Technology Tetris: Clinical Tech Stack for Consolidators

27min
Season 1
Listen directly on:

This week on the Consolidate That! Dr. Julien Renard, Co-Founder of Vetstoria, joins Dr. Ivan Zak and Ryan Leech to discuss the successful execution of a clinical tech stack and the importance of knowing how to measure success.

Topics discussed:

  • Vetstoria appointment bookings in the customer journey;
  • Implementing software for large scale organizations;
  • Change in the hospital workflow and clinical staff behavior;
  • Key KPIs that Vetstoria provides for the veterinary groups;
  • The importance and influence of having meaningful actions based on KPIs;

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Speakers

Dr. Julien Renard is the Co-Founder of Vetstoria that is the world’s leading online veterinary scheduling platform, loved by 2,000+ successful practices worldwide.

Transcript

Ivan-Zak
Dr. Ivan Zak

Welcome to consolidate that! Today’s an exciting episode. We have a friend of mine, a colleague, Julien Renard. He is the CEO and the founder of Vetstoria, the appointment booking platform, and now it does way more than that. He has the background as a veterinarian, just like me.
What I learned today, actually, he’s really into racehorses as the veterinarian, not as a gambler. And his dream is to have a horse farm one day. And he also has a background in the business school as well as he’d been at Vetstoria for how long Julien, how long has been going on?

Julien Renard
Dr. Julien Renard

10 years now? 5 years doing online booking, but 10 years in total.

Ivan-Zak
Dr. Ivan Zak

So tell us the difference between what you’ve been doing just with the booking and what is it now. What’s Vetstoria doing now? 

Julien Renard
Dr. Julien Renard

The majority of what we do is around online booking. That’s really the key feature of Vetstoria and that’s what we want to focus on, and we want to always be more performance.
So online booking is really the key activity of Vetstoria.

Ivan-Zak
Dr. Ivan Zak

Ryan, good to see you here as well today. And I think that today’s going to be an exciting discussion is just the beginning of the series that we talked about before. We’re going to talk about the tech stack for consolidator, meaning what software consolidator should use for the successful execution of the value creation plan.
And as the beginning of that patient corridor, Julien represents the software that helps with that. So this is the initial sort of stream, if you will, of Consolidate That podcast where we will talk about the technology.

Ryan Leech, Director of Sales
Ryan Leech

I’m excited for it. I know we’re really happy to have Julien here. Julien’s another one of our international guests, coming from overseas in the UK and he’s formerly French or still French.
So Ola, Bon Jor, Cheerios, all of those sorts of things. So thank you so much. Ivan, we’ve talked a lot about the patient corridor and I’d love to get some more of your opinion about it and learn more from Julien about how he sees the patient corridor.

Ivan-Zak
Dr. Ivan Zak

Yeah. So Ryan, the patient corridor, I think the term, the first time I heard it is from actually by our previous guest Thom, but basically really what it is, it’s if you imagine sort of the journey of the customer, a lot of the times, people talk about the customer journey map. So, this is the journey of the pet that needs to get into the hospital. You start with a concerned owner that has the need to bring the pet to the hospital and then somehow they need to find the vet. They need to book an appointment. They need to show up. They need to be checked in. And then, you know, everything that happens in the hospital, whether it’s diagnostic, surgery, then at the end they’re prescribed medication, then they go home and then follow up. So that’s what I call the corridor.
And then Julien represents that front part of this corridor. And, Julien, why don’t you help us understand what does Vetstoria do? And then how that plays that role in initial engagement of the customer that needs to see a vet?

Julien Renard
Dr. Julien Renard

Sure. So, Ivan and Ryan, first of all, thanks a lot for inviting me. So, what the customer journey starts, you mentioned by taking an appointment, but actually starts itself before that.
And the practice needs to engage with two types of customer in some way. First of all, the new customers, so they need to find and acquire new clients. And the second part, they need to engage with clients and have them coming back. So the retention aspect of it. And Vetstoria will be a key piece of the journey of both these types of clients.

Ivan-Zak
Dr. Ivan Zak

So, Julien, in that context of the patient accord or this customer journey, I always thought that the appointment booking is important upfront when the customer is looking to book an appointment and automating that is important for the veterinary clinics. Now, you also mentioned in the conversation prior to the recording here, that that’s also important at the end of the visit.
So can you expand on that please?

Julien Renard
Dr. Julien Renard

Sure. So, a practice needs to do two things, acquiring new customers on an ongoing basis. We know it’s essential to maintain the customer base of a practice and grow the practice. Second element, you need to have the clients coming back. You need to have the clients coming back. I mean, most of the practices have tech stack around the client retention. It can be an app. It can be appointment reminders, which are integrated in the PIMS. Having these pieces of software to actually allow your client to schedule online is essential. So to have your clients coming back, integrating online booking into your reminders, into the application used by your client is absolutely essential.

Ivan-Zak
Dr. Ivan Zak

Yeah, absolutely. So the forward book and is something that the dentistry adapted a long time ago, and then veterinarians, actually, when you look at the stats, I think we’re adopting it better. But then it’s the discipline of having your clients to book that next appointment.
So, when you implement to consolidators, because it’s a large scale implementation and you know, we’re focusing more on consolidators. How do you do the change in the hospitals and change their behavior? And how do you roll out the similar workflow to the organizations that I know you work with some that are hundreds of the hospitals?
So how do you roll out that unified approach and what is the sort of change management tactics that you use?

Julien Renard
Dr. Julien Renard

Well, first of all, we don’t have the objective to change the way of practice work. That’s actually potentially the most important thing. We know one thing is that each practices are different and they are different because they have doctors who all have the specificity, their own skills, and all the operation of a practice is centered around this case of these doctors.
They have a process. And usually when consolidator buy a practice, they buy a practice, usually, the practice is successful and for them to come and change the way the practice works is very risky. So what they want is to carry on delivering value as they have been doing and just supporting them with the surrounding element of the operation of a practice.
That’s what their goal is. So, when it comes to online booking, what we want to do is very simple. There is a scheduling process, which is delivered by the receptions of a practice. And what the reception is do is they’re going to deliver a scheduling process as been dictated by the vets, the nurses, which are within this practice and Vetstoria is going to replicate exactly this scheduling process.
So we have no intention to change it actually, or attention needs to match exactly the scheduling process. So, consolidators might have a hundred practices, but they will have a hundred different scheduling process. We match this process, that’s what we do.
Now, they are all the elements of these, what we can do is optimizing the customization of each account to make it more successful. So that’s coming usually as a second step, but usually and it has to be done in collaboration with the practice and still be aligned with the operation of this specific practice. So to respond to your question, we don’t change it.

Ryan Leech, Director of Sales
Ryan Leech

That’s actually really timely that you mentioned that our last episode was about consolidators coming in with the intention of not touching anything and sort of needing to make changes and apply growth levers while still being able to know what they’re doing, isn’t changing the day in and day out life of the veterinarian.
So, that’s really neat to know that Vetstoria is an option for the groups that want to come in and make changes, but not change the day in and day out life with the veterinarian. Those growth levers are important and really neat to see.

Ivan-Zak
Dr. Ivan Zak

I think that’s the key. I think that’s really important. And we also talked about this concept of the growth levers and that’s how the consolidators change the practice.
So, you know, the one side of the value creation plan is always arbitrage and that’s, you know, those that mostly don’t change anything at all, and they don’t want to capitalize on the margin expansion. But when we talk about Vetstoria and helping the margin expansion at the front, so that means that they’re hitting the top line. And the top line increases using your solution. And then if you will sort of summarize and where does it fit in? It’s one of those probably marketing tools, if you will, that increase this patient inflow, is that correct?

Julien Renard
Dr. Julien Renard

Yeah, that’s correct. If I can just go back to the previous question, if you don’t mind, Ivan. You know, I say that we don’t change anything. Yes, we don’t. We really much, as I said, the existing booking process. However, what we can do is that when we have matched this process, we can help the consolidator to improve it. But at least the starting point is matching the starting point of the clinic.
So we can actually work together with the practice when they are comfortable with the technology. When the operational team of the corporate is also comfortable. Because I mentioned the practice, but the regional manager, for example, are hugely important, they are the team which are in direct contact with each hospital manager.
And when everybody’s comfortable, that’s where we can together adjust and fine-tune the software in order to improve and increase the performances. So that’s really something I wanted to had is a, you know, that’s the second step.

Ivan-Zak
Dr. Ivan Zak

That’s massively important. So, we talk about, you know, this change management at these clinics. And then we also talk about the different levels of the organization and the regional management specifically should be the gatekeepers to the initiatives that are changing at the level of the practice. And because you’re a mature software now. And I think we met when we were both startups, but you learn this the hard way that it’s not like you can just come in and sell something to consolidate and roll it out into a hundred practices. You really need to know their capacity, the ability and the readiness of the clinic to implement change. If they were just acquired, if they’re all distressed, if they’re just going through this, you know, owner change, leader change, values change. And then on top of that, there are more appointments for you that you can really burnout people and they will start leaving practices.
So I’m really glad that you’re making emphasis on that. And it’s very important.

Julien Renard
Dr. Julien Renard

Actually, when we, in some way, have sold the software we don’t start implementing without explaining the concept to the operation team of the consolidator without providing the explanation, without making the efforts to provide this additional explanation.
We don’t even try to implement. Simply because we know it’s going to be harder to do this job in a second step. So for sure, it’s very, very important to have the operation team on board. And actually, we have practices, you know, when they are 700 practices, there are always clinics which are more ready to implement than others.
I mean, we clearly have a clinic that goes first and some which are delayed because of, you know, whatever the reason they have.

Ryan Leech, Director of Sales
Ryan Leech

That’s really exciting. It’s nice to see that you can set an interesting baseline for the way that the business is working and their style of doing work within their practice.
Once you’ve done that and applied Vetstoria what’s a way that you measure success.

Julien Renard
Dr. Julien Renard

Well, corporate consolidator it’s… The numbers are very important, that’s the only way for them to have an accurate and objective view of the situation.
So, we measure key KPIs such as the number of appointments. That’s a pretty obvious one for what we do. The number of new customers acquired through the online booking tool, the number of appointments, which are made outside normal waking hours. That’s, I would say, the value provided by our software as the fact that you know, a clinic can schedule an appointment when there is no receptionist when the practice is closed.
So that’s one of the key metrics. Or corporates, which are more advanced, measure the percentage of appointments made online versus over the phone. So that’s another important KPI. And then we start, I would say, going down the route of, you know, measuring the impact of the marketing campaign. For example, kind of a corporate running a two months marketing campaign on dental, for example, going to put a budget in Google, in Facebook. And what they want us to do is allowing them to kind of close the loop and being able to measure the return on investments of customers. We’ve been taking part or joining the practice, or either schedule an appointment if they are an existing customer. What was the ROI of this marketing campaign on dental? For example. So that’s for, I would say, the consolidator which is more advanced.

Ivan-Zak
Dr. Ivan Zak

That’s awesome. And so Julien, I want to catch you off guard if you have any numbers on top of that, but it’s very interesting to me to know, like, do you have any stats on average, a good hospital the uses online booking? What is the percentage or how do you measure it, is it a number? Is it per doctor as a percentage? You know, online versus over the phone? And then the percentage of appointments booked out of office hours? Cause you know, some people may never think about it that when your phone is not working people just not book appointments if you don’t have a system like that.
So throw us a couple of numbers, if you can.

Julien Renard
Dr. Julien Renard

Sure. Appointment made outside normal working hours. We are between 40% to 45%.

Ivan-Zak
Dr. Ivan Zak

That’s crazy.

Julien Renard
Dr. Julien Renard

That has been consistent for the last five years. Hospitals who have a heavier usage of or very heavy usage of online booking tend to have a percentage of outside normal working hours, which is smaller, but generically we are sitting I would say 35 to 45% of appointments made. And usually, we consider outside the normal working hours 7:00 PM to 7:00 AM and also Sunday all day per Saturday afternoon. That’s what’s caused, what’s outside of normal working hours. Now, when it comes to the percentage of appointments made online versus over the phone, the response that we need to give you is unfortunately not, I would say, precise.
Well, actually it’s precise, but the range is pretty big. We can have hospital scheduling 5% of the appointment online, up to clinic scheduling 90% of the appointment online. Now, with corporates, I can tell you that there are some significant differences between their practices. I would just put the range between 5-60% of the appointment online.
And this 5-60% is determined by one and one single thing, not the pet owners, not the CT where they are based in, is only one thing is the buy-in, the dedication of the regional manager and the practice manager to implement. It doesn’t matter if, as I say it could be in the countryside somewhere lost, it would be a success. It will work if the clinic decides that actually we are going to make this work. If the clinic decides that they don’t want it, even if they’re in central New York, they can potentially, I would say, not make it successful because they actually don’t embrace it. And because they don’t embrace it the percentage of apportionment would be lower. That’s something that is the only single thing that makes success.
That’s why having the regional team and the practice manager onboard is absolutely essential. And the only way to get them on board is just to explain. That’s it.

Ivan-Zak
Dr. Ivan Zak

That’s crazy. I had no idea that these are the numbers and, you know, I can think immediately how that translates into the cost savings. If you have the majority of the appointment is going not through the front desk.
First of all, they’re more relieved to deal with the customers at hand, and then also all the appointments they’re going in there. So that’s the saving on the labor. And then the other one is crazy to me about 45%. That is not cost-saving. That’s just lost business. If you don’t do that. That is directly to not having someone available in the clinic. And then they try to call the next day. And then when they call the next day, all the symptoms are not there. I mean, that is a crazy number. Do you have people shocked, like me hearing that?

Julien Renard
Dr. Julien Renard

Um, yes, I’m not shocked anymore because I’ve seen his number four for a very long time, but what is even more crazy, Ivan, is, you know, you could argue that. Okay, maybe they could call in the morning and everything. Okay. Right. But we have to think about one thing. Is customer search for a new vet practice when it suits them. And when it suits them is when they have some time. And usually, unless they are very bored at work, but usually people buy a product or search for new services when they have the time.
And when they have the time is basically outside normal working hours. So basically they do that on the weekend. In the evening, diving to search for the vet, they are going to book an appointment for the first vaccination of the new puppy. That’s it. And the fact that you can secure, a practice can secure actually that specific slots when they are searching for it. Is huge.

Ivan-Zak
Dr. Ivan Zak

That’s impressive. So there’s one thing that Ryan and I have been talking about a lot, about the difference between the European market of consolidation right now and the US. And from what we heard is that Europe is much more consolidated. And Jillian, you mentioned before, there are different numbers across Europe as well. But you know, where I sort of heard, and probably it just because you were more focused on the UK, but it’s like 60 and North of 60% consolidated. And then in the US, it’s 20%. With that, if you can answer to me what is actually the split there, but also do you see that your product is more needed in the European region because that is truly margin expansion, as opposed to when it’s a new sort of consolidation era in a particular region is more of arbitrage and a land grab.

Julien Renard
Dr. Julien Renard

I don’t think so. I think it’s needed by pretty much every practice. And at the end of the day, practice always needs to grow. And at some stage, they will have to deliver growth. When I say at some stage, the consolidator has to deliver growth. So yeah, not at all. I think that you know, we actually, at the moment we have quite a few corporates, which are, I mean, early stage. Who is focusing on, you know, just growing the practice as quickly as possible? I mean, that’s one key difference too, is that I think that the UK started 10 years ago, but the technology was less advanced one. While now the consolidator starting and in the US, they know they have the technology available while others, you know, couldn’t access this technology a few years ago.

Ryan Leech, Director of Sales
Ryan Leech

Is there a difference Julien, between working with a consolidated group that’s been around a while, a new one, and independent practices for you?

Julien Renard
Dr. Julien Renard

Huge, very, very big difference. So consolidator, they clearly set up team around, and there’s usually have for us the marketing team around the online booking system. We see that more and more.
We have corporates in Europe who have a team of 30, you know, a marketing team of 30 people. And we are interacting with quite a lot of these team members. So that’s one element. Consolidator which is much early stage, you know, they are building these teams. They only have one goal is actually to be at the same place then the more advanced consolidator is. The corporate team member we are interacting with is, as I say, marketing. When it comes to independent practice usually they have as a goal to improve the operation. You know, we are overwhelmed, you know, the phone keeps ringing and we want to have our staff more available for in a clinic, you know, interaction. Or either to pick up the phone for, you know, the appointment that requires conversation, which I imagined seeing, I mean, actually I would like to cut down massively the number of vaccination or wellness exam conversation because it doesn’t require to have a conversation.
So yeah, we see some big difference between these three types of customers.

Ryan Leech, Director of Sales
Ryan Leech

Julien, there’s always a couple of questions that we’d like to ask every guest. And the first one that I’d love to ask is who, when they’re listening to this podcast should pick up the phone, shoot an email directly to you because they’re so excited about what you’re talking about. I personally, I think we’re doing you a disservice by just having you on a podcast, being able to sit here and look at how excited you are, and the way that you’ve lit up while talking about the product and the solutions that you guys have.
I think people need to get on a Zoom with you, or hopefully, after COVID a see you in person because it is really amazing to see how excited you are about what the software can do. So all of that to say, who should reach out to you, which one of our listeners would be the best person to give you a call?

Julien Renard
Dr. Julien Renard

I mean, marketing team members that want to enable the digital customer journey of the clients.
Those who want to focus on acquisition clearly, you know, are very welcome to reach out. As Ivan said, when we started the conversation, clearly the online booking is a key piece of retention. I mean, including an online scheduling link to an SMS or an email reminder or an app notification is a no-brainer.
We clearly see that consolidator wants to acquire more customers and they need the integration within the digital acquisition journey. That’s it. So I would say CMO.

Ryan Leech, Director of Sales
Ryan Leech

So my final question for Ivan would be, if any of our listeners want to read something or dive more into some of the knowledge that you guys both have, what would be a great book for people to pick up and read, to learn more?

Ivan-Zak
Dr. Ivan Zak

I knew you would ask that. I was just a… One book that was circling in my head. When Julien was talking about the metrics that I have no idea about or had no idea about, now I do. Usually, when we work with consolidators, we talk about different metrics and everybody wants to know the benchmarks and knowing the benchmarks is really hard because you know that number, Julien knows that number, but then you have a bunch of people that have no idea that what is good.
When you start measuring something new, what is good and what is good for the industry? So my answer usually to that is that if you’re starting measuring something really cool, which you know, that has a huge impact, you need to develop your own normal and to develop your own normal. There has to be a methodology behind it.
So there’s an incredible book by Mark Graben, it’s called Measure of Success. He’s a sort of lean guru in the human healthcare space. I was just on his interview recently and that’s an incredible book. It’s incredibly boring, very scientific, but it’s a very good book to understand how to establish metrics on anything you want in the organization.

Julien Renard
Dr. Julien Renard

If I can add one thing, Ivan, I fully agree regarding the benchmark. But I will add one thing is identifying what’s good, what’s average, what’s poor is important. So benchmark, yes. But what is even more important are the next stage is what’s the action, what should I do? What are the actions based on my metric? And that’s sometimes a little bit challenging. We are measuring more and more KPI and it’s not because I like a lot of KPI. Actually, I would like to have less KPI, but more meaningful, as meaningful as possible. And actually what the really important thing about KPI is that what actions should I take to improve the KPI? That’s really the key thing and also making this automated is absolutely essential for consolidator because they have so many clinic that does the only way to scale this.

Ivan-Zak
Dr. Ivan Zak

Yeah, no, I absolutely agree with you. The first book that I was thinking about, it was a Lean Analytics and that’s by Alistair Croll and Benjamin Yoskovitz. Basically, they talk about how to establish the metrics that are not vanity metrics, because there’s so much stuff that people measure.
And even if they develop the benchmarks, but what do you do then? You know, I was just looking at the dashboard of one consolidator. They had appointments, like you said, they were measuring appointments. Having on your dashboard 16 million appointments last year, what does it do? It’s like, you know, what is your fattest cat last year in all the hospitals?
Like, you know, okay, it was 14 kilograms. What does it tell you? Nothing. So, you know, you’re right. It’s important to know what metrics you’re looking at. What do they mean? What do they benchmark, but what do you do when they’re out of range? And that’s very important.

Julien Renard
Dr. Julien Renard

Well, and also what’s, I mean, what’s the goal.
I mean, we, we do QBR with a customer and we, I mean, they tell us, look, this is where we are. Okay. This is where we want to go when we want to be at X% from my booking or completion rate of X%. What are we going to do together to achieve this goal in 6 months, 9 months, 12 months? And that’s really essential.

Ivan-Zak
Dr. Ivan Zak

Amen to that. Julien, always a pleasure to see you. I know there’s a lot of stuff going on in your life. Hopefully, you’ll deal with that easily but I really appreciate you joining us on a call and giving us this inside hopefully listeners will learn a lot and hopefully by lots and lots of Vetstoria from you.

Julien Renard
Dr. Julien Renard

Ivan, Ryan, thanks a lot!

Ryan Leech, Director of Sales
Ryan Leech

Thanks, Julien.