Episode 165: Harnessing Data: Streamlining Therapy Practices [featuring Tory Krone]

Show Notes

In this episode, I speak with Tory Krone, a seasoned clinical therapist, group practice owner, and co-founder of PracticeVital, offering some incredible insights on how data can empower therapists and practice owners to make informed decisions, ensure sustainability, and improve overall practice health.

Here are 3 key takeaways:

1. Data-Driven Decisions: Implementing a custom dashboard like PracticeVital can provide real-time insights into the health of your therapy practice, aiding in data-driven decision-making and improving sustainability.
2. Transparent Communication: Offering clinicians access to their own data fosters transparency and accountability, leading to better performance and client outcomes.
3. Identifying Improvement Areas: Tracking metrics such as retention rates, revenue per session, and cancellation rates enables practice owners to identify issues early and make informed improvements.

More about Tory:

Tory Krone is a seasoned licensed clinical therapist with 15 years of experience spanning therapeutic practice and leadership roles across all levels of care. As the founder and managing director of a successful group therapy practice in Chicago, Tory has always been at the forefront of innovation in mental health services. In 2023, driven by a passion for making things easier on group practice owners, Tory collaborated with her husband and two other family members to create a custom dashboard tailored to the specific needs of her practice. This project led to the co-founding of PracticeVital, the first-ever automated dashboard designed to offer real-time insights into the health of therapy practices and to empower teams with actionable data.

Tory is offering all listeners of this podcast $30 off of their first month of PracticeVital if they sign up using the code "AllThings" at practicevital.com.

• Facebook: facebook.com/groups/practicevital
• Instagram: instagram.com/practicevital
• Website: practicevital.com

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Transcript

PATRICK CASALE: Hey, everyone. Welcome back to another episode of the All Things Private Practice podcast. I'm your host, Patrick Casale. I am joined today by Tory Krone, who is a seasoned licensed clinical therapist with 15 years of experience spanning therapeutic practice and leadership roles across all levels of care. She's the founder and managing director of a successful group therapy practice in Chicago.

Tory has always been in the forefront of innovation in mental health. In 2023, driven by a passion for making things easier on group practice owners, Tory collaborated with her husband and two other family members to create a custom dashboard tailored to the specific needs of her practice. This project led to co-founding PracticeVital, the first-ever automated dashboard designed to offer real-time insights into the health of therapy practices and to empower teams with actionable data.

Tory, thank you so much for coming on. And we're going to talk about how to use that data in terms of really supporting your practice and ensuring the sustainability and the health of the practice in general. So, anything I missed in your bio that feels really important to note?

TORY KRONE: I don't think so, not from the bio, at least. Yeah, thank you. It's great to be here.

PATRICK CASALE: Yeah. So, you have created this dashboard and this program. And I want to know a little bit more about the why? Like, what was happening beforehand and what led to the creation of something that feels really data driven. And why does it feel so important?

TORY KRONE: Yeah, yeah, absolutely. So, yeah, back in 2022 I was on maternity leave. And at that exact moment it's about when I decided to start growing my practice a little bit more, not intentionally, but it just sort of started to happen in a way. And so, I felt like I just didn't have a good grasp of what was happening in my practice while I was gone. We had people pulling some spreadsheets. I was really probably one of the farthest from data-driven practice owners there could be. We didn't even have a weekly minimum for clinicians. I was kind of just like, "Oh, I'm a flexible practice owner and everyone can do what they want."

But in doing that, I lost the grasp of kind of the business side, as many of us do. And you know, most of us don't go into this field as numbers people. We're often not numbers people. We're driven by helping people. And, you know, there was a lot of information I felt like I was missing in terms of really getting a complete picture of my practice.

So, the first step was I was hearing people talk about dashboards. I felt like this is something that I must need, but I didn't really understand how to do it, how to pull it in, how to get the numbers, and then, what are the numbers really going to tell me? And I think a lot of practice owners can relate to that.

And so, I started with having my husband help me. He's a technology consultant. And I said, you know what would be really useful, though, is that the therapist could see it. Like, I don't want to have data that they don't have, and I don't want to just share with them, emailing numbers, where I'm emailing them, you know, "This is how many numbers you did, or how many sessions you had this week, or this is your cancelation where like…" Like, they should get to see that number themselves. So, that was my main intention, was let's create something where they can view it whenever they'd like to.

And from there, we started to share the concept and kind of how we were working on it with our family members, a cousin, and cousin's husband. He's a software engineer. And she's got a background in marketing and design. And everyone was really jazzed about the idea of it, and just started kind of working together really for my practice first.

And then, we realized we had something really special because we started automating the metrics. So, we were pulling them out of the EHR, gathering all the data, and then putting it in this really visually appealing way that I could make sense of my data for the first time. It was really the first time where I was like, "Oh, wow." Even. I knew how many sessions I was doing by month, sort of, seeing it in a bar graph, seeing it in a visual representation, being able to adjust the time frames, being able to compare year-over-year or pull up an old, you know, retention for a therapist from the past, like all of that really helped to paint a different picture for me. And we just thought this is something other people are going to want access to.

So, we started sharing it, and that was just as of, basically, December of last year, in 2023 and now we have over 200 practices around the country who are using it. We have practices as small as two, you know, that just kind of want to see their own information and are just curious how things are going, and they don't want to pull their own reports. And then, our largest practice right now is 80 clinicians. We've even had practices of 100 to 200 asking us, but they're, unfortunately, not on supported EHR that we work with. So, yeah, yeah. I think when you get that big, you often go into a different kind of system.

PATRICK CASALE: Yeah, for sure, you start to white label, you start to get into some really custom-designed EHRs that maybe don't have some of that functionality or some limitation. So, I want to talk about what you're saying because I think that's a common story for a lot of group practice owners, myself included, where you kind of don't know what's happening beneath the surface, right? Like you're kind of like laissez-faire. I don't want to micromanage. I want to create a supportive workplace culture. And all of a sudden, everything you've created to set out, to build, and structure, and support kind of starts to crumble because you don't know what's happening financially. And you take a little bit of a peek, and you're like, "Ooh, this is horrifying. I'm going to put the curtain back, and I'm going to ignore this for a little while." And then, it just continues to snowball.

And I think that's really common for a lot of mental health clinicians and professionals who just don't have any business training, where the money is a really daunting topic, especially, when you're employing other people, and then you have to start setting accountability measures.

So, having this data so crucial. Our practice really thrives and believes in saying transparency around the money. Like, we need to know what's coming in, what's going out. I think when our clinicians know their numbers, specifically, and individually, and they can see it, and it's tangible and it makes sense, there's a different level of accountability there, opposed to the group practice owner, or the office manager, or the admin leader, or whoever going in and saying, "Nobody's hitting their numbers. This is problematic. Like, everyone's out of compliance." That's not a great way to communicate this information.

TORY KRONE: Exactly, exactly. And, you know, people don't know what they don't know, and they can't make changes if they don't know. And data is power. I mean, it's meant to help us make changes. Without it, I don't know if we know where to make changes.

And so, being able to really concretely see where a clinician can change their own whatever it is, it might be something as minor as my cancelations are really high, and that's interfering with client care. And so, when I see that, all I have to do now is be curious about the numbers and get to the root issue, and then, I can have a conversation with the client and say, "Hey, you know, I noticed that you're canceling a lot. Like, are you still committed to this? Is this working for you?" A lot of it is just driving conversations based on curiosity, and then, being able to plan more effectively based on having data.

So, you know, really intentionally thinking, Okay, if our retention is low as a team, let's all get curious about what could be happening. And let's talk about ways that we could intervene as a group. You know, maybe our clients don't even know how to be clients at this point, and so, we have to teach them.

Like, I was thinking about it the other day, I was thinking it's kind of like showing up for a job for the first day as a new client. And if you've never been in therapy, or even if you have every therapeutic experience can be really different.

So, somebody shows up and they're just expected to tell their story or start talking, but they don't even know what is the process like? How long does this take? And they might not even know the right questions to ask. So, I think it's our job, partly, as therapists to set the stage and kind of give them some direction around, you know, typically people come for at least eight sessions so that they can meet their treatment gains or their treatment goals.

And so, what if we plan on doing that, and we schedule you out for eight sessions, and then we can regroup and talk again and see how things are going? But without that kind of feedback, clients just don't know, and then, the practice is struggling, the therapist is frustrated because they're not, you know, seeing the client on a regular basis. And so, there's a lot of spin off from that.

PATRICK CASALE: Absolutely, yeah, that's really well said. And I think that's a super important piece that gets missed a lot. We just kind of have this expectation that someone's going to come in and understand how to do therapy because we know how to do therapy.

And I think therapists get lost in that a lot of the time. And that even shows up in marketing stuff, right? Like, when we're talking like walking DSM-5s, it's like, no, not everybody went to school for this, so not everybody understands what you're saying.

TORY KRONE: Exactly.

PATRICK CASALE: I think the data also informs marketing, right? Like, the data kind of shows us where should we be allocating resources? Where should we be editing? Where should we be tweaking? If we are seeing in the data a large number of calls that are not being converted, or clients who are just leaving after one or two sessions, are we seeing the right clients? I think that's important too. Do we have to redefine our niche or our target population? Do we have to get really clear as a practice about who we are and who we support? Because I think that's also a big piece of this.

TORY KRONE: 100%, yep, yeah. And yeah. So, we track churn rate and we define that as the percentage of clients who leave before the fourth session. And when there's a higher churn rate that's some of the first questions we're asking is, are these the right referrals for that clinician? You know, maybe you're sending them a lot of clients who are struggling with trauma, and this clinician doesn't feel like they have a lot of training in that area, or they don't feel very able to help the client. And so, we want to start with getting curious, again, asking questions. Is that an area that we can train you up in? Or do we want to pass those clients to somebody where they're going to have a better experience right off the bat?

It could also be a sign of burnout, you know? And so, it was interesting, I was talking to a customer the other day and they were saying, "You know, I was really surprised about this one clinician. Their retention rate seems to be pretty low, you know, compared to what I would expect. You know, they're pretty seasoned. They've been with me a long time."

And so, I said, well, let's just be curious. So, we looked, and the person's retention rate was like 50% or something. So, you know, half the clients were leaving before the eighth session. And so, I said, "Well, first, let's check because your instinct is this clinician is a strong clinician, and, you know, is able to meet the rapport with clients."

And so, we looked back at 2023 and the data was totally different. It was like 70%. And the year before it was 80%. And so, I said, "Well, I think this therapist could be struggling." And the practice owner was like, "Gosh, they have seemed a little different." You know, and I realized maybe there's some things going on with them at home, and they've been doing this for a while, maybe they are starting to get burnt out. And that was reflected in the numbers. And so, "I said your instinct wasn't wrong, that this is surprising based on what you know about them, so why don't you start with a conversation and just see if you can support them in more ways?"

So, you know, I think that it's a jumping-off point. It's a place to start to get to the root cause of what might be going on, and then, be able to intervene in a way that helps everybody.

PATRICK CASALE: Yeah, I agree 100%. It gives us so much insight that if we're just trying to read between the lines, or if we're just trying to take things at face value, we can miss a lot of information. And then, I think that as therapists and mental health professionals, even those of us in leadership, a lot of us really struggle to have, like, really direct conversations, to solicit feedback, to kind of check-in and hold people accountable. And then, all of a sudden it's like a rudderless shit that's kind of driving off into the distance.

And too many group practice owners that I know of are too burnt out worrying about everyone else's livelihoods, being really concerned about what their next step is. And in reality, it's like we're digging our own holes a lot of the time, and it's really hard to kind of climb out of.

TORY KRONE: Yes, and you wouldn't believe the number of practice owners I talk to who are like, "Oh, this is why I'm losing money. This is why I'm making less than my therapist, you know." I have overextended myself. I've tried to support everybody regardless of whether they're meeting kind of what we need to do from a business standpoint. And, you know, I don't see those things having to be in conflict. I see the data as a win, win, win, where, you know, we can support the therapists in doing their jobs in a way that works for them, helps them to be financially more stable, maybe it tells us we need do need to market in a different niche. Or maybe you're doing too many of the wrong kinds of sessions. You know, maybe we have a million 90834, and so no one's making any money.

And so, I think just having the information is so empowering. And also, I think it's going to help practice owners, and has helped practice owners stay in business. And at the end of the day, it is a business, even if we also want to have the best culture and, you know, the safest workplace and all of those things, we still have to have it be profitable, or it's going to tank, and then, everyone's out of jobs.

PATRICK CASALE: Yeah and… Go ahead.

TORY KRONE: I was just going to say, you know, just one of the biggest things I feel most passionate about at this point is that small practices, large practices, group practices, can stay afloat. You know, in this economy and the way that our culture is going right now, it just feels like we can't compete very easily against these huge VC-backed companies. And I see that as a real shame, and we need tools like this to be able to help move the needle and help people have the insights and make their lives easier. Like, the number of hours that it saves for them each month, and just the reassurance it can bring, and the clarity, and then being able to pivot and make the business sustainable is really what our goal is.

PATRICK CASALE: Yeah, absolutely. And I think that's a really important point, especially, with all the VC companies, like you mentioned, all the tech companies coming out, all the new platforms. Like, if you want to take care of the collective, you almost have to be a little less concerned about the individual's preferences in certain aspects. And I think that's a hard line to walk as a group practice owner and a leader is to recognize, like, I employ X amount of people. For me, it's almost 30. We have to ensure the health of the collective is strong and sustainable, or 30 people are out of jobs.

And I think that's a really daunting thing to juggle as someone who is in a leadership position because those are the things that definitely keep a lot of us up at night. However, with the appropriate information, the data, the numbers, like the math is the math, right? Like, if we look at the numbers and we separate our emotion from the numbers, that's all they are. And it really is a helpful compass/guiding point in order to be able to look at those things with an accurate picture, and lens, and representation.

TORY KRONE: Yeah, yeah, absolutely. Yeah, and a lot of the data, yeah, it can help us to make more, you know, concrete rituals around it in terms of, you know, making simple changes that don't have to impact anybody negatively. It's all really positive. You know, one person was telling us she's now doing welcome bags for clients to just help to, you know, again, explain that process therapy and really welcome them in as if, like, this is your home now, we're helping you on a journey. This isn't like a one-session stop. And that really simple change has made it so the whole practice is now thriving the collective. Because, to your point. I mean, I love that, that concept of we could focus on the individual, we can be stuck on one person, and then the whole group is going to suffer because of it. Or we can be focused on the greater good of the practice and keeping it sustainable. So, it can be really small tweaks that can make a really big difference.

PATRICK CASALE: Absolutely, 100%. So, you had mentioned some EHRs that this is not compatible with. Can you name some of the ones that it is compatible with? Some of the ones that might be a little more popular and prevalent?

TORY KRONE: Yeah, yeah. So, SimplePractice, we're fully integrated with SimplePractice, TheraNest, TherapyNotes, and Intake/PracticeQ. We are considering continuing to build with additional ones, but we just want to make sure we're doing each of those really well and not biting off more than we can chew. And yeah, being really intentional.

So, the whole tool has been built based on primarily user feedback and stories, and so we are constantly gathering feedback from customers, making changes. We just added in revenue data based on that. So, now we're tracking average revenue per session by therapist. This is super helpful for also being able to make sure that caseloads are balanced and that clinicians are able to, you know, especially, if you're doing something like a percentage split, that it's roughly even, or if you're not, then being able to do a flat hourly rate compensation model around a percentage of what the average would be.

So, a lot of those kinds of decision-making can come out of this as well, but that was really born out of our customer's requests. So, we're continuing to build, continuing to add in. Our onboarding process is super easy. I know that's always a concern with people, and you know, we're all so short on time regardless. But I think people are afraid to take on another tool. But ours is really… it's not like building out a, you know, I've done monday.com and that kind of thing where you have to build the whole thing yourself. It's really as simple as you add us as an email address into your EHR, and we start to pull in your data automatically, and from there, we have you fill out a form to customize the metrics to your practice.

So, it's like you can choose the average number of sessions that you have as a goal for each clinician individually. You can set how you scale each CPT code. You can even adjust your cancelation rates. We kind of program it to industry standards but you can adjust the rates, or if your retention for your practice, you'd like to be 10 instead of eight sessions, then we can do that.

And then, from there, it's all up and running. It pulls the data back all the way from 2022 and you get to see the data, you know, all in front of you in this really visually appealing way that I think that's one of the biggest benefits of the program, is that you can see all of the information in a way that clicks for both therapists, for the leadership team, for the admin, practice owner, it makes sense, and it's all in one spot.

So, we've all had the spreadsheets where you pull one spreadsheet and then you go to another page or another tab to get the next answer. And here it's like all in one spot where you can find every answer that you're looking for.

PATRICK CASALE: Wow, sounds like you have something really unique and really special in your hands, and definitely something that it sounds like is going to continue to evolve and transform as more feedback comes in and you work with more practices. So, very, very cool. Anything you feel like you haven't talked about in regards to how this can be helpful, or do you feel like you've hit and checked all the boxes?

TORY KRONE: You know, I think that we're just constantly hearing additional stories from customers in ways that we didn't even recognize that people would use it. So, you know, I think the main thing is it's really helping them uncover the story and make sense of their data, and then know what to do with it.

And so, yeah, I think, you know, a lot of times the question we get from practice owners is, I feel like I'm giving constant new referrals to, you know, a bunch of clinicians. And it just seems like, you know, it's happening a lot, but I don't know if we have an issue, a marketing issue, or do we have a retention issue? And they're just not sure.

And so, within about five seconds, I do a free coaching call with everybody after they've onboarded. And we look into the numbers, and I say, "Oh, well, these clinicians had 60 clients so far this year. And you know, this is the retention rate, and this is what the cancelation rate is. Oh, it looks like they're not booking that many each week. So, we might have to just have them book more, but they actually have a lot of clients to [INDISCERNIBLE 00:23:32] from."

So, I can then easily paint that picture for them, and then they're like, "Oh yeah, next time, I can do that with my other clinicians and make sense of it." So, I think that's a lot of it, just the ease of telling this full story, the ease of decision making, even when to hire your next clinician. We even gather the data by location or by supervisor, so you can, at a glance, see how well-utilized is this location. Oh, it might be time to hire somebody new for this spot.

So just, you know, endless kind of comparisons and even something, you know, I think most dashboards don't have is average number of sessions that you have across the practice per client. So, the whole practice average, but then, also by clinician. And that can really help you with financial forecasting as well. So, [INDISCERNIBLE 00:24:25] love working with our tool. Most people have their CFOs, or their integrators, or whoever on there. But yeah, I think that that kind of hits the main points.

But again, we're still learning, and we do monthly meetups with practice owners where everyone can show up. And a lot of times people have leadership teams, somebody else comes. So, we learn one thing from a clinical director and then the intake coordinator from another practice says, "Well, I've been using it this way, and you know now I know how many bookings that I really want to have each week in order to even make sure that we break even our expenses. So, I know that if we're short one week, and we're going to really ramp up our Google ads, or we're going to reach out more."

So, again, the whole practice is using that. It's not just the practice owner. It's really every person in the practice who can benefit.

PATRICK CASALE: That's really cool. It sounds like a lot of you who are listening would definitely benefit from something like this, myself included. So, Tory, thank you for coming on, and please share where they can find that because I imagine you're going to get quite a bit of downloads after this episode ends.

TORY KRONE: Thank you so much. So, they can visit www.practicevital.com/. That's our website. Complete a Contact Form. We'll get you scheduling for a demo. And if you use the code All Things, you can get a $30 discount off of your first month.

PATRICK CASALE: And all of that information will be in the show notes too, so that you have easy access to everything that Tory just listed, so you can try out PracticeVital and see if it helps you solidify, and organize, and understand your data behind the scenes. And I think that what a wonderful tool. So, thank you so much for coming on and making the time.

TORY KRONE: Thank you so much for having me. It's a lot of fun. Thanks.

PATRICK CASALE: To everyone listening to the All Things Private Practice podcast, new episodes are out on every single Saturday on all major platforms and YouTube. Make sure to follow, like, download, subscribe, and share. Doubt yourself, do it anyway. We'll see you next week.