HMDG Retention Engine
Retention Report

What your rebooking number is hiding

Your PMS tells you your rebooking rate. That number is calculated differently depending on the system, and it is often overstated.

It counts appointments the patient never turned up to, follow-ups pencilled in at the end of the first visit that were cancelled the next day, and bookings the front desk entered speculatively. The number on your dashboard is a measure of what the software saw, not what the patients actually did.

Retention is what turns capacity into revenue. You can book the rooms full, but if patients only come in once and never return, every other clinic metric quietly falls apart underneath you. If your rebooking number is wrong, the decisions you make off it are wrong.

Enter five operating numbers taken directly from completed activity, and any of the three your dashboard does report, so the tool can show your retention beside what it is telling you.

Your last six months

Five operating numbers taken directly from completed activity, plus any of the three your dashboard does report so the tool can show them side by side.

Whatever your PMS shows on the dashboard. Leave blank if you are not sure.

Whatever your dashboard shows for average visits, sessions per patient, or similar. Leave blank if you can't find it.

Whatever your dashboard shows for average patient value, lifetime value, or revenue per patient. Leave blank if you can't find it.

Unique patients seen for the first time in the last six months.

Of the new patients above, how many actually attended a second visit. Pullable from any PMS as patients created in the last six months with more than one completed appointment.

Unique patients seen in the last six months who had been seen before that.

Completed appointments in the last six months, all clinicians.

Completed revenue in the last six months, excluding VAT.

First-visit retention

PMS

78%

Clean view

50%

Needs attention

Episode depth

PMS

4.5

Clean view

2.0

Needs attention

Patient value

PMS

£380

Clean view

£200

Diagnosis

The biggest weakness appears to be first-to-second visit conversion. Fix that first. If patients do not come back after visit one, every other retention number downstream gets worse.

How the numbers actually work

Why your PMS rebooking rate can be misleading

Rebooked is not the same as came back

Most PMSs count any patient with a future appointment in the system as “rebooked”. That includes appointments the patient never turned up to, follow-ups the front desk pencilled in speculatively at the end of the first visit, and sessions the patient cancelled the next day and never replaced. The question that actually matters is: of the new patients you saw in the last six months, how many completed a second appointment. That is the number in the Clean operating view column.

Why appointments per patient matters

Throughput is not the same as episode quality

Your PMS reports total appointments and total patients, but not the ratio that matters. Many MSK cases require more than one or two visits to get a meaningful result. If this figure is low, it usually means too many patients are dropping out early, though case mix and maintenance work can affect the picture. The dashboard usually does not surface this because it is designed to show diary activity, not whether patients progressed through a meaningful course of care.

Why patient value matters

Revenue per patient is not a number most PMSs show you clearly

Most PMSs will show you total revenue and total appointments but not revenue per unique patient in a form that is easy to act on. To get the figure in the Clean operating view column you have to cross-reference takings against the count of distinct patients seen in the same window. It gives you a much cleaner answer to the question: what is a patient actually worth to me?

Why six months

Long enough to see an episode, short enough that the data is still true

Six months is long enough for a full episode of care to play out end-to-end. A patient who comes back ten times over ten years is not a retention signal; it tells you nothing about how the clinic is doing today. Annual windows let old cancellations, schedule changes, and patients who quietly stopped coming blur the numbers. Monthly windows are too noisy, because one bad week of DNAs or a clinician being off skews everything. Six months is the cleanest picture of what your clinic is actually doing right now.

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