Transcript
Marla: Hello everyone and welcome. I'm thrilled to have you all here for today's discussion on setting up your clinic for success during big transitions. And I want to thank everybody. I know our time is really valuable and it means a lot that you're spending the next hour with us and you're spending your time with us here today.
As some of you may be a clinician, a leader, or an owner, Whatever you are on this call, change feels like it's happening every day in the clinic, and it can be overwhelming. We see this with navigating new hire, leadership, and structural shifts, or implementing new technologies. But basically, change is inevitable, and it doesn't have to be disruptive.
So that's what we're going to be discussing today. And as Gail Sheehy once said, if we don't change, we don't grow. If we don't grow, we aren't really living. So as we continue to evolve, And our ability to embrace, manage, and communicate change effectively determines not only our success, but also the well being of our teams and our patients.
And of course, that's really what we're here for today, is to make sure we're taking care of our teams, we're taking care of our colleagues, and most of all, our patients are having a phenomenal experience. So before we dive in, I just want to emphasize that today's live streaming is very conversational.
It's informal, so we highly encourage you to ask questions as we go. Just hit that Q& A icon at the bottom. That way you can put your answers and questions in the chat, and then we can go ahead and answer them at the end if we haven't gotten to them today during our session. And let's make this an interactive session.
We want to hear from all of you. So please be engaging. So we'll start with a quick poll before we dive in. You'll see it pop up on your screen. And I want to know, are you either preparing for a transition currently in the middle of a big transition? or preventing a big transition. So just avoiding it at all costs.
So if you can all answer that poll and then write down in the chat what that transition is and if you're an owner, a leader, or a clinician, that would be great because we want to hear from you. We want to hear what you're currently going through so we can really make this a great talk and session for all of you today.
All right. Fantastic. So now I'd like to introduce our incredible speakers who bring a wealth of experience in clinic operations, leadership and technology adoption. First, we have Brian Buck. Brian, great to have you on this call today.
Brian: Great. Thank you for having us.
Marla: And Brian is the Chief Revenue Officer at JAG Physical Therapy.
He leads all aspects of revenue cycle management across more than 150 physical therapy locations, ensuring financial sustainability while optimizing operations. He has over 20 years of experience in revenue cycle management and healthcare operations. He combines strategic expertise with a results driven approach, a streamlined billing process, enhancing peer relations, improving revenue management, all while keeping patient care at the forefront.
It is a pleasure to have you here today. Thank you, Brian.
Brian: Thank you.
Marla: And next we have Mike Evangelist. Mike, give us a wave.
Mike: Good afternoon. Thank you for having me. Excited to be here.
Marla: Great. And Mike is the Senior Vice President of Clinical Services at JAG Physical Therapy. He oversees clinic operations and strategic management of JAG's 150 plus locations, ensuring that high quality patient centered care remains the foundation of the organization.
He has over 20 years experience as a physical therapist and healthcare executive, and he brings Clinical expertise with operational efficiency to drive growth, innovation and best practices across JAG's extensive network. And a fun fact, Mike and I worked together 20 years ago for my first job out of PT school.
Mike: That's right. That's right.
Marla: Great. And then finally, I'm Marla Ranieri, and I am the head of clinical innovation and clinical strategy at Prompt, and I'll be guiding our discussion as we explore how to successfully navigate big transitions in your clinic without disruption. Let's get started. There's a lot of different topics to talk on today, but one of the biggest challenges as we see clinics that are starting off small and starting to grow is there's a lot of staffing changes, leadership changes, bringing in new teammates or adjusting leadership structures, and that could be really unsettling for staff.
Mike, love to hear from you. What do you think staffing changes are? Why do you think they're so difficult and hard for people adapt to?
Mike: Yeah, it's a great question. And change is definitely constant. And as you alluded to in your intro growth is a very positive thing. But growth also can bring change.
But I think the important thing is to make sure everybody understands that change can be a positive thing, right? So many people especially physical therapists are creatures of habit, right? You get into your daily, weekly workflow, and you have a certain level of comfort, right? And they think to themselves, is this going to be a leadership change?
Can that comfort be temporarily disrupted? And they think to themselves, how will this affect me? So it's very important for the incoming leadership and also the company itself to be very transparent, right? And to make sure there's support from all levels of the company, right? So Also, the trust component is huge, right?
So it's really important that the new leader builds that trust, right? Because the outgoing leadership probably had some trust and respect going back and forth in a two way manner, right? With their employees. So the new leadership's first goal in that first 30 to 60 days should be to gain trust.
from their team. That's really important. We need to get to know their team and create that two way professional and respectful relationship.
Marla: Absolutely. And like you said, that trust, clear, open communication and authenticity is really important. And to be proactive about that is, is even more important.
So Brian, love to hear from you from a leadership perspective. What are the proactive steps that clinics and leaders can take to prepare their teams for this either new hires or a structural transitional change?
Brian: Yeah. So first off, I really love where Mike started with the trust, because from a leadership perspective, it all starts with trust, do your teams trust you?
Does your, staff trust you? Your other leaders, do they trust you? And as we unpack what that means and what that looks like, I like to look at it from three different lenses. Number one is you've got to be able to provide crystal clear direction. And you ask, what does that mean?
How do I do that? First, let's figure out what's already working. If you've got a process that's working or a change coming, let's borrow from what's already working instead of reinventing the wheel. Second is we've really got to script the critical move. So of those changes that are coming part of that crystal clear direction.
Is making sure that those critical moves, those critical changes you have that you've got those outlined extremely well for your team. And then number 3 is have your eye on the destination, understand where you're trying to get to and what the ultimate goal is. And then for your, you're able to bring the team along with you.
So they understand. Here's how we go from where we are today to where we're going. Second is getting people on board. And again, the start of that is really with the trust. It's knowing that something You know, knowing something isn't enough to cause change, just because we know it isn't going to change it.
We actually have to do it. So we got to make sure that our team feel something that they bought into the idea that they bought in to where you want to go to make sure they have a sense of ownership. In the change process, really bring them along and bring them into that. Next, as far as getting people on board, when you present a change and it's this big audacious goal or this big audacious idea, some people get overwhelmed by that and having that big idea out there might work for others, but for others, it's overwhelming.
And so from there, it's breaking that change down into small pieces to where they can absorb it. They can say, Hey, if we get this done, then we move on to the next step. And the other part of that is encouraged growth, encouraging your team to grow with change, hopefully the change that you're bringing or thinking about bringing or that you've brought has allowed your team to grow and provide that, that, that opportunity for your team for growth.
And really the third way that I like to look at this is create the right environment. Okay. And you really bring in those other 2 1st key points of crystal clear direction and getting people on board. That 3rd, 1 is taking those and then creating that right environment. You're constantly tweaking the environment.
You're constantly trying to provide opportunities for people to be successful. You're trying to build those right habits in that new environment, having high accountability. Whether it's from process improvement to reporting to clinical leadership, or, back in we're office type functions as well and then realizing to that with the right environment, your behavior is contagious.
You can spread that desired behavior to others. And, hopefully permeate that throughout your organization.
Marla: Yeah, and since you said a lot about the communication and the clear vision, what are you using to get that out? Having 150 clinics, it's a lot of providers. So are you guys doing that through a big webinar?
Are you doing it locally through each clinic? What is your best method there?
Brian: So it's a little bit of everything. We recently went through a big system change and, Process change and really upended everything. And it started at the top with our CEO, John Gallucci, sending out an encouraging message out to the whole team out to the whole organization and really casting that vision of, here's where we're at.
Here's where we want to go to. These are the benefits and really outlining that. And then as leaders were able to then take that and filter that down to our teams. And then our leaders are taking that back to the clinics. I think Mike and Sprott. Yeah. Mike can probably speak a little bit more to the clinical side of it as far as how he's got the clinical team structured and how those clinical leaders really carry forward that vision and that message.
Marla: Great. Mike, we'll keep to hear from you on that and then also to hear what mistakes you see happening too.
Mike: Yeah as far as communication in the clinical department we utilize different methods. So one we did build an intranet within our within our company that we highlight every single day, every single week.
It is the go to place. For messaging, right? And anything that we want to post that's important for any employee within the company across all departments. So that's 1. but really, Brian alluded to it in his answer in that it starts at the top of the communication. And that communication needs to be streamlined.
down, very lucky to have a great executive team and a great regional director team and great clinical directors. From the top at John Gallucci, our ceo all the way going down, that same message has to be brought down, right? Crystal clear. And on time, it can't be a delayed message.
The message can't be confusing. It has to be clear this way. Everybody understands what's happening and everybody understands the why behind any change. But so to me, it's the streamline of communication, having the right people in place to bring that down, but also having that background of the intranet as a resource for anyone to go to in case they have a question outside of.
Brian: So just to add a couple of things that I can, some other things that we do is we do meetings like this with our teams where we have zoom meetings or teams meetings, depending on which kind of team chat you use. We do that. We've got emails. We've got. The intranet that Mike mentioned.
So it's not a one stop shop when it comes to communication. It's trying to reach people through meetings through recorded training sessions. We just went through a training session back in December with the clinicians and broke it out into several different meetings so that we could accommodate schedules and we record them.
We post them out there. So if somebody is not able to attend, they're able to go back and watch it. The key is trying to get out in front of. Our teams, we're, we've got 156 clinics. So we're, we've got quite a bit of territory to cover both geographically and from a personnel standpoint.
And so it's trying to meet people where they are as far as the communication aspect goes.
Marla: And that central communication platform is fantastic to have a highly encouraged that I know we use slack in our company, but being able to have that ability for everybody to see a message and communicate with their own internal teams is fantastic.
Great. Staffing instructor changes is definitely one of those big topics, but moving on to another huge topic, which I think we all experience every day because technology is a vital piece of our. Of our industry. It's continuing to grow more and more, but it tends to be one of the hardest ones to implement.
Clinicians don't love technology changing. So we know it's going to be really helpful for it. Maybe a new you are a payroll system or trying time tracking tool. It can often create a ton of pushback, though. So Brian what are the most common fears or concerns you see when clinicians transition to new technology?
Brian: Sure. So it's a very wide ranging question and answer potential there. And I think I'll start with kind of from my perspective, more on the back end of things with revenue and accounting and finance part of it. And I think the first fear that I see is from a financial aspect. It's what is this going to do to our numbers?
Ideally, you want your numbers to go up. What's it going to do to my cash flow? You think about getting claims out the door. Can we get that done? How's the clearinghouse set up? How are we going to post payments? How are we going to work AR and denials? It's really upending Your process and your comfort of what you're used to doing.
And I think ultimately, we've got to be able to collect what is due from payers right? When for the services that, Mike and. And others perform, it's making sure that we can build it and collect it. And one of the biggest fears in a transition is what does that look like from a cash perspective?
How long is it going to take us to recover that cash? And I think. The pressure then falls back to the clinician on are we documenting correctly? Are we making sure that we're building enough units? How do we know that, we're going to capture everything we do? And is that system that we're moving to going to help support that now?
Are they going to help us making sure that all of our units built are correct? That we're compliant, between them? CMS and AMA, right? They're a little different and making sure that there's some understanding there with that. And so I think ultimately, from my perspective, from more of a revenue standpoint is, are the activities that we're capturing is the work that our clinicians doing?
Are we going to get paid for it?
Marla: Yeah. Yeah. That's obviously the whole business, right? And I love to hear that there's, it's going to be a better, that's why you've chosen it, but the unknown and the fear, and that prevents a lot of people from implementing new transitions and technology.
Brian: And I think one other piece of that too, with the technology that, we really took into consideration with ours is the patient experience, because, without the patients. We wouldn't be here. And so we want to make sure that our patients have the best experience and hopefully that new technology that you're implementing carries that forward, and, that's one thing that I'm proud of Jack for is that from a patient perspective, our patients really do come first and we really do have our patients in mind.
When we're making decisions and we're making changes. And so it's really making sure to that, from a patient standpoint, will they have a better experience? Or at least at minimum, will they continue to have the same good experience that they've been having? So creating as little disruption for them as possible is also, one of those fears of what is it and how does it impact our patients and what are they going to see and feel first?
What do we see and feel
Marla: Yeah, and you hit the nail on the head with patients and clinicians. So Mike, from the clinical side, would love to hear your perspective on that too. Just what do you do? How do you get those clinicians to buy into a new technology change and to ease their fears? What are you doing on that end?
Mike: Yeah, it's we've learned a lot over the last year here at Jag. We've gone through, three major technology changes from our EMR, obviously on to prompt and then a payroll system change and financial system change. So financial software. So we've learned a lot.
And, I'm happy to say everything's gone very well. And overall, I think it's important for the company to explain to the employees, the why why you're doing this, instead of just saying, we're switching to this and that's the decision you have to explain to everybody. Why? So give exact examples of how this technology is going to help their workflow. Improve operational efficiency, as Brian said, improve patient quality of care. So if they understand the why, then they think it through and then they realize, okay, this can be better, right? Other things too, is it's very important for the company to be transparent with the transition and implementation plan of any technology change and to do that well in advance because that shows that it's well thought out.
It's organized. And it's setting up every single employee for success. If it's something that you're not transparent with, or you're giving last minute instructions while all of these clinicians and or patient access employees are busy doing their jobs, treating patients, scheduling patients, etc.,
everything else they do you're giving them enough time to plan ahead. And if there's training involved, whatever it may be to prepare, they could then have an autonomy in preparing the way that they see fit. So that's important. The other thing I think that's really important as far as communicating this is that is making sure to understand that people learn in different ways.
Some people learn from live training. Some people learn from watching recordings, some people want PDFs right in front of them to read through, some people need all of those live Q and A sessions, to learn, to get actually get answers on the spot can be another very powerful tool, but realizing that and for us in a company of 1800 plus employees, not everybody learned the same way, and I think that's really important to know as well.
And then lastly, is being very, again, going back to being honest and transparent that not everything's going to go as planned and not everything's going to be perfect. If you tell everybody this is what it's going to be, and this is exactly how it's going to roll out, and at the end we're going to be, everything's going to be flowers and roses, right?
That's just not reality, right? But, letting them know that we as a company are there for support every step of the way. Okay, and our technology partner is also there every step of the way to help them in any situation that comes up They're not alone and they're gonna get we're all gonna get through this together
Marla: That's great.
I think really having the why is so Important because even though people are afraid and sometimes they just don't want to take on this They think it's going to be a lot harder, even though they know it'll be easier in the end, knowing that why really helps them get to that end goal. And we do have a question in the chat.
They loved hearing how you guys have that internet, but they want to know for somebody who doesn't have an internet and maybe when you guys were a little smaller, how did you communicate those changes and get it to every clinician without that central communication piece?
Mike: I could start.
So yes, it's it's not something that Jag has had for the entirety of its existence. Prior to that honestly, it was more, it was a cadence of email. So if we had any kind of policy change, we would have a policies change day on once a month on a Monday. This way, we're not sending out changes in policy three times a week or five times a month.
Everybody knew that on the first Monday of the month, an email would come out from the operations department and or clinical department basically announcing any policy changes. So we set it a cadence and a schedule that the staff kind of expected. And everybody knew to look out for that in advance.
Marla: That's really helpful because sometimes they're just getting tons of emails all over the place and they don't know what to pay attention to. But having that expectation of this is when those important updates occur really can help get it out to the team. So thank you. Appreciate that.
Brian: Just to piggyback on that just a little bit, with And in past experience, not a Jack, but at other locations, we had several different things we did.
We definitely did the specific timing of newsletters and updates and I love the point that Mike said about making sure that you've got to get cadence on it because I think most of us, we get emails throughout the week throughout the day and it's hard to keep track of every email. But if hey, on the 1st, Friday of every month, we're going to give a big monthly update or maybe it's every Friday.
Yeah. There's an update going out, whether it's clinical or whether it's payer guidelines. Being able to have that on a consistent basis on a regular cadence is important. The other thing that we've used in the past, too, is there's like online project management tools out there that you can aggregate information on.
You can create workflows and you can drag and drop documents into. So I've used that in the past. If anybody has any questions about specifics afterwards, happy to share who I've worked with and who we've used. Bye. Bye. We've done that, and that's supposed to be well too, 'cause it can drive some workflows as well.
And then as far as the intranet goes, we use SharePoint, the, it's the Microsoft product. It comes with the Microsoft Suite. And so we've got the SharePoint sites that we use as far as our intranet goes.
Marla: So you're saying it might be worth putting some effort into setting up that something like an internet or SharePoint prior to a big change so you do have that central piece where they can learn anything about it or have that where they know to go to.
Brian: It's definitely helpful as you go into any type of big transition or project to have that central repository that you can refer back to and now if from a scale standpoint if it doesn't make sense I would definitely Probably lean towards that regular cadence of emails and just being able to categorize that so that they can be saved in folders in your email box, or you can have them, with Outlook you can set rules based so that it goes to folders and things like that to make sure that you're able to track it and keep up with it.
Marla: Great. And do you have a policy of maybe not X amount of changes at the same time, or how many things do you feel like your company can handle to implement? Because that tends to be a hard one, too.
Mike: Sure, it's not.
Brian: Yeah, I was gonna say we don't have a set policy on a certain amount of things. It's more of where do we want to get to?
What we talked about earlier. It's where's the final destination? Where do we want to get to for the next 3 months, 6 months? And, it's making sure we've got the right people in the right position to take on those projects. And as Mike said, we did 3 large. System changes, technology changes last year.
And so not all of them lived with clinical, not all of them lived with operations. They were spread out amongst the teams, but there's really no policy on a limit for us. But it's more on making sure we've got the right leaders available to help lead those projects so that they're successful. Yeah.
Mike: And to add to that, I would say, we're definitely a company where. We do ask our employees to bring ideas up. Certainly not every idea is coming from our headquarters. And we definitely encourage everyone to do that and we get everything filtered up the chain and then we vet it out.
And as Brian said, we don't have a policy of number of changes at a time. But we will look at to see what, we'll prioritize and we'll decide these are all great ideas. Let's do this in Q1, this in Q2 maybe this one we can push to the following year. So that's how we generally try to handle those situations.
Marla: And do you communicate that roadmap to your team well in advance about the changes coming, or do you communicate it as it comes?
Mike: No we're very transparent. We communicate everything when a decision is made, right? So a decision could be made that may not take effect for six to nine months, but we do communicate that decision and say, we'll provide more detail as we get closer, but this is what we have in our roadmap.
Marla: Great. And then we just had a question come in. Do you experience any pushback from clinicians when it comes to keeping themselves up to date on actually like checking their emails and reading those policies? So is there a way you can track or how do you deal with those different staff members?
Mike: Good question. Because again, clinicians are busy treating patients. And then after that documenting. But it goes back to the answer from before where the message comes from the top. And in order to succeed. In our company, it is important that you pay attention to communication coming down.
So our clinical directors do remind our staff clinicians and all employees within the clinic to keep an eye on their emails. Do they have to check it five times a day? Absolutely not. Once a day would be great just to make sure they see anything that comes down.
Marla: Great. And I'm sure with any new technology implementation, you guys have some set KPIs and goals that you want to achieve post.
Implementation. So how do you handle that? And are you communicating that with the team as well?
Brian: Yeah, it's what we've talked about where it's communicating that vision of where we want to get to. And, through any type of transition, we've got roadmaps of what we're looking at and where we want to get to.
We've got historical benchmarks that we look at and say, here's where we're at. We think we can get to here. And so we're constantly looking at those benchmarks and data as to where we want to get to. And how do we measure ourselves? So it's definitely something that we review as an executive team. Monthly, weekly, certain KPIs we're reviewing weekly, others are monthly targets, but we definitely have our eyes on where we've been, where we are, and then where we want to get to.
Marla: Great. And sharing those wins along the way is always really nice as the staff to say we got there, we're doing this and those little wins, right? Yeah. Changing gears a little bit. We know transformation and change doesn't always go as planned. It's not always successful, so we'd love to hear, Mike, from a time if you can share an example of when a big change System change didn't go well.
What happened? And what did you learn from it? So I'd love to hear some specifics on that.
Mike: Sure. And the example I'm going to use, I feel is more of an industry wide challenge versus just a jag challenge. So early last year, we started a RTM remote therapeutic monitoring program. And this is somewhat new to the space of physical therapy over the last several years.
And remote therapeutic monitoring for patients was something that was foreign, right? The patients that came to physical therapy and physicians that referred to physical therapy, honestly had absolutely no idea what it was, right? So one, you have the patient. Having to get used to a new program to you have clinicians who some of them, some have been in the field for 20 plus years and even your new graduates who are unfamiliar with our team is a program as well.
So now you have to teach two sets, right? Two different groups of individuals. What this program is develop a process, right? That's going to work, right? And also helping them understand back to what we talked before is the why. Why is RTM? Why is RTM beneficial to the patient? We all know why RTM is beneficial to the patient, but do the patients realize that touch point in between each in office visit is helpful to the in office therapist?
Did the in office therapist understand that touch point was helping them get the patient to reach their functional goals, right? And finish their plan of care effectively, right? It was definitely a challenge. There were, there was some, I think one of the biggest challenges was the communication between the RTM therapist and the in office therapist.
That was something that, We did not anticipate as being as much of a challenge as it was but again we've learned from it. We're ready to move forward and have a go at it again. We're working on that now as a company. The other thing too is the method and the method of communication and the cadence of communication to the patient, right?
I feel like it's a very sensitive line that you have to, that you have to think about because if you're if you're a team program is communicating too often, right? That might push the patient away. Okay, but also communicating too little, especially in a way that they're not going to respond to or pay attention to them.
Really? What's the point of it? So it's a very very fine line that you have to figure out what the the method of success is there. Our team was our challenge. Okay. Over the last year or two, but again, it's something that we've we learned we took all the information in and we're going to improve upon as we move forward.
Marla: Great. And we've got a bunch of comments from the crowd here. We've got if you don't mind, can you share if you've seen great success with your RTM program and if you don't mind sharing your RTM protocol.
Mike: So what was the first part of the question? I'm sorry.
Marla: If you've seen great, if you've seen great success with your team program or what success have you seen?
I'll be free.
Mike: Sure. Yeah. We, we have 155 offices. We tracked every single office as far as conversion into the RTM program. And we had probably, I would say, quarter of our offices really succeed in converting our patients and and registering for the RTM program. Also, we were able to track outcomes for that.
And we did see those patients that were involved in RTM Had improved outcomes, right? So it works. We know it works, right? The key is, though, is, what is the buy in from the clinical leadership from the staff clinicians? And then also, of course, the patients, right? It's one of those things.
It's a little bit of a culture change in the office. And it starts with our leadership. And again, everything goes back to communication. Communicating with the staff and communicating to the patient. I would say the biggest thing that we saw is there was a correlation between RTM success and functional outcome improvement.
Marla: Great. We, I've seen that in the program I was utilizing as well. So happy to see that's transcending. I think a lot of times with RTM people are saying, is the juice worth the squeeze? Like you said, there's so much to setting it up and it. As you said, the processes may have been not the best that you had done right then and there, but ready to come back and do what you learned from it and try again.
Mike: Yeah.
Marla: So I've got another just comment. Someone who said they pivoted. They pivoted to a provider driven RTM model versus remote RTM model, and that helped with supporting staff and assisting in tech. So good. Good to hear as well.
Mike: That's great.
Marla: So well, let's change shifts a little bit to you said that was an experience that you learned from you guys are taking back.
You're going to reimplement it, retry it. Can you tell us about a change or implementation that went really well and what you think may have contributed to it going really well?
Brian: Sure. So the example I'm sharing is not just because we're on the call with you, Marla, but we just went through a prompt implementation and, an implementation this big.
Really goes into the whole conversation we've had about setting direction, setting our goals, making sure that we've got buy in from the very top communicating what that looks like and what that is. And some tangible things that we did early on that I think really made a big difference.
Is number one is that we put together a true operational project management team. It wasn't based on title. It wasn't based on seniority just to be quite frank. It was based on who we knew could get things done and also who had the capacity to get it done as well. And so we put together a strong team of those that understood workflows who understood.
The clinical side who understood the operation side who understood the billing side and we put that team together and really, charge them with owning their individual parts. And so we had several that worked hand in hand with Mike and his team on. the templates and on the clinical kind of changes and workflows that needed to be done.
We worked hand in hand with our credentialing department, making sure that any new E. D. I. Agreements in our conversion were updated and ready to go that our payors set up in the system was ready to go. So we had spreadsheets that we had downloaded and really worked through. With these pairs and the mappings and with any system change too, you've got different technology and different ways to view it.
So saying one way is right. And one way is wrong. It's just different. And so we had to get accustomed to that too. Other things that we did early on was for us we hired and built a brand new revenue cycle team from the ground up. So we brought in some very strategic hires very early on in the process that could be fully devoted to building out the billing side.
In advance of go live so that we had fully dedicated to this project helping build out the system as we got closer to go live, it was training. We set aggressive training time when we had trackers to make sure that everybody had completed their training. And then really that last month before was all hands on deck with training.
We had people hosting. Live teams meetings for us where we had a team chat open and it was open all day. It was open on the weekend. As people were going through their training, they were able to hop in and hop out of the chat, ask questions that they had questions that they were working through a test patient.
And they got stuck somewhere they could hop in into that team chat, ask their question and then hop out. So we were very intentional about making sure that communication was there that open line of communication was there well before the go live and. We were pretty aggressive in testing our data conversions and our data test.
I've seen in past experience where data hasn't come over correctly. You're at the very last minute trying to scramble and scrub data to get it correct. And so that was one thing that we wanted to make sure was done right. So we You know, push to get our data testing and data conversions done earlier.
And then that way we could run several tests. And I'm glad we did because we found things that needed to be remapped or things that we thought were mapped one way were mapped another. So that gave us an opportunity to really run through those and work out the kinks before we got to go live day. And then all of a sudden realize this isn't working.
We've got wrong information in there. And then I'd say just as important from The pre go live is the post go live. And that's where getting back to your earlier question about how do you set those metrics of where you've done and how do you gauge whether it's been successful? It's really checking in with the team and making sure they've got the support after the fact.
So we have people deployed strategically throughout our clinics and throughout our regions, making sure they were there to help out. We have the line chat open. During go live week as well. And so it's more making sure that our leaders and our subject matter experts are available and ready to assist the clinicians and patient access and then others throughout the company.
Marla: I've got to pinpoint something that you said that's so important that sometimes I feel like clinics don't do is you said you really assign project managers to different parts of it and we tend to find that our clinicians are amazing and they can do anything but we pile on everything to maybe one or two people versus really saying this is what you guys are tackling, this is what you guys are tackling and using all different types of people from the clinic, not just your quote unquote leaders because it really helped get the buy in from everybody.
That's great.
Brian: That's important. And I think too, like what helped us out is that the people that we had over those projects. used to be in a clinic. So they've been providers. They've moved on to more operations, but they've been providers. They've been in the clinics, and so they understood the workflows and they understood from a clinician standpoint what they would be looking for.
So when they set out to help build templates, they understood What the feedback was from Mike and his team. They understood what that feedback was. So it's not just putting people in charge of projects, but putting the right people in charge of the right projects, making sure that they can see it through.
Marla: And I have somebody who in the chat said a sauna was a great tool when onboarding with prompt. So I'd love to just hear your feedback on having a project management tool as well.
Brian: Yeah, so we use the sign of that. That was prompts project management tool. We've got some others that we use internally.
But it's not it was great. That's 1 of the ways we could go in and check in as that operational leadership team on that to go in and check the due date. Check what's due have the assignments out there. It really helps you stay on track to where you have the due date. You might not have something due till 30 days, but you've got milestones along the way.
That you've got to check hand and make sure it's done because you're not going to get it done the last two days before it's due. And so it helps you track your progress. It helps be able to track when things were sent, when things were received. If you've got internal deadlines that you can do, so for instance, I'll use the example of the payer setups, right?
If we need a payer list and we need certain things updated on that payer list, whether we've got to get Things categorized correctly, the right category, we've got to get the address information updated, or we just got to clean up the payers in general and get the right name. And we know that it's due at the end of the month.
I don't want to wait till the end of the month. So we set up some internal deadlines of 1st review, 2nd review, 3rd review so that we're ready. Before it's finally due back to the system that you're integrating with. That it's ready to go and it's live. You're not having to go in behind the scenes and make changes.
And I'm not saying that's not going to happen, but the idea is to eliminate as much of the back end work as possible.
Marla: Yeah. And Mike, from your perspective in the clinic, this is when you change an EMR, you're changing their documentation, their home exercise program. It's like you're changing multiple things at once.
Tell us a little bit about how you handled that in the clinic and how your clinicians were able to do that.
Mike: Yeah, so it started with making sure every, we listened to everything that prompt recommended to us. As far as, readiness, when to begin training how to roll out training, so making sure that we listen to prompt.
But honestly the support that we also had. From prompt was second to none. We had, we had live Q and a sessions for all of our providers with Brian, when we have four, four different Q and a sessions At least for all of our providers, which were very heavily attended, and the feedback from those was huge.
And the other thing, too, is that to make sure that we were there for any questions or concerns that came up. There are some people that were more adept to taking on a new technology and a new EMR, and there were some that were not, right? And those that were not, that's okay. Not everybody has to be comfortable with it and not everybody's going to learn the system in two weeks, right?
So there are some people that it took a little bit longer, right? But now we're you know, we're four or five months post and everybody every single clinician is beyond happy. So making sure that we you know that we respected everybody in the way that they were learning the other thing too is inter department communication was I think a big reason for our success.
The clinical department worked very closely with patient access and Brian's operations team and their marketing team, right? Everybody had to be involved. The clinicians knew a little bit of what the front desk had to learn. The front desk knew a little bit of what the clinicians had to learn because those are very interchangeable as we know.
It's not just, working in silos inside of a physical therapy clinic, right? Everybody has to work together. And hence, when you're learning a new system, everybody has to know what everybody else is learning. So it's a lot. It's definitely a lot for everybody to learn. But I think that outlook that we had from the start really helped us to go well.
Marla: Yeah. And I I was on the end of a patient cause I've been a patient in a JAG clinic. So I actually got an amazing email as a patient. Telling me about this EMR change and highlighting all the benefits that it was going to be for me as a patient. I thought that was fantastic and really loved that you not only were thinking in the clinic, but you were also, did that outreach of actually communicating to every patient you ever had, not just your current ones.
Mike: That's a great point.
Marla: Yeah. And going back to Brian, your fears of earlier when we said, what's the biggest fears of technology change and you went to revenue. Are we going to collect? Is it going to ruin our, the big picture, right? The money that's coming in the door. So love to hear a little bit about that.
Brian: Sure. With the planning we did, I was pretty firm on what my expectations were with not only the prompt team, but with my team as well wanting to get claims out day one, wanting to get payments in as soon as possible, and I'm comfortable saying we did, we were able to get claims out day one.
We got payments back within the first week, which showed me that. That the system was working. And that was my biggest point of that is that if we're not able to do that based on what we had prepared for, then something has broken along the way, not in a bad way, just something we have to go fix. And so that's where, for me, again, going back to our earlier discussion about those milestones and those checkpoints for me, one of the checkpoints from a cash standpoint was the billing.
Because if you can't get claims out the door, you're not going to get paid. And so it was making sure we had that ready to go with our clearinghouse making sure we had all of the EDI set up correctly, the pay set up correctly so that it was smooth. And, We've been able to collect cash.
We've been able to bill out claims. Not everything's perfect, which you don't expect, but it's making sure you've got the right checks in place to catch those. And, as Mike said earlier too the right technology partner to help support you and walk along with you in that journey to help fix things as they come up.
And that for us really came down to how well we prepared as a team, it. As Mike said, across marketing, from patient access, to billing, to clinical, to our executive team, just how well we communicated and prepared so that when we got to go live day and the lights came on and they were bright.
Yeah, I feel comfortable saying that we performed exceptionally well. And again, that's not to say we didn't have our own tickets, but the fact that we're able to get claims out the door day one were able to get paid later showed me that our processes were working and we just had to go back and fix the few that, needed to be tweaked along the way.
Marla: Yeah. Wow. I love to hear this where you guys really were very proactive. You took a lot of time. You dedicated the resources and for any therapist or clinicians or teammates that weren't necessarily or were afraid of it, you, you really just said the secret of change is focusing all of your energy, not on fighting the old, but on building the new and going towards that, that shared goal and vision.
And then, like you said, constant feedback, constant communication. Hopefully everyone learned a little bit of something from this. I know I learned a ton, and I appreciate all of your insights, some things that you felt could have been better with different transitions, things that you learned from and did better, and how you are.
You're clearly communicating the message down to your whole teams and using project management tools, project managers to be able to implement those changes. So hopefully you know that everyone on this call can reach out to you guys if they have any questions. But appreciate that insight and making change not such a burden.
Because if we don't keep changing and evolving, this industry is going to end up it's going to end up stale, right? We, our patient experience has to get better. So appreciate you guys continuing to grow and continuing to adapt to new technology and new ideas for your company. Now, I just want to, do a few housekeeping items.
I know that we've only got about 10 minutes left and and Mike, I know you have some important. Important topics that you want to touch on to outside of transition and E. M. R. Changes. So we'd love for give you the floor a little bit of a call to action that you're asking everyone on this call to do.
Mike: Thank you very much, Marla. This there's something very important. I want to make sure that all clinicians and really everyone is aware of there's a possible very pivotal moment, not only in physical therapy, but in health care right now, in that there's a very crucial piece of legislation.
That's in Washington, which is called the Medicare patient access and practice stability Stabilization Act of 2025. very much, Marla. Thank you. Which essentially ensures that physical therapy services are more accessible to all Medicare beneficiaries. Not only would this bill re, improve our reimbursement rates, but also stabilize the practice of physical therapists nationwide, right?
I'm asking everybody just to take 30 seconds, and there's going to be a link posted on the chat shortly if it's not already and this is going to be a link through APTQI, and I'm going to ask you to click on urge your lawmakers to stop the 2025 Medicare cuts, right? It's a preloaded letter, which basically asks your specific congressman or congresswoman to.
Just co sponsor this and to make sure that physical therapists get paid the amount that we deserve. And in terms of, and from doing that. We're going to make sure that our patients get the quality of care that they deserve. So again it should only take 30 seconds. I think it's very important for our profession.
And I really thank you for your time for that.
Marla: Thank you. Thank you. And as we all come together in the industry, these are the different things that we should be doing. And we should be sharing with our teams to make sure that we are advocating for this field. And making sure that we're having the best patient experience.
So in ending, we'd love to just hear any final comments. Mike, Brian final messages to our audience from what you've learned and what you've discussed today.
Mike: Go ahead, Brian.
Brian: So first off, thank you for having us. It's been great to be able to share just our thoughts and have definitely enjoyed the conversation and appreciate everybody on listening.
It's definitely well appreciated. And I'd say my final thoughts are with any transition. It's just prepare. It's gonna look different for everybody, depending on what size you are, big or small. I'd say just prepare and communicate and make sure that you've got a clear vision of where you want to go and just outline it for your team, try to bring them along as early in the process as you can.
And, for the most part, if you prepare the right way, all things considered, it's I would hope that they would go well.
Marla: Great. Thank you, Mike. Any final words from you?
Mike: Brian, you said it perfectly. Change isn't easy, but change, if done the right way, can be extremely positive and improve a lot of things for a lot of people, not only the people going through the change and implementing it, but those on the other side of it as well.
So preparation, communication, transparency Brian. And working together. Those are the keys
Marla: and going back to your first point. Trust creating that trust from day one. Your teams will always have your back because you guys have invested in them and they trust you to make those decisions and those very choices.
Being part of JAG. I know that's something absolutely that's felt throughout the entire company. It comes from the top down and then you've got it from every teammate that is able to exude that and be able to express that. So appreciate that. And all of your insights there. I will be sending out a little bit of a survey.
Now you'll see it pop up if you want to learn more about Jag. If you want to learn more about Prompt or both, please feel free to reach out. We are all here to better the industry and to work together. So we'd love to connect and make sure that we are also helping everybody on this call achieve what they want to achieve from in the beginning, when we said if you're going through a transition or thinking about one or maybe avoiding one, hopefully we've given you some tips not to avoid that transition, but to help you prepare for it.
So thank you all for joining. We'll give you a few minutes back to your day and really appreciate you being here until next time. See you all.