Proven Results Make Olympia Vision Clinic Come Back for More

January 8, 2015 – Olympia, Washington After previously working with Tony Milian and Chuck Smith, Practice CoPilot co-owners, Olympia Vision Clinic knew just where to turn when their Olympia and Lacey offices needed some fine-tuning. With the Clinic experiencing growth, the addition of two new doctors and a continuous growth in staff members, it was time to streamline their operations again. For more than three decades, Olympia Vision Clinic, owned by Dr. Dale Tosland, has been providing its patients with quality and dependable eye care. For almost a third of that time, Operations Manager, Susan Johnson has been there to oversee the Olympia and Lacey offices’ daily procedures. Both in agreement, Johnson and Tosland knew it was time to call on the Lean experts at Practice CoPilot.

Since Practice CoPilot’s consultants were no stranger to Olympia Vision Clinic, their familiarity with Olympia’s goals and daily operations allowed for a smooth assessment of both offices. After a few days of observation at each office, both offices were shut down in order for the Olympia Vision Clinic team to meet with Practice CoPilot. Practice CoPilot consultants broke everyone up into groups and handed each group a problem the office was facing with the task to solve the issue. They would pop into each group to collaborate as well as offer helpful hints and suggestions. Johnson found this team oriented exercise especially rewarding. “During the whole process, the consultants never came across as dictating. They had great insight and shed a totally different light on each issue. They made you see the problem with their eyes as opposed to a person who is in the office day in and day out.”

One of the main difficulties facing Olympia was their phone line that had no extension options. “Our phones had become a major issue. Not only was our front desk bombarded with phone calls at both of our offices constantly during the workday, but also during our staff meetings even before our normal business hours, the phones would still be ringing off the hook with patient questions. The calls were causing unnecessary interruptions throughout the entire day,” declared Johnson. The solution? A call center in Lacey. Having one call center would centralize the scheduling for both offices. The call center made scheduling more consistent and improved how the scheduling template was being used. The call center also alleviated basic questions from patients like location and hours, which could now be easily answered with a phone tree. Front desk staff could now be more focused on checking patients in.

“Our productivity increased by 10% and incoming calls decreased by 25% with the new automated phone system,” said Johnson. Many practices are under the preconceived notion that automated systems annoy patients and make them stop calling. However, their objective is to move the calls to the right person within the practice to reduce the amount of busy work the front desk has to perform.

Along with adding the new phone system, Practice Copilot developed a script to help the front desk capture more email addresses and cell phone numbers. These were critical items to collect in order for Olympia Vision Clinic to use their CRM to send out more confirmations via text and email rather than having the front desk spend significant amounts of time calling for confirmations. Another issue Olympia was challenged with was the growing demand at their Lacey office where they were consistently short on technician support. A schedule of rotations was setup for the technicians between both offices. One technician head from the Olympia office was added to the Lacey office. The rotation schedule helped make the technician work more consistent across both offices as well as ensure that each technician had an opportunity to work with a different doctor every couple of days throughout their rotation.

Another major improvement implemented by Practice CoPilot was on the schedule for dispensing appointments in optical. Previously, when glasses were ready, the opticians would call patients letting them know that their glasses were in. In turn, the patients would then show up at an unannounced time that was of their convenience. This type of unplanned scheduling was now a thing of the past. Now as soon as the patient completed their glasses purchase, they would be provided with a dispensing appointment on the calendar 10 days out. This appointment would be when the patient would come in and pick up their glasses. This new scheduling practice also had the added benefit of reducing incoming calls because patients weren’t calling in to see if their glasses were ready to be picked up.

All of these changes to the workflow at Olympia Vision Clinic allowed for a more streamlined process at both offices from the start to the end of the workday; and even the time in between. Johnson and Tosland were pleasantly satisfied with all of the significant improvements Practice CoPilot had successfully implemented on Olympia Vision Clinic.

“I really can’t say enough about Practice CoPilot. I would recommend them to any office that is looking to streamline their operations from start to finish. They have the expertise and experience to help your business succeed.”

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MedVine Press Release Featured in North and Central Florida Issues of Doctor Magazine

We are very excited to be featured in the December issue of North and Central Florida Doctor Magazine.  Please follow the link below to the article.

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Optical Lab Doubles Capacity Through Help of Practice CoPilot and Lean

December 10, 2014 –  Pensacola, Florida   “It was a chaotic mess,” declared Rolando Domingo, co-owner of Best Price Digital Lenses, Inc. in Pensacola, Florida, when asked about his lab’s production line. “Our lens demand was growing. We were receiving shipments of over a hundred lenses a day and were spending almost half the day just sorting through the lenses and placing them in the correct bins. Our current lab process just wasn’t working for us anymore.” Knowing a change needed to occur, Domingo enlisted Practice CoPilot, a company specializing in lean practice management consulting as well as products that enhance high quality patient encounters through cutting edge technology.


A lean assessment of the lab was conducted by Practice CoPilot co-owners, Tony Milian and Chuck Smith. The goal of the analysis was to understand and increase capacity while eliminating waste.For the assessment, a day was dedicated to filming the entire lab process, station by station, so time studies could be conducted on machine and operator to determine the ideal layout for maximum production.  Milian and Smith then identified the constraining step in the lab process and built around that for optimization of production without any additional expenses such as space, staff and equipment. “We also focused on positioning resources where the work was to be performed and not just where there was space,” said Milian, “By doing this, we were able to minimize wasted movement or travel for staff which increased productivity significantly.”

One of the main issues addressed in the assessment that Best Price Digital Lenses, Inc. kept facing was shipping and receiving problems. Station 1 was labeled the receiving stage. The lab was receiving over 100 lenses a day that needed to be sorted through and placed in proper trays. Hours were spent in the sorting stage instead of the production stage. Another issue was station 5, the shipping stage. Every day, staff would have to stop production at 3pm in order to fill the orders to be ready for shipment. “After our observation we noticed the flow of the production line felt unorganized due to the stoppage time required for receiving and shipping the lenses,” shared Smith, “we quickly reorganized their work flow for shipping and receiving and made the process much more efficient.”


By refining the production line, shipping was implemented into the final inspection where lenses would now be packaged and ready to ship. The shipping station had entirely been eliminated. With the newly executed plan, 150 orders were filled every day instead of only 70 and with 3 less full-time employees. The whole process was now continuous like a wheel. Practice CoPilot more than doubled the capacity atBest Price Digital Lenses, Inc.After Practice CoPilot came in, we became a well-oiled machine,” said Domingo.


Domingo was admittedly skeptical beforehand, stating “It’s funny because before Practice CoPilot came, I was telling my partner I couldn’t wait to see what ideas they were going to come up with to change our lab.  But I was all wrong, it wasn’t better ideas, it was all about the layout and engineering the actual lab process.  I was pleasantly surprised. I was skeptical because I’ve been doing this for 20 years and kept thinking there wasn’t anything I haven’t thought of already, but it wasn’t about that.”


In the end, Domingo was more than pleased with the results from Practice CoPilot’s new production improvements. “Because of Tony and Chuck, we have quadrupled the amount of work we are able to do.” Also impressive was the manner in which the plan was implemented. “Once Tony and Chuck came up with the game plan, they didn’t just say okay now everyone has to follow this plan because it’s the only right way to do it. They instead gathered all of our staff together so they could listen to everyone’s ideas and thoughts about the plan that they had devised. ”

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Sometimes its the decisions that matter

I start this story with an example from a recent experience in manufacturing but the implications are very important for the world of health care where decision making is critical.  I worked on a rapid improvement event in a manufacturing facility with an extremely talented team this week.  This team is essentially tasked with taking scrap metal from a very large yard and loading it into a huge melter that melts the metal and creates an alloy with very specific properties.  The team must blend different types of scrap metal in throughout the day in order to obtain the desired alloy properties in the melter.  Needless to say, when you are dealing with scrap metal, a lot of things can happen.  As one of my colleagues says, “its like a box of cracker jacks.  You never know what the prize is going to be inside.”

The objective of this event was to standardize how each operator goes to the yard and select the materials they use so that they are all using the same sequence of materials to blend the alloy in the melter.  Because of the seemingly endless variability in the incoming scrap, no two days are the same.  It became a nearly impossible task to develop a standard process for how to blend.  Even if we did, no one would have followed it.

We quickly realized that what was way more important was understanding how each of the operators arrived at the decisions they were making to select the right material for the blend.  These decisions were incredibly complicated.  There are environmental factors like rain, cold, material availability, melter temperature and level, etc.  Each of these conditions dictated a different path that they would have to take to choose the right metal to put in the melter.  In total we calculated over 3800 different combinations based on the most important environmental factors.

With a little analysis, we came up with 41 different combinations that made up the bulk of the work taking place.  With 41 combinations, the work became manageable.  We then developed a decision tree that guided the operators towards the right decision based on the specific conditions that were taking place.  The standard work essentially became more about following the decision tree so that every operator arrives at the same conclusion and the output becomes much more consistent and predictable.

Standard work is a great tool to use when you are dealing with inherently stable processes, but when the process is very unstable, what usually matters more is how to make sure that everyone is making decisions consistently the same way every time.   This couldn’t be a truer statement in the world of a health care facility.  In health care, the process is almost always inherently unstable.  When you are dealing with humans, there are so many factors in play that it’s hard to treat every case exactly the same way.  Developing standard work in many health care situations is almost futile because of the human variability.  This is where decision trees come in.

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Lean is not a diet plan

Alex and Amy, my brother and sister are two of the fittest people I know.  Every day like clockwork they go to the gym in the morning.  They have a workout regimen that would leave me crawling on the floor begging for mercy.  Every time I go out to eat with them, the pick the healthiest thing on the menu, and they never ever reach for the desert menu.  When I ask them how they do it, they tell me that they don’t even have a desire to eat sweets anymore.  They have programmed their lifestyle to live this way day in and day out.  That’s the difference between going on a diet and building a sustainable lifestyle around being trim and fit.

The same thing applies to living a lean philosophy in your practice.  Lean center’s around the concept of continuous improvement.  It’s all about building in a routine of continuous dissatisfaction.  You celebrate where you are today but you are constantly on the lookout for the very next opportunity to make something better.  It’s not just about being more efficient or making the patient experience better.  It’s about making your day to day life better too.  So the next time you go to print something and the printer is out paper, don’t just put a ream of paper in and call it a day.  The same thing will happen tomorrow and the day after that.  Step back and develop a better process.  Now if I can just get past the irony that I’m the “Lean” guy but I’m also the fattest sibling…

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Want your employees to exhibit the right behaviors? Repetition is the key to success

Rituals are repetitive actions that help establish the behaviors you want your employees to exhibit.  We are not talking about black magic or voodoo here.  Rituals are incredibly important in ensuring that anything gets implemented successfully. Simply posting something on the wall for your employees to see isn’t going to drive the behaviors you want from them.   It’s human nature.  If we don’t repeat things, they don’t become part of our physical or mental muscle memory.  World renowned coach and speaker Tony Robbins starts every morning by thinking about all the things he’s grateful for.   Successful Lean practices are no exception.  One of the most successful companies we have worked with takes the Target Behaviors we posted in our last post and asks every employee to repeat these target behaviors out loud are at the beginning of every meeting.  Sounds like overkill?  Maybe, but they live and breathe these target behaviors in everything they do.  Take advantage of staff meetings to develop a ritual.  Start every staff meeting by repeating something that is important to your business with your staff.  After a while, they will exhibit these behaviors on a daily basis without even knowing they are doing it.  This is an actual example of what this dialogue sounds like at every meeting:


Meeting Leader:  “Why are we here?”

Group:  “To secure our future”

Meeting Leader:  “How are we going to do this?”

Group:  “By embracing change”

“Thinking and acting like owners”

“Acting like one team”

“By practicing respectful, open and honest communication”

“By meeting our commitments and doing what we say we are going to do.”

“By taking responsible risks”


Throughout the course of the meeting or the day, you will hear the employees say things like “is that really acting like an owner.”  That’s how you know you have en-grained the behaviors into the culture.

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Getting your employees to act like owners

Establishing the target behaviors you want your employees to demonstrate on a daily basis is a critical success factor. Target behaviors give you a true north every time little hiccups occur with employees. We can’t tell you how many times we have worked with practice owners that say “If I could only get my employees to act more like owners.” Here is an example of target behaviors from a very successful company we work with. These target behaviors are clearly posted in multiple locations so all employees see them on a daily basis.
1. Embrace change
2. Think and act like an owner
3. We are one team
4. Practice respectful, open and honest communication
5. meet your commitments, do what you say you are going to do
6. Take responsible risk

Goal: To secure our future

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Practice CoPilot introduces MedVine – a Revolutionary Technology for Patient Communication


For immediate release:

For more information contact Maria Chrissovergis, MC PR Agency
(904) 762-4573


October 9, 2014 JACKSONVILLE, FL: The iPad alarm clock app went off at 4:45 am but 38 year old, Maria Chrissovergis never really fell asleep. Maria was scheduled for a hysterectomy at Baptist Medical Center in Jacksonville, Florida. While it’s a fairly routine and common procedure, Maria’s medical history is anything but common for an otherwise very healthy woman in her late thirties. She endured seven surgeries and procedures to remove large ovarian cysts her physicians often feared were malignant. This summer more problems ensued and Maria’s gynecologist, Dr. Mary Ellen Wechter requested a biopsy from the patient’s uterus. Again, clean pathology but due to family history and Maria’s long reoccurring problems, the patient and physician agreed to move forward with a hysterectomy.

“We’ve been through this drill several times but it was always easier before I became a Mom,” Maria shared, “It’s kind of like who’s on first. My husband stays with me at the hospital, my Mom is in charge of my two kids and everyone else is on standby. “ She explained everyone wants to be at the hospital for updates but logistically that’s just not ideal.

Baptist Medical Center was the very first to use a new application, MedVine, during Maria’s surgery to keep her loved ones informed. MedVine, a product of Practice CoPilot, enables surgery centers to provide status updates to patient’s friends and family members via HIPAA compliant text messages during surgery. “I wanted to be at the hospital with my daughter but she needed me most as the caregiver to her children until she was released,” Kathie Tsataros, Maria’s mother shared, “receiving the text message updates from pre-op until the end of surgery were truly the next best thing. It was very comforting to know her status while still being at home where she needed me most.” Maria’s husband who was sitting anxiously in the hospital lobby said the text messages were even updated before the communication screens in the lobby. “We had family members out of town attending a funeral and MedVine was able to keep everyone up to date without any interruption or taking time for me to call and notify family,” said Milton Chrissovergis.

“Incoming phone calls from concerned family members become a major disruption, sapping staff of valuable productivity throughout the day. With MedVine, friends and family members stay informed of a patient’s progress through text messages sent at the click of a button so they don’t have to call the office looking for an update,” says Chuck Smith, co-owner of Practice CoPilot.

“The need for this new app became obvious through personal experience and working with ambulatory surgery centers. It can be aggravating when you accompany a loved one for a procedure and then spend the next few hours sitting and waiting for an update,” adds Tony Milian, co-owner of the company.

The app is extremely simple and straightforward. Upon checking-in:

• Patient enters up to 5 family or friends cell numbers and selects either English or Spanish
• As the patient moves through the center, staff update their movement through a series of buttons on desktops or iPad
• Each progress button automatically sends a pre-set text update to the numbers listed upon check-in
Furthermore, the MedVine app has an internal surgery center benefit also. Mr. Smith adds, “Whether the patient wants notifications sent or not, staff have an ongoing visual of where all patients are located within the center and their progress. This benefit increases staff productivity and internal communication.”

As for the patient, while she started the morning with an app waking her up for an emotional day ahead, it gladly ended with an app text message to her loved ones from MedVine letting them know Maria was in recovery where she rested until her release.

Practice CoPilot is a company ( dedicated to assisting healthcare practices, delivering efficient and high quality patient encounters through cutting edge real time location system (RTLS) technology and efficient Practice Consulting. Practice CoPilot currently offers MedVine, an application to keep patients’ loved ones informed through HIPAA compliant text messages and Maestro, a system that displays real time awareness and efficiency of practice for improved communication and enhanced patient care satisfaction. For details contact Practice CoPilot at (904) 701-3084

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So Many Numbers…But what does it all mean?

After several years consulting and otherwise working with practices all across the country; more than 500 in total, we’ve seen pretty much every methodology for tracking practice success.  Everything from hand written notes to the most intricate and technologically advanced software.  Capture rates, dollars per patient, frame turnovers, staff to revenue, days outstanding on revenue, you name it, it’s collected.  And don’t get me wrong, it’s important, vital actually.  A medical practice is and will be most owners’ largest investment.  Having ongoing knowledge of performance allows you to sleep at night; or not.

But, here’s my question.  What exactly does your optical capture rate tell you?  In general, how many patients purchased right.  Great, now that you know this, what do you do?

This is my point, these metrics are critical but they don’t tell you what’s right or what’s wrong.  It’s like buying new tires for your car due to wear but having no idea what is causing the wear.  So you replace your tires and they look great for a while, but the out of align front end is just going to wear out the new set prematurely also.  You must know the cause for the slipping capture rate to make a correction.  Otherwise, you just keep buying new tires.

Financial metrics are only a piece of the puzzle.  This is really a new paradigm of thought for most of us; primarily because operational metrics have not been a discussion point previously.  Here’s a simple example of how operational metrics play a role:

Your capture rate has fallen off recently and thus dollars per patient.  Reasonably, you begin talking to optical about how they are selling and putting plans into place about regaining your captures. By now, most practitioners know door to optical time is important for sales, both in captures and dollars.  So you keep track of a handful of patients and find that your average door to optical is 63 minutes; not good.  Going deeper, you find that patients are spending 16 minutes checking in and 23 being worked up.  Now we’re getting somewhere.  We have some things to work on which have a direct and immediate impact on your capture rate.  But short of tracking this you would have never known.  I know this because without fail, every time I bring up measures like this, doctors and staff are surprised.

And this isn’t unique to medicine.  I spent several years managing sales people.  We operated off of what was called a PQ (performance quotient).  Essentially 100% was considered strong and the higher you went from there, the better.  Employees, including myself as a manager, were measured by this number and our “worth” derived from it also (not necessarily the best way to do things, but it’s the hand sales people play from).  I never coached my teams or even discussed this number with them.  Why bother?  I could beat on you for two days about an 86% and nothing would change.  Instead, we discussed and worked on how many calls they made a day and the content of those calls and how many times they had lunch with a client and whether it was the right client.  By focusing on these activities (operations), we made change happen, positive change.  That sales team went on to win top performing district 2 out of 3 years and second in the third year.

So what are your operational metrics?  How do you collect them?  How often do you look at these measures?  Are you beating on your staff about dollars without truly knowing the cause?  It’s natural, there aren’t many people out there discussing the operational side of things; but don’t let yourself get caught in the trap.  Call us and let’s talk. 

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ECP Interact Engagement – The Eye Care Factory

Please join me on ECP Interact on October 6th.  I will be teaching a 5 part course called “The Eye Care Factory.”  The course focuses on taking eye care practitioners outside of their industry and into the world of manufacturing.  For many years, manufacturing facilities have developed specific tools and techniques to improve processes, reduce waste and increase productivity.  Health care can learn a lot from manufacturing facilities about how to continuously improve.  This course focuses on 5 things that manufacturing facilities do exceedingly well with respect to continuous process improvement.

This and many other great courses focused on the practice of Eye Care are available at ECP interact.  Please follow the link below to sign up for the course:

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