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Jay Lawrence

Jay Lawrence is the CEO of PatientWay, a leading provider of patient self-service technology and process improvement services.  Jay's vision of bringing measurable cost and time efficiencies to health care organizations, while improving patient and staff satisfaction, is quickly being realized as leading providers such as Sunnybrook Health Sciences Centre, Southlake Regional Health Centre and the Stronach Cancer Care Centre, are just a few of the many that have adopted PatientWay technology. Jay is a recipient of the Ottawa Business Journal's Forty under 40 Award in 2009, Industry Canada Innovation Leader also in 2009, and Chair of the Information and Communications Technology Council (ICTC) Path to Recognition (PTR) National Steering Committee.

The real cost of no-show patients (warning: it’s worse than you probably think)

Written by Jay Lawrence on March 4th, 2013. Posted in Appointment reminders, Healthcare Technology, Hospital scheduling

Empty waiting room 233x300 The real cost of no show patients (warning: it’s worse than you probably think)

“Mr. Smith? The doctor is ready to see you. Mr. Smith, are you here?”

That lost money could have bought the country:

  • a new hospital, or
  • 115,000 hip replacements, or
  • cataract surgery for 800,000 people, or
  • 110,000 heart bypass operations.


It’s true: no-shows—also known as DNAs (Did Not Attend) and unattended appointments—are extremely costly to healthcare providers.*

Not to mention, an administrative nightmare. Patients who don’t attend their appointments:

  • interrupt the scheduling process,
  • disrupt the healthcare delivery system, and
  • waste administrators’ time trying to track down patients to fill the slot or rearrange bookings.

Benefits of automated appointment reminders

Studies show that automated reminders are an extremely effective way to reduce no-shows.

Not only do these types of reminders help reduce no-shows between 29% and 36%; but the majority of patients actually want to receive automated (email) reminders for preventative and follow-up care.

Ultimately, automated appointment reminder technology can help improve healthcare profits while enhancing patient care and simplifying office workflow:

  • Improved two-way communication. Patients can be informed by phone, email or text about a scheduled appointment, and can easily confirm if they will attend.
  • More advance notice. Patients can give facilities advance notice that they will not be attending—allowing the healthcare facility to fill that timeslot in a more timely manner, and maximize staff on shift.
  • Improved patient health/preventative care. By attending their appointment, patients decrease the chance that they are potentially delaying the identification and treatment of serious health issues.
  • Streamlining daily work for administrators. Automated reminder systems take the manual work out of administrators’ hands. This technology can even provide no-show statistics and analysis, which can then assist administrators with staffing requirements.

Take control of no-shows

A 2011 survey found that text or automated reminders cost less than US$.80 per patient—significantly less than the cost of missed appointments.

At that rate, automated reminder technology is a solid investment that can minimize lost revenue and wasted office time, as well as ensure patients get the best care they need.

* While the NHS represents a multitude of healthcare organizations, single hospitals like this one have lost more than $1 million in revenue due to patient no-shows.


IKEA self-service flop: a lesson for healthcare (part 2)

Written by Jay Lawrence on February 18th, 2013. Posted in Healthcare strategy, Healthcare Technology, Hospital kiosk, Hospital management, Patient registrations, Patient satisfaction, Patient Self-Service

Heavy boxes IKEA self service flop: a lesson for healthcare (part 2)

“Heavy lifting required? Maybe self-service checkout isn’t a good option”

In a recent blog, I shared how healthcare folks can learn from IKEA’s failed efforts with self-service technology.

Granted, IKEA’s applications for this technology differ greatly from that of healthcare facilities. At IKEA, customers used it to make purchases; while hospitals and medical clinics typically use it for things like patient pre-registration, registration or check-in, wayfinding, and completing surveys.

Still, IKEA offers us much food for thought (and I’m not just talking about its delicious Swedish meatballs).

Here are two more takeaways:

Lesson #3: Self-service may work better in some environments than others

It’s one thing to use a grocery store check-out to buy a box of cereal and a carton of milk.

But at IKEA, customers often have big, bulky furniture that requires a wide, awkward cart to maneuver. Flipping boxes over to find the barcode can require some major muscle. And even then, it can be tough to scan the barcode with a pricing gun.

Put simply, self-service technology doesn’t make sense for all service providers—sometimes, not even those working in the same industry.

Where healthcare is concerned, a simple Google search will show you there have been many success stories—in hospitals as well as medical clinics, large as well as small, and across a number of countries. The challenge is in figuring how best to use it to meet patients’ needs, as well as your own.

Lesson #4: Self-service should demonstrate its value to users

“When self-checkout is done well, customers love it….However, when it is clunky and confusing, the customer is left to think, ‘I have to work this hard to give you my money?’”—Sheridan Orr, Interrobang Agency

When first introducing self-service technology, many organizations tout it as a value-add to users. Whether that’s true or not, however, is ultimately left to the discretion of the users.

Given the many frustrations IKEA’s self-service check-out lanes created for users, the retailer gave consumers the impression that the customer experience was not as important as saving money and reducing headcount.

There has to be some realized benefit—tangible or intangible—to the person using the self-serve technology.

In an industry like healthcare that is known for delays and backlogs, being able to save patients’ time is one visible and measurable way to demonstrate value.

The user experience

Ultimately, it’s the users who will decide whether or not the technology is a success. All you need to do is look at IKEA’s experience as proof.

Yet, despite the failure of self-service at IKEA, the retailer did something right by yanking its kiosks from its US stores: it showed that it had listened to its customers. This says a lot about the company.

In healthcare, the patient experience is critical to what we do. While any technology may have its hiccups, it’s our responsibility to ensure it helps—not hinder—the people we service.

IKEA self-service flop: a lesson for healthcare (part 1)

Written by Jay Lawrence on February 4th, 2013. Posted in Healthcare Technology, Hospital kiosk, Hospital management, Patient satisfaction, Patient Self-Service, Uncategorized

Ikea IKEA self service flop: a lesson for healthcare (part 1)By Jay Laurence, CEO, PatientWay

For perhaps the first time ever, you’re going to get something from IKEA that doesn’t require assembly or an Allen key: a lesson.

In August 2012, IKEA announced plans to remove all self-service checkout systems from its US stores.

The reason? According to an IKEA spokesman, “It wasn’t as efficient as we had originally hoped.”

Despite IKEA being a retailer, its failed experience still teaches us a few things about using self-service technology in healthcare.

Lesson #1: Self-service should not be mandatory

IKEA cashier lanes were opened only on the busiest shopping days—so customers often had no choice but to use the self-service checkout lanes to make their purchases.

News flash to IKEA (or not): not everybody is comfortable with technology—including seniors, people with vision disabilities and/or low literacy levels, and those who speak minority languages.

In a high-stress environment like a hospital or medical clinic, providing an option for service—for example, having a staff member available to assist patients face-to-face if they prefer not to use a kiosk to check-in or register—can help ease anxiety and add to (rather than worsen) the patient experience.

Lesson #2: Self-service should offer instructions

IKEA customers often found kiosk directions unclear—and no demos were provided on operating the scanners (despite the kiosks being designed to offer tutorials).

If you expect your users to readily take control of their own transactions, you have to anticipate that they will have questions—obviously, when the technology is acting finicky, but also in the best of times.

If the technology allows it—and it should, if you are making such an investment—ensure your kiosk includes patient instructions and/or a “Help” feature or call button for face-to-face assistance. (And make sure the person doing the assisting is not only friendly, but well-read on troubleshooting!)

Perhaps Francie Mendelsohn of Summit Research Associates Inc. summed it up best when she said: “The secret to self-service — any kind of self-service, including candy vending machines — is don’t make me think.”

Checkout time

Stay tuned for my next blog article, when I offer two more lessons learned (courtesy of IKEA)—including how they apply to the use of self-service technology in healthcare

Patient registration: the impact of an error-prone process

Written by Jay Lawrence on January 28th, 2013. Posted in Hospital kiosk, Hospital process redesign, Patient registrations, Patient Self-Service

Patient registration form Patient registration: the impact of an error prone processConcerned about data errors introduced through your patient registration process?

If not, you should be.

Errors—even seemingly small ones—represent not only a significant financial burden, but your ability to provide proper patient care.

In other words, your error-prone patient registration system may be hurting the very people you’re trying to help.

The cost of “rework”

Research shows that up to 80% of billing office staff time is dedicated to rework due to registration data errors and incomplete information.

For example, a missing guarantor or subscriber information, invalid policy or group number, or missing authorization can lead to insurance claim delays and denials.

Almost 100% of all claims must be submitted to insurance companies more than once—in fact, this study reports that insurers must go back to hospitals two times on average to get all the information needed to pay a claim.

In the US, healthcare administration consumes more than one-third of healthcare costs. This can likely be blamed in part to delayed or lost billing revenues arising from claims denials—which can cost a hospital millions of dollars.

Increased patient risks

Every single error also elevates the risk to patient safety (not to mention a legal risk to healthcare providers).

Duplicate medical records are one of the most critical issues facing health information technology departments. Most often, they are created as a result of inaccurate data entry.

With the existence of multiple records for a single patient, it is likely that healthcare providers will miss critical information because it is located in the duplicate. They may also have trouble locating certain files when needed for patient interactions.

Building a foundation to reduce errors

More often than not, patient data errors introduced through registration are the result of registrar human error, incorrect information provided by the patient, or a change in the patient’s information.

But fixing an error after it happens simply isn’t a cost-efficient use of your healthcare facility’s time or resources.

The solution is to build a foundation for accurate, clean data.

A patient self-service kiosk is a preventative (rather than reactive) solution that helps reduce the potential for registration errors before they can occur, by:

  • eliminating, if not reducing, the need for patients to interact with staff to register/check-in;
  • making it easy for patients to validate and correct their demographic information through customized prompts; and
  • frees up staff’s time by automating many registrar tasks such as printing forms, wristbands, updating tracking boards and other systems, and even logging data to databases.

The quality of your patient registration data is critical to the work you do, and how well you do it. If you haven’t yet considered the havoc that errors can have on your finances and patients, now’s the time to start paying attention.

Privacy breaches in the waiting room: how your check-in process affects patient safety

Written by Jay Lawrence on January 21st, 2013. Posted in Healthcare Technology, Hospital kiosk, Hospital process redesign, Patient registrations, Patient Self-Service

Waiting room privacy Privacy breaches in the waiting room: how your check in process affects patient safety“Why do you need to see the doctor today?”

“Um…I have [insert embarrassing symptoms here]…”

Each question asked and answered in a waiting room represents a risk of privacy breach, and, consequently, a threat to patient safety.

Consider how uncomfortable it already is for a patient to discuss their symptoms, conditions and test results. But if they believe others in the waiting room can hear them, they may also be more likely to:

  • withhold important medical information; and/or
  • speak in hushed tones, rendering speech recognition less accurate—and leading to medical errors.

In other words, if the patient’s perception of privacy is threatened, their way of dealing with it may actually put their own personal safety at risk.

And to boot, a breach of patient confidentiality can negatively impact their trust in your healthcare team—even resulting in them taking their business elsewhere.

Do you have an auditory privacy problem?

You don’t have to be a sound engineer to figure out if your waiting room has a problem with oral privacy. Just listen.

  • Can seated patients in the waiting area hear others as they check in with the receptionist?
  • Can people standing in line hear conversations that are meant to be private?

If you answer yes to either of these questions, you should consider creating safeguards to better protect your patients’ confidentiality.

Transforming your registration / check-in process

There are several ways to minimize the possibility of privacy breach between staff and patients.

For example, music or a television can help drive focus away from the registration desk; and acoustic ceilings, carpeting, and barriers like doors and walls can help with noise.

But the most effective solution may be to make changes to your actual registration/check-in process.

In a 2012 PatientWay client survey, more than one-third of respondents said that patients complain about cramming people too closely in a lineup, as it puts their privacy at risk.

Consider making changes to the way patients share information with staff upon arrival, such as:

  • Asking patients to stand a few feet back from the registration counter.
  • Creating a waiting barrier line by placing tape on the floor with a sign saying “Please wait here.”
  • Implementing a patient self-service kiosk. Many patients prefer the experience of checking in using a kiosk to registering with a nurse or administrator. Patients can enter their personal data on a touch screen designed to prevent others from reading it at an angle. This allows patients to provide sensitive information much more discretely than they would face-to-face with an administrator at the check-in desk.

By providing a waiting room where patients can disclose their personal information freely and comfortably, you will not only help decrease the risk of privacy breach: you will also increase patient safety, and maintain their loyalty.

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