Creating a culture of gratitude in healthcare


Every week, Dr. Katie Jarvis reached into her mailbox at the small-town hospital where she worked.

She only received two kinds of mail. One was from recruiters trying to entice her to move to a bigger city. They offered lucrative positions and the amenities a metropolitan area could provide.

The other was from her hospital administration. They made rounds every morning, delivering newspapers and checking in on patients. When they heard positive stories, they wrote a brief note sharing the feedback with the providers.

“I kept those cards for the days,” Jarvis says. “You know those days when I had a person, he or she had cancer or had to run a code; we have days where the hours just continue on. Those days, it’s not the money that keeps me going. It’s the impact I make. The notes are reminders of that.”

Today, even after starting her own healthcare technology company, Jarvis occasionally works shifts as a hospitalist. “I can’t give up the notes,” she says.

Science suggests that grateful patients and administrators do more than provide warm fuzzy feelings to providers. Gratitude actually alters their well being and even the care patients receive.

Gratitude reduces burnout

Burnout among doctors and nurses is on the rise. The causes are numerous and include a loss of autonomy and a move away from the high-touch medicine of previous decades toward “treating the data, not the patient.”

One antidote may come in the form of gratitude. A study published in 2019 in the journal BMJ Supportive & Palliative Care found that expressions of gratitude served as a source of support for providers in difficult times, improved mood, and provided encouragement to continue and rewards for their effort. It also increased professional satisfaction.

Nancy Congleton has been a nurse for more than 16 years and says that when a patient is grateful for her care, “it makes everything else irrelevant, such as: exhaustion from being 11 hours into my 12 hour shift; having to skip lunch; not getting to pee, or going from patient to patient without a breath in-between. Simply put, when patients are grateful to nurses, it erases the hardships that go hand and hand with the nursing profession.”

Gratitude balances negativity

Stanford physician Dr. Gregory Hammer has a similar outlook. Three years ago, he was an attending in the intensive care unit at Lucile Packard Children’s Hospital Stanford when an 8-year-old girl arrived by life flight.

She had collapsed on the playground at school with cardiac arrest. When she arrived in the ICU, doctors discovered she had a heart condition that can cause seizures or, in some cases, sudden death. Remarkably, she recovered almost completely and went back to school.

Her family still sends Dr. Hammer a card every year.

“It’s really heartwarming that they are so grateful. It reminds me that I’m doing the right thing,” he says. “Grateful patients have a positive impact on physicians. They provide balance to how we beat ourselves up over every negative outcome.”

Dr. Hammer wrote the book “GAIN without Pain; The Happiness Handbook for Physicians.” He points to the human tendency toward a negativity bias and says that gratitude helps neutralize the discomfort of negative outcomes.

“Our patients can see, they know if we’re burnt out. They know if we’re happy and enjoying our work. They’re as aware of that in us as we are of them,” he says. “When our patients are grateful, it’s very rewarding. Generally, humbling. We see that we can make a difference in the way they think and feel, both their physical health and mental health.”

Express gratitude even when things go wrong

In medicine, as in life, things don’t always go according to plan. Schedules get overcrowded, providers call in sick, and sometimes outcomes are unexpected, even tragic.

Catherine Burger, a nurse for more than 30 years, remembers one patient who experienced unexpected quadriplegia after spinal surgery to correct scoliosis. “I recall this young man gently taking the hand of the surgeon who had performed the surgery that had gone so poorly for him, looking in his eyes and telling the surgeon that he was going to be OK, and he wanted to make sure the surgeon was going to be OK too,” she says.

She said his act of compassion left a lasting impact on her of how meaningful gratitude is especially in the face of negative outcomes.

Gratitude improves patient care

Not only does gratitude have a positive impact on physicians and nurses themselves, but it also impacts the care patients receive.

A study published in the journal Pediatrics in 2019 found that gratitude from patients significantly enhanced medical team performance. The study observed 43 NICU teams who encountered one of the following scenarios: maternal gratitude in which the mother of a preterm infant expressed gratitude to NICU teams; expert gratitude, in which a physician expert expressed gratitude to teams; combined maternal and expert gratitude; and a control group.

Team performance improved among the NICU teams who experienced maternal gratitude, particularly impacting their information sharing abilities.

“The effect of gratitude comes from the salience and meaning it gives to our work, thus it has a profound effect if it comes from patients or their families,” says study author Dr. Arieh Riskin.

When gratitude is missing

Unfortunately the converse is also true. Rudeness from patients, colleagues, and administration can hamper providers’ outlook and performance.

A study published in 2015 in the journal Pediatrics found rudeness compromised the performance of NICU team members in their ability to diagnose and to treat patients. In this study the rudeness came not from a patient, but from an outside “expert” in a simulated event.

Researchers observed that medical teams routinely experience rudeness in a hospital setting.The result is an immediate and direct effect on cognitive ability, reduced creativity and flexibility, and a decrease in helpfulness.

Dr. Sashini Seeni says it’s easy for patients to forget that doctors are human and the profession requires long hours, dedication, and sacrifice.

“The toughest part of being a doctor is not the treatment, the procedures, or the surgeries,” she says. “It is to deal with their colleagues, superiors and ultimately the patients.”

She describes an unfortunately common scenario in her hospital setting — a doctor is brusquely corrected by a superior for a mistake and receives little support from their colleagues.

“How will this doctor treat the patients if the patients start to complain and being mean?” she asks. She acknowledges that the correct approach is to put on a happy face in spite of the negative environment, but that takes its toll.

Research published in the journal Mayo Clinic Proceedings observed, “Physicians who remain in practice while burned out show higher propensities for making medical errors and diminished quality of medical practice and professionalism. Worse still, patients of depleted physicians are less compliant with physicians’ care plans.”

A simple “thank you” is often enough

Among the doctors and nurses who contributed to this article a theme emerged: providers don’t need elaborate gifts or public displays — a simple “thank you” is often good enough.

They also pointed to some more deliberate gestures that have a meaningful effect, including hand-written notes and telling the provider that you feel better because of their care.

Psychiatrist, Dr. Amy Ricke of Your Doctors Online says a simple heartfelt verbal “thank you” can go a long way in letting a provider know they are appreciated, a thank you card or note even more so.

“I have saved the cards I have received from patients over the years to remind myself of why I chose to be a doctor when I’m feeling less than fulfilled,” she says.

She also encourages patients to complete surveys following their visits. “Unfortunately, often times the only people that respond to those surveys are those who are dissatisfied with their care.  Filling out the survey positively can make a big difference for your physician,” she says.

Cultivating gratitude in health care

Burger also said that organizations can do a lot to cultivate an environment of compassion and positive feelings towards their patients.

“Most importantly, educate all employees — and hold them accountable — in creating caring moments for patients and one another. Patients feel supported in facilities where staff are encouraged to care,” she said

In 2013, Scripps implemented a program called Excel Together in response to employee feedback requesting recognition when they performed excellent work and made a difference, The system-wide program provides a platform for staff to thank colleagues and nominate them for great work. It recognizes employee’s specific achievements that make a difference and support the Scripps culture.

But it doesn’t have to be a big program — even something as simple as scribbled thank you notes shoved into a mailbox can have an immediate and lasting impact. ♥

WELL Health and Wolters Kluwer partner to deliver diabetes self-management education

Diabetes self-management education and support improve patient outcomes,

But only 50 percent of diabetic patients receive it. In honor of National Diabetes Month, WELL and Wolters Kluwer have partnered to embed EmmiEngage® interactive multimedia programs on diabetes education into the WELL platform. The communication is aimed at helping diabetic patients make informed decisions related to their health.

The partnership provides health systems with a streamlined and effective way to educate diabetic patients, whether on an individual level or with an entire patient population. It improves care activation and nurse efficiency and reduces readmissions.

It also provides trusted clinical information from a single source — patients receive all communication directly from their provider.

Why diabetes self-management education matters

More than 34 million people are affected by diabetes (10.5 percent of the U.S. population) and patients diagnosed with the disease need to adhere to their treatment plan to avoid complications and poor outcomes.

Given the sheer volume of patients requiring diabetic care, many health systems struggle to stay up to date with delivering educational materials in the most efficient manner to their patients. This often results in patients with diabetes falling off of their treatment plans or not managing their condition appropriately.

Streamlining delivery of patient education

With the WELL and Wolters Kluwer Partnership, educating patients and providing answers to clinical questions automatically has never been easier.

WELL supports multiple triage and proactive outreach, whether automated workflows or post-encounter follow up, including redirecting patient inquiries from the traditional call center to more efficient modes of communication, such as text messaging. Because WELL offers two-way texting, patients can ask follow-up questions and receive support directly from their provider’s office.


Here’s how it works. When a patient attends an appointment related to treatment for diabetes, WELL automatically reaches out post-encounter with self-management education. WELL’s bidirectional capabilities enable the patient to respond with questions, upon which they can receive additional educational content and converse with their provider by text message.

Provider: Hi Jane! Thank you for attending your diabetes checkup. Check out this video on how to learn more about pre-diabetes

Patient: Great thanks! Any foods I should avoid as a pre-diabetic?

Provider: Great question! A good place to start is this video on foods to eat for Pre-Diabetic conditions feel free to text back with any more questions!

Patient: Thank you!

Unified communication for diabetes education

WELL Health unites your messaging in one communication hub. Your patients receive all care-related messages from one number they recognize at a cadence they can handle. WELL’s bidirectional capability creates an open channel for conversation between patients and staff. Deliver clinical, financial, and logistical information to your patients — all through one secure platform. No app required.

Wolters Kluwer is a leader in patient solutions and provides trusted clinical technology and evidence-based content that drives effective decision-making and outcomes through its EmmiEngage® multimedia programs. ♥

Cerner aims to simplify patient communication with WELL Health

Through WELL, Cerner offers new capabilities designed to help unify and automate previously disjointed communications; enhance patient engagement

Cerner Corporation, a global healthcare technology company, today announced capabilities focused on helping providers improve patient engagement and satisfaction through intelligent and automated communication powered by WELL Health Inc. The move is designed to help providers continue to transform the healthcare experience with added emphasis on timely and meaningful patient communications. By teaming with WELL Health, Cerner is offering health care organizations a modern way to communicate with patients, simply by texting back and forth.

“WELL Health is focused on what patients expect today – near real-time, personalized communication on their terms. We aim to move beyond the days of playing phone tag, leaving voicemails, and expecting patients to continue showing up,” says Guillaume de Zwirek, CEO and founder, WELL Health.

“WELL supports patients to text their health care provider like they would text a friend. For a provider’s staff, WELL is designed to unify and automate disjointed communications across the organization, helping to reduce unnecessary stress and limiting potential errors.”

Why texting patients matters

More than 5 billion people spend nearly a quarter of their day on their mobile phones. In fact, in the last few years, the number of active cellphone subscriptions exceeded the number of people on earth. Giving patients the same person-centric digital experience in health care as they receive from other industries has become increasingly important. Teaming with WELL Health, Cerner is focused on making technology more useable for health systems and patients by meeting consumers where they are spending their time.

Cerner patient communication hub

These new capabilities, incorporated into Cerner’s patient portal HealtheLife℠, act as a patient communication hub that extends beyond email. It is designed to help unify communications from the myriad of different systems and apps accessed throughout the patient care journey into a single text message conversation. Combined with advanced notifications and appointment reminders, organizations will be empowered to leverage automation to help improve the patient experience.

“Cerner is committed to helping providers create the engaging, comprehensive health care experiences patients expect and deserve,” says David Bradshaw, senior vice president, consumer and employer solutions, Cerner.

“We are focused on strengthening our clients’ ability to build meaningful relationships with patients, drive enhanced care experiences and deliver greater value through efficient and intelligent messaging.”

Automating patient communication

Organizations can use the new features to automate patient communications like delivering critical health information, sending flu shot reminders, rescheduling appointments, scheduling virtual visits, and prompting patients to set up needed medical transportation. Additional benefits to patients and providers are expected to include:

  • Decreased time spent scheduling and communicating with patients by using automated workflows that reply and route based on patient responses.
  • Reduced staff time spent on billing and payment collections by auto-notifying patients when new bills are ready for payment.
  • Improved patient satisfaction, retention and acquisition through timely communication and reduced hold queues, missed calls and email delays.

Consumer experiences have never been more important than in today’s environment, as patients desire more digital health solutions and providers engage in value-based contracts where satisfaction is paramount. Today’s patients expect the same person-centric digital experiences in health care as they receive from other industries and may be more likely to switch providers after a poor experience.

There are over 100 unique ways providers can use the new capabilities to aid in providing timely and informative communications with the goal of helping reduce the possibility of error or delays. Through automated and intelligent communications from WELL Health, Cerner aims to help clients improve patient satisfaction and enhance staff efficiency through meaningful engagements.

WELL launches Use Case Library to offer best practices and product use cases

Do you know what health systems in COVID-19 hotspots are doing to reach their patients?

How about how hospitals of your size around the country increase survey response rates?

With the WELL Use Case Library (UCL), you can learn best practices and product use cases from our internal expertise and leading healthcare organizations around the country.

Learn how other healthcare organizations similar to yours use WELL to its fullest extent to streamline workflows, improve patient experience, and maximize value.

WELL provides the UCL at no charge. It offers effective workflows and instructions for launching use cases. All are developed and validated by WELL and our clients to better serve organizations like yours.

“We created the WELL Use Case library because we recognized that our customers were eager for more ideas about how to use our communication hub. We wanted to empower them to expand at their own pace,” says Meg Aranow, VP Platform Evangelist at WELL. “We believe the library will position our customers for continued success in patient engagement while maximizing the ROI of their WELL partnership.”

What is the WELL Use Case Library?

The UCL offers an evolving repository of use cases, organized by category and searchable by keyword. Use cases cover everything from parking instructions to post-op followup.

WELL administrators can discover impactful use cases, understand best practices, and learn how to deploy each workflow. The majority of use cases can be implemented at no additional cost to your organization.

Each use case offers sample language to use in communication with patients. You can implement this language into your automations immediately. Use cases also provide demonstrated benefits and referenced clients, so you know the value of the use case before you even put it into practice.

WELL aggregated use cases across a broad spectrum of its client base and has brought experience from leading health systems as well as internal expertise to enable all WELL clients to excel

Why it’s important

WELL clients include many of the leading health systems in the country, such as Cedars-Sinai, NYU Langone, UnityPoint Health, and Houston Methodist. Benefit from their depth of knowledge and process improvements within the UCL.

In addition to the larger health systems, WELL serves academic medical centers, FQHCs, and community health centers. Whatever the size of your organization and the patient population you serve, the library offers unique use cases to meet your patient communication needs.

WELL clients pride themselves on continuous learning and improvements. We are thrilled to be a part of this insightful and collaborative community. Through the WELL Use Case Library, we offer a shared platform to drive value for healthcare organizations and patients. ♥

7 ways WELL protects patient health information


There’s no shortage of headlines on data breaches in healthcare.

Once again, federal agencies warn that cybercriminals are unleashing ransomeware attacks against the U.S. healthcare system designed to lock up hospital information systems. These and other frequent revelations erode consumer trust in health systems to protect patient data. And they send a chilling warning to chief information officers — protect PHI or risk millions in fines and litigation.

Health systems rely on third-party vendors for care delivery and coordination. But they present an additional vulnerability. Any weakness in their security is a weakness in yours.

“Healthcare has always been a target of cyber security threats, most recently shown by the spike in ransomware attacks to U.S. hospitals and healthcare providers. WELL remains committed to deploying and enforcing the latest security measures to protect the integrity, confidentiality, and availability of the data we receive and store,” says Sam Jo, WELL Chief Information Security Officer. “Protecting our customers and the patients they serve is and always will be a top priority for us.”

#1 Security starts with people

Research published in the Journal of the American Medical Association found that more than half of data breaches in healthcare were triggered by internal negligence. Carelessness. At WELL, we take this risk to heart. We conduct security and compliance training upon hire and regularly throughout the year. Additionally, prior to receiving access to systems, employees must complete additional compliance and best practices training. They also must acknowledge their understanding of our acceptable use policies.

#2 Maintain an information security management program

WELL guards patient health information carefully and remains fully committed to deploying and enforcing the latest information security frameworks. We will protect the integrity, confidentiality, and availability of the data we receive.

We maintain a comprehensive written information security program that covers all aspects of our information security practices, policies, and procedures, including all 19 domains of HITRUST.

#3 Develop with security in mind

The WELL development team employs secure coding techniques and best practices from The Open Web Application Security Project (OWASP) as well as SANS. Each of WELL’s developers receives formal training in secure web application development practices. We also use a peer-review model to ensure code complies with stated objectives.

Additionally, WELL’s code base is scanned at minimum on a quarterly basis, and the security team is tightly integrated with the development process to ensure secure coding practices are being followed.

#4 Store and encrypt data

WELL has a robust program for storing and encrypting data. We store data in the US in two distinct geographic regions and run databases in a private subnet. That means they’re not exposed to the internet, and access is restricted to the WELL application and authorized personnel. WELL also encrypts data in transit and at rest, and performs nightly backups.

WELL maintains a documented vulnerability management program. It includes periodically scanning, identifying, and fixing security vulnerabilities on servers, workstations, network equipment, and applications.

#5 Simulate threats

WELL is Veracode Verified and works with third parties to conduct penetration tests at least annually. These tests mimic an outside attack to ensure a full view of our environment. “WELL is committed to delivering secure code to help organizations reduce the risk of a major security breach. Companies that invest in secure coding processes and follow our protocol for a mature application security program are able to deliver more confidence to customers who deploy their software,” said Asha May, CA Veracode.

#6 Manage risks

The WELL risk management process aims to promptly address any potential risks that could affect the business and assets of the company. WELL utilizes the NIST framework for internal risk assessments. We also employ independent external auditors and consultants to perform risk analysis of WELL’s security posture.

#7 Prepare for the worst

Even with all of the correct security safeguards in place, incidents happen to even the most reputable organizations. WELL maintains a trained Incident Response Team which includes members of all integral functions across the business in order to quickly address potential incidents. The team meets regularly and has a clearly defined approach for handling potential threats.

Choose a vendor that takes security as seriously as you do

WELL serves many of the leading enterprise health systems, including Cedars-Sinai, Houston Methodist, and NYU Langone. Their security standards are the best in the business.

Deepak Chaudhry is National Health IT & HITRUST Leader at BDO, whichc conducted WELL’s HITRUST audit. He said, “WELL’s security program is particularly impressive, and security has clearly been a primary focus since the company’s beginning. WELL has made sure to consider the end-to-end data flow process, and they’ve conscientiously deployed all the necessary controls to best address safety, privacy, and potential risk.”

“We protect the patient information we receive as if it’s our own, because we have that responsibility,” Jo says. “Our environment and processes are built and maintained with a full understanding of the weight and sensitivity of the information we handle, and knowing we need to protect against the many threats that exist within information security.”♥

When disaster strikes, text all of your patients at once with Broadcast Messages

As wildfires, hurricanes, and other natural disasters threaten healthcare operations, WELL offers the flexibility to text all of your patients at once.

When the largest wildfire in California history to date roared through Ventura and Santa Barbara Counties, many Community Memorial Health System locations had to close. Providers couldn’t go to work. Even the call center had to move to another location to escape the fast-moving blaze.

“It was a massive undertaking trying to reach that many patients,” recalls Lori Hooks, Director of Practice Systems at the prominent Ventura, California health system.

Phone calls are tedious and ineffective. Whether it’s due to a wildfire, hurricane, or simply a provider calling in sick, calling a large group of patients at once is tedious. When the conditions change minute by minute, it’s virtually impossible. For CMHS, by the time they had reached patients to let them know of location and schedule changes, the appointment time slots had already arrived. Now the health system uses WELL. Its Broadcasts feature allows CMHS to schedule a message to go out at a moment’s notice.

“WELL is a mini-preparedness kit,” Hooks said.

Text all of your patients at once with Broadcast messages

Broadcast Messages provide an easy solution to text all of your patients at once and at the last minute. Here’s how it works. In the WELL platform, you can quickly select up to 1,000 patients per practice per day and send them all a customized message.

Make it even easier by using Smart Phrases and Quick Response Templates.

Smart Phrases are like shortcuts and allow you to customize communication with your patients. Compose a message as you would otherwise and insert Smart Phrases into the text. For example, {clientFirstName}. Once the message is sent, the data dynamically populates from your EMR or scheduling system and automatically tailors itself with each patient’s specific information.

How it looks to your staff: Hello {clientFirstName}, this is {staffFirstName} with {practiceName}. Due to the rapidly spreading LCU Lightning Complex fires, your appointment has been moved to our {eventLocationName} at {eventLocationAddress}. {eventConfirmText}.

How it looks to your patients: Hello Kevin, this is Bridget with Valley View Health. Due to the rapidly spreading LCU Lightning Complex fires, your appointment has been moved to our Almond Grove location at 1000 Main Street. Reply Y to confirm or N to cancel.

Disaster preparedness can start now

WELL Quick Responses are pre-written responses for common scenarios and questions. They’re ready to go when disaster strikes, there’s a power outage, or a provider comes down with the flu. For example:

Hello {clientFirstName}, this is {staffFirstName} with {practiceName}. Due to the construction on State Street, please use our Anacapa entrance and allow an additional 10 minutes to arrive.

Field patient questions with ease

With WELL’s bidirectional functionality, if patients have questions or concerns, they can easily send them via text. Call centers can respond as they have time and speed things up with Quick Responses when appropriate. Bidirectional texting in healthcare keeps call volume low and patients informed.

WELL’s Broadcast feature coupled with Smart Phrases and Quick Responses ensures your health system can handle whatever nature throws your way. ♥

WELL highly rated in new KLAS COVID-19 report


A new KLAS report includes WELL Health on a short list of high-performing vendors for its support of healthcare organizations during COVID-19.

KLAS Research released a Specialty Report revealing what provider organizations in the heart of the COVID-19 crisis say about their technology and services vendors’ responses.

The report uncovers what technologies organizations have relied on and what solutions are making the greatest impact. It also reveals how COVID-19 will shape organization budgets moving forward.

WELL rated in the top right quadrant, demonstrating “excellent performance” with higher overall satisfaction before the pandemic and COVID-19 response scores greater than 8.5.

“As more waves of COVID-19 cases are likely, KLAS hopes this report helps vendors improve their response and helps provider organizations know where to turn for additional assistance,” the report says.

The clear winner: telehealth

Telehealth dominated healthcare technologies during the crisis, with 43 different vendors listed by the healthcare organizations surveyed. KLAS found that most organizations surveyed scrambled to implement telehealth solutions, sometimes overlooking long-term strategy in their haste. As COVID reached a tipping point in the U.S. in mid-March, vendors who provided the quickest implementations won the majority of bids.

Health systems also relied on acute care EMR and AI/analytics vendors throughout the ongoing crisis. Artificial intelligence helped with infection control, coordinating a mobile and remote workforce, and quality and risk management.

Tech vendors step up their game

COVID-19 brought out the best in most healthcare IT vendors, particularly those who already have high KLAS ratings. Healthcare professionals rated vendor performance on a scale of 1-9 on how well vendors supported them during the crisis.

WELL responds to COVID-19

In response to COVID-19, WELL worked with our partners to fund and engineer the Rapid Release Program (RRP). It has allowed health systems to manage urgent COVID-19 patient communications at scale and can be fully deployed in just 48 hours.

The program eased the burden on call centers and front desk staff to provide consistent and timely communication during the pandemic. For patients, reaching out to their providers became as easy as sending a text or email or starting a web chat.

WELL deploys timely COVID-19 solution

UnityPoint Health, which serves patients across Iowa, western Illinois and southern Wisconsin, deployed the Rapid Release Program in April 2020.  “When COVID-19 began to show up in the communities we serve, we wanted an additional tool to communicate the evolving changes and help reduce community spread,” said Lauren Hardison, Executive Director of Strategy & Business Development at UnityPoint Health. “We had already been in talks with WELL and knew the platform could support our patient communication needs in this critical time.”

WELL designed RRP to quickly onboard new health systems with frictionless patient communication tools. RRP automates a high percentage of the communications traffic. This allows provider responders to optimize their time and efforts on scenarios that require a human touch. In addition, provider resources can perform these tasks from any location, including their homes.

About KLAS

KLAS is a data-driven company on a mission to improve the world’s healthcare by enabling provider and payer voices to be heard and counted. Working with thousands of healthcare professionals, KLAS collects insights on software, services and medical equipment to deliver reports, trending data and statistical overviews. KLAS data is accurate, honest and impartial.

The research directly reflects the voice of healthcare professionals and acts as a catalyst for improving vendor performance. To learn more about KLAS and the insights it provides, visit ♥

How WELL Benefits Orthopedic Practice Management

Orthopedic practices are often overwhelmed by patient calls and enquiries. Effective patient communication software can streamline orthopedic practice management, and help doctors respond to those in need as rapidly as possible. 

It’s Monday morning. Your neck is aching. Your skis are hung up in the garage for what might be an indefinite amount of time. And you’re on hold with your orthopedic surgeon.

This could be awhile.

“Orthopedics, by its very nature, is such an unpredictable specialty,” said Siobhan Palmer, Director, Santa Monica Orthopedic & Sports Medicine Group.

The busy clinic, part of the Cedars-Sinai Kerlan-Jobe Institute, sees a huge spike in call volume Monday mornings due to weekend accidents. Palmer wanted an orthopedic practice management software that would enable the clinic to quickly and painlessly reach patients and communicate with them at the time they need it most.

She found WELL.

Communication’s significance in orthopedic practice management

Orthopedic practice management is a complex challenge. WELL understands the unique challenges that orthopedic practices face. Terri Werner, HIM Supervisor at New Mexico Orthopedics, expresses it succinctly: “We want to make things better for patients. If you’ve ever been a patient, you have an idea of what it’s like.”

However, a diminishing surgeon workforce and an increasing number of patients needing orthopedic care mean more work for physicians and shorter appointment times for patients.

Add in the last-minute schedule changes and you have an administrative headache.

Calls go unanswered. Patients get annoyed. Doctors and office staff shoulder the burden.

At least, that’s what we’ve heard from the many orthopedic groups that have sought out WELL. Here are some of the primary issues ortho practices face, and how our patient communication app has helped them address these challenges and implement orthopedic best practices.

Reduce high call volume

At St. Charles Orthopedic Surgery Associates in St. Peters, Missouri, a glut of incoming phone calls about simple, non-clinical issues crowded the phone lines, preventing patients with more pressing issues from getting through. 

The same was true for 360 Orthopedics, which has served patients in Florida since 1978. They had a significant volume of phone calls, that were a mix of emergencies needing immediate attention, and non-urgent queries. These calls all had to wait in a queue, creating a large workload and poor patient experience.

That’s a problem — especially because most people calling an orthopedic surgeon are probably already having a pretty bad day.

“We are always thinking about how to improve communications with patients,” said Suzann Crowder, administrator at SCOSA. “They often contact our practice when they are at a low point.”

Chad Nettleman, CIO of 360 Ortho agrees: “In today’s digital age, people expect someone to answer personally when they reach out via call or text – just like you’re standing in front of them in the lobby.”

Streamlining things with the right orthopedic practice management software makes a big difference. After implementing WELL’s bi-directional messaging capabilities, the busy practices saw a huge reduction in call volume. Automated messages provided answers to routine queries, such as “Where is your office located?” and staff could easily enter the conversation when necessary. WELL’s patient communication software reduced stress for office staff and greater satisfaction from patients.

Handle last-minute scheduling

Whether they sustain injuries on the trails or in a car accident, orthopedic patients often need last-minute appointments. Couple this with the realities any clinic faces—inclement weather, running behind schedule, or a physician calling in sick—and office staff needs patient communication tools to quickly and easily communicate last-minute changes.

Doctors at Rocky Mountain Orthopedic Associates see as many as 30 to 40 patients per day, so when a change arises, it’s especially challenging. Janis Hoppe, the practice’s subject matter IT expert described the situation this way, “We would have to try to contact every single patient at the very last minute. It’s incredibly disruptive to try to get a hold of that many patients.”

The Colorado-based practice implemented the WELL patient communication platform and immediately saw staff workflows streamlined and workloads lightened. With our orthopedic practice management software, they also saw an increase in patient responsiveness. “For some reason, when we text them, we get a response immediately,” said Pam Bachorski, the clinic’s practice administrator.

WELL’s broadcasts feature allows practices to streamline orthopedic practice management and quickly select up to 1,000 patients to send them all a customized message – great for last-minute schedule changes or notifications.

Reduced no-shows

The no-show rate for orthopedic follow-up appointments can be as high as 26 percent, according to a study published in The Journal of Bone and Joint Surgery in 2014. Those with spine and back complaints are the most likely to miss appointments. That results in lost revenue, more administrative work for staff, and less likelihood of attracting new patients – those looking for those last-minute appointment slots. 

In addition to reducing their call volume, the WELL patient communication app introduced more benefits to SCOSA. They saw 50 percent reduction in no-shows and 11 percent increase in patient bookings within the first quarter following implementation. “WELL is one of those rare solutions that makes the patient care experience better without breaking the bank,” Crowder said.

360 Ortho, meanwhile, saw its no-show rate drop by 17%, to less than three percent – half of the industry average. This resulted in an impressive 208% return on investment. Moving forward, Nettleman anticipates more opportunities for WELL’s broadcast feature. “We’re always looking to move forward and expand it to where it makes logical sense. Now, WELL is one of our better tools, that’s for certain.”

Streamlined Revenue Collection

Software that aids effective orthopedic practice management also streamlines revenue collection. Take New Mexico Orthopedics. The busy orthopedic practice sees an average of 800 patients a day across its three locations. NMO wanted a digital front door that welcomes and remembers patients even before they set foot in the clinic.

To that end, NMO integrated WELL’s patient communication software with SwervePay, a cloud-based payment application. This helped streamline the check-in process further, allowing patients to quickly make their payments with a quick text message link.

Adoption grew quickly, and now, 17% of NMO patients pay their copays in advance. Furthermore, the advanced copay collection process reduced staff workload by nearly two hours a day. 

“Before, when the front desk took payment, staff had to manually enter it into the practice management system, which was a multi-step process,” said Sally Martin, Director of Revenue Cycle Management at NMO. “Auto-posting patient payments real-time is a huge win and saves on labor.”

Improved patient experience

A two-way communication between patients and doctors is one of the emerging orthopedic best practices. Ortho Northeast provides this to their patients through WELL, allowing ONE to differentiate itself in a crowded marketplace. They saw an impressive 96 percent patient utilization of WELL’s platform and also saw no-shows cut in half.

Tia Brown, Appointment Reception Supervisor at ONE, said, “With the consumerization of healthcare, our patients now have more power than ever before. WELL allows us to focus on retaining them, making them happy, and most importantly focusing on our core competency.”

Similarly, NMO patients have quickly taken a liking to their new and advanced copay collection process. They especially appreciate not having to log in to a separate portal to make payments. NMO also anticipates that, in the future, patients will opt to pay their outstanding balances this way, which will reduce payment lifecycles. 

As for SMOG, with effective orthopedic practice management, the clinic was able to reduce call volume by 20 percent and nearly double the number of those calls answered to a much healthier 85 percent — meaning happier patients and maybe even a quicker return to the ski slopes.

New report predicts telehealth to remain at 15 percent of visits

A report published by the WELL Data Analytics Team predicts telehealth will account for 15 percent of patient visits through the end of 2020.

In June 2020, the WELL Data Analytics Team looked at client data from February through June 2020. The survey uncovered several fascinating trends, including how telehealth services served as a stopgap in maintaining appointment volume, current healthcare recovery rates, and projected telehealth trends through the end of 2020.

“The data illustrate how hard COVID-19 hit health systems — not just in ICUs and EDs but also in outpatient settings and with elective procedures,” said Evan Welsh, Senior Data Analyst on the project. “Nevertheless, there were some bright spots. Telehealth really saved appointment volume during April, and we project it will continue to ensure access to care well after the pandemic.”

Download the Report

Cancellation rates reached 80 percent overall

The report found that 80 percent of medical appointments were cancelled during the week of March 23. Health systems initiated the majority of those cancellations. But, given patient fears about entering a healthcare facility, they likely would have cancelled at a higher rate if health systems had not done so first, the study’s authors concluded.

Not surprisingly, New England was the hardest hit by cancellations, reaching 83 percent of appointments cancelled by early April. Even in mid-June, health systems in the region continued to see as many 47 percent of appointments cancelled.

The data represent two critical needs for health systems in pandemic preparedness: the ability to deliver cancellation and rescheduling notices to patients and the ability to receive cancellation requests from patients.

Telehealth services were a stopgap in maintaining appointment volume

Before the pandemic, telehealth accounted for less than 1 percent of total visits. Between February and April, health systems saw exponential growth in virtual care, some as high as 50x increase. By April 6, virtual visits accounted for 43 percent of all appointments.

While in-person appointment volume began to rise again through May and June, virtual care visits leveled off. The data suggest that telehealth will continue to account for roughly 15 percent of appointments through the end of 2020.

But telehealth won’t replace in person care. Think of it as an adjunct, not a replacement. This will be dependent on reimbursements for telehealth continuing at an acceptable rate after the pandemic, among other factors.

West Coast millennials continue to lead in telehealth adoption

Telehealth showed the greatest adoption in the Pacific region. It accounted for nearly half of all appointments in that region during the first wave of the pandemic. Even through mid June, health systems in the region continued to see 27 percent of all appointments conducted virtually.

Adults ages 40 and under had the highest overall telehealth adoption rate and continued to use virtual care for 20 percent of all appointments by mid-June, twice the rate of other age groups.

If this demographic continues to drive healthcare decision making for themselves, their children, and increasingly their aging parents, telehealth will stick around long after the pandemic.

Patient appointment volume still lags by 13 percent nationwide

Overall appointment volume remained 13 percent below pre-pandemic levels as of June 15. This has troubling implications for both health system revenue recovery and patient health.

Given the thin margins upon which health systems operate, the data suggest current appointment volume is not enough to sustain revenue or compensate for the shortfall, just 51 percent of appointments at the lowest level. Additional measures to recover lost appointments will be essential in reaching pre-pandemic appointment volume and recovering lost revenue.

The pandemic created not only a backlog of missed appointments but also an as yet unknown volume of missed cancers, heart attacks, strokes, inadequate vaccinations, and poorly managed chronic conditions. After COVID, patients will require more care to make up for shortfalls and more communication. They need to know it’s safe to seek care.


WELL had the capacity to reach roughly 24 million patients during the research period. It compared appointment data from 116 health systems. The survey included specialty clinics, private practices, and multi-site health systems, all with 100 appointments or more per week. All health systems had been live on WELL prior to the pandemic, eliminating interfering data from new health systems. ♥

Download the Report

Automate patient recalls to increase appointment volume


Whether your patient needs to follow up in a month or next year, increase the likelihood they’ll schedule an appointment with automated Recalls.

The days are over of having patients complete a self-addressed postcard reminder to schedule their next annual appointment. So too is having your staff manually call each patient to schedule a recall.

Instead, set up automated Recalls with WELL to send patients the nudge they need, in the medium they prefer. Not only does it reduce gaps in care, but it also keeps patients within your healthcare system.

Why Recalls Matter

Getting patients to schedule and attend their follow-up appointments is challenging and costly. The amount of time your staff spends calling, coordinating, and following-up (once, twice, often more) adds up.

WELL Recalls streamlines the process by automating the workflow  — there’s no need to call patients multiple times to schedule. And it’s fully integrated into the EMR, so patients receive personalized messages specific to their provider and location.

Increasing the number of successful recalls also improves your quality and performance related metrics and optimizes revenue.

How WELL Recalls Work

Health systems can create automations based on visit type, provider, location, and more. When a patient goes in for their primary care appointment and the doctor asks them to come back in six months, this is how Recalls work within WELL:

    1. WELL creates a Recall based on the follow-up date with the same appointment type, resource, and location as the original.

    2. Eight weeks before the follow-up — or whatever time interval you select — WELL automatically texts the patient to prompt them to schedule an appointment, if they haven’t already.

    3. If there is no response, WELL automatically follows up on a customizable cadence.

    4. After the patient schedules appointment, WELL marks the Recall complete in the EMR.

Following the automated Recall workflow, WELL’s patient appointment reminder system kicks in, increasing confirmations by 200 percent and reducing no-shows by as much as 71 percent for many WELL clients. Overall, the process is far more efficient than manually calling patients. And, it’s more effective. People read 98 percent of text messages within minutes of receipt.

Streamline your recall process with WELL Recalls.♥

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