In & Out


Is your patient intake process an asset to your business? Technology might be the answer.

By Michael Vacon, PT

When was the last time one of your patients complimented you on how quick and easy the intake paperwork was to fill out prior to their initial evaluation? My guess is never, right? How many times do patients show up exactly at their appointment time, or 15 minutes late, even though you asked them to show up 20 minutes early to complete their admission paperwork? I would imagine this happens a lot. Having that new patient show up 15 minutes late and then taking another 15 to 20 minutes to fill out their intake or admission paperwork can really put a damper on how much time you have to complete a thorough evaluation, review some home exercises or treatment, complete your documentation, and then get ready for your next patient. In my practice it is something we struggle with on an ongoing basis. Some days it flows well while other days are an all-day log jam.

If you ask patients what is their least favorite part of attending any type of medical appointment, I would guess that many would cite the endless amounts of paperwork. It would be great if there was one national repository where all the patient information lived and we could just push a button and instantly get up-to-the-minute, completely accurate data on all our patients, but that is just a pipe dream.

Imagine my surprise when I recently found myself in a situation where as a patient, I complimented a medical office on how easy it was to fill out their paperwork. I found myself in need of a magnetic resonance imaging (MRI). When I called to make the appointment, they asked for the basic demographic and insurance information, a few simple questions about things that might prevent me from being able to have an MRI, and then booked my appointment. When I arrived 15 minutes early to fill out my paperwork I was handed a tablet. The program had me confirm my demographic and insurance information, sign Health Insurance Portability and Accountability Act (HIPAA) and informed consent documentation, as well as go through a medical history questionnaire . . . and it took me less than five minutes to complete. I was so impressed with their system that I reached out that same day to the corporate office to ask about what program they were using and how I could get my hands on it. I wanted to have my patients feel the same way about the intake process I just did.

Unfortunately for me, I learned that it was a program that the company had developed themselves, so it was not “out of a box” and it was not for sale. However, I was put in touch with a regional business director and the lead person on the team whose vision helped bring their system to fruition. I was invited to meet with her so I could learn more about their system, the team they put together to build it, and how it worked. What I ended up learning was much more important that just how they came to build this system.

A few years ago, this company decided to undergo a corporate culture change and implement a Six Sigma philosophy. Essentially, Six Sigma at many organizations simply means a measure of quality that strives for near perfection. Six Sigma is a disciplined, data-driven approach and methodology for eliminating defects (driving toward six standard deviations between the mean and the nearest specification limit) in any process—from manufacturing to transactional and from product to service. The director reached the Green Belt Level of Six Sigma, and the project she worked on to help reach her level was a full paperless system to take a patient from intake, patient interview, imaging, and subsequent radiologist interpretation . . . no small task indeed. They realized that a large amount of time was taken up by producing, scanning, and tracking paperwork on their patients. Not having the right paperwork done at the right time, or in the right place at the right time, could be disastrous. They had many goals for the project, but the ones that resonated most with me were the improvement of the patient experience and the reduction of resources dedicated to the paper chase that is health care right now.

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This company already had a strong awareness of how long it took a patient to fill out paperwork, how long it took their staff to conduct a patient interview, and how long each “scan” took. They were also keenly aware of how many staff it took to make the process flow smoothly. Similar to physical therapy, a large portion of the cost associated with providing imaging studies involves the staff. They realized that being able to automate the intake process and truly have a paperless flow allowed them to provide the same high level of patient care, but with fewer resources. They realized that although having a great front office person can be a wonderful thing in your facility, the real reason patients are there is to see the technologist and have their imaging performed. The same goes for a physical therapy appointment. The faster you can get the patient to the technologist (or physical therapist), the happier the patient generally ends up being with the service. I can attest to that having gone through their intake process, the patient interview, and the MRI and getting the chance to see firsthand how seamlessly their system worked.

What this made me realize is that in my own practice I spend a great deal of time thinking about the patient experience from the treatment perspective, but very little about the perception of how cumbersome and time consuming our paperwork can be. I can honestly say that I have never really sat down and taken a good look at how to make the process simpler. How great would it be to have patients tell me how easy and fast the paperwork was rather than having a patient who is both flustered and irritated by the whole process. As a practice owner, I can also appreciate the potential of reducing costs through automation of systems that now require multiple people to complete. The initial investment in the technology might be steep, but in the long run, the ability to improve patient satisfaction and help improve my bottom line by doing more with less could all be well worth it.

I wish I could end this article by telling you that I found the perfect “out of the box” system for physical therapy practices . . . but I cannot. What I can tell you is that I will be starting my own performance improvement project within my organization to improve and simplify my intake process. I am not sure that I will reach the seamless, paperless system that I had the pleasure of experiencing, but I now have a better understanding of how important the ease of intake can be for patient satisfaction and I plan to achieve it. Is it time for you to look at your process too?

Michael Vacon, PT, is the managing partner of Blue Hills Sports & Spine Rehabilitation, which is part of the Pinnacle Rehabilitation Network. He is a PPS member and also on the editorial board of Impact magazine. He can be reached at

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