City Clinic

www.cityclinic.com.au

Executive Summary

City Clinic was established in 1998 as a fully serviced multidisciplinary injury and health management centre.  The company provides fully equipped and managed offices for health professionals within the Sydney CBD area.  Based in Sydney, New South Wales, City Clinic employs six full time staff and 20 subcontracting health professionals.

From the company's outset, CEO Brad Robinson viewed e-commerce as an ideal method for improving traditional front-end business processes. Using the Internet, Brad aimed to streamline front desk tasks through the automation of bookings, patient communication and customer relationship management (CRM).

Utilising CRM software, City Clinic have automated many of their front desk processes such as scheduling, patient records management, billing, patient correspondence, management reporting and debtor management.  Practitioners can now focus on treating patients and staff can spend more time on revenue generating tasks.

Additional revenue generated through City Clinic's online booking and CRM system amounted to $580,000 in 2001 through the expansion of its practitioner base and efficient processing of patients.  The company's e-commerce initiative contributed an additional $232,000 to gross profit in addition to cost savings of $132,600.

City Clinic's e-commerce initiative is an ongoing project with continual development and expansion.  In particular, Brad would like to increase the size of the exercise and injury library (an electronic library containing lists, examples, explanations and diagrams of injury conditions and remedial exercises for patients) and be able to send these items directly to appropriate patients to further develop the CRM focus.

The Business

City Clinic was established in 1998 as a fully serviced multidisciplinary injury and health management centre.  The company provides fully equipped and managed offices for health professionals within the Sydney CBD area.  Services provided include administration and office management, fully equipped treatment facilities and marketing services for health providers.

Based in Sydney, New South Wales, City Clinic employs six full time staff and 20 subcontracting health professionals.

Getting Started

From the outset, CEO Brad Robinson viewed e-commerce as an ideal method for improving traditional front-end business processes.  Using the Internet, Brad aimed to streamline front desk processes through the automation of bookings, patient communication and customer relationship management.

Brad directs the company's e-commerce strategies himself, incorporating suggestions from the practitioners to develop solutions.

Customer Relationship Management

Customer Relationship Management (CRM) refers to the way in which a company manages its information and processes in order to offer enhanced customer service.  A key aspect of CRM is gathering customer data in order to strategically align products and services with customer needs.

City Clinic maintains a CRM database used to automate the procedures associated with a patient consultation, from initial appointment to follow-up consultations.  New and recurring patients can make appointments with City Clinic practitioners directly from the Internet.

When appointments are made (either through a receptionist or electronically), the messaging functions within the smartAPPOiNT™ software send confirmation emails to both practitioners and patients.   Both parties are then able to update their electronic calendars with the email information.  Practitioners are able to access their appointment schedules on the Internet through a traditional connection or by using their PDAs (Personal Digital Assistant) and mobile phone to connect on the move.  Patients also receive SMS (mobile phone Short Message Service) messages as reminders for their appointment.

When a new patient visits the website to make an appointment, the system asks the patient to complete a registration process.  A confirmation email containing a specific logon password is then sent to the patient.  These details are automatically entered into the CRM database allowing staff to view patient details when they present their credit card and health care card for payment.

Upon payment for the consultation, the system asks the assistant to schedule the next appointment and print a payment receipt.  The receipt details the next appointment and the system automatically sets an SMS appointment reminder in place to contact the patient prior to their next appointment.

Current e-commerce strategy

In addition to making appointments, the company website can be used by registered patients to view their upcoming appointments, available appointment times, and information on the company.

Patient education is also facilitated via the website with interactive injury management information on the website.  Patients can view several levels of information including diagrams of the injury process, therapeutic processes and treatment options.  Pathology is also available for viewing. 

All of City Clinic's administrative functions are performed electronically.  These include online banking, supplier payments and online processing of health funds using the National Australia Bank HICAPS system.  For example, when a patient payment is received after a consultation, the patient's records and City Clinic's bank account are automatically updated.  Simultaneously, the patient's health fund details are uploaded to the health fund, which then credits City Clinic's account.

City Clinic uses an inventory management program to electronically manage some inventory such as physiotherapy tape, oils and bandages.  As levels fall below a certain threshold more stock is automatically ordered from the supplier.

Most of the company's equipment is sourced over the Internet and some of the payment and financing schedules are also managed electronically.  Debtor management is outsourced to an external debt collection agency.  Every three to six months the agency is electronically forwarded the account details, and outstanding accounts are chased electronically - electronic logs and email communication.

Revenue and Costs

* Note: Capital Expenditure was amortised over a four-year period

Financial Analysis

Additional revenue generated through City Clinic's online booking and CRM system amounted to $580,000 in 2001 through the expansion of its practitioner base and efficient processing of patients.  The company's e-commerce initiative contributed an additional $232,000 to gross profit in addition to cost savings of $132,600.

The automation of processing has increased staff efficiency with savings of $60,000 with a further $4,000 saved due to reductions in administrative errors.  Through the use of email, significant savings of $40,000 were made in the time taken to communicate with patients, practitioners and suppliers.  City Clinic's CRM implementation has streamlined after sales service processes saving $10,000.  A travel expenditure saving of $2,400 resulted with four fewer trips required annually at $600 each.

Online banking and automated health care card processing decreased bank charges by $3,000 and improved staff productivity, saving $5,000.  Other administrative costs reduced through online processing and electronic documentation were in photocopying ($5,000), printing ($2,000), and stationery ($1,200).

The initial investment in e-commerce totalled $162,450.  A major portion of this was invested in website development ($130,000) as this is the primary point for patient interaction.  Brad spent $5,000 in time researching potential IT solutions before recruiting external consultants to implement the solution and a further $12,000 advertising on YellowPages Online.  Five domain names ($950) were also registered to enhance the company's presence on the Internet.  One domain name was also purchased at an online auction.

Additional hardware infrastructure required to implement the e-commerce solution consisted of a backup server ($2,300) and tapes ($1,500), two printers at $1,600 each, and a firewall ($2,300) to protect internal network data.  City Clinic's Asymmetric Digital Subscriber Line (ADSL) broadband Internet connection required a $2,700 setup investment for cabling and hardware.

Total ongoing costs associated with the e-commerce implementation in 2001 were $145,263.  System administration costs are $50,000 annually and software expenditure is $700 plus annual licence fees of $4,500.  Website hosting is $4,800 per annum and ADSL Internet connection is $3,600 per annum.  With an ongoing system development strategy, City Clinic recruited IT specialist staff as an alternative to expensive external IT consultants, costing $40,000 annually.  Capital expenditure is amortised over a four-year period at $40,613.

Non-financial Benefits

City Clinic's innovative solution has generated benefits for practitioners, patients and staff.  Referring doctors, practitioners and patients alike all have the convenience to access their City Clinic schedule via the Internet.   Patient service is enhanced with alternative and automated communication methods including email confirmation, SMS messaging and collaboration with existing electronic diaries.

The HICAPS system has also streamlined the private health care claim process as the patient no longer has to pay for the full consultation and then lodge a claim at their health fund branch.  They can simply claim the benefit and settle the account by paying the gap amount after receiving their treatment.

Challenges

The main hurdle encountered by Brad was the significant costs associated with the initial set up and continuing development.   Initially, financing was arranged to ensure a high quality solution could be implemented.  Costs have been further reduced by the employment of a full time IT consultant to bring website maintenance and development in-house.

Brad attributes the excellent results of the implementation to the collective desire and commitment to success of City Clinic staff and practitioners.  He advises companies embarking on e-commerce solutions to create a business plan for the project, noting the goals the company wants to achieve and to be flexible on desired outcomes.

Future

City Clinic's e-commerce initiative is an ongoing project with continual development and expansion.  In particular, Brad would like to increase the size of the exercise library and be able to send these directly to appropriate patients.  Future development of the website will enable practitioners, referrers and patients to access the front desk remotely to manage appointments.  This functionality will also allow practitioners and referring doctors to review patient notes in a limited form.