Leakage is an Ugly Word. But That’s Not the Biggest Issue.

I don’t care for the word “leakage.”

But it’s not just because the word is gross. I hate what it represents: patients not getting the care they need.

But despite my best attempts to resist it, the word has become popular in the healthcare business services vernacular, and in my field, I use it often, hear it regularly and routinely see it boldly represented on slides. Recently I met with a tenured healthcare marketing leader and confidently described the incredible improvement Blockit is making in patient leakage. Her reaction was priceless. With her face scrunched up and her head shaking, she simply said “eeeew…..that’s a disgusting word.”

We both laughed for a bit, and then she proposed something interesting: “You should call it keepage.”

I liked her idea, but I realized that even if she and I changed our language, leakage would persist. The only way to get rid of the nasty word is to eliminate the problem it represents, and that would require an entirely new way of thinking, one that would be open to change. Changing our language will help, but it’s really just the beginning.

The Bigger Problem With Leakage

As most providers know all too well, leakage is when a patient enters a healthcare system through an access point but drops off somewhere in their continuum of care. This mostly happens when there is a lack of effective care coordination that would establish the patient’s next step on their care journey. Too often providers stick with the traditional referral method where a provider offers a business card or the name of a specialist and then leaves it up to the patient to schedule. The health system rarely sees them again.

“What would it be like to measure what you keep instead of what you lose?”

Study after study shows that this leakage stuff happens a lot. One report states that 47% of patients who receive a referral through the “traditional” method end up slipping out of the health systems network and choosing a different provider. But our leakage problem is so much worse than lost revenue for individual health systems. Leakage also has negative effects on improving clinical outcomes and direct implications to rising healthcare costs and ineffective utilization of clinical services.

Leakage is yucky, negative and hopeless. To quote my marketing friend, it’s simply “ew.”

The word itself measures failure, not success, but we don’t have to be bound by it. Leakage doesn’t have to win, and that’s why I think the marketing expert was on to something when she suggested we change our language.

What would it be like to measure what you keep instead of what you lose.

The Hope of Keepage

“Nearly twice as many patients follow-through when their provider simplifies the process for them.”

The same data that identified the 47% lack of followthrough also showed a positive trend in healthcare. In the (unfortunately) rare cases when the sending provider made the appointment for their patient at the time of service and provided the patient with appointment confirmation information right then and there, the likelihood of that patient following through went up by 72%. Nearly twice as many patients follow-through when their provider simplifies the process for them.

Providers who use Blockit’s care coordination platform experience even higher follow-through rates, many which are in the upper seventies or even mid eighties! We’re hardly having to use the term “leakage” as the idea becomes less relevant and more providers keep their patients in network.

Let’s look at what else happens when keepage happens beyond just revenue retention:

  1. Patient Satisfaction: Our data shows that patients love having their next step not just recommended by established for them. They feel good, much less burdened and certainly cared for.

  2. Clinical Outcomes: Keepage ensures that we have the opportunity to improve the clinical outcome and as many of my physician colleagues tell me, I can only help if they would only come.

  3. Continuity of Care: The continuity of care collaboration is vastly improved through shared data and shared dialogue.

  4. Cost and Quality: Cost is reduced and quality increased as the patient is responding to directions that will ensure that they get to the right physician at the right time to receive the right care.

  5. Keeping Patients in Network: Lastly, keepage means keeping patients within the health system’s share of care, reducing the opportunity for readmission liability or worse...penalty.

I am excited to begin changing the healthcare services vernacular not because I like new words, but because I think it will positively affect the communities we serve.

After all, it isn’t the word leakage that now makes me say eeeew but what it stands for.

It's time to eliminate leakage and start thinking about keepage, and with Blockit’s digital care coordination solution we not only can think it but we are doing it at many amazing healthcare systems and you can to.


Dave Gregorio is the Chief Customer Officer at Blockit and the author of the Purpose Quotient®, a nationally recognized framework for Organizational Development. A 30 year healthcare industry professional with a passion for people, Dave is the founder of the Heroes to Healthcare mission and CEO of ImPowerQ Associates LLC.

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