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Most clinics lose an average of 20% of their revenue due to missed appointments. Lost revenue may not be the largest problem clinics face due to no-shows. Other problems span health damage, patient liability risks, reduced accessibili

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

ty, and impeded resident education. Rigorous no-show management methods utilizing powerful vericle-like technologies, which integrate scheduling and billing data, reduce no-show rates and improve associated revenues by more than 50%.

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

No-Show Frequency Distribution

No-show rates average at about 20%, where 10% clinics have less than 10% no-shows, 42% clinics - 10%-20%, 34% clinics - 20-30%, and 14% clinics - more than 30% no-shows. Further, the top ten clin

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

ics range 3%-9% for no-shows, while the bottom 10 clinics reach 33%-57%.

No-Show Impact to Clinic

A missed appointment poses five kinds of problems:

Health damage: Damage to patient's health due to interrup

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

ted continuity of care or missed an opportunity to solve an acute health problem. The doctor also loses an opportunity for a timely review of patient health, treatment progress, etc.

Liability risk: A patient that m

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

issed an appointment and suffered an injury may have a viable cause for a lawsuit against the practice. To avoid such risk, the doctor must maintain evidence of giving clear directions and making reasonable efforts to ensure patient's

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

compliance with care program, including keeping follow-up appointments.

Reduced accessibility: Other patients were postponed and did not get access to care because of a no-show or cancelled appointment.

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

Impedance to resident education: Resident doctor missed an opportunity to hone care skills.

Loss of revenue: Clinic is unable to make up revenue due to missed appointments.

Three-Phase No-Sho

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

w Management Strategy

An effective no-show management strategy is based on tracking, rescheduling, and follow up:

Track
1. Record all no-shows and reconcile with billing on a daily basis
Reschedule in real time
1. Allow patients request appointments online using Interne

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

Overbook, use waiting lists

Fill new openings with walk-ins or patients from waiting list

Follow up

Activate a sequence of reminder calls/emails to all patients 10

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

, 2, and 1 day prior to appointment.

Follow up call to find reasons for no-show and reschedule

Follow up with warning letters after one no-show

Dismiss from practice after three no-shows

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

i>

Reminder calls or emails prior to appointment remains the most effective method to prevent missed appointments. Additionally, sending reminders via email and allowing patients confirm online turns an office reminder into pat

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

ient's action item, significantly outperforming the impact of a voice message or postcard.

Note that outsourcing reminder calls to calling services and using the Internet reduce the cost of reminders. Therefore reaching all pat

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

ients prior to appointment makes good business sense.

Three technologies are especially useful in implementing the no-show management strategy outlined above:

End-Of-Day Report: End-Of-Day report displays New patien

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

ts, Visits, Cash, Insurance, Free, Insurance (Billed, Collected), Cash Collected, Missed Appointments, Recalls, Patient Visit Average. End-Of-Day allows the manager to reconcile revenues with patient visits, eliminating no-charge visits

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

and unbillable appointments.

Scheduler:

Allow patient access to Internet-based appointment scheduler
Update available appointment list due to cancellations
Alert about ne

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

w openings for patients on the waiting list

Alert about appointments with missing authorizations

Most schedulers allow monthly, weekly, and daily views. Today view should change color for no-show appointmen

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

ts, prompting the front-office person to follow up immediately or at the end of the day

Search: Search feature must allow finding all no-shows within specific time interval subject to specific patient na

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

me, attending physician, CPT and/or ICD-9 code combinations, or other demographic conditions. Upon finding specific appointment, drill down should be available for related appointment history or recurring appointment plan.

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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