This Week on the Uncharted Podcast…
This week on the podcast, we have a cross-over episode! That's right, this is a Cone of Shame episode. Imagine a CSR working from home, checking a client out and booking appointments from his home, or a technician live-chatting with three different pet owners through the clinic webpage from her apartment, or a doctor doing telemedicine appointments from another state? This isn’t fantasy. There are practices actually making these things happen today. Christina Freeman and Summer Burke-Irmiter join Dr. Andy Roark to talk about how their clinic is breaking the mold to give employees (and clients) flexibility like never before. Let’s get into this.
You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, or wherever you get your podcasts.
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Upcoming Events
October 6-8, 2022: Get Sh*t Done Shorthanded Conference Event
Want to hear more from Summer and Christina about their virtual CSR model? You can at the upcoming Get Sh*t Done Virtual Conference! They will be doing a workshop and there will be 3 days of content all about how you can get sh*t done when you're shorthanded (who isn't?)!
While Uncharted Membership is always encouraged, you DO NOT have to be a member to join us for GSD! Non-members, here’s your chance to see what all the buzz is about and get a taste of the Uncharted experience.
August 10, 2022: Believing WE Can – Leading A Solution-Oriented Team with Senani Ratnayake
In this 2-hour workshop, we will:
- Discuss what leaders can do to set themselves, and consequently their teams, up for success in problem-solving
- Focus on tactics with a twist – activities that are enjoyable, engaging and unexpected.
- Learn how to implement these activities to help the team explore being solution-oriented and action-oriented in fun ways.
All Uncharted Veterinary Community Workshops are LIVE! You will be able to ask the instructor questions that help you address your practice’s unique problems. This will not be 2 hours of silent screen time. Gear up for interactive, fun learning!
Episode Transcript
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Stephanie Goss: It's a crossover episode that's right this week we are sharing an episode from our sister podcast the Cone of Shame podcast. Andy did a discussion interview with two amazing women from Adobe Animal Hospital and I just thought it would be something that our audience would love to hear, because they talked about virtual team members, virtual csrs, using technology in amazing and absolutely nerdy ways that I completely love. So we are going to listen to Andy talk with Summer Burke Armature and Christina Freeman from Adobe Animal Hospital and nerd out about how Adobe Animal Hospital is doing work from home and virtual vet med.
Meg: And now the Uncharted Podcast!
Dr. Andy Roark:
Welcome to the podcast, Christina Freeman and Summer Burke-Irmiter. How are you guys?
Christina Freeman:
Good. How are you?
Dr. Andy Roark:
Doing really good. I am super excited for this conversation. For those who don't know you… Let me just say why I'm excited for the conversation, and then I'll introduce you guys through that. You guys work at Adobe Animal Hospital, which is out in the San Francisco Bay Area. You guys are part of Uncharted, which is a community that I love and get to run. And you have been for a number of years and you are one of my fanboy hospitals that I crush over because you do these cool, cool things. You were the first hospital that I was aware of that was an open hospital, meaning that people could go basically wherever their pets go.
Dr. Andy Roark:
My head hurt for a week after I first talked to you and really came to understand what you were doing and what that meant. You guys just, you do these things that get me excited and just remind me about what's possible, and that medicine can be very different from what it has been in the past. And so I am a huge fan of you guys and the work that you do. Summer, you are the hospital administrator and the owner. Christina, you are the remote manager, which is how we come to be here today. Summer shared with me a couple of weeks ago, a new program that you guys were rolling out with what you called video client representatives.
Dr. Andy Roark:
So I'm not talking about CSRs that are answering phones from home. I'm talking about you guys have screens in your lobby that people can see traditionally, a CSR, a customer service rep. That they can see the customer and they can check out with this video screen. And you have people not just answering phone, but actually dealing with clients in the building while they, the employees are at home. And that's amazing to me. And so I was like, “I want to talk…” First of all, I want to go through the system with you. I just want to unpack it and understand what you guys are doing.
Dr. Andy Roark:
I'm so impressed with just… And let me just say this too. I know this is a new program, you're only doing it for a while. I love that you are doing this and putting it out, and I just think that so many people, as we're looking at the great resignation and people changing jobs and also battling burnout and people being able to work from home. That has been shown to decrease levels of burnout, when people get to spend some time and say, “Hey, I'm changing my environment. I'm going to work in a more relaxed place. Even just a limited amount of time.” I am really looking hard at burnout. I'm looking hard at efficiency. I'm looking hard at making the jobs better and more flexible.
Dr. Andy Roark:
And I feel like you guys are actually out there in the wilderness doing the thing. I didn't say you were lost in the wilderness. I said you are out in the wilderness, more of a Lewis and Clark, like headed westward sort of feel. That's, how I feel about it.
Summer Burke-Irmiter:
Definitely.
Dr. Andy Roark:
Definitely. Those are the things I'm geeking out about, and so let's go through. I just want to go ahead and start to walk through the journey that you've made so far with you. Go ahead, why don't you guys tell me just a little bit about Adobe. I mentioned a very high level. Give me a clear picture of what you're working with as far as the hospital, what makes it special? Just so people can have a mental picture of Adobe and what we're talking about.
Summer Burke-Irmiter:
I'll jump in there. Adobe is a really amazing place. We have two hospitals here in the Bay Area, one, which is a 15-exam rooms, three surgical suites, full cat and dog ICU, full lab and pharmacy. And so we're big and I love it, 15 exam rooms. Overall between our two hospitals, we have 22 doctors and about 145 team members. Yeah, we're a big guy. We have a second location about 20 minutes away that's six exam rooms, ultrasound suite. They can still do major surgeries. They're open six days a week there.
Summer Burke-Irmiter:
You mentioned the thing that I think makes Adobe special and amazing, which is the open hospital. So clients can go with their pet to ultrasound. They can help us set up an x-ray and then step out. We do vaccines and blood draws in front of owners. And because of that, our have a different level of trust with us. And our doctors all practice the medicine, they feel as best. So as a business, we actually don't have a lot of hard lines with our medicine and what we recommend. We want the doctors to talk with the patients and the clients decide what the [crosstalk 00:07:15]
Dr. Andy Roark:
Talk with the patients too. You never know what you're going to get.
Summer Burke-Irmiter:
Where are they going, what their risks are. For vaccines, we don't say you give every puppy these set of vaccines. You talk with the owner and see what's going to be best for that puppy and for that owner. Those are the two big things that I think make Adobe in general. Christina, what would you add to that?
Christina Freeman:
Truly the open hospital, I think is one of the big things that makes Adobe different and drew me to Adobe. When I first read that applying, I was like, “Oh, that's awesome.” I had grown up in a little small town hospital where I got to go wherever I wanted to go, but yeah, I saw other people not be able to do that. So it important to me. It honestly gives a huge hospital that small town feel because you're part of your pet's care. I think that was definitely one of the things that drew me to Adobe.
Christina Freeman:
I'm not from the Bay Area, I'm from North Carolina, which is where I currently live. Why? I'm the remote manager, but I think what's kept me with Adobe is just the constant creativity and growth, and the fact that we're always changing things up to make things a little bit better for namely the pets. That's always the first and foremost. That's how we've gotten here, is keeping pets first.
Dr. Andy Roark:
Talk to me a little bit about the idea of remote work. When did Adobe start to really look at this as a concept? You guys were way pre pandemic when you started to kick this around. People are like, “Oh my God, look how far they've gotten in the last two years.” And I'm like, “No, you guys were way out ahead starting to work on this.” But help me really understand that, when did this idea of remote employees, when did that come together and why did that come together?
Summer Burke-Irmiter:
It's been some while so I always have to remind myself. I think it's eight to nine years ago we started.
Christina Freeman:
Yeah.
Summer Burke-Irmiter:
What happened is, here in the Bay Area, the cost of living is very high. A starter home within an hour of Adobe, you're going to be at least 600,000 plus. And so a lot of our staff already live farther away, and then if you're going to buy a home and raise a family, oftentimes our staff would move out of the area. And that's what happened, is we had a staff member who was going to leave the area and we didn't want to lose them. We all know how hard it is to get really great staff. And when we were faced with one of our staff members moving, we were like, “No, we need to make this happen.” I was like, “I need to make this happen.”
Summer Burke-Irmiter:
We keep good team members. They're part of our Adobe family, and so how do we do this? And why are we limited by our building? Why can't we do more? And so there's so much work to do. There's always work to do at Adobe, and so we just started figuring it out, really just one step at a time, lots of trials and errors, but it was to keep our team members. And so that original person did start out, I think like many hospitals now have a remote person, which is helping answer phones, helping call back clients for us. So it did start small and it just kept growing.
Dr. Andy Roark:
You guys also started to do remote communications with pet owners. Tell me a little bit about that. That's different from having people work from home. That's having pet owners stay home. How does that come into this?
Summer Burke-Irmiter:
One of the areas that I was really excited to explore was getting into chat. I don't know about you guys, but pre pandemic, I loved chat. I actually had apparel companies that I would chat with all the time back and forth. I was on Zappos once and buying shoes. And I was chatting with this CSR on there with a question about the shoes and we ended up talking her cute pit bull that she just rescued. And so I saw that you could have a connection and get really great, fast help. And so really started looking at different platforms, what could we use? That's where we initially settled on live chat, and this is where Christina actually comes in and I'll let you take it from here because you can give all kinds of information.
Christina Freeman:
Yep. That was Summer's crazy idea. I came to her and needed to move back for my family to North Carolina and she said, “Well, if you'll stick with me, I've got a crazy idea. What do you think?” And I loved it, and so we really started small. It was truly just, we had a couple people trying some things out, but when we first started chat, it was just me for the first couple weeks. And then we grew to a couple people and added one of our doctors who was remote at the time or starting in the remote world. We were shocked at how fast our clients adopted it. Through the live chat platform, we just popped a widget up on our website.
Christina Freeman:
And so whenever someone would come on the website, the way we started originally was very organic. We would ask the client if we could help them with anything. And they would say yes or no, or some were thrilled. We really found… I think at first we were all like a little bit worried it would feel impersonal, so we really tried to give it a good conversational spin and not using forms and things like that. Just really us talking because I really wanted to create the atmosphere that this was real people, real Adobe people who knew what they were talking about and we were not a robot, and it worked. And our clients adopted it and really quickly and started coming repeat back questions day after day after day, short, little questions.
Christina Freeman:
Little questions about the hospital, little questions about their pet. We love it because we can send videos and pictures back and forth. That really helps us triage, especially like a surgical patient. We can look at that incision site without the client having to drive in and we can get really good images too. So we were thrilled at how interactive we could be with the clients. Another thing that I think surprised Dr. Lau and I, when we were first doing this, we would cover a lot of the evening hours. And we had a lot of our senior pets or our hospice pets that would come day after day after day.
Christina Freeman:
We got really invested in these people and their pets and their journey through what they were going through and just really created a nice, comfortable rapport and atmosphere with the clients that you don't always have time for in the clinic. And so we really found it not only helped clients, but it sometimes enhanced their experience with us. That was really rewarding and kept us pushing. And as time went on, word got out. And so we became pretty overwhelmed pretty quickly with the load. And so we've grown our team from one to 24 in the last two years or three years, I guess and we've been really pleased at how the clients and the staff members love it.
Christina Freeman:
We have some staff who still work in hospital that help us with chat, some on a part-time basis, so they're part-time remote, part-time in hospital. And now we have a lot of people who are fully remote. And it's helped with people whose life has changed or a medical condition has changed. And so we've really been able to keep our good people and keep their skills in this field through this.
Dr. Andy Roark:
I have to point out the elephant in the room here, at least what it is for me can. One, help me understand what chat looks like. I guess what I'm saying is, what are the most common things that people ask? And then two, the reason I'm asking this is, when you guys are talking about chat and you're very excited about it and you seem to really love it. I'm imagining complete pandemonium in chat of like your own social network and people talking about their grandkids and and like a Friendster network on my webpage. Conviince me of the return on an investment of chat.
Dr. Andy Roark:
You have 24 people doing chat. As a business owner, I'm like, that sounds like a nightmare. Convince me of the value of this. I'm trying to get my head around what this really means for the pet owner and what it means for you guys from an efficiency standpoint. It like more, not less and I want to get my head around that.
Summer Burke-Irmiter:
And actually before-
Dr. Andy Roark:
You're both laughing real hard as I say that. I think I'm probably having all of the anxiety and the nerves and the worries that you had at the beginning. I'm having this now of… But first of all, my first thought would be, what if this fails? And my second fear would be what if this succeeds? And I can panic in both directions. Talk me down off this ledge.
Summer Burke-Irmiter:
Well, actually I'm going to add to that ledge just a little bit.
Dr. Andy Roark:
Holy crap.
Summer Burke-Irmiter:
It's not to brag and just really show how big this can get. Christina and her remote team, since we started the live chat in 2018 have helped 60,000 clients. They've taken 60,000 chats. And now that's not the back and forth that you can have. That's not counting each one of those. That's a single session with a client. I'm going to add that mind-blowing right there.
Dr. Andy Roark:
I feel like you're helping people in Brazil. That's what I feel. I feel like there's people who've just found you and they're like, “These people will talk to me. If you're lonely and have a pet, they'll talk to you.” That's what I feel like. Is that true?
Christina Freeman:
There was a handful. I think the farthest I've ever spoken to someone was Singapore when IAMS Pet Food stopped creating their vet diets. It became like this frenzy of finding people with these products. That's as far as it's gone. but for the, I would say 97% is our actual clients. We are careful, we don't, we do. Every time we start a conversation, we get the pet details. We look up their record.
Dr. Andy Roark:
Smart.
Christina Freeman:
If they're not our clients, we do recommend that they speak to their local hospital, just so that history is with them. We're not trying to push people off, but we do feel like, don't talk for me for 30 minutes about diarrhea and then go to your hospital and expect them to know what we talked about. That is one thing that we are pretty careful about. And the great thing about the chat is every single thing we say, every single thing we share, we upload into the medical record, so when that pet does come in a couple days later or later that day, it's all there, that history's there. So they don't have to go back through that again, our medical staff can read through that.
Christina Freeman:
Just a short thing on the ledge, and I know Summer can, can help remove people from the ledge quickly, but what we've done with our team is allow the in-hospital team to focus on the pets that are in the building, rather than you're sitting there helping a pet and you've got four people waiting on the phone that have a question for a doctor. We're able to take that load from them so they can focus. And we can seamlessly help the client. The client has no clue in cases that we're not actually in the building.
Christina Freeman:
We stay in constant contact with our doctors who are on the floor, they're feeding us advice. And so we're able to take that load off of the team in the building who need to focus 100% on the pets.
Dr. Andy Roark:
Okay. No, that makes a ton of sense.
Summer Burke-Irmiter:
And you bring up a good point there, Christina is one of the reasons we started looking at this in 2018 is at that time, if we all can remember past then. I know it's been eons, seems like a decade, not just three years, we were already experiencing that short staffing with technicians in particular. With the high cost of living in the Bay Area was compounded, and Adobe had always offered medical advice to our clients. We're probably way more open than most hospitals about that client calls. We will talk to them through, make sure there's no contraindications. And then if it's that vomiting lab, we'll go ahead and give them a bland diet, what to look for and when to call back.
Summer Burke-Irmiter:
And we were looking at losing that. That was something that I felt was really important to Adobe. And by figuring this remote piece out, we were able to keep something that I thought was part of Adobe and part of Adobe soul and just move it out of house. And that worked out really well. And yeah, to talk you off the ledge there, Andy, there are some tips and tricks behind the scenes with these chat systems that really make it helpful. One of which is, and this is good for everybody to know, they can see what you're typing before you hit enter. Remember that.
Dr. Andy Roark:
Really?
Summer Burke-Irmiter:
So when you're about to be like [inaudible 00:21:10], and then you erase it, they saw it.
Christina Freeman:
They see all that.
Summer Burke-Irmiter:
You see all that. So when you can already see somebody typing out about the diarrhea, and then what you're doing is there's scripts that Adobe did, ourselves, but you can have a diarrhea script. So as soon as that client is done, you press enter on the diarrhea script and it's got all the questions we always ask. How is their eating? How often? What's the color? All of that. So then that gives you a minute to either work on another chat. Our chatters who are super experienced can take multiple at a time. You can't take multiple phone calls at a time per person, but you can with chats.
Summer Burke-Irmiter:
Or it gives you that moment to either take a breath or to do another task, which is a lot of what the remote operators they're doing. They're then working on something else while that person fills in their answers with the diarrhea. And you're already seeing again what they're doing. So if you're like, “Ooh, they just said blood.” You're going to be ready for that and you're going to get them in the hospital. Or, this is where Christina mentioned Dr. Lau. We have two remote doctors for video visits, which came in 2019. And those doctors also help the remote team with advice, questions of, “Hey, what should I recommend for this?”
Summer Burke-Irmiter:
Or if it's more specific, “This client is asking a medication question that their dog's currently on. Can you help us with this?” And so that's where behind the scenes, they'll also with that. There's a lot of tools behind the scenes to help out with those 60,000 chats that they've taken.
Dr. Andy Roark:
Okay. I have some questions. Let me start to dig into this. The idea of having some scripts makes total sense, and especially like follow up questions of when they talk about diarrhea, here are the follow-up questions. That makes my innovative efficiency smooth workflow heart so heavy. And so that totally makes sense. Okay. Talk to me a little bit about chats uploading into the medical records. That sounds like it could be a Herculean task. It also sounds like it could be turnkey smooth as silk. Which one is closer.
Christina Freeman:
You're in the middle. One of the things Summer and I have been talking about recently is there are some pain points in some of this because we're starting at the very beginning. But the great thing about it is the companies are really listening to us that we're working with. We are feeding them our problems and they're helping us solve them. So that has been great. It's been challenging to be in it, but it also, we are discovering the problems as we go that need fixing. And so the companies are super helpful to help us. We are transitioning with companies major that reason. Right now it is manual, we do copy and paste this into the record, and we're talking about six key strokes to get it in the record.
Christina Freeman:
But the company that we're talking with now is going to make that automatic. As soon as we finalize that chat, it's automatically fed into the record. This has been fun to be on the innovative front of like, “Okay, here's our problem. Help me solve it.” And so that's going to speed us up. Summer mentioned, part of the glory of chat is we can do multiple things at the same time and we can help clients at the same time. When you're speaking medically, and you're looking for medical records, and you're having to bring up the pet of, if you're a seasoned chatter, three is tops because you need to be focused and make sure, like three pets at a time.
Christina Freeman:
But as Summer said, you're stuck on the phone with one call, where with a chat. And also you don't get those visuals that we can get via chat. We can say, “Hey, could you go snap a picture of that?” The owner runs away and snaps a picture and comes back while we're helping another client, or we're picking up a phone call or we're answering an email. So there's a lot of other administrative things that we can do behind the scenes while all this is going on, while we're also helping pet owners via chat.
Dr. Andy Roark:
Cool. Who are the companies that you're working with on your chat?
Christina Freeman:
Well, we've been using live chat and we're transitioning to TeleVet. And TeleVet is a more veterinary-centered product that is helping us build the things we need and these automated things.
Dr. Andy Roark:
Hey, everybody, I just want to jump in here with a couple quick updates. If you're listening to this podcast and you're like, “Oh my gosh, vet clinics are doing stuff like this. This is amazing.” You should join Uncharted. The Uncharted Veterinary Conference and Community, that's where I met Summer and Christina, is where we learned about Adobe. This is the type of stuff that we talk about in there. Everything from open hospitals, where pat owners go wherever they want to virtual medicine, to work from home, to the classics about getting the staff to come together as a team.
Dr. Andy Roark:
Building culture, solving problems, growing people as leaders and communicators and visionaries. That's what we do in Uncharted. If you're like, “God, I want to live in this world. I want to practice medicine in this other way. I want to be the captain of my own ship.” Check out Uncharted. Guys, our April conference is coming up, April 21st through 23rd. If you've not been to an Uncharted conference, I promise you have not been to anything like this. We do choose your own adventure sessions where attendees make sessions on the first night that we then put on during the event, it is all networking focused.
Dr. Andy Roark:
You will make friends. You will talk to people who are doing incredible things. You will get re-inspired, you will get reinvigorated. You will learn techniques and tips and tricks and strategies for running a smoother, more efficient, more rewarding vet practice. That is what this conference is all about. The 21st to the 23rd, is in Greenville, South Carolina. I'll put a link in the show notes. You can become an Uncharted member. We have a vibrant online community. We talk constantly. It is not a thing where people get in there and it's a ghost town or where there's canned content.
Dr. Andy Roark:
We are constantly talking as a community about solving problems, about growing practices, about doing new and different things. About making our lives better and easier, about handling hard problems together as a group. That's what we do. So anyway, if you're not familiar, if you haven't tried out Uncharted and this episode is inspiring you, this is your call to action. This is what you need to do.
Dr. Andy Roark:
Gang, I also have to stop here real quick and just say, thanks again, to Banfield Pet Hospital. Through their help, we're able to have transcripts for episodes. And this is all about increasing accessibility, inclusivity in vet medicine, and making sure that everyone has access to the materials that we're putting out. We could not do this without them. They have supported The Cone of Shame and having transcripts and The Uncharted Veterinary Podcast, which is our other podcast. It's a business management podcast. But thanks to those guys for stepping up and leading the charge to make vet medicine more open and inclusive. They really are doing amazing things. Anyway, guys, that's all the announcements I got. Let's get back into this episode.
Dr. Andy Roark:
Talk to me a little bit about how the veterinarians support this. You've got veterinarians that do telehealth visits, and I want to put a pin in that and come back to that in a little bit. But let's just say that you have veterinarian behind the scene that is lending support. How do you back channel that? You've got someone and they're working remotely, I'm assuming, and then they're doing the chat, and then they're… How does that person feel supported and not feel like they're out by themselves? How are you handling that behind the scenes communication?
Christina Freeman:
It's been interesting. Being remote, we have built some closer relationships than we ever had in the hospital, which we… I've been working with Dr. Lau for three solid years all day, every day and I had never actually gotten to hug her until about six months ago. And we actually converged accidentally at the same time on a trip to California. She works and lives in Virginia and I work and live in North Carolina. We're close, but it just hadn't happened. But it is remarkable the trust that we've all built working together. We are in constant contact via… We use Google Hangouts a lot.
Christina Freeman:
We do a lot of remote training together with each other and with our new team members that we've grown so quickly where they are just on video all day with us, and they're just watching what we're doing or vice versa. We're watching what they're doing. So we are literally, virtually side-by-side all day, every day, which has been really good for team building and bonding and training. We've been really surprised at how the efficiency of our training through video. And it's also grown into like we're starting to train some in-hospital people through video because it is so efficient and we can be a little bit more open about times and hours and availability.
Dr. Andy Roark:
Let's let's follow that thread a little bit. So I said we were going to put a pin in the telemedicine doctor visit stuff. Let's follow the video path. So we've talked a lot about chat and then let's talk about how do you guys use video… I started off talking about the video client representative but let's go into the telemedicine part first, just walk me through your approach in video communication.
Christina Freeman:
A lot of our chats do generate into a video visit. So we're having a conversation with an owner and we're talking about new puppy owner. They've got a lot of puppy questions, but they also have got diarrhea going on at the same time. So pet stable, we've answered all the scary questions and everything's okay. So very natural progression to move into a video visit with one of our doctors. That lets the owner be at home, they don't have to come in, that lets the pet be at home, be comfortable. And we've seamlessly gone from the chat to now a video visit where they meet with the doctor. The doctor's able to see the pet and evaluate what's going on. Medication is needed or give a little bit deeper advice on how to get that pet back on track or what that puppy might be experiencing.
Christina Freeman:
Same thing on the senior side where owners contact us and they have a senior pet, got some concerns. We're able to move that into a video visit pretty seamlessly most of the time, same day. So it's very convenient for the pet owner, they don't have to leave the house. Sometimes we can go straight from a chat into a video visit if we have availability. Now that we have two doctors, that's quite often what we do. So a lot of our more, I don't want to say simple but more straightforward issues, that's how are born from chat into a video visit the natural progression.
Dr. Andy Roark:
Good. Talk to me about doctor scheduling for this. So again, I really appreciate you guys just letting me pick through this. So that's the other thing. People always say, “How do you have doctors…” I think that's a big hurdle for Telehealth is how do you make the doctor's schedules work? So do pet owners have the ability to make telehealth visits? And then also we flex chat appointments in to fill that schedule out. Is there a standby vet just support chat? Did that happen at the beginning? Or did you add in some Telehealth visits after you had built the chat up and you were having these conversations and you felt like, “Oh, now we've got enough of a caseload that would support this vet.”
Dr. Andy Roark:
Yeah. Share with me your thoughts on that because there's a lot of people who were like, “Oh man, we've been talking about Telehealth visits… I think for me, when I look at Telehealth, it makes sense if you can generate the volume. Because otherwise you've got that hanging out, not seeing appointments. And then if they go and start seeing appointments in the physical exam rooms and you say, “Well, how do we get them back out to be on time for these other things?” I think a lot of people are balancing these logistics and you've got this really neat outside around the way you have done this. And so yeah. Talk to me a little bit about doctor scheduling for these types of Telehealth appointments.
Summer Burke-Irmiter:
Okay. So yeah, with Dr Lau, who I have to give credit for, for finding our video visit platform. She found TeleVet and we originally thought we would go with a human-based video visit company because they were established, they had worked through the kinks. But it turned out that the human systems were super complicated and really didn't fit the veterinary world. So with TeleVet, the reason why we originally got excited about them is they had chat on their platform and we're like, “Okay, if we have chat and they have chat, this might work out well.”
Summer Burke-Irmiter:
And they were super responsive. What we didn't realize at the time is the reason they were responsive is they were I think a two and a half person company at the time. And it was the big male who was chatting with us. Straight awkward, but. But we loved the response, we loved how engaged they were, the platform fit well, and then as we onboarded and started getting used to it, they would make all these tweaks and changes that really fit us. And again, that's what called to my heart is we were making this fit for Adobe and that was really fantastic. So I'll stop there though and let Christina talk a little more about the scheduling and how the juggling that they do over there is amazing.
Christina Freeman:
Well, in the beginning it was just Dr. Lau and I, so we had luxury and the flexibility of being at home and so we worked when the demand was high. And so we were able to monitor the website and know when people came on the website and so when they came on, we made ourselves available and we were there to chat with them and help with them and I'd ping Dr. Lau and be like, “Hey, can you do a video visit?” And she's like, “Sure.” And scrambling together from whatever else she was doing. So we were very organic in the beginning in the fact that we just saw when our clients were needing us, and so that's what we did.
Christina Freeman:
As we grew, we needed more structure, we needed a life. We were available 24/7 in the beginning just to get this work in it had figured out. But then we really did discover the peak times that clients wanted and needed us. And so we built a Dr. Lau's schedule around that. And then as we added Dr. Nakamura as well, he balanced the other parts. So we do have a doctor available to our chatters and for video visits seven days a week between the two. And I guess truly what we did is we looked at the peak request times and managed our time from that. So if you want to get started small, totally able to do that, look at your clientele, look at when they're asking for things, just very generalizing. It's going to be early evening hours and sat morning hours when clients first get home from work and they discover there's a problem.
Christina Freeman:
So you get home from work at 5:30 and you're like, “Oh, my puppy has diarrhea.” Or you get home from work and you discover your senior has had some changes during the day that you need some advice. And so running some hours in the evening, two or three hours to fit in those requests between getting home and people going to bed. And then those Saturday mornings where you wake up and you're like, “Oh, I should have called the vet on Friday.” Everyone knows what calling a vet on Fridays is like, so that's the way we started in the beginning. But now as we've grown, we have the luxury of having 24/7 or 7-day a week help during our peak hours.
Dr. Andy Roark:
Gotcha. Okay.
Summer Burke-Irmiter:
And also, especially early on but they still do a ton now. There was a lot of duties that the in-hospital doctors were doing that remote is able to help with and Dr. Lau and Dr. Nakamura are able to help with. So they actually do a few things. They do a lot of the general refill requests, so that now goes on a live spreadsheet online that they can access so they can go through there, especially for doctors who are on vacation, who aren't going to be in for couple of days. So instead of the technician or the pharmacy tech having to go to that doctor at their desk and be like, “Hi, sorry, but you look at this heart garden prescription.” They actually do that first thing in the morning.
Summer Burke-Irmiter:
And so pharmacy gets in, they've got meds to fill or clients to immediately call back and say, “I'm so sorry, the doctor's really suggesting that we need to do this blood work first. We'll get you a couple days worth.” So they do a lot of that. They've also taken on a lot of doctor flow things in regards to, “You know what? It's that last day of your work week and you just did blood work on a patient. They need to be called the next day. It's not one that should wait until next week when you're back, the remote doctors will help with that.” And they also can help with bridging even if you have two doctors on a case, that's outpatient, then they can actually help bridge with some of those callbacks as well.
Summer Burke-Irmiter:
And so they've helped with a lot of in-hospital things. During COVID, we were doing our shelter in place here in the Bay Area. They also became what we call the COVID doctor would help with all kinds of things just because we did go curbside, which was a huge change for Adobe from open hospital. And so all that extra work, they really helped out a ton with that. So we did initially, they weren't booked with video visits all the time, they were helping with that. We've actually, over the last couple years had to reduce how much that they're doing of that admin work because they are getting busier and busier there.
Summer Burke-Irmiter:
And actually he's okay with me being pretty open about this. When COVID hit, Dr. Nakamura's immune compromised. He had to leave. And if we didn't have this option, he wouldn't been in the hospital for a year and a half. So we didn't lose the doctor, added a doctor. He sees exotics as well, and a lot of the husbandry for exams is really nice to do because you can see the tank, you can see what they're using, what they're set up is by using that video camera.
Dr. Andy Roark:
Yeah. So that makes a ton of sense. So we've talked about chat, we've talked about video consultations. What are some other jobs that you guys are doing now remotely at Adobe?
Summer Burke-Irmiter:
Yeah. I've actually got the list in front of me. Christina, do you want me to read it-
Christina Freeman:
Go for it.
Summer Burke-Irmiter:
… off real quick? Okay. So with our entire remote team, they do voicemails. So this is doctor voicemails transcribing them into an online live document. Doctors, go on and say, “I'll call this one, I'll just call this one back and do a recheck.” They'll then go ahead and call that client. They're doing our advice lines. So we do allow clients to still call in if they be to for medical advice and or triage. And so they're doing those advice lines, they're doing live chat, they're also looking and using TeleVet, especially for prepping clients for their video visits, things like that. They do pharmacy. We actually have a large pharmacy group now of pharmacy technicians who do all the admin work for on the floor pharmacy techs. Surgery, this is actually, I want to say something here. Surgery scheduling. Sorry.
Dr. Andy Roark:
Okay. Yeah. That's appears [crosstalk 00:41:50] like virtual surgery.
Christina Freeman:
Little robotic arm.
Dr. Andy Roark:
Yeah, exactly. We have a robot and they log in with a PlayStation controller.
Summer Burke-Irmiter:
Well, actually that's our next, that's where we're going to.
Dr. Andy Roark:
That's where we're going next. Yeah.
Christina Freeman:
We're headed there.
Summer Burke-Irmiter:
Is robot doctors. But until then. So surgery scheduling has been an issue in Adobe since I started 14 years ago. We've always had our surgery team on the floor who scheduled. And then we had one full-time scheduler in-house. Pre pandemic, it was sometimes embarrassing to admit this. It was up to 14 days before you might get a call back to schedule a surgery. And we were just so busy, the team was busy, our single scheduler was busy. And with all of our different doctors, it's not easy to schedule. And it's not because of the team. The team is just busy. And so we have now through a year long process, fully moved this over to remote.
Summer Burke-Irmiter:
We have a surgery scheduling team. They schedule all of our surgeries. We are within actually a couple of days of them. 100% taking it over after training and a prolonged period there, they got to same day callbacks within less than a week. So they now do same day call back for all of our surgery scheduling, take care of the entire process. We do now still have our surgery scheduler in-house when she came back from COVID and maternity leave. So get this, during a time when we're all short staffed and crazy, we were actually able to add a service. So be because this full-time scheduler is not doing any of the emails or voice messages that we're getting for surgery, she's able to go directly into the room. If somebody wants a schedule right now, she's in the room and she's scheduling it. So we have an in-house in-room scheduler because we have this team taking care of everything else.
Dr. Andy Roark:
Yeah. That's amazing. Let's go ahead and unpack here at the end where we started. Talk to me about the video client representative and how that works and how you rolled it out and what the reaction has been to you having virtual CSRs, actually working with clients who were in the building.
Summer Burke-Irmiter:
Yeah, I think it's probably the craziest idea my team has let me do.
Dr. Andy Roark:
I saw photos and I was like, “This is bonkers.”
Summer Burke-Irmiter:
Yeah. When I brought it up, I think they all thought it was crazy. You could have beat it, Christina.
Christina Freeman:
Nope, totally on, totally on. It was born out of true necessity. We just didn't have enough people in the hospital to cover the front desk. And so, someone and I were talking one day and we're like, “Why don't we just turn one of those screens at the front desk around and put me on it?” And that's what we did. And we tried it out. And so it grew into… It started out with we wanted to do in-room checkouts. So each room has a computer, the doctors use to access the medical records. And so we just hijacked that computer and added a camera on. And so that was where we wanted to start, but it grew into the whole process being a virtual. So each exam room, we just added a camera to the screen. So super easy and take a lot of extra tech to do.
Christina Freeman:
And so now when you're finished with your visit, one of us pop on the screen and we are able to talk about your private address and getting all of your personal information correct in the system, your phone number, your email address, things that people don't like shouting out in the lobby. So we're able to go over that. We're able to talk about the finances, which is not great to talk about in the lobby. You're able to stay in the room with your pet, you don't have to juggle the leash. You're able to pay. We have TeleVet that we work with got really excited when we wanted to do this and so they've helped us build this process but we have credit card terminals in the rooms. And so you're able to pay.
Christina Freeman:
So the checkout process has been a real value add to the client. Clients are thrilled, they enjoy it. They're like, “Oh, this is so nice.” And we've seen adoption. I have not run into someone yet and we've been doing it since November, that's been displeased with that. So that has been nice. Now the front desk video screen is a little bit harder to sell because people are used to having a person up there, but it works. And we are able to do everything via this screen that we would do in person, the only thing Summer and I teased about, but she solved that problem too. I was like, “Well, we can do everything except clean up the pee in the lobby.” And Summer's like, “Oh, there's robotic-
Summer Burke-Irmiter:
Roomba.
Christina Freeman:
… Roomba.
Dr. Andy Roark:
Like a Roomba. Yeah. With a wet-
Christina Freeman:
A mop.
Summer Burke-Irmiter:
Right.
Dr. Andy Roark:
A wet mop Roomba.
Christina Freeman:
So if there's a problem, we keep figuring it out. But so when clients come into the hospital, there is a monitor there on the front desk with signage that says, “Check in here.” And it's cute. Clients smile and also they recognize us. So a lot of us used to work in the hospital, or all of us right now used to work in the hospital. So they're seeing familiar faces, they're hearing familiar voices and they're like, “Oh, I missed you. How are you?” And so we're able to keep connecting with our clients.
Christina Freeman:
And so it doesn't… I think Summer and I both had the worry that the monitor on the front desk would feel a bit impersonal. We've actually found this the opposite. We're chatting of, they're holding up their little pets, we're chatting with the dogs as well and so we've been pleased with the adoption. And also with COVID, it's been a safety measure as well, a surprising safety measure. We're able to speak to them without a mask, they're able to hear us because we're remote. And so that's helped with this process.
Dr. Andy Roark:
Yeah. I imagine it's like self checkout at the grocery store. If there's a cashier standing there, I'm going to that person. But as soon as there's two people in line, totally self checking out.
Christina Freeman:
But imagine that self checkout with a human talking to, because that's the problem, you get your broccoli and you don't have your code number and you're like, “Ah.” But you've got a human there to help you with your broccoli. So we are-
Dr. Andy Roark:
Well, I know it. That's it, they can recommend ice cream flavors. All right guys, where can people learn more about Adobe and your amazing hospital?
Summer Burke-Irmiter:
Yeah. So few different areas. You're welcome to come our website, adobe-animal.com. And you'll probably see our chatters on there. If they are busy, they'll ask you to leave a message that they will respond to. And so that's the other thing with chat is you don't have to take them live by That moment if things are busy. And then also I think we sent over some picture.
Dr. Andy Roark:
Yes.
Summer Burke-Irmiter:
You guys, and so you can check out some pictures. Because I know initially when we talk about VCR, it can seem like this big wild concept. Once you see how simple it is. I feel like it's the post-it note for veterinary hospitals right now. Everybody in a year or two is going to be like, “Oh yeah, VCR, whatever. We're all doing it.” Because it's so easy. But right now it can be hard to conceptualize and so check out those videos where you'll see Christina and her backdrop in her home. Yep. With our lovely vinyl background, that's the background of our reception areas, and fools a lot of clients. And then you'll also see though pictures of her on the monitor around the hospital, checking people in.
Dr. Andy Roark:
That's awesome. So I'll probably put a link to our blog post about the episode and then I'll put the photos in there for sure. Also guys, we are posting podcast episodes as YouTube videos. And so we're going to drop them in there as well if you guys like your podcast as YouTube videos, you got to see photos there. Last question, Christina. I have thought the whole time that you were in some remote location because there's an Adobe Animal Hospital, big logo on the wall behind you, and that's your house?
Christina Freeman:
Yes. This is my house [crosstalk 00:50:52] here in North-
Dr. Andy Roark:
What does your family think about the fact that you have a work logo? Your husband was like, “What the heck is this?”
Christina Freeman:
Honestly, they love it. It's been a very exciting crazy journey which is my life is, but one of the great things is I'm here. I have three children, they know exactly what I do. They see it, they hear it. Sometimes they're… Actually, my five-year-old got a pencil from the pencil box while we were talking. But so that's been a great thing for myself and my family. If your kid grow up and don't know what you do, but they know exactly what I do. And it's cute because in the background, they'll be like, “Shh, mommy's helping a pet with diarrhea.” And they've learned so much too. They're like, “Are you going to tell them about the bland diet?”
Dr. Andy Roark:
Yeah. I could totally see that. I would be getting advice from my kids in no time. And they would be like, “Dad don't forget.”
Christina Freeman:
Yeah. Oh yeah, they keep me on track too. So live chat has little auditory cues when you have an incoming chat. And so it says in a British accent, “Incoming chat.” Now guys. Nope, nope, Nope. [crosstalk 00:52:05]
Dr. Andy Roark:
Now they're making appear on camera. Okay. All right. The wheels are coming off here. Yeah. I know how that goes. That's-
Christina Freeman:
Hi, darlings, now you heard what I said, y'all have to go downstairs.
Dr. Andy Roark:
That's me. That's my life all day, every day. I love it. It's so true.
Christina Freeman:
They heard me. I'm sure they were downstairs like, “What's she saying?”
Dr. Andy Roark:
[crosstalk 00:52:24] She's talking about us let's go.
Christina Freeman:
Like, “It's her chance roll the ball.” But they made up Carol of the bell at Christmas, incoming chat, incoming chat. So they'll run behind me and sing that and freak me out. Because I'm like, “Where?” Because once you've been chatting forever, you know the words incoming chat, [crosstalk 00:52:47]
Dr. Andy Roark:
Where you're here and just-
Christina Freeman:
Exactly. Start to salivate, so.
Dr. Andy Roark:
All right.
Christina Freeman:
They love to sneak up behind me and go, “Incoming chat.”
Dr. Andy Roark:
Oh, so cruel. I love it. All right guys, thanks for being here. Guys, thanks for listening to the podcast. I'll talk to everybody next week.
Stephanie Goss: Thanks for listening to podcast I'll talk to everybody next week. Hey, if you loved this episode and you want to hang out more with Summer and Christina you can you can hang out with them at ‘Get Shit Done' that's right, ‘Get Shit Done' is happening in October. It is October 6th through the 8th come join Christina and Summer and I AND Andy AND everybody in the Uncharted community from the comfort of your couch or your bed or your front porch because ‘Get Shit Done' is virtual. That's right! You do you and come hang out with us and talk about how do we get stuff done, particularly how do we get stuff done shorthanded. I think talking about virtual csrs is exactly a step in that direction and I'm super pumped for that workshop and more you can head on over to the website at unchartedvet.com to find out registration information, can't wait to see you there.
Stephanie Goss: And, we have to just say thanks to a generous gift from our friends at Banfield Pet Hospital we are now able to provide transcripts for all of our podcast episodes. Our friends at Banfield stepped up in a big way and said, “hey we are striving to increase accessibility and inclusivity across the profession”. To check out the transcript and find out more about what Banfield is doing to increase accessibility and inclusivity across the vet profession head over to unchartedvet.com forward slash blog and you can find each one of the podcast episodes and a link to find out more about equity inclusion and diversity at Banfield take care everybody.
