anticipated future cost increases
  • Increases in practice costs for a particular product or service
  • What other practices are charging
  • Inflation
  • Time since the last increase
  • Location and area standards
  • Demographics of local pet owners
  • Fee references such as AAHA, WMP
  • Gut instinct

The most commonly mentioned factors or strategies for non-shopped services included all of those used in pricing shopped services as well as:

  • Frequency service is utilized by pet owners
  • Anticipated downward turn in economy
  • Client perception of value

Click to view the detailed report along with some sage advice on pricing strategies.


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