How To Easily Track KPIs For Your Practice

Uriah
Hello, Tory. Welcome to the podcast.

Tory
Hi, Uriah. Thank you so much for having me.

Uriah
Yes. It's so fun to be able to chat with you officially on the record about all the things that we're mutually interested in. Yes.

Tory
Totally. I've been listening to your podcast for a long time, so totally psyched to be here today.

Uriah
That's fantastic. People won't be able to see this, but I am, in fact, wearing a Practice Vital T-shirt. I am representing... No sponsorship, no affiliate links here, I don't I think, but I am representing Practice Vital, so that's pretty cool.

Tory
Yeah, you've been a great fan, a good loyal fan. Thank you.

Uriah
That's awesome. For folks who don't know about you and Practice Vital, it'd be awesome just to share a little bit about your story and how you came up with the idea and what it is.

Tory
Yeah, for sure. I am a practice owner and a therapist, and I've been a practice owner for the past 10 years. Really, Practice Vital, first of all, it's an automated dashboard. The only automated dashboard that exists at this time. It was born out of my own pain points as a practice owner. I had three kids in five years and was on maternity leave and consistently working from the hospital. I have a child, and then I'd have my laptop right afterwards. I think the third time, I just realized my practice can't run without me very well. I had hired a few new people and just felt like, I don't have a good of what's going on. Had I had Practice Vital at that time, I think I could have just breathed a sigh of relief or known exactly what needed to change, but I didn't. I had nothing that showed me any data besides a few spreadsheets which were optionally kept up to date. I was hearing about people talking about dashboards all the time. It was just people would talk about them in Facebook communities, and I was like, What is this? How do I get It seemed like you could go to a really expensive training and maybe they would set one up for you or give you some version of one, but that just isn't what I was looking for. I enlisted my husband. He was a consultant for many years and in technology. I asked him to build a dashboard for me, whatever that meant. We started working on it together, and I said, A big part of this isn't for me to just have the data. I want my therapist to have the data. I want them to know how they're doing. It's empowering, and so we're all on the same page and have joint accountability for what's happening at the practice. We said, Well, then we need to probably set up some Looker studio where they can see it. Some people have versions of that. We got started with it. Over dinner one night, we had his cousin over for dinner and her husband, and started telling them about this idea. They've always been entrepreneurial and excited about different ideas that we've had. They just said, Let's get How did you get started on this. This sounds like a really fun project. Just to work on it for my practice. Tom, who is our software engineer, went to MIT. Very impressive software engineer. He got to work and started building something that was beyond my wildest dreams of what this could look like. The four of us, my husband, me, his cousin, and his cousin's husband. It's always like, who are we all to each other? But we're very close. We live nearby, and we all do it full-time now. It's been a remarkable journey. We only started last October, but we are displaying all of the metrics and key performance indicators that people haven't had access to before or haven't been tracking consistently or certainly haven't had in an automated way.

Uriah
That's amazing. Two thoughts. Number one, it's not fair that you have so much strategic advantage within your family That's not fair, but it's wonderful. Then also, I love when a business is birthed out of a pain point that you're experiencing. Same thing for me with Productive Therapist. I needed part-time admin support. How am I going to do this? Then I realized that other people needed the same thing, and the story goes. I think that's fantastic because you know you're building something that is useful because there's a lot of people like you. I think that's a fantastic place to start, isn't it?

Tory
It It is. It really is, and you feel passionate about it. Making things easier on practice owners is a dream for me. It was so hard. It has been so hard to be a practice owner. I just think that if we can do anything to make it a little bit easier, we should be, especially to help practice owners compete against all the giant conglomerates that are out there now and give us a little bit of an advantage to really have a On our business. That is real.

Uriah
Yes, that is real. As you were talking a minute ago, I had this picture in my mind. It started with a car, but then I moved to an airplane. But would you say that running a group practice without some dashboard is like flying a commercial jet with no instruments or with no readouts in front of you? Is that a good analogy?

Tory
I think it's a great analogy, totally. Yeah, not when I thought it before.

Uriah
You shouldn't do it.

Tory
But it's not advisable, right?

Uriah
Maybe you could pull it off, but you might crash and burn. Yes.

Tory
Totally. What we pay attention to grows. If we're not paying attention to the data, we're just blindly going about. It's interesting. I'll talk to different customers, and sometimes they're disheartened when they see their data and they're like, Oh, my gosh. I had no idea it was this bad. To me, knowledge is power. You need to know that it was that bad before you can make a change. You can turn a blind eye and you can keep doing things exactly the way you were doing. That's an option. Or you can use this data to make important changes that are going to boost your revenue and help your clinician do their work in a more effective way for their clients.

Uriah
I wonder if that's true for a lot of therapists in terms of numbers and paying attention to numbers. It's true for finances often. They don't necessarily want to at that and run their business with the financial data in mind, maybe a little bit more on feeling and intuition and all these things. I wonder if that's similar for practice owners not wanting to really know the ins and outs of their other metrics. I don't know. Do you think that would be true?

Tory
I think that we like to... Or it depends? I think we often make decisions based on feeling, and it's really common for therapists and practice owners. We like people, so we want to keep them. Then We just are in a really unique situation where we're the only field, I don't know if you can think of another field, but we're the only one, in my opinion, that does our business is all behind closed doors. We don't actually have any idea how our team is doing. We just trust and they go behind, they do their work, and they close the door, and then we think, Probably something good is happening. But suddenly there's a revolving door of clients where we have a sense of that going on, but we don't I have a really good sense. There's no other business that runs that way.

Uriah
That's an interesting observation. I've thought about that many times with my group practice. Of course, I try to hire the best people and give them resources and empower them, train them. But at the end of the day, I don't know the clients. I don't have any oversight into what's happening in those rooms with the closed doors. We just look at the numbers of session counts and revenue and all these kinds of different things. But in my experience, I'm sure we can get into this, but getting the data out of my EHR and out of other sources and trying to pull it together was always a painful experience for me. I'm guessing that's part of the challenge that you're solving with PracticeVital. Is that true?

Tory
Yeah, absolutely. I think just the downloading the pivot tables that no one quite to do. But it's interesting because a lot of the people who actually are our happiest customers or who are customers of ours, say they love data. They say that they've been really curious about it, and maybe they even know how to do the pivot tables, and they know how to make the dashboard. But it still had shortcomings where it wasn't automated. It wasn't something they could share openly with their clinicians. A lot of the benefit of our tool is the design behind it and the esthetics. It makes it very motivating for clinicians to see their information in a way that makes sense to them. If they see it and they see their numbers, see their retention in the way that we present it, they're really struck by that. Whereas if you send them some numbers in an Excel sheet or you send them an email that says you have overdue notes, it just doesn't have the same impact.

Uriah
Yeah, that's interesting. I think most therapists want to know. On some level, we want to know how we're doing, if we're doing a good job, especially when it comes to client retention and outcomes and do people stay with us. We want to know that, but usually we just guess or we go on feeling. I think most of my clients get better, but we don't always know. This is one way to know, how are you actually performing as a therapist in this role? If you don't have the information, then What do you have to go on? You just guess.

Tory
It's so much guesswork. I think therapists don't even know really basic things about how they're doing. A lot of times, they don't know what they're averaging per week, and they don't know. Then the end of the year comes and they think, I didn't as much money as I was hoping to this year. Then they realized they were really averaging 18 clients a week instead of the 25 that they were supposed to have or that they thought they were having. I think there's just a lot of empowering information, having it regularly at their fingertips. We encourage people to send the reports to their clinicians once a week, and so they're seeing it regularly. There's no surprises. Nobody's surprised anymore. But to your point, I had an with a therapist who left my practice a couple of years ago. She said her main feedback for me was I didn't feel like I had a lot of information about how I was doing. I wanted more feedback. That really struck me because I thought, Well, I thought that I said, Good job, but I didn't have much to go on in terms of what was a good job or much information to provide to her. I think you're right that people want to know how they're doing in any job. They want to have a sense of whether they're moving ahead, whether there will be an advancement, are they on track for a bonus? What therapist am I?

Uriah
Positive affirmation is helpful. Everyone wants to hear a good job from their boss. But it's so much more powerful when it's tied to like, Hey, look at these numbers. Look how you're improving in this area and in this area and in this area. That's actual feedback that helps with professional development and growth. That's really a gift, I think.

Tory
Yeah. To the point on professional development, I think one thing we're finding is that a lot of our practices are actually promoting people who they're seeing have a very strong retention rate or a low churn rate, high utilization. They're saying, What are you doing to make that happen? Why don't you be the one who trains the rest of the team? I like that. It's you have the right people in the right seats based on the numbers, but then also empowering those people to share their information with everybody else. That's a great one. It really helps to have a path within their practice. I think that also helps with retention. If people feel like I can really stay within this practice and continue to grow.

Uriah
Promoting the superstars is always a good idea in some way. Yeah. Let's get into the specifics a little bit. What do you think are some of maybe the top two or three metrics that you see clinicians and practice owners finding the most useful to look at on a regular basis?

Tory
Sure. Well, number one is I think it's something that we all know we need to be tracking, but it is nearly impossible to track on your own. It's just so time consuming. Almost every practice owner I've met with will say, We were tracking retention, but six months would go by and we would just not do it because things would get busy and it was just too cumbersome. We have a lot of practices with 80 therapists or just very, very practices. Imagine doing that for that many people. Oh, thank you. It's just not possible. Retention is key. What we do is we track it based on eight sessions as the standard, the industry standard. There's research that shows that client outcomes are much better if they stay for longer than eight sessions or eight or more. We set it to that, but then we have an entire retention report where we can look at which clinicians are retaining or what is their percentage of retention at three sessions, at four sessions, at five, all the way up to 21. You're really able to see where the cliff might happen. Some practice owners have been able to say, This clinician, they keep people for four sessions and then something happens. Let's figure out what's happening there. One tip I'll often give them is have your practice manager reach out or your intake coordinator at the four-session mark and say, How are things going? Give some evaluation. We can always move you to another therapist if things aren't working out so that you're not losing those clients altogether if they are a polarizing therapist where some people stay, some people don't.

Uriah
Client retention is number one. That makes sense. That's what I'm always concerned about and paying attention to. I totally relate to what you're saying there. I would be really good about tracking those metrics and sharing them with my staff, with my team, and then I would completely stop doing it. Some of those conversations were always There's so many variables to retention at times. We would look at it and we would go like, Okay, well, let's look at these four people and why did they leave too soon? Four different reasons. It was like, Was this a helpful conversation? I don't know. Did it feel helpful? No. That was always a little bit of a trick to figure out. I'm just thinking as we're talking here, I found those conversations not as helpful as I wanted them to be. I think that's probably part of the reason why I stopped doing it, because I don't think their takeaways were terribly valuable, and I wasn't sure that I was helping them. Does that make sense?

Tory
It absolutely makes sense. One thing I recommend is... One thing that our tool does is we'll sort people based on retention and who's retaining people for the longest and how many sessions people are having on average. If people are in red, which tells us there's a concern, I'll group them together and say, Why don't you meet with these five people who are really struggling with retention in particular? Give them our blog post on retention, five tips for improving retention, and just have a conversation, because these are tools that will help them to become stronger therapists throughout their careers. We really want to help them do that. We want to help them. Sometimes it's as simple as therapists don't know how to sell themselves in the beginning. They might be really good at listening for the first couple of sessions and people stick around and then they realize we haven't even told them that here's the plan for treatment, here's the treatment goal. Sometimes it's just some really simple tips that you can give your team that will help with really improve their retention. I do some coaching around that with people after their customers. The second metric, I would say, is average sessions per week. It's something that we... Almost every practice owner has an expectation or a commitment for their therapist to meet each week, and yet we're not tracking it on a weekly basis. We might track how many sessions they had that week, but we're not looking at what the average is. People will I had 25 sessions this week. The next week they had 18. The average is really closer to 21, and yet they're not aware of that. Again, just making that top of mind can really help to help to be more motivated around cancelations, around vacation time, and really to think through the long game in terms of getting that average up.

Uriah
That was really helpful. I definitely have heard from a lot of practice owners who have challenges with Helping their team members live up to their commitments in terms of number of sessions. Having that information to be able to present it as a part of those accountability conversations, I think, is really useful. I think some of us avoid that because it's uncomfortable to be able to say, Hey, you committed to 15 sessions a week. Your average is actually 12, or whatever that might be. But it's super important. If we don't do that, then ultimately, that clinician probably doesn't get what they're looking for in terms of accruing hours or generating income, and then the business is suffering as well. A hundred %. Good info.

Tory
Yeah, and I learned from working with my accountant that our break-even point at my practice was 13 sessions. If I have somebody who's coming and then you think about benefits and all different things, so you really have to know what your break-even point is, and then also make sure that your clinicians are sticking with that commitment. But the data is a great neutralizer. It takes the emotion out of it. I know it can be challenging to have those conversations, but being able to come in and just say, Here's the data. It's not coming from me. This is what's out there has been so helpful for practice owners to minimize those challenging conversations.

Uriah
That's good. Do you have or have you thought about creating some simple scripts for practice owners to start those conversations and have those conversations? Because that could be really helpful.

Tory
That's a great idea. I model them, I think, a lot when I'm having the calls with people, just here are some talking points. We also have a guide that all of our customers give their therapists that say, Here's why all of these numbers are helpful for you. Really, the numbers are a win-win win. It's helpful for them, it's helpful for their clients, it's helpful for the practice. We share that information, and that makes it a lot easier as well.

Uriah
That's good. Have you heard any stories about practice owners sharing metrics metrics and data with a clinician and it causing problems for that clinician, whether that's anxiety about their performance or something else? Have you heard any of those kinds of stories?

Tory
I have not, yet I have practice owners express fear about that happening a lot of the time. Then they usually come back, and if I talk to them a month later or something, they're like, This has been life-changing. Having these numbers has made the conversations easier. No. I share them with my team, and my team has been really excited about it. They like this information. One of our customers gave us this idea, and it was brilliant. What if you just asked your team how often they wanted to see their information or if they even want to? That's another way of empowering them. I have this information. It's helpful for us for running the practice. Would you also be interested in seeing it? If so, how would that be?

Uriah
I do like that. I imagine introducing something like this would be a change for the clinicians in a practice initially, but once they get used to it, it's just part of the way things are. Then for new clinicians that are hired, they come into the practice and this is just what we do. Obviously, I think most therapists would want to frame this as a positive, growth-minded, abundance-minded experience, not like corporate oversight of some sort.

Tory
Yeah, which it definitely is. I think a lot of people are just seeing their practice overall thrive. As we know as practice owners, if you don't have a profitable practice, you don't have a practice. It's really in the best interest of everyone to have a practice that's running efficiently, that's working well, where everybody's working together towards common goals. Otherwise, we're just shooting in the dark.

Uriah
We all want to be effective in the work that we're doing, not just to feel good, but to actually do the good. That's What is on the roadmap for PracticeVital, if you don't mind sharing?

Tory
That's a fun question. We're adding additional EHRs that we work with. We just recently added intake queue/practice queue. We're figuring out what will be next after that. Then we're working on revenue right now. We're adding in revenue data about average cost per session, different percentages by payer. A lot of helpful information for making decisions for the practice overall.

Uriah
That's good. I like it. One thing I was thinking about recently was the concept of the lifetime value of a customer or client. On average, how long do people stay? If we bring a client into the practice, about how much is that worth to the practice? Could someone take information that they find in practice vital and get that A number? Or do you already have that?

Tory
We have those. You do? Okay. We have a practice-wide dashboard now. It's a sum of all of the totals from different clinicians. I know my practice-wide retention rate is 72%. That will tell me that- Yes. Yeah, 72% of our clients are staying for at least eight sessions. We can see that information in a number of different ways. But I think I can also look at our retention report, see the average that each client stays. I have some clinicians who hold on to clients for 21 sessions on average, some who stay for 13, but I can average all of that out, and I can find that out. Yes, so definitely. Okay, that's good. Yes. I know Casey Compton had said at the last conference, she said that their practice loses money if a client stays for fewer than seven sessions.

Uriah
Is that right?

Tory
Seven sessions. Wow.

Uriah
I'm guessing I would want to ask her a follow-up question on that one, but I would guess that has something to do with their cost to acquire that client, potentially? Because what are the other Otherwise, what are the costs involved? Yeah, right.

Tory
Yeah, I've been thinking a lot about that, too, because a lot of practice owners, it's interesting, they'll tell me their numbers so they know. I think it's certainly like Google Ads are expensive. A lot of the marketing costs. Then the time of completing the paperwork and then the, I think a lot. Admin costs, of course. Potential as well. I remember her saying something like, When I hand a new client or refer a new client to one of the therapists on our team, it's like I'm handing them $1,000 in saying good luck. Because maybe that's what they would be earning for the practice. If they lose them after one session, that's a loss of $900. I think that's another way to think of it.

Uriah
Definitely. That's interesting. For some reason, that makes me think about the book that I'm listening to right now. It's called Unreasonable Hospitality. It's fantastic. It's written by a guy who has spent 25 years in the restaurant industry and won the Best Restaurant in the World Award for Eleven Madison Park. But the book is all about how to create a culture in a business, both with the team and with your customers, that creates belonging and a sense of hospitality and welcoming. I'm listening to this book and I'm applying it to both of my businesses and thinking about, how can we do that more and really surprise and delight the clients that come in. I don't know how that connects to our conversation exactly, but it's pretty inspiring.

Tory
I love that. Well, the idea of just really great culture and the idea of hospitality, I think it's a different way to think of it, too. We talk a lot about culture group practice, but to say hospitality is a really interesting way. I think that can feed into… It's almost like we're having a conversation about these metrics and these numbers, but then the numbers mean something. A lot of it's about how you treat your clients. Maybe it's about how welcomed they feel into the practice as well. There are so many different factors that go into that, and I think that's part of the fun is figuring out what the magic equation is. It creates that dynamic that makes a client feel really understood or safe for her.

Uriah
I think that's such a nice thing. It's the counter opposite to What do you call it? Big box mental health, where maybe you go to Walgreens to get your itch cream and a little bit of therapy. We can do better than that, right?

Tory
It's scary what it's becoming.

Uriah
I know. I'm so interested to see what our industry is going to look like in 2-5, 10 years. I really don't know. I have some ideas, but I don't know what it's going to look like. But I definitely believe in companies like yours and mine that are doing good for the mental health space and trying to empower therapists and help them succeed. I think that matters a whole lot.

Tory
I just want group practices to survive. I think there's so much power in the group practice model or a group of clinicians, I should say. Working together, and our jobs are so isolating as it is, and we're behind closed doors so much of the time. To have a community is so important, and I feel like we need that. I want group practices to be able to compete against all of what you're talking about and Walgreens. Definitely. To be able to compete against Walgreens.

Uriah
I couldn't agree more. I definitely don't want group practice to become the local bookstore in the era of Amazon. That's what I don't want to happen, genuinely. Honestly, it's not good for anybody.

Tory
It's not good for anybody. I fear that could happen. In whatever way, Practice Vital can help group practice owners just feel like they can compete, they can stay afloat, they can just breathe this. I have relief or make things easier. Yes, I want to do that.

Uriah
That's good. There's no doubt that running a data-driven business is going to help you keep the doors open, continue to offer services, and hopefully, create the life that you want to live as the owner. Let's connect more people with Practice Vital. Where can they go to find out more? Sign up.

Tory
Yeah, thanks. Our website is the best way to reach us, www.Practicevital.com. There's a contact form there. That's the best way. Then from there, we send you a calendar, a booking link, and you can schedule with us. It's such an easy, honest onboarding process. It really is.

Uriah
It couldn't be easier.

Tory
Yeah, you're right. You're a great customer. It takes 30 minutes, probably, to fill out our form, and then you're up and running. There's not a whole training process where you have to learn how to use it. Your numbers are just there. We would love to hear from any group practice owners who are interested in making their lives easier.

Uriah
That's fantastic. Of course, we'll put those links in the show notes. But your domain, your business name and your domain, so easy to remember, I think. Good job on that. I know it's hard to come up with something that is available and- Exactly.

Tory
It was tricky. We've got a Facebook group. Any practice owners are welcome to join us, customer or not, to talk all things metrics, and then a newer Instagram handle as well.

Uriah
Okay, fantastic.

Tory
Thank you so much.