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Top tags: key performance indicators  veterinary finances  veterinary management 

Telehealth

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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Workplace Violence

Posted By Administration, Tuesday, February 26, 2019
 

Workplace violence ranges from threats to verbal abuse and ultimately to physical assaults and homicide. It can occur at the workplace or otherwise be related to the workplace even if it doesn’t occur at the physical work location. Without a doubt, it is a growing concern for both employers and employees. VHMA’s 2019 February Management Survey asked veterinary practice managers where things currently stand in their practice.

 

When asked “Has your practice ever experienced a workplace violence situation (involving employees and/or clients)?” sadly, 35% of the managers answered yes to this question.

 

When asked “If yes, what type of workplace violence situation was your practice presented with?" By far the biggest perpetrators of violence in the veterinary practices surveyed were clients followed by employees of the practice.

 

Regardless of the type of violence, it is prevalent enough that practices feel the need to put in place policies and procedures to prevent workplace violence and educate employees about how to protect themselves and others. Almost 2/3 of the managers’ surveyed respondents answered “yes” having a written policy or procedure ensuring employee/client safety. Keep in mind, while a written policy by itself cannot stop a random unknown shooter, a policy CAN help set expectations about behavior in the workplace and educate employees about the kinds of behavior and conversations that can be red flags. The policy can also help demonstrate the practice’s efforts to protect its employees should it be involved in legal action following an incident. 80% of the managers who responded said their practice has a written policy banning weapons, drugs and violent or threatening behavior by employees in the workplace. Unfortunately, while most practices have workplace violence policies in place, only about 30% do any training related to this topic.

 

When asked about security features in the practice lighting, video surveillance and limited public access to most of the facility were the most frequently cited.

 

Workplace violence is a scary issue, and most small businesses are less prepared to deal with this issue than larger companies with extensive resources. Some of the actions a practice should consider include:

 

1. Establish a policy regarding workplace violence. Some topics to include are:

  • Zero tolerance for violent behavior
  • List and description of prohibited conduct
  • Consequences for such behavior
  • Required employee training
  • Grievance procedures
  • Types of dangerous situations that should be reported to management, to whom they should be reported and how

2. Establish emergency action plans for various kinds of situations including exit strategies for all employees

 

3. Educate all employees about reporting unusual client, vendor or employee behavior; it is not tattling and is the responsible action to take

 

4. Setup a confidential way for people to report dangerous situations

 

5. Design and regularly provide employee training. Some topics to include are:

  • Red flag behavior or conversation that should be reported to management
  • The types of situations that may arise and what to do
  • Personal safety training from an outside expert

6. Perform background investigations during the hiring process

 

7. Annual review of the premises to identify any vulnerabilities that could contribute to violent behavior

 

8. Follow up promptly on all concerns and reports; take action where needed

 

 

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Corporate Social Responsibility

Posted By Administration, Sunday, January 27, 2019
 

Corporate social responsibility (often abbreviated as CSR) isn’t a term used much in veterinary medicine, but the concept certainly exists. The vast majority of veterinary practices give back to their communities in one way or another, and most practices have a strong belief in a responsibility to actively contribute to the health and quality of life of those communities and encourage our employees to do the same.”

 

There are many different definitions of CSR and many different types of initiatives and ways they are implemented in different kinds of businesses and different countries. The concept is broad and can include efforts related to human rights, health and safety, the environment, working conditions, economic development and, of course, animal welfare.

 

Veterinary hospitals participate in a large range of community and charitable activities for example:

 

·         Pet rescue and adoption

·         In-house pet foster care

·         Free educational events for pet owners

·         Participation in local career fairs

·         Providing clinic tours to schools, youth groups, and community groups

·         Hosting a low cost or no cost spay/neuter clinic

·         Hosting a low cost or no cost vaccine clinic

·         Offers a charitable fund to help pet owners with limited resources

·         Support local organizations’ fundraising events

·         Provide employees with paid time off to volunteer

·         Provide supplies and/or services for disaster relief

 

Small businesses often contribute back to the community just because they think it is the right thing to do. While this is true of some larger companies as well, bigger entities have also started to recognize that social responsibility is a good business strategy. Customers prefer to do business with companies who give back.

 

According to one report, 2017 Cone Communications Study, 87-92% of customers say that when a company supports a social or environmental issue, they:

 

·         Have a more positive image of the company

·         Would be more likely to trust the company

·         Would be more loyal to the company

 

Eighty-nine percent of consumers are likely to switch brands to one that is associated with a good cause, given a similar price and quality. Eighty-seven percent said they would purchase a product because the company stood up for or advocated for an issue they cared about, 88% also say they would stop buying a company’s products if they learned of their irresponsible or deceptive business practices.

 

There is also a strong feeling in the business world (and many studies to support this feeling) that it has become increasingly important to employees to work for companies that give back. This is especially true for millennials.

 

CSR is becoming an ever increasing issue. While your practice may be doing this for the best reason—because it’s the right thing to do—there isn’t any reason not to tell the world. Pet owners and potential employees want to know!

 

For whatever reason the practice gives back; make sure you do it right. Be transparent and honest about what you do. Recognize that consumers and employees want to know that your motives are authentic.

 

Review the full report, VHMA's Insiders' Insight Report, January 2019, to see what practice managers have to say.

 

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