Stop Sending Reminders. Start Preparing Patients.

A Step-by-Step Guide to Pre-Visit Communication That Actually Works

Most healthcare practices send appointment reminders. What they are not sending is preparation. In this solo how-to episode, Melissa Gilkes-Smith walks through all twelve steps of building a pre-visit communication system that actually reduces patient anxiety, improves check-in flow, and demonstrates a Culture of Care before the patient ever walks through the door. This is an interactive working session; download the Pre-Visit Communication Workbook from the show notes and work through each step in real time.

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Pre-Visit Communication Workbook  

PX360 Assessment 

Transcript

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Here is a scenario I want you to sit with for a moment. A patient schedules an appointment, they hang up the phone, and then they start to wonder, what do I need to bring? Where do I park? Do I need to fast? Should I complete forms ahead of time? How long is this going to take? Some of them will call back and ask, most of them won't. They will show up uncertain, unprepared, sometimes late, sometimes missing documents your staff will spend the first 10 minutes of the visit trying to track down. That gap between the scheduling call and the moment they walk through your door is where the pre-visit communication touch point lives. And most practices are leaving it almost entirely unmanaged. Today we're going to fix that together in real time. This episode is different from most. I'm going to ask you to pause, to pull out a pen, to answer some honest questions about what your pre-visit communication is currently doing and what it needs to start doing. Before we begin, I want you to go to the show notes and download the pre-visit communication workbook. You'll need it. Ready? Let's get to work. I'm Melissa Jilk-Smith, and today I'm your guide through one of the most underused touch points in the nine pillars of patient experience framework. Pillar three, previsit communication. Here is what I want you to understand before we get into the steps. Pre-visit communication is not a reminder system. A reminder tells the patient you have an appointment. Pre-visit communication prepares the patient for the experience. Those are two completely different things, and the gap between them is where patient anxiety lives, where no shows are born, and where check-in friction begins. Today I'm going to walk you through 12 steps drawn from my blog on this topic and from years of patient experience consulting work. At each major step, I'm going to ask you to pause the episode and do the work. This is not passive listening. This is a working session. If you have the workbook open, turn to the first section. If you don't have it yet, pause now and grab it from the show notes. I'll wait. Good. Let's start from the beginning. Step one, stop treating pre-visit communication as a reminder. Before we build anything, I want you to look at what you have right now. Pull up your current appointment reminder, that one that goes out automatically after a patient schedules. Read it, really read it. Ask yourself these five questions. I'll read them slowly. One, does this message only confirm the appointment? Two, does it help the patient prepare for the visit? Three, does it answer the most common questions patients ask before they arrive? Four, does it reduce friction for your check-in team? And then five, does it support the clinical team by improving patient preparedness? If your current reminder says something like, your appointment is tomorrow at 10 a.m. with Dr. Smith and not much else, it's not doing enough. It's confirming, it's not preparing. A reminder tells the patient you have an appointment. Preparation tells the patient, here's what I need you to know so this visit goes smoothly. Here's our first pause point. Take out your current appointment reminder. Write down the three most important things it is missing. What questions are patients asking your front desk that this message should have already answered? That list you made, that is the foundation of everything we're building today. Step two, build pre-visit messages by appointment type. The single most common pre-visit communication mistake is sending the same message to every patient regardless of why they're coming in. A new patient visit is not the same as an established patient follow-up. A procedure appointment is not the same as a telehealth visit. A visit requiring fasting is not the same as a routine annual exam. When you use generic reminder for every appointment type, you create one of two problems. Patients receive information they don't need, or they don't receive information that is critical. At a minimum, I want you to think about seven categories of appointment types that likely need their own communication template. New patient visits, established patient follow-ups, annual or preventative visits, procedure visits, testing or imaging appointments, specialist consultations, and telehealth visits. Each of those categories has a different information need. A new patient needs forms, insurance information, medical history, medication lists, and arrival instruction. A procedure patient needs preparation steps, medication guidance, fasting requirements, and postprocedure expectations. A telehealth patient needs login links, technology instructions, and a backup plan if the connection fails. Here's your pause point. On your workbook under step two, list all of the appointment types your practice schedules. Then place a check mark next to each one that currently has its own customized communication template. Circle the ones that don't. Those circles are your gap. Most practices I work with have one or two templates at most. By the end of today, you'll know exactly what you need to build. Step three, tell patients what to bring. One of the most preventable check-in delays in healthcare happens to be a patient arrives without the documents or information they need. And in most every case, no one told them clearly enough what to bring. I want you to think about this from the front desk perspective. When a patient arrives missing something critical, their insurance card, a referral, prior test results, a medication list, your staff has to stop, problem solve, and either slow down the entire check-in process or delay the clinical encounter. That is operational friction that lands directly on your team and the patient. The fix is simple and specific. Every pre-visit message should include a clear list of what the patient needs to bring, not please bring all applicable documentation. That means nothing. Specific, readable, direct. Instead, please bring your photo ID, insurance card, current medication list, and any recent test results related to your visit. If you want patients to follow instructions, give them instructions they can follow. Pause point. On your workbook under step three, write the bring list for each of your top three appointment types. What does a new patient need to bring? What does a procedure patient need? What does a specialist referral patient need? Write the actual words that you would put into the message. It means your internal process for what is required may not be fully defined yet. That's worth knowing. Here's step four. Explain how to prepare. Some appointments require preparation. And when that preparation is missed, the consequences are not just inconvenient, they can be clinical. A patient who is supposed to fast and didn't may have a test that cannot be used. A patient who is supposed to stop the medication and didn't may need their procedure postponed. A patient who is supposed to complete forms ahead of time and didn't creates a bottleneck at check-in. These breakdowns are frustrating because most of them are preventable, and they are preventable through communication. The key word here is clarity. Vague instructions produce vague compliance. Follow preparation instructions before your appointment is not an instruction. It's a placeholder. Clear looks like this. Please do not eat or drink anything after midnight unless otherwise instructed. If you take daily medications, call our office at this number to confirm whether you should take them before your visit. That is specific, that is actionable, that is what patients can follow. Pause point. On your workbook under step four, identify which of your appointment types require special preparation. Fasting, medication adjustments, clothing, transportation, forms, anything else. For each one, write two sentences of clear preparation instructions the way they should appear in the patient message. Not clinical language, patient language. Read what you wrote out loud. Would a nervous patient understand it? If you hesitate at all, rewrite it. Step five, tell patients what to expect. This is one of the most powerful and most overlooked elements of pre-visit communication. Patients often arrive with anxiety because they don't know what's going to happen when they get there. They don't know whether they will see a nurse first, they don't know how long the visit will take, they don't know whether they will leave with the results or have to wait, they don't know whether a physical exam is part of the plan. And when expectations are unclear, patients feel out of control. A brief what to expect section in your pre-visit communication is one of the simplest, highest impact additions you can make. It doesn't need to be long, it needs to be clear. For a new patient, during your visit, you will check in at the front desk, meet with the member of the care team, review your health history, and then sue the provider. Your visit is expected to last approximately 45 to 60 minutes. For a follow-up, your provider will review your progress, discuss any recent results, and determine next steps in your care plan. Procedures. Your visit will include check-in, preparation by the care team, the procedure, and postprocedure instructions before you leave. That's it. Three to five sentences, and it eliminates a significant source of patient anxiety. So here's the pause point. On your workbook under step five, write a what to expect paragraph for your top two appointment types. Keep each one under five sentences. Use plain language. Write it in the way that you would expect to explain it to a patient on the phone. Step six, include parking, entrance, and wayfinding instructions. If you listen to our episode on arrival and wayfinding design, you already know that the patient experience begins in the parking lot, not at the front desk, in the parking lot. GPS will get a patient to your address, not to the right garage, the right entrance, the right floor, or the right suite. And a patient who spends 10 minutes lost in a medical complex before they even get to you has already had a bad experience before anyone on your team has said a single word. Your pre-visit communication should include arrival instructions that are specific enough to eliminate confusion. For a standalone practice, the parking lot location, the main entrance, accessible parking, and any landmark that helps identify the building. For a practice inside a larger medical building, the building name, the parking lot or garage, the best entrance to use, the floor, the suite number, and a landmark inside the building. For example, our office is located in the North Medical Building, Suite 420. Please park in Garage B and enter through the main lobby. Take the elevators to the fourth floor and turn left. Our suite will be on your right. That kind of specificity prevents avoidable stress. And it saves your front desk from fielding the I can't find you calls. Pause point. On your workbook under step six, write out the arrival instructions for your practice the way they should appear in a patient message. Be as specific as a first-time visitor needs. Then ask yourself, if a patient followed only the instructions and nothing else, would they find you without confusion? Step seven, make forms easy to complete before arrival. Forms are one of the most consistent sources of check-in friction in healthcare. And most of that friction is entirely preventable. The problem is rarely that patients refuse to complete forms. The problem is that the process is unclear. Patients don't know which forms are required. They don't know how they will receive them. They don't know when to complete them. They don't know what to do if they can't access them online. And so they show up and complete them in the waiting room, which slows everything down. Your pre-visit communication should tell patients exactly what to expect with your forms, which forms are required, how they will receive them, when they should complete them, what to do if they cannot access them online, whether they can complete the forms in person, and how early to arrive if forms are not done ahead of time. For example, you will receive a link to complete your new patient forms before your appointment. Please complete them at least 24 hours before your visit. If you are unable to complete the forms online, please arrive 20 minutes early so we can assist you. That message does two things. It sets an expectation and it gives the patient a path forward if the primary option doesn't work. Both matter. Pause point. On your workbook under step seven, write out your form instructions the way they should appear in a patient message. Include the what, the when, the how, and the fallback option. If you currently have no clear process for forms, note that too. It means the operational process needs to be defined before the communication can be written. On to step eight, confirm communication preferences. Here's something that gets overlooked in almost every pre-visit communication audit I've done. Sending a message is not the same as communicating. Sending a portal message to a patient who never logs into the portal is not communication, it's documentation. Your pre-visit communication is only effective if the patient actually receives it, understands it, and can act on it. And that means knowing how your patients prefer to receive information and using that method consistently. Some patients prefer text, some prefer email, some need a phone call, some don't use patient portals, and some need language support. Some have a caregiver who should be included, some have accessibility needs that affect how information should be delivered. The fix starts at scheduling. Ask patients their preferred communication method when they book the appointment. Then use that information every time. Here's your pause point for step eight. In your workbook, under step eight, answer this. Does your practice currently ask patients how they prefer to receive appointment-related communication? If yes, how consistently is that preference honored across your team? If no, write down exactly where in the scheduling workflow you would add that question. This step is about making sure the right information reaches the right person in the right way. Everything else we've built today depends on it. Step nine, internal communication. We've been talking about what you communicate to patients. Now I want to talk about what you communicate internally. Because a patient can do everything right and still have a poor experience if the organization is not ready for them. Missing records, incomplete referrals, unverified insurance, appointment type errors, forms that were completed but not reviewed? This is internal disorganization that the patient experiences at poor care coordination. And it happens more than any of us want to admit. Before every visit, someone should confirm, is the appointment type correct? Is the required referral on file? Has the insurance been verified? Are the forms complete? Have outside records been received? Are labs or imaging available? Are there any special needs documented? Does the provider have everything they need? This does not need to be a complex process. It needs to be a consistent one. It needs ownership. Here's your step nine pause point. On your workbook, write down who currently owns pre-visit preparation in your practice. Not the task, the person. If the answer is it depends, or no one specifically, that is your answer. Write that down too. A process without an owner is a process that runs on luck. Step 10. Use pre visit communication to reduce no shows in late arrivals. No shows in late arrivals are not always a patient behavior problem. Sometimes there are communication. Communication problem. Patients forget, patients get confused about dates and times, patients cannot find the location, patients don't know how to cancel, patients are anxious and avoid the visit, and some of those outcomes are within our control to prevent through well-timed, well-worded communication. The research and the practice are consistent on timing, a confirmation at scheduling, a reminder 72 hours before the appointment, a reminder 24 hours before, and for some appointment types, a same-day check-in message. Each of these touch points should do more than confirm the time. The 72-hour reminder is a preparation reminder. The 24-hour reminder reinforces what to bring and when to arrive. It keeps the visit top of mind without being intrusive. And make cancellation easy and clear. A patient who wants to cancel but doesn't know how becomes a no-show. That is a fixable problem. Step 10 pause point. In your workbook, map your current reminder sequence. How many touches do you currently send? At what intervals? Does each message do more than confirm the time? Write down the one change to your reminder sequence that would have the biggest impact on no shows or late arrivals in your practice. Step eleven, measure the effectiveness of pre-visit communication. You cannot improve what you are not measuring. And most practices measure appointment volume, wait times, and patient satisfaction scores, but not previsit communication effectiveness specifically. Here is the question you should be answering. Are patients arriving prepared? The indicators are there if you look for them. No show rates, late arrival rates, percentage of forms completed before arrival, how many patients arrive are missing required documents, how many patients call asking for directions, how many visits are delayed because of preparation issues. Staff feedback on recurring questions and problems they see at the check-in every single day. They know exactly where the pre-visit communication is failing because they spend their mornings fixing the gap it leaves. If patients are consistently showing up at the wrong entrance, the problem is not the patient, the problem is arrival instructions. If patients are consistently missing forms, the problem is not the patient, the problem is the form process communication. The data tells you where the experience is breaking down, but only if you're collecting it. Step 11 pause point. In your workbook, write down three metrics you could begin tracking that would tell you whether your pre-visit communication is working. Be specific, not patient satisfaction. But what specific observable thing would tell you that patients are arriving more prepared than they were three months ago. Here's the last step. Connect pre-visit communication to your culture of care. We've spent this episode building a system, but I want to close with the reason the system matters. Because systems without purpose become compliance exercises. And compliance is not where we're going for here. Pre-visit communication done well is one of the clearest expressions of a culture of care before the patient ever arrives. Accountability shows up when you set clear expectations and consistently follow through on them. Every message you send is commitment. Compassion shows up when you recognize that patients may be anxious, uncertain, or overwhelmed before a visit. And you design your communication to reduce that, not add to it. Collaboration shows up when you help patients participate in their own care through preparation and understanding. You are not doing the visit to them. You are doing it with them. And that starts before they arrive. Empathy shows up when you anticipate the questions patients have before they have to ask them. When your communication says, we thought about what you need before you got here, that matters more than practices realize. Here is what I want you to take away from today. Pre-visit communication is not a reminder system. It is a preparation system. And when it is built with intention, with specific messages, clear instructions, the right timing, and a genuine commitment to the patient's experience, it changes how patients feel about your practice before they ever walk through the door. Patients should not have to guess what to bring, where to go, how to prepare, or what to expect. Your communication guide should guide them, and that guidance is a moment that matters. Before I let you go, look at your workbook. You have now done 12 assessments of your current pre-visit communication process. You know where your gaps are, you have draft language for your messages, you have identified who owns the internal preparation process and what you need to measure. That's not listening to a podcast, that is doing the work. Here's your next step. In the next seven days, I want you to rewrite one pre-visit message, just one. Pick the appointment type you schedule most often and build a communication that actually prepares the patient instead of just confirming the time. Use everything from today. And if you want to go deeper, take the PX360 assessment to see how your pre-visit communication fits into the full patient journey across all nine pillars. The link is in the show notes. Every interaction is a moment that matters. I'm Melissa Jilk Smith, and this is Touchpoints. If this conversation moved you, subscribe wherever you listen and connect with me on LinkedIn. I'll see you at the next TouchPoint.