Episode 44: Navigating Past New Mountains in the Patient Journey

Even before the pandemic, mountains were standing in the way of patients getting the care they were seeking. On this episode, Jessica Walker, founder and CEO of Care Sherpa, dives deep into firsthand insights her team has discovered that are helping providers overcome operational errors. Learn how consumers are feeling now about procedures that have been cancelled or delayed and how guiding a prospect with a more human touch benefits both the practice and the patient.

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Full Transcript

Announcer: It’s time to think differently about healthcare. But how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans and many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together, and here’s some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.

Jared: Welcome to “The Paradigm Shift of Healthcare,” and thank you for listening. I’m Jared Johnson here today with my co-host Scott Zeitzer. On today’s episode, we’re speaking with Jessica Walker, the founder and CEO of Care Sherpa. Welcome, Jessica, thank you for coming to the show. How are you doing today?

Jessica: I am fantastic. Thank you Jared and Scott for asking me to be a part of the show?

Scott: It’s our pleasure.

Jared: I hate to say it but I’ve been trying to find just the perfect time to bring you in and get you here on the program, and I feel like…yeah, this is the perfect time. We have a lot to talk about, especially with everything going on out there with patients trying to understand what does it really mean, how safe is it to come back and have any kind of procedures done. And providers trying to figure out how do they communicate, what does that mean, you know, how are they responding to things. The world is in a lot of commotion right now and I feel like…timing is everything, right? 

And I feel like the timing of Care Sherpa being founded and getting going and starting up when it did, to me, I don’t know if it feels the same way to you, Jessica, but I feel like the timing of it couldn’t have been more interesting because the world needs you now more than ever. And I’m not just saying that, like everyone needs some healthcare. And I feel like the story of Care Sherpa itself just illustrates the need for patients to get back and to get help, to navigate the whole system, everything about healthcare.

I know you refer to things, you think of them as mountains in the way of patients and providers. Maybe that’s a good place to start. If you can tell us about some of those mountains that keep patients from getting the care they need today…

Jessica: Well, Jared, I’m so glad you kind of brought in that reference, and it’s very pivotal to kind of the organization how it was founded, and of course the name. So, after my years of working with health-care providers, with patient acquisition strategies, and amazing marketing campaigns, the number one thing I noticed is that, no matter how hard we worked, we would still look like the campaigns without the investments were not successful. And that was because of that next step, of what happens when the patient says, “Tell me more?” they fill out the web form, they make the phone call. And what we discovered is that there are these operational or functional or, frankly, just frustrating barriers that get put in front of this person that says, “I need your help. I need your medical care.” And we, as an organization, as an industry, have made it so difficult for patients to move forward.

So, what Care Sherpa was founded to do was to really identify what are those barriers. And I like to call it around the Wizard of Oz, meaning that those barriers may still exist but Care Sherpa comes in and everything in front of the curtain where we manage it, where the consumer has a streamlined conversion experience, it’s a superhighway. But, you know, these things that if, we aren’t thinking about them as we wanna grow and be profitable as a health system, they will keep us from being profitable.

Jared: Yeah. So, you know, let’s dig into that even a little bit more. As a patient gets started, as they do fill out that form, as they do say, “I’m interested in some kind of procedure, some kind of care,” and they start along this journey, then some of these mountains do get placed in their way. Let’s talk about some of those things. Like, on a typical patient journey, we’re talking even pre-COVID, right, because we’ll get into how COVID-19 has flipped everything on its head, but even pre-pandemic, what were some of those mountains?

Jessica: Well, I’m gonna just start with some basic blocking and tackling. So, in our research, what we discovered is that the average health system, when they get a new prospective patient…so, let’s call it a new lead, right, so, someone fills out a web form, somebody responds to a paid advertisement, somebody even makes a phone call, that new lead initiation, healthcare providers, on average, now, I hope you’re sitting down, is over 72 hours or longer before they even respond to this lead.

So let’s think about that from a consumer perspective for a minute. If you are in a moment of truth, so, let’s use the example of bariatric weight-loss surgery, I’ve been researching this for some time, I’ve been thinking about it, the time is right, you know, I saw your ad, and it’s like, “It’s time.” And if I pick up the phone or I fill out that web form and you’re not calling me back until 3 or more days later…if you call me at all, by the way, because 38% of all leads are not even responded to at all in anyway, it isn’t any marketing automation, any text response, or even acknowledgement, “Thank you for submitting your interest.” But then, on top of that, I may have lost my momentum. I may have, frankly, also started to talk to your competitor. I may have been now like talking myself out of it or life gets in the way. Right?

So, when we think about the barriers, the mountains, that is one thing that many health systems do to themselves, just not being responsive and thinking from a consumer mindset. So, Care Sherpa is an example. We have a 20-minute rule, we are gonna be in touch with a lead within 20 minutes of an actual human interaction. We’re gonna have faster responses to acknowledge, and thank, and create a warm personal relationship. But an actual human on the phone, connecting with you, interacting, 20 minutes or less.

Scott: Wow. So, would that be 24 hours a day or…

Jessica: I’m glad you asked that. So we really looked at that, Scott, to say, “Does it make a difference?” And, you know, you do have people, so, cosmetic procedures is a great example, bariatric procedures, or other…even like hip and knee replacement where I’m researching it, maybe the pain has woke me up at night and I’m thinking about it, we actually found that you may be researching it and, you know, right now. You appreciate being acknowledged. So, we have set up some personalized responses. So, when a submission comes in, they are getting acknowledgment but it’s time-based. So, if it’s 2:00 in the morning, you know, you are getting a personalized email and setting the expectation when we’re gonna follow up with you or asking you, you know, from automated chat-bot response, when’s the best time to reach you. It depends on the program. However, I do work with the behavioral-health drug-and-alcohol recovery organizations and those are 24 hours, those are the moment of truth.

Scott: Makes sense. Yeah, it really does. I mean there’s a big difference between somebody rolling over and saying, “Okay, I’ve had it, you know, my shoulder,” insert body part here, ‘hurts too much,” and somebody who truly is begging for some help in the middle of the night, I think that’s a great great thought. When you work with institutions, are they mostly larger institutions or is it a bit of a mix? You also work with small practices in this area?

Jessica: Yes. Great question. So, I’ll tell you. When I founded Care Sherpa, my intent was to work with those health systems that have so many layers of teams and functions and operations that that kind of turned into the mountains in itself. Right? All these silos that get placed in front of like, “Who’s gonna call the person back? Is it the clinic? Is it the call center?” da–da-da. Where we come in and just cut all that aside, say, “I’m not gonna fix all those problems, we’ll come in and super highway, supercharge this pathway for, you know, this high-margin high-value procedure.”

Now, what’s been interesting, and I think that your listeners will appreciate this too, the time to get that to do what’s right, to take care of these leads, take care of these patients, it’s been a very long cycle for us to get implemented because of so many layers of approval, so many people involved in the decision. Right?

So, while we were working with these large systems, we were contacted by smaller providers who are immediately recognizing they’re losing volumes, they’re losing revenue to a competitor, and they’re like, “What can you do?” So, for an example, our most recent client was in the cosmetic space. We were up and working with them within less than 2 weeks because they were ready to go. Now, I have a health system I’ve been working with for almost a year now, trying to get through to just get approvals. So, that’s the reality of our healthcare industry today.

Scott: While you were talking to me, when we deal with individual practices, and we deal with a lot of orthopedic and spine, but we’d have some cosmetic as well, and I always beg the surgeon to dial the front line. “Don’t call the back-end line, don’t call the special phone number, don’t call the cell, be like a patient and call.” And they’re always like, they call me back and like, “Oh my god, I had no idea. I pressed four buttons just to get to my, you know, office manager.” And I’m like, “Yeah.” So, if you’re wondering why you’re losing people, like forget about me where I’m doing, like you’re saying, like the website or the online marketing, the conversion form, if you’re not responding to the request for an appointment, I can’t help you. If the person on the phone line is mean, that’s a tough one too. It’s all part of the equation.

Jessica: I was asked recently whether or not health systems and how partners should start to use furloughed nurses to start answering leads and follow up with folks. And I said, “Not if they don’t have that sales mentality and that service heart, you’re gonna do more damage than good.” And I think you’re right because right now a lot of the organizations we work with, they’ve been thinking about this lead follow-up and this lead nurturing…and frankly, this is a sales process, you spend a lot of money to get this person interested. And they’re treating it as a secondary part-time when-I-have-time versus, you know, putting it at the front.

Jared: So, Jessica, how have things changed because of the pandemic? Because you were looking at these things and you were really working with all sorts of healthcare organizations to get around these mountains beforehand. So, how have things changed?

Jessica: When you were talking about the timing being right for Care Sherpa, I’ll tell you what, come February, March, I was sure questioning that. When we’re working with elective procedures, right, high consumer choice, and then, that entire pipeline completely stopped. So, obviously, stopped for Care Sherpa, but more importantly, for my clients. So, what was interesting is that, you know, one of the things that Care Sherpa is also founded on is those insights and analytics. We are constantly evolving our approach. And so, you heard me talk earlier about the way that we tested a few different ways of responding, what got us to the admission sooner or what got us to progress the lead faster, and so, with that in mind, we started to dig in and say, “Okay, what are happening to these people that were in the pipeline?” you know, where they’re at emotionally putting that patient-experience headset on.

And so, we spent the time working with our clients, when procedures were shut off, really just reaching out to the prospective patients, “How are you? What questions do you have? How can I help you?”

And what’s interesting then, that prompted us to do a national survey. And I’ll be candid with you, I mean this is my service heart showing, but it broke my heart when we reached out to some patients who were scheduled for procedures. And here we were…you know, at this point, we were in the midst of the middle of COVID and there was 60% of the people that we spoke to had not, you know, heard anything after the cancellation. And 38% of those, since the cancellation, had not heard anything about whether or not the procedure was gonna be rescheduled and if it was safe and where they were. So the emotional turmoil, you know, in terms of where they were mentally.

And again, as we think about this sales process and this conversion, I think that that’s where many health systems are missing the boat is that it is a psychology, emotional decision. And even when they’ve committed and set the appointment, you know, there’s gonna still be possibilities of cancellations because of how they feel and the fear. So, all that to say, post-COVID, now that procedures are opening back up, a lot of the work that has come to us as we’ve been trying to help organizations is just get their pipeline back in order and understand where is it and who’s on first, who’s on second, and frankly, prioritizing the people that are in the pipeline from, “Are they ready to go? Do they still have insurance? Do they still need the procedure? Are they still clinically-qualified?” And then, you know, even frankly, from a revenue perspective of who’s gonna help us repair some of this revenue leakage, and then, put that all into this formula around how we’re managing the pipeline?

Scott: Yeah, you know, it’s interesting because, from your perspective, do you think that patients are starting to now feel like it’s safe to come back? Is there still a lot of trepidation? And then, the follow-up to that would be how do you make the patient feel like it’s okay to come back?

Jessica: Great question, Scott. So here’s my answer, it depends. My cosmetic clients, people were pounding on the door, right, “When does it…” They were already in that moment, they’re ready committed to it, they’re ready to go. And I’ll actually say that, some of my newer clients in that space, that that’s been a big part of it is that they’ve had an influx of demand because people had this period of time of not being able to, you know, move forward these procedures.

Now you flip that to things such as like an orthopedic practice where my moment of truth was, “I was in pain, it was limiting my life,” right, “but now maybe the symptoms, because I had to wait, have changed.” So how do I get remotivated? Which is coming back and reminding you, when you first called us, you were worried about being able to, you know, go on your…you know, be there for your daughter’s wedding in the fall. Well, let’s take care of that now, right, kind of that motivation connection.

But all that to say, what we have discovered is that the organizations that have done a really good job on purpose with just reaching out to their patients, and again, asking that first question of, you know, “We apologize. We’re so sorry this happened to you. How are you?” and then, conveying their sense of, “here’s how we’re managing COVID, you know, and your safety, and here’s our methodology.” And then, then asking that question of, “Let’s talk about your ability to be rescheduled.”

They have a much higher, not just reschedule rate, but also actually completion rate versus those that are functionally calling you and saying, “Okay, Scott,” you know, I’ve got next week Tuesday for your surgery, let’s get you on the books.”

Scott: Yeah, you know, we’ve got close to 1,000 surgeons on our platforms, and I’ve been repeating myself over and over basically saying, “You’ve got to be very specific about what you’re doing to keep your patients safe, yourself safe, your staff safe.” Don’t say stuff like, “Oh, we’re following CDC guidelines,” it’s like what does that mean? You know, here’s what I’m doing in my office, here’s what I’m doing in the operating room, here’s what I’m doing at the imagery surgical screen. Right? I mean and I really do believe this, the quicker you can get the word that, “Here’s how I’m taking good care of you,” the quicker they’ll be able to get people back in that pipeline. And frankly, they may even be able to take some people who were thinking about going next door, right?

Jessica: You’ve got it. We’ve been doing a pipeline rebuilding with our clients and doing exactly that, Scott, and refining in these marketplaces where the competitors are not managing their pipelines and now they’re booking people all the way out in September, and they was supposed to have this procedure in May. Right? And so, capitalizing that, and then, doing as well as, you know, frankly, crazy enough, it depends on where we are, so, especially in my highly-elective areas, there’s even been a big opportunity for upsell here because they could not get access otherwise or they were, you know, in additional needs. But it was just having the conversation, and again, re-engaging on a level that is beyond this functional transactional.

Scott: Yeah, no doubt.

Jessica: I wanna make one other note here too is that, what we also discovered in our survey, in our research, and we’re actually gonna go back and validate this here soon in terms of what happened since then, but we ask patients that, “If you did reschedule, would you actually show up for the procedure?” Because our concern was that, if a provider was not managing that safety perception and making me trust and feel confident, that they may schedule it but not show. Our early indication with clients that we’ve just started go back and look at and get them started, they’ve seen that, that people committed because they wanted to get that placeholder, but when the day came, because no one called them, no one checked in with them, they no showed or they cancelled.

Scott: Yeah, it makes perfect sense. I mean, you know, it’s amazing, healthcare, whether you like it or not, if you wanna get ahead of the curve, you’re gonna have to start realizing that the consumerization of healthcare is here. And if you’re not treating your patients accordingly, you know, think about that. That stat that sticks in my head, at the beginning of the conversation, 72 hours to get back to somebody…I mean if that was just like, “I need someone to mow my lawn,” you would’ve dropped that person. “No, sorry, you’re out, man. You know, I’m gonna go find someone else.” And I do understand this, especially for people who’ve been in the healthcare-providing field for some time. Yeah, “But I’m special,” it’s like, “yeah, maybe. You know, depending on where you are in the country, you could very well be the only provider of X service.” But in more and more places, you’re not the only person on the block and you better start treating your prospective patients with a little bit more respect.

That’s what fascinated me, there were two parts that fascinated me about what you’re doing, one is just getting people to understand that you gotta take better care, you know, of your prospective and current patients. And the numbers, you know, the research, the analytics that you provide, it’s just great stuff. I’m just very impressed.

Jessica: Thank you, Scott. And I’ll give you a little bit of my secret sauce here for a minute for your listeners, since, obviously, they’re savvy and they’re, you know, listening to your podcast. So, one thing that we discovered in our research, this was pre-COVID but very much during COVID, and we’re continuing to monitor this, is that it actually, when we talk about where the patient is and their decision-making process, and frankly, even their willingness to move forward, where many organizations are getting it wrong is that they’re missing the influencer. And what I mean by influencer is that, “This is not just me and vacuum making this decision, this is my decision with my family member, my spouse, my caregiver.” And we incorporate that person in the process because, if we’re not helping the patient…so, let’s think about this for…it’s nerve-wracking, right? Especially during COVID, that, “I’m gonna go under anesthesia and the risk of then putting myself in a facility and people are worried if I walk into the facility, can I be in contact with COVID.” Right?

And so, are we engaging that dialogue with the caregiver in this process so that it’s not a secondhand telephone game of the patient having to say to their spouse, “Well, they told me they do this?” Like let’s have a direct conversation. And by doing that, I won’t give you all my stats because it’s part of our, you know, pieces, but I will tell you, it is one of the top predictors of overall progression in a relationship.

Scott: You know, it’s funny, I can’t wait to get onto your website and, if you wouldn’t mind, telling everybody your domain name so people can log on…we’ll have it on the page as well. But what is your website again, just give a little…

Jessica: Thank you for asking, Scott. It is caresherpa.com.

Scott: Pretty quick.

Jessica: Yeah. C-A-R-E-S-H-E-R-P-A. So, think of Sherpa as in helping you get over those mountains. Right? And of course care, for all things related to healthcare.

Scott: Yeah, guys, I’ve been on this site, it’s a great site. It’s very eye-opening. And, you know, when I say, “There’s a lot of people that I deal with,” so, I deal with a lot of practices and it is about…you know, you mentioned the care giver, I can’t tell you how many times I would have a conversation with, say, an orthopedic surgeon who would say like, “Yeah, but you know, a lot of these older people aren’t on mobile devices,” and I would very politely go, “yeah, actually they are. They wanna talk to their grandchildren.” “That being said, don’t you talk to the mom and dad, their children who are now moms and dads, a lot as well about what’s going on?” And they go, “Oh, yeah.” It’s like, yeah, you know, these are the people who are gonna be taking care, or helping taking care, of your patient when they’re done. You’ve got some of those numbers.

And then, the other people we talk to a lot are medical-device companies. And medical-device companies tend to get into this very bad habit of saying, “Here, health-system or medical-care provider, here’s some free brochures.” It’s like, “You know what? That’s not gonna be enough. Like that’s great and it’s probably a brochure that is really meant more for a surgeon than for a patient, but even if they just have a patient brochure, it really doesn’t connect the dots. That’s what I really like about what you’re doing, you really do help connect the dots.

Jessica: We do. And Scott, one of the things that really prompted me to found Care Sherpa, and Jared will laugh because he knows me and the story, but I just got mad. I got mad about the amount of waste from marketing, and spend, and all this, you know, effort that was spent on these beautiful billboards, or whatever the case may be. Right? But things that never really led to admissions or never really led to conversions. But then, candidly, the other side of it is that, you know, the solution was always like, “Oh, let’s just get more people at the top of the pipe. Let’s keep putting more in the pipeline, at the top of the funnel.” 

And that’s not it. You know, so, one of the things that makes me so happy when we work with our clients is that we come in and, as we progress in the relationship and get the data and get the, you know, pipeline fix, we’re actually able to come in and help them save significantly on marketing spend. Because we can directly say, “Okay, that’s a beautiful ad but all the leads that are coming from that are garbage.” You know, or, “That’s a beautiful ad but no one’s picking up the phone and calling from it or connecting to it.” Or, “Candidly, you know, at the end of the day, it’s not performing. Let’s double down on this one where you’re getting high-margin, high-value, ready-to-go leads.”

Jared: Yeah, Jessica. I feel like one part to really…I don’t know if anyone else is really answering or addressing right now for a provider, is how they do know which patients to focus on. How do they know which patients are ready to come back? It’s clear that not all patients are going to be ready to come back and one danger we see is, when we just lump them all together, “Hey, all patients are ready,” or, “all patients are not,” when we know some are and some are not. Like it is such a spectrum. Any insights there into where to start? Like how does a provider understand how a particular patient is feeling right now?

Jessica: Yeah, great question, Jared. So, it kind of goes back to what we talked about earlier with how are you handling this interaction. And in a lot of ways, you can’t just assume, because they were in your pipeline before, that they still are or that they’re at the same position in the pipeline. So, that first interaction, you’re almost starting all over again. You’re talking about eligibility, so, you know, “Are you still clinically-eligible?” And then, if not, “Now what?” Right? Then, the second question is financial end payer, so, “Do you still have the ability to pay? Do you still have the same insurance?” and, you know, etc. Then, as we talked about, overall motivation and readiness. “Does your life situation still allow for this? Maybe you can’t take the time off work anymore or maybe your home situation has changed.” And so, it’s starting from that place of like service and connection.

And then, even beyond that, some of the things we covered in our research was also looking at the prioritization is so important right now. So, you think about, let’s be real for a minute, where we are in healthcare is we’ve got to be conscientious of dollars to the door. Right? And why would I, either for a patient who’s not ready that I need to almost resell, or a net new patient who comes in but maybe isn’t quite ready to move, why put them on the calendar now? Let’s keep those spots open for people that are ready and need it and are motivated and we know that their life circumstances…you know, because we think about the other things that could impact their readiness, such as, from a mental-health perspective, overall health status…heck, let’s be honest, the continued COVID risk, right? And so, let’s think about all those things so that the people that we’re seeing and we’re investing our time in now are those that are gonna bring dollars to the door sooner.

And then, we need to be conscientious of, “How do we maintain the relationship with the other ones who maybe need more time, maybe need someone to hold their handle a bit more, make them feel more confident that it’s okay to have this procedure?” Or, candidly, you know, maybe we changed their pathway because of where they are in their life circumstances. That’s where, you know, the miss is right now, not thinking about this from a prioritization.

Now, let me take a pause here because I don’t want your listeners to come after me with pitchforks. That’s why Care Sherpa is founded because I realized that you don’t have time on top of managing the practice, on top of managing all the other things that you do for day-to-day. And so, working with partners and tools that help you think through these things, that’s the optimization that, you know, would help you move forward.

Scott: Awesome.

Jared: Well, Jessica, I think I speak for all of us in saying it’s inspiring to see how much passion and work is going into this to help patients navigate the healthcare system. We all see the need for it, and I just wanna say keep going with it and thanks for joining us, giving us a few minutes today. Stay safe and stay well.

Jessica: Thank you so much, Jared and Scott. It was a pleasure and I appreciate the opportunity to share, obviously, as you can tell. I get on my soapbox here, and then, we think about patient experience, the way they move forward. So, thanks again.

Scott: Oh, you definitely have a passion for it. It’s great talking to you.

Announcer: Thanks again for tuning in to “The Paradigm Shift of Healthcare.” This program is brought to you by P3 Inbound, marketing for ortho, spine, and neural practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.