There a numerous reports available in RxWorks that are designed to help you manage your practice. The problem is not that there isn’t a report, but it’s deciding which one you should use. Just as you use Vital Signs to gauge the health of your patients, you need a similar tool to look at the health of your business.
What we are looking for are those activities that “drive” the practice.
Key Performance Indicators (KPIs) are measures of how your practice is performing. They are non-financial as well as financial – and are all important in helping you judge how you are doing.
To measure anything, you have to have something to compare with.
The RxWorks KPI analysis compares to last year and the prior year.
If you see something that needs further investigation, use the “drill-down” capabilities to get more information. Also, there are several reports available in RxWorks that have a more detail. The KPI will help you to decide which is best.
“Performance Pack” extracts data from your database. It then calculates the KPIs as well as the comparison figures.
This manual will take you through the steps to produce the KPI analysis. It will also discuss the Indicators and how they can help you manage the practice.
Navigating to the Key Performance Indicator Report
To get to the ‘Key Performance Indicator’ Report:
- Go to the RxWorks Task Panel.
- Select ‘Reports.’
- Select ‘J: Advanced Analysis.’
- Click on ‘Business Key Performance Indicator Status’ from the list of reports.
When the report first opens in Microsoft Excel, if the message shows, you may need to select the ‘enable content’ button as indicated below before you start.
How to Generate the Key Performance Indicator Report
To generate the RxWorks ‘Key Performance Indicator’ Report:
- Choose a period of time to analyse from the drop-down list.
- Select the EXCEL button to generate the report.
Or select ‘Other’ and enter the start and end dates for the period you want to analyse.
Selecting A Practice To Report On
Defining A Percentage To Indicate Major Changes In The Kpi Report
The KPI Status Report uses arrows to bring to your attention any major changes that have occurred within your practice.
Here, you have the power to decide what percentage you want to indicate as a major change.
To see the selection entry, make sure that you have selected All on the shortcuts buttons.
What each arrow tells you in the KPI Report
Indicators that have a green arrow pointing upwards next to them are showing a major change for the better (in this case we chose 5% as being a major change).
Indicators that show a yellow upwards arrow have had a positive change, but not a major one.
Indicators that show a yellow downwards arrow show a negative change, but not a major one.
Indicators that show a red arrow pointing downwards have had a major change for the worse.
Obviously you should review those items that have red or green arrows first. They have changes that you consider to be major.
What the Key Performance Indicator Report Shows
Moving Around The Report
There is a lot of information that’s available in the Key Performance Indicator Report. To make it easier to view, we have included short-cuts to show only the details that interest you.
Filter the information to best suit your needs by using the following options at the top of the KPI Report:
‘Drilling Down’ Into The Report Details
As you look over your report, you’ll see items that warrant more investigation. This is where drill down becomes very useful. Normally you would have to search out and generate another report to get what you want.
Use the ‘+’ and ‘-‘ symbols to the left of the listed group to expand and collapse further details.
What Do The Status Report Columns Show?
The KPI Status Report columns are first broken down to show daily activities for the current week. We don’t use comparisons for the daily figures as they have little meaning.
We can then view the current week, month or year-to-date. These are all compared with prior years’ activities.
When we are looking at any changes, we compare current figures with those from last year and the year before that. We use the normal accounting term “variances” to describe the change in any value.
We calculate variances by subtracting comparison figures from the current. The comparison figure can be last year or the year before. Then we calculate the variance as a percentage of the comparison figure.
What are the key performance indicators (KPI’s)?
We have broken the KPI’s down into sections that include related Indicators.
The first section is looking at an analysis of client activity.
The Client Analysis KPI – Explained
Let’s look at the sub-headings for Client Analysis:
Sales is self-explanatory. It is how much you have billed in the period – in this example, the year ending December 31st.
By clicking the ‘+’ next to Sales, the report shows the breakdown of the sales by the status of the client.
Individual Clients Who Visited
This is the number of clients who visited the practice in the period. If they visited multiple times, they are only counted once.
Clicking the ‘+’ next to the heading shows the same status as for sales, except it counts each client that visited.
No. Of Client Visits
This is the total number of visits by clients in the period. If the client has had more than one patient who visited in a day, it’s only counted once.
Avg Client Spend Per Visit
This is the total Sales divided by the No of client visits. This is the average amount you have billed for every visit in the period.
Clicking the + breaks down the average spend for each client status.
The next Indicators are based on annual activity and are not included in the other periods’ statistics. By clicking on + alongside the indicator we can get the analysis for each client status.
Avg No. Of Visits Per Year
This is the Number of client visits divided by Individual clients who visited. It shows the average for the number of times each client brings in a patient to be treated in a year.
Average Client Spend Per Year
This is Sales divided by Individual clients who visited. This shows the average amount each client spent in your practice in the year.
It’s obvious that Sales is a KPI. But it is the end result of the other KPIs we covered so far.
To increase sales you can increase the number of client visits or the average spend (or both). But the approach you use for each varies.
To increase the number of visits means changing some of your standards of care – instead of annual exams you would recommend twice per year, etc.
To increase the average spend, increase your fees or provide more services per visit. Fee increases have been the traditional way of raising more revenue.
A more acceptable method to clients is likely to come from the other sources and should help create a stronger bond.
If you choose to increase fees, use Performance Pack to help you determine the fees that are “shoppable“. Increasing fees for those services could expose you to your competitors and possibly lose you clients.
Performance Pack will also help you determine what the fee for the other services should be, based on your costs. Proper fee management coupled with good client communications can prevent client concerns. Avoid blanket increases if at all possible.
To increase the number of services provided in a visit, you must know the ones that are due according to your standards of care – and communicate that to the client when the appointment is being made. Use HealthCare Manager to help your support staff explain why the services are needed.
There are practices that see patients an average of six times per year. This is done by spreading out treatments over a year, instead of trying to do everything in one visit. Typically clients reject services based on the perceived high cost for the single visit. Having multiple visits normally decreases the cost per visit but increases the annual spend per client.
Whichever strategy you decide, use these KPIs to measure how successful you are.
The growth and stability of your practice are affected by whether activities are coming from existing (bonded), new or returning clients. The age of your practice will dictate which should have the higher significance. New practices will place more emphasis on new clients. More mature practices should make sure that the number of bonded clients is improving as well as returning clients.
In the case of clients who are returning it’s probably worthwhile allocating one of your custom fields in the client record to record a reason why they are returning- then use the Query capability in RxWorks to see what you are doing right.
It’s generally accepted that educated clients are the better clients. Use these KPIs to measure the success of your client education and communications. Make sure you are making effective use of HealthCare Manager, Performance Pack, Recall Manager and Automated Message Manager to help your staff do their job.
This is the number of individual clients who visited the practice by the period end in prior years year, but haven’t this year. This assumes that you have at least one treatment that should be done on an annual basis – like a vaccination.
This is calculated using the difference between the number of clients who visited this year and prior years. This shows how you are doing in making sure that your clients keep coming to the practice.
These are two more KPIs that indicate the stability of your practice. They show the level of client satisfaction or dissatisfaction with your services.
Increases in Lost clients over prior years, should be taken as important warning signs of poor client service. Increased Retention is obviously much more pleasant news.
The Patient Analysis KPI – Explained
The report shows the same kind of information as for Clients, except the analysis is now for patients.
There are some of these KPIs that have greater significance for patients than they do for Clients.
Individual Patients Who Visited
This shows the number of individual patients that had a visit in the period. A visit is counted when it has both medical history and charges and has been completed. If a patient comes in several times in the period, it’s only counted once.
No. Of Patient Visits
this is the total number of visits for all patients.
Average Patient Spend Per Visit
This shows the average bill for the total number of patient visits.
Average Number Of Visits Per Year
Shows the average number of visits made by each individual patient in the year. Note that this is only available for yearly figures.
Average Patient Spend Per Year
This shows the average amount spent for the year on each patient that visited.
The main drivers of the business of the practice are the number of patient visits and the amount billed for each of them. The Patient KPIs outlined above help monitor them.
They will show if your strategies are effective.
You could have a strategy to increase the amount spent for each visit, or one that increases the number of visits per patient. Both will result in an increase in the average amount spent on a patient in a year. But the activities that will increase those two KPIs are different and can conflict with each other.
Prudent management of fees and preventative care standards is essential in both situations. Review “Performance Pack” and “HealthCare Manager” to make sure their setup matches your goals.
The Analysis by Species KPI – Explained
Let’s look at the sub-headings for Analysis by Species:
This shows the total of sales made to all species
By selecting the ‘+’ alongside Species we get a breakdown of sales for each species we have seen.
No Of Patient Visits
The number of visits made by patients in the period.
Clicking the ‘+’ sign gives an analysis of that number for each species seen.
Average Patient Spend Per Visit
This is the total sales divided by the number of patient visits.
The “drill down” analysis shows the average amount billed for each visit of the species. The percentage shows how the average for the species compares with the average for all species.
These KPIs are extremely valuable when considering where you want to the practice to focus its resources.
If the feline average spend is much lower than canine, do you want to invest in educating cat owners to help increase it?
Or would the investment be better in increasing the number of canine patients by adding services you don’t presently have – such as hydrotherapy?
The KPIs will then help you monitor the effectiveness of your decisions.
The Revenue Group Analysis KPI – Explained
Let’s look at the sub-headings for Revenue Group Analysis:
Non Product Sales
This is the total of sales generated by professional services, ancillary services (such as boarding), sub-contracted services and other non-product sales. The percentage alongside shows how much of total sales comes from non-products. The numbers to the left of the group are the General Ledger Account Numbers from the “RxWorks Chart of Accounts”.
By clicking on the ‘+’, we can see what sales come from professional services and the other services. In this case the percentage shows the share of total non-product sales for each service.
Product Sales/Consumable Packs
This shows the total sales for all products in the period.
Using the ‘+’ we can then see the types of products that make up the sales and their share of the total.
Discounts & Bad Debtors
this is the total of all discounts and bad debt write-offs applied in the period.
The ‘+’ selection gives the breakdown into discounts that were given on bills and write-off and settlement discounts made to client accounts.
One of the difficulties in managing a veterinary practice is the different revenue sources it has. It’s a medical practice, a pharmacy, a pet store, etc. Getting the mix correct for those sources is critical in ensuring growth and even survival in today’s environment.
The major factor in this is the ratio of professional services to product sales. Sales of most of products are facing increasing competition from non-veterinary sources. The margins that you were able to get are under pressure. Internet vendors are getting more successful in penetrating your client base.
All of the industry experts are advising practices to place less emphasis on product sales and focus on professional services. This is good advice, but it does not mean that sale of products should be disregarded.
Increasing the number of patient visits and more preventative care services will help. “HealthCare Manager” and “Performance Pack” are valuable tools in those activities.
Use these KPI’s to measure your progress in that direction.
The Product Sales Analysis KPI – Explained
Although we may want to decrease their importance in the total picture, product sales are a fact of life in a practice. And knowing how profitable they are is even more critical. The next set of KPIs provides that information.
This is the total of product sales excluding consumable packs.
The breakdown shows the sales for each product group. This is the same as for Product Sales in the Revenue Group Analysis. The reason for repeating them is to make it easier for you to compare sales and gross profit for each group.
This shows the gross profit earned by each of the product groups. The percentages show each group’s share of the total gross profit.
Gross Profit %
Gross profit as a percentage of sales
Increasing gross revenue typically is very positive –unless your gross profit is decreasing. Use these KPIs to make sure that’s not happening.
If profit is going down on non-medical products, such as merchandise, consider if it is worth spending the time of your staff and allocating space.
There may be better uses of those resources in client service and patient care.
If you have made efforts to increase client acceptance of your standards of care, you should see an increase in some product sales.
You would expect that sales of vaccines and parasiticides would go up as more clients accept your recommendations for preventative care.
This is another performance indicator to help you monitor your progress.
The Service Area Analysis KPI – Explained
To view the analysis click on ‘+’ alongside Service Area Analysis.
This shows the breakdown of sales for each service area. The percentage alongside the sales amount is contribution the area has made to the total sales for the period. Examinations have generated 32% of total sales for the current year. This compares with 19% for last year and 14% for the previous year. So there is steady growth in the Examinations service area.
Use this KPI to monitor the services and make sure they are meeting your expectations.
Regularly check the trends by looking at the variances with prior years.
The arrows – red and green – identify those services that need attention.
The Business Area Analysis (1) KPI – Explained
Let’s look at the sub-headings for Business Area Analysis:
This shows total sales for the period.
Clicking on ‘+’ displays the amounts generated by each of your Business Areas. The percentages alongside the sales show the contribution each Business Area has made to your total sales for the period.
No. Of Patient Visits
This provides the analysis of the number of visits by patients in the period, to each of the Business Areas after clicking on the ‘+’.
Average Spend Per Visit
This shows the average amount billed for each visit by a patient in the period. The percentages alongside show how the average for the Business Area compares against the average spend for the practice as a whole.
The Business Area Analysis (2) KPI – Explained
Let’s look at the sub-headings for Business Area (2) Analysis:
Billable Minutes Vet
This is the total time for the veterinarian that was allocated to the services that made up the sales. This time is defined in “Performance Pack” and also used to calculate the recommended fee for the service.
Full Time Vet Equivalent
This is the number of full-time veterinarians needed to provide the services. This assumes that the veterinarians spend 100% of their time on billable services. It is intended as a measure of the efficiency of the practice and not as a guide to the number of veterinarians needed. In the example, the FTE for veterinarians is 0.60 for the period. This should be compared with actual number of veterinarians who worked.
Billable Minutes Nurse / Full Time Nurse Equivalent
This is as for veterinarians, but using the time allocated to nurses in “Performance Pack”.
The time that’s available for billing is a limit on the growth of your business.
Also how effective you are in using that time dictates how successful you are.
It’s obvious that you cannot use 100% of the time that’s available.
But in order to have a plan you must set goals for percentage of the time that should be billed.
It’s then very simple to calculate the billable time goals.
The KPI report collects the time that’s billed through the Procedures for each veterinarian and nurse.
You use this to measure how efficient the processes are in your practice.
If your staff are not using their time as effectively as you planned, you have an “opportunity cost”.
The Economist’s definition says “the notion of opportunity cost plays a crucial part in ensuring that scarce resources are used efficiently”.
This KPI helps you manage those scarce resources.