Why Patients Drop Out Before the First Appointment

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0:00 The 15 pieces of paper on a clipboard just screams antiquated practice, right? It's almost 2027 at this point. Let's not forget that they've actually had at least 10 to 15 touch points with your business before they're even sitting in front of you. I almost always find one point where we can say, hey, let's fill this hole so then when we pour on AI, it's gonna scale. Right? Yeah, I'm not the first one to say this, that AI is gonna replace your job, and there was some fear there.

And that couldn't be farther from the truth in some of the things that we have built, right? It really is on you to bring the right questions to that demo. Put yourself in the shoes as a shark in Shark Tank, and ask the questions that really matter to your practice.

Welcome to the Zero Friction Podcast, Terry Coutsolioutsos here, and I have a remarkable guest with me here today, Jenn Denham. She is the chief growth officer of Aloha, which is formerly known as Review Wave. Jenn has spent roughly the better part of a decade helping small businesses, mainly in the consumer healthcare space, sort of build their businesses from the ground up. So, Jenn, great to have you here today. I'd love to hear more about your personal journey, as well as learning how Aloha is helping taking friction out of the chiropractor world, I believe, right?

Absolutely. Thank you so much, Terry, for having me. Zero friction, ultimately, is the goal. So great alignment here today on this podcast. But yeah, I've spent, ooh, I'm going to date myself. But yeah, about 20 years, really, in marketing and growth marketing in the last eight, and really in the healthcare tech space. So helping a lot of those practice owners in your local community, whether that's your eye doctor, your optometrist, your chiropractor, your dentist, really help use AI and automation to help those practices grow, help their staff not be burdened with just some of those data entry mundane tasks, but ultimately really have better patient outcomes, right?

2:40 That's the goal that we're all aligned with from the healthcare side is help those doctors be able to focus more on their patients and the staff to focus more on revenue generating activities than just being in there doing data entry like it's 1998, right? There we go. So make it smooth and efficient, create better patient experiences, allow for more human connection probably instead of administrative tasks and burdens. What are the typically in the consumer health space or more lining up with the chiropractor space, What are the top three friction areas that you and Aloha are helping to solve for today? Yeah, absolutely.

And I think it'll be helpful to do a little background on Review Wave and where it started. Our founder, Matt Prados, came from the largest chiropractic family in the industry. So over 80 chiropractors in his family in the Guinness Book of World Records, but ultimately decided to become the black sheep and start a tech company to help these chiropractors grow their practice, right. And 8, 9 years ago, that was really reputation management. Right. What doctors, what chiropractors in my local community have the best reviews, right?

And so hence Review Wave was born. But over the years, we found that it was actually more than just reviews and your reputation. It was also removing those points of friction, right. So how easily can I go from looking you up and seeing those great reviews and then scheduling that appointment? And that's where we find those points of friction. So again, Review Wave grew from just reputation management into then rebranded, still privately owned by Matt Prados and his family. But Aloha. Aloha was a better name for us as we added on more solutions.

But to your question, the friction points we see, and I'm sure all of your listeners can attest to this, when we want to do business with a local business or really anywhere, right? We're going to book a hotel, book a car. We're doing that from our phones 99% of the time, right? And so even if we get a referral and Terry, you tell me, hey, Jenn, you know, your shoulder's hurting. I have a great chiropractor for you. More than likely, I'm still going to look them up, check out their reviews, right? But then from my mobile device, I'm going to want to book an appointment.

And then I'm going to want to get a confirmation text. And then I'm going to do my intake forms, right? And so every practice is different. But from a patient experience, it's really not that different. We want to be able to get that to-do done as simply and as quickly as possible. So those friction points that we identify really start in the beginning of a patient's journey, right. And so the old school way would be, Terry, I would call your practice. And then right now, you're probably really busy.

5:26 It's Monday, right? And so you're not going to answer my call. I'm going to leave a voicemail. Then you're going to call me back at lunch, and I'm going be on a webinar, so that's going to go to voicemail. And we do this song and dance. And ultimately, I'm probably just going to go to a different practice, right? So it really starts with that touch point. And Aloha solves for that with Charlie AI. So our first AI agent that's available to these practices is a voice receptionist that will answer calls when you're busy.

The phone rings three times during business hours. Charlie will answer that. And because of our integrations with EHRs, which is the electronic health record system where your patient data lives, we'll be able to read your availability and appointment types, and Charlie can go ahead and get new patients and existing patients scheduled, even complicated scheduling. Recently we had Charlie schedule a mom with three kiddos, and two of those kiddos had different last names, and we were ultimately successfully be able to schedule those meetings or those appointments for that family and get it on the book.

So if you think about that from a revenue standpoint, especially if you're running marketing for your practice. If that first experience isn't seamless or is complicated for those new patients, we honestly have more than enough options to go to the next business, right? So it really starts with that first touch point with your patients. And then that next one, Terry, which I think it's more of a pet peeve for me than anything because I have two kiddos and when I go to doctor's appointments, if you hand me a clipboard or you tell me to print something out on my nonexistent printer or fax you something, it's not going to happen, right?

And the 15 pieces of paper on a clipboard just screams antiquated practice, right? It's almost 2027 at this point. And so we wanted to absolutely remove that point of friction for these practices by creating mobile-friendly intake forms. And what that looks like is as soon as you schedule that appointment, you get that text message confirmation, and then you say, hey, go ahead and fill out your intake forms. But if I don't complete that, I'll also get a reminder to complete that form before I come in, or I'm going to need to come in 15 minutes early. Nobody wants to do that.

So the completion rate of those forms is extremely high. It's great for that patient experience, right? I'm already subconsciously getting an idea of what it's going to be like to do business with you. Man, I was able to book this appointment with you at 10 o'clock on a Friday night. I got the text message confirmed. I got the text message to fill that form, most of that information auto-populated from my phone, right? My name, my email, and my address. I'm all right. All right. This is great. I like Terry's practice, so I'm getting so much done.

8:08 But from the staff perspective, too, right? We want to eliminate that friction for them. And in the old way of doing business, they would have to call you, hey, Terry, want to confirm your appointment? Hey, I'm going to email you these papers. Please print them out and fill them out. Again, feels antiquated. But then even if you bring those papers in, what does that staff typically have to do? Put them in. Manually? Yeah, and they have to read my chicken scratch, right? So they're gonna have to try and decipher what my email address is and put that into the EHR, which again, is just taking away this time that they could have focusing on new patient acquisition, better patient outcomes, better patient experience, being able to walk out from behind the desk and greet patients and take them right into the exam room.

So I think a lot of the things that we focus on at Aloha and that I've really been an advocate for in my journey with healthcare is how do we focus on removing these small little points of friction that patients experience and that staff quite honestly feel overwhelmed with to where ultimately, like we had said, the outcomes become just better patient experiences which we really, really need in this country. I will tell you that AI and I use a lot of AI on revenue and lead acquisition processes.

So I help companies use AI to identify ICP. I help my customers actually do the lead conversion process. And so I get how AI builds intelligence, it builds consistency, it builds framework. And all those things kind of come into play with a busy practice, because most employees, I'm guessing, come in for an eight to 10 hour work day with 15 to 20 hours of work to do, right. And I'm guessing that you're allowing your AI systems are taking those repetitive, low value activities, and AI is getting passed on to them so that they can actually have more time to do the high impact human to human, customer, patient, client experience opportunities that you're helping them try to create.

Yeah, a hundred percent. And I think we all have heard in one way or another that when AI first came on the scene, there was a lot of conversation. And I'm not the first one to say this, that AI is gonna replace your job, and there was some fear there. And that couldn't be farther from the truth in some of the things that we have built, right? What we want yeah. To do is to empower your amazing team to use AI and automation, to be able to then focus on what we're talking about as that patient experience, right? And not feeling bogged down with typing in everyone's email address into the EHR.

10:49 And I also think a lot of the fear in the beginning was the staff members thinking I'm going to have to go to an AI class, I'm going to have to learn prompt engineering, I have to learn how to set up agents, and it could become overwhelming to where they just, you know, kind of black it out. And what we've done, or I've done from a lot of my workshops and conferences that I speak at with both chiropractor and optometry and dental, is let's actually step back before we, you know, go headfirst into AI, which I love, right? I'm a huge fan.

Our whole company is just, you know, head over heels in love with AI, for sure. But when we look at the average practice, there could be some overwhelm there. And so what we want to start with is, hey, let's sit down, pull out your phone, and let's be a brand new patient with your practice. And hmm. Let's write down every point of friction that we run into that as a consumer, if you are going to go book an appointment or do business with this practice, wouldn't really fly with you, right?

And so we actually in our workshop, we sit down and we say, look for you. Look for, you know, Terry Chiropractic in, you know, Salt Lake City, Utah. And where do you sit on that? What do the, you know, AI engines report back about your practice? And then let's go to your website on your phone. How easy in three clicks is it for me to book yeah. That appointment? And on your lead generation point, Terry, if I start to fill out most practices, when you go to book an appointment, you pick a date and a time first, right? Right.

But again, I'm a mom. I have two kiddos. If I'm looking at this, and I pick a date and a time, and I'm like, oh, wait, I think we have something going on that day, and I leave, right. You're never going to know I visited your site, right? So what we've learned at Aloha is we actually put in fill out your contact information first, then right. Go to calendar. And so if I hop off, you're immediately going to get a text message saying, hey, Terry, I look that you're trying, I look like you're trying to book an appointment. You know, how can I help you do that today?

You didn't those finish are, or something, right? Hey, saw that you weren't able to complete the task. What can I do to finish this for you or whatever that might be? Oh, yeah, great exactly. Idea. So as we kind of go through these points of friction, we're identifying them from the patient journey, but also from the staff's experience, right. And even my rockstar practices, right, there are some phenomenal practices out there in SMB, but also your mid-market and your enterprise. They have great systems set up.

But even when we do this in those settings, they sit down and they go, oh, I never knew when you scroll down to finish this, it gets stuck in the footer. Or, you know, hey, I never knew that we actually didn't have a specific place to send my myopia management patients in optometry, right. Right? And so there's these aha moments where we may have said AI, shiny object, and grabbed onto it, where what we want you to do first is, again, go through that entire patient journey aligned with what the staff experiences.

13:48 Find those points of friction first, and say, is there some simple automation that's going to help us here first? And then when we layer on an AI agent, it's going to be scalable. Because what we don't want is the doctors to go to some amazing conference and see some amazing AI tools and come back to the team and say, all right, we're going to see 100 new patients starting next quarter. And the staff says, yay. And ultimately, they're thinking in the back of their head, the wheels are going to fall off, right.

Right, when I have to order 15 more clipboards and 10 more chairs for the waiting room. And oh, I'm going to use our budget for the entire year on printing out all of these papers, right. So right. We really just want them to have this audit, this opportunity to audit their current systems and processes. And I almost always find one point where we can say, hey, let's fill this hole so then when we pour on AI, it's gonna scale. Right? Yeah, that's a great idea. And I think secret shoppers are always a great avenue, not only for yourself, but doing those audits.

Having the staff, or even better yet, the owner, go through the buying experience themselves, or the scheduling experience is always, and when I had all of my companies, I've always tried to play the buyer on the other side. Go to the website, try to schedule, will try to book an appointment, try to actually find information, just what does that whole click-through process look like for somebody who's got a baby in one hand and a phone and a thumb on the other hand and trying to balance both at the same time.

And I think that's, what a great visual, by the way, like you brought it up where like, you got two kids yourself, you're trying to schedule something, they're in between a soccer match or whatever it might be, but it's like you're trying to use your time most efficiently. And the platforms and the service providers that are making it easy for you and removing the friction, even if it's just click through friction, not even like walking in the door friction are the ones that are really going to win moving forward.

And AI is changing the whole world on that, whether you're using conversation AI with messaging and email, whether you're using AI on your website, whether you're using voice for phone rollover or weekends, or, you know, you're on your couch and the only time that you can schedule something is at 10 o'clock at night. And, like, frankly, I've been there trying to schedule something and, like, I end up finding some system that allows me to book it when I want to book it, not when you want to be open.

16:32 And I think AI is really allowing for that that world to really transform itself. Right. And so I think we have to really put ourselves in the modern patient or consumer seat, and think through, you know, what does this experience say? There's so much subconsciously that happens before I'm even sitting in front of you as my provider. And yeah, I don't think providers think about that. There is much that I go to these conferences and they're talking about, you know, when the patient's sitting in front of you.

And that's amazing, right? There's amazing things that they can do with AI scribes and focus on that patient while they're there. But let's not forget that they've actually had at least 10 to 15 touch points with your business before they're even sitting in front of you. Right. And so I may be coming in like, you didn't tell me that there was no parking and I should have, you know, allotted for 15 minutes and the best place to park was, you know, a block in a free public parking and so I circled for 10 minutes with my kiddos and then you handed me 15 pieces of paper to sign my name 10 times.

You know it's so it's all of these things where if we just think automation and software can help me solve for these things. They can get a text message of hey we're looking forward to seeing you today just remember the best place to park is X. Please bring this with you. Don't forget to bring your glasses with you to your eye doctor appointment. It's all of these small things that then I show up feeling like you're on it's modern, I feel confident in doing business with your business.

But then also, Terry, when we leave, what's a huge pain point for these providers right now is that patient relationship. Unfortunately, we have shiny object syndrome and we get very easily swayed by, you know, the new eye doctor in town or the new chiropractor in town. And so retaining that relationship with their patient is also where we can use a lot of automation and AI. Usually what will happen is they'll hand you a folder, right? You just got some new glasses. They hand you a folder with a bunch of printed out paper, and you'll walk out the door and if you're like me, or many other busy parents, working parents, you're going to put that next to the coffee pot.

And then eventually it goes into recycling in about a week, right? Where if we turn a lot of that information you want to give to your patients into short recorded videos that are evergreen, and you text me some information around myopia management for my child and, you know, proper usage of devices that evening or next morning, when I click on that link from my phone, and it's a quick YouTube video that opens up, not only am I probably going to watch that entire video and gain that information, but I'm going to see you and I'm going to hear you and I'm going to strengthen that relationship that we had within your practice.

19:07 And so it's just these really simple things we can do that completely changes what ultimately the practice wants is that lifetime value of that patient, the average patient, you know, spend with that practice. And then for the patient, those patient outcomes, right? I'm really going to learn about what the right things are to do with my child, with their eye health, because honestly, I'm not sure I'm going to get through those 10 pages that you put in a folder for me you know, it's just, you just brought up so many things that I love to think about myself in terms of, you know, following up and building authority with customers, building trust, having automated systems that are smart, that will know what type of patients you had and you can send them through certain algorithms and it'll channel the right communication to the right customer at the right time.

It's just totally amazing. So let's flip the cards a little bit. I think we have a great understanding of the offering, what you bring value to a consumer health kind of practice, whether it's optometry or dental or even chiropractor areas. Talk to me about your role as a chief growth officer. Tell me, like, what are the big friction points in terms of you and your team? And like, you know, I'm sure you've got like huge goals and huge targets. Everybody's so excited about AI today. What are some of the biggest friction points you have as a sales leader in your role today?

From a go-to-market growth leader. As we evaluate new verticals, you always have to understand the way that even within one vertical, how one practice runs is not the way another practice will run, right? And so as you build software to bring to market and you evaluate really what that value proposition is going to be, you have to understand the operations of different types of practices and who you're a great fit for. And honestly, maybe who you're not quite ready for yet. I think some of the things that we've run into is a little bit what I touched on earlier is there will be some great doctors that come to these conferences and they'll see an AI agent and they'll just be sold.

Hey, I wanna bring this into my practice. But I don't think that yet we've been taught, or the industry has been taught, how to ask the right questions when buying software, and specifically AI-empowered software, or AI agents. And so I think that I've been trying to do a lot of that as I go to conferences and I speak on panels, is a lot of times they'll come up and say, how much does it cost? And sometimes something can be very low cost, especially if these agents are used across multiple verticals. Hey, we serve automotive and dental, and we serve chiropractor and hospitality.

21:48 Sometimes these agents won't exactly operate the way you want them to specifically for your practice. And so I think one point of friction, and it really is just an area of opportunity, is as a consumer of AI and automation software for your business, and even if that's outside the healthcare sector, is to really do some due diligence, right? Talk to your team before you go to these conferences, before you get on a demo, and identify those points of friction for your team and for the patient experience. And then bring some great questions.

I have a really great colleague, Dr. Brianna Rhue, who is an eye doctor. She's a big speaker as well. And she has created a book that helps doctors identify those questions. And she really says, you're kind of like the shark in Shark Tank. You get to go to these softwares and say, tell me how this is benefit my practice, but then ask those really smart questions that the sharks do. Does this integrate with my existing systems or is this just going to be an email notification that someone left a voicemail that then becomes data entry?

What is your onboarding process and how involved are you in training my team? Ultimately, we're utilizing what we're paying for to the most, to the biggest extent that we can. I think that's something that's not necessarily a friction point for Aloha in general but just for the industry We have so much that's available out there to us, but sometimes we get shiny object syndrome and we get things without understanding it is going to take some time to train an agent, just like you would a new office manager.

It's going to take an internal champion within your practice that you say, hey, Terry, we're bringing in this voice AI receptionist, you're going to be the internal champion of this project. And you're going to make sure we roll it out correctly. And the point person with this company who has hopefully an onboarding specialist that's gonna help you in that journey, right? And so I think if we approach how we buy software, how we buy AI agents and automation, I think it will remove a lot of what some of our companies feel is just they buy it and then they freeze up, right?

Like, oh, we have to train the agent on how to answer the phone. Well, if you hired a new person, you would absolutely you have to give it some training. But the great thing about AI agents, as I'm sure you know, is once you train it's in there, right? And so it's just, the training is so much more expedited and scalable than a human, and you can use your amazing team for those other tasks. Know, and just like anything in the software or the technology world, adoption and transformation is all about how you actually achieve the value that you've designed to put together when you actually invest in the software systems themselves.

24:33 And so, you know, again, I believe what you said is, you know, what is the training that is going to be supported by the organization that you're partnering with to bring into technology, number one. Number two is what's the ongoing support after the initial training. Cause that's just as important, by the way, is the initial training because that ongoing support is how actually things get retained and you build habits, and then three, the internal champion piece to make sure that everything happens on a consistent basis so that again, if you're spending, you know, $500,000, whatever it might be on these AI agents, you know, they cannot just like anything else. I thought you put it so well is that everybody believes you just bring these agents in and it's all said and done.

At the end of the day, they need direction, they need supervision, they need to be accountable. And it all takes some sort of human intervention with AI as well. So, you know, I love it when you go on LinkedIn and they sit there and they say, I just got rid of 37 people and I have all agents working for me. And at the end of the day, I have to work with AI. I have four computers running every day, but I have to supervise my agents every single day. No matter whether they're doing lead acquisition or whether they're doing lead conversion or whether they're doing follow-ups or whatever it might be, I have to make sure that I monitor and I measure and I coach and I correct.

And those are things that most people in the AI who are not in the AI world today need to understand that it's an ongoing process that in order for you to enable and totally optimize your investment, these are the things that you have to do on a single day basis, especially if it comes to acquiring new customers, converting new customers, retaining customers, all those big things that AI can do so very well. Yeah, and again, if we're talking about, it sounds like you have a very sophisticated system, and so you know the time it takes, but there are some great tools out there that are a great fit for the practice.

So I do want to end on a high note that I do believe that AI is the future, I think in the area in which we sit with healthcare practices, and their staff, we have to approach it a little bit differently, right? It needs to be something that is easy to implement. But a lot of these practices, again, if you own a dentist, an optometry practice, a chiropractic practice, there are some great tools out there. The way that you will succeed out of the gate with these things is, one, to ask great questions on the demo and assign an internal champion and then evaluate how that is going for you.

27:17 And what I ultimately don't want is for these practices to just try a bunch of stuff for 30 days. You know, you have a staff meeting, no one really owns it. And then they just throw it out. And then a statement of AI didn't work for us. That's not what I want. Right? I want you to really see the power of what automating these things are. I think the examples I use are, are no brainers, right? Remove the clipboards, mobile intake forms. That one I would highly doubt that any practice would say, no, I think we like killing trees all day long and printing out all these papers for patients. Patients love signing their name 15 times, right?

So there's some easy no brainers. And so I think for those practices, let's just get those things out of the way. Let's make it a modern experience for your patient and for your staff. And then if you're like, Jenn, we've been doing that since 2024, awesome. Let's layer some gasoline, AI, on top of that to scale and get your, you know, patient volume up and really get your staff excited, right? I mean, there are some staff members that are sitting at the front desk that may be a little nervous that there's so much AI and automation being marketed and they're getting those emails to the front desk too.

And I think if we can flip that conversation in your next meeting to say, what are some things that would be exciting for you to learn about in your role? Would it be an AI receptionist that can answer calls? So when you come back on Monday, you're not spending two hours trying to track down people that probably aren't answering their phones. So I think we can identify our staff and say, let me help you become the next best version of your role at this practice by giving you a tool. And then they get to own that piece.

And I think that's where the excitement happens, you're also the staff as they get trained in AI, make themselves more valuable in their careers as well. Right? Like, you know, every practice probably out there is looking for AI experts to help them internally. So what a great opportunity if you are a staffer today to embrace this new sort of AI champion role and develop yourselves into something more in the future too. 100%. And I think that's where we're going to see the industries like healthcare turn around a little bit.

These private practices say, susan at my front desk or Bill at my front desk was very hesitant, they really love talking to patients, but we're closed on Mondays and throughout the weekend and no one answers the phone after five o 'clock. And so instead of coming back to voicemails, they said, I'm gonna understand how to train this AI agent. It's gonna forward automatically. I don't have to do anything, but I can go monitor some of the calls that this agent had over the weekend and tweak it and train it just like I would a new receptionist.

30:00 And the cost is exponentially lower. And you're right, it's gonna really help them feel like, wow, I get to put on my LinkedIn that I was the champion for an internal AI receptionist that empowered our practice to book, you know, 10 to 15 new appointments in our off hours, which is a huge, you know, point for them. And what a great opportunity from a business perspective to like it's, you know, whether it's finding ways to book retaining current customers, doing patient re-engagement campaigns, all those things where AI is such a huge value.

What other points do you want to leave the audience with today in terms of Aloha or AI in general in terms of? Before I go there, I do have one more. When it does not go well, where are the top two or three things that you see practices when AI adoption has not really achieved the optimal way and people get frustrated. What are the couple points where, you know, we can point out to some, the audience maybe, what to look out for if it's not going well.

Yeah, I think one, again, it's going to start from your discovery phase. And I think you have to, as much as you want to lead the charge and buy software for your practice, have to include your team, right? Especially if they're the ones that are ultimately going to be interfacing with that software. So I would highly encourage you to sit down and help your team, have your team identify those points of friction. Then when you go into the demo, or when you're on the sales floor, believe me, our sales team's amazing.

So many companies are, and they're gonna have that value proposition. But it really is on you to bring the right questions to that demo. Put yourself in the shoes as a shark in Shark Tank, and ask the questions that really matter to your practice. Because ultimately, if you set up your practice correctly, you should be focused on patient care and your team should be focused on executing, right, executing as you've directed them their goals. You set what the goals are for the practice and how you're going to get there. But when you do these demos, have your office manager on it.

Have your COO on it and make sure that they're a part of that conversation. And then also when you're training, they need to have that time, right? So you can't expect your team to be setting up their AI agent after hours. So you're going to say, hey, you're an internal champion. You're going to have about, you know, an hour a week where you're going to be doing this for the first two weeks while you're launching with this person. So one, does that company have live onboard training?

32:37 Is there someone to pick up the phone and talk to, or a chat, what we don't want to do is have to put in a ticket or talk to someone ultimately overseas that doesn't understand our practice. So really, is that support there with that company? And a lot of these practices will understand, but does it integrate with your native systems? We need the integration to be able to make these things seamless. And so really, it's on you to make sure that those questions are answered. So do due diligence, you can ask, Claude, hey, I'm looking at this system, whatever your AI tool is, and here's my existing systems.

What are some questions I should ask as I go into this demo? Right? Those are the points that I would really stress that will set those practices up for success. And then dive in, right? There's going to be some training that's needed. And I think if you have identified points of friction, we'll leave it with three things. Identified those points of friction, identified who your internal champion is, and understand that the system you've selected is integrated and has support, you're gonna do great. Well, there you go, Jenn Denham from Aloha.

I appreciate you being here today and, you know, good luck. It's, I think that you're bringing a great service to the consumer health community, number one. Number two is, you know, more AI adoption fanatics like yourself are definitely needed in today's marketplace, kind of removing those shreds of doubt and helping people sort of get through this transformation phase because AI is going nowhere. I mean, it's going to be here. It's going to be a part of our lives and learning how to embrace it and take it on and educate it on how to do what needs to be done is a big part of that.

So thank you for being a part of that journey. Yeah, absolutely, Terry. Thank you so much for having me.