Initial Training
Hopefully, the required training program was outlined in the initial contract. However, outlines and implementation can often become two completely separate things, and this is where we often see a breakdown when introducing new technology into a practice. To facilitate a productive training environment, the physician and staff need to dedicate their time and attention to learning the new system. Rushed trainings are more likely to produce more stress during first-time usage, so allot the appropriate time necessary.

• Make time to speak with the various trainers from the manufacturer and have them outline what the training will encompass and who will benefit most from attending.
• Try to schedule training during off-hours  to facilitate complete focus on the education and application.
• Select personnel to be trained according to job function and skill level. Specific areas to consider may include: phone skills; lead tracking and follow-up protocols; patient flow options (phone to surgery); and seminar formats.
The clinical training will require more specialized attention. Some device manufacturers have training prerequisites that include computer skills, and clinical or surgical experience. Ensure training for the clinical-care staff working directly with patients and the new device, and another qualified member as backup during vacations or sudden emergencies. Rotate backup staff monthly to refresh skills and operating knowledge.

Follow-up Training
We highly recommend follow-up training after the first 30 days of using your new device.  Refresher training will provide the opportunity for any questions to be answered, and everyone will become more proficient and confident in the integration of the new device.

• Keep a tablet near the device so notes can be jotted down during its initial usage.
• Schedule weekly staff meetings to discuss challenges and to share successes. Keep meeting minutes so you can refer to them when you speak with the manufacturer's trainers.
 
Internal Processes
Prepare for change. What worked yesterday may not necessarily work today. And if you start exceeding volume goals, you will most likely feel the growing pains associated with inefficient processes that may have worked while the pace was slower but are clearly not working now. Patient flow is another piece of the puzzle that will require attention.

Phones
When we speak of patient flow, that encompasses more than exams and surgery day. Patient flow comprises initial contact and the entire patient process. Patient contact begins with the phones. With an external marketing campaign being ramped up as is always the case with new technology, you should expect that the phones are going to ring even more than usual. So, incorporate into your plan a system that will allow for efficiently capturing inquiries. These are just a few of the many questions to ask yourself:

• Will you need a separate phone line for your marketing campaign?
• Can your current phone system accommodate a high volume of calls?
• Do you have the right people in place to handle inbound and outbound calls?
• Would it benefit you to outsource a company to handle calls for this marketing campaign?
• How will after-hours and weekend calls be handled?
• Will phone skills training be required?
• How will you monitor phone quality control?

Goal Setting for Best Patient-Flow Template
For calls to be properly funneled into the practice, it is essential to review the current scheduling template as well as employee roles and responsibilities. By setting goals, you can back into your scheduling process and call volume to create a better scheduling template. Basically, you need to take a good look at your current conversion numbers.

• What is your conversion rate from phone to appointment?
• What is your current no-show rate?
• What is your current conversion rate from exam to procedure?
Once you have established these conversions, you can determine the (1) number of inbound calls needed (2) the number of exam/consult slots needed and (3) the number of surgery slots needed to achieve success. Then you can look at your needs and ask yourself these questions:

• With the current scheduling system we have in place, can we accommodate these patients?
• Do I have the staff to accommodate this schedule?
• Will I need to redefine roles and responsibilities with my administrative, marketing, clinical and surgical staff?

Roles vs. Responsibilities
Multi-tasking is a necessity that all businesses share, but it can become a process-flow nightmare if not practiced efficiently. Typically a staff member is hired for a specific role but may then be utilized to pick up slack in other areas such as handling phones, filing, billing, etc., which can result in a lack of focus on the patient by the staff, and suddenly having unmotivated employees.
Define job roles within your practice. In the case of clinical and surgical roles, it is important not to inter-mix their responsibilities. Crossover will cause delays, affecting your practice process system. In cases of administrative duties, you may have targeted specific individuals who work independently on operations and have very little face to face interaction with patients. These employees would not fit well in the marketing and practice development areas.

In clinics which accommodate both surgical and clinical patients, (sometimes on the same days), separate teams are designated so that they can take care of their individual role responsibilities. Again, crossover responsibility inter-mixing can affect your practice process system.

Physican Patient-Flow Pearls
Because patients can be anxious about change, try to put them at ease by implementing some of these suggestions:

• Try not to mention the word "new" when educating the patient. This may cause the patient to feel that you are not experienced with your new equipment. Work with words such as "proven, FDA-approved, enhanced, etc."
• Role-play with each other, so you will feel experienced when you see the patients.
• Time the process from check-in to check-out. This will help you fine-tune your systems and see where the bottlenecks may occur.
• When at all possible, send the patient information on your added technology prior to his arrival. If education begins in the chair with the doctor, it has started too late.

First Time Protocols
Keep in mind the following before the first day technology initiation:

• When preparing to use your device for the first time, make sure the physical elements of your exam lane or surgery suite are ready.
• When scheduling patients for your first-time usage, schedule patients conservatively. You and your staff will be trying to get familiar with the system's operation, and the manufacturer's clinical trainer will be walking you through the process.
• Communicate to patients that you are integrating a new technology into your practice, so waiting room and exam room times may run slightly behind schedule. Patients can be more forgiving of waiting when they are made aware of the situation.
• When first using a surgical device, track patient outcomes. Not all surgical devices are the same, and some may require you to make changes in your surgical nomogram.

Marketing Budget
No doubt you have set aside funds for your marketing plan. Some questions to ask yourself:

• Have I set a system in motion for effectively monitoring the success of my current marketing efforts?
• Have I set aside a budget for maintaining relationships for the leads generated through marketing, as well as the word of mouth referrals I hope to receive from my treated patients?

All too often, these areas are overlooked during the initial plan. Additionally, while spending money to make the phone ring is the main focus of external advertising, there are other other areas on which to focus your attention:

• Put into place an effective lead- tracking program for monitoring referrals and maintaining patient contact.
• Plan a budget for the possibility of new hires as the practice grows.
• Consider contracting a marketing field expert to coordinate your plan.

Integrating anything new into your practice can be time-consuming and challenging but if you plan ahead, these potential pitfalls can be avoided,. allowing the process to be a very exciting time for you and your staff.

Ms. Lapointe is a marketing and practice development specialist with IntraLase Corporation. Contact her at clpointe@intralase.com. Ms. Watson is a clinical applications specialist with Alcon Laboratories. Contact her at Jan.Watson@alconlabs.com.