A Data-Driven Approach to Build Physician Relationships to Drive Business

orHow to Save Our Physicians

Corrigan Partners CMP Project Design Studio, 10/26/15 Catalyst Ranch, Chicago

Suzanne Hendery, VP Marketing & Public AffairsSuzanne.Hendery@Baystate Health.org

Why This Work is Needed Now Today’s physicians, see themselves not as the “pillars of the community” but as “technicians on an assembly line,” or “pawns” in a money-making game for hospital administrators.” Sandeep Jauhar, MD

2012 survey: 8 of 10 MDs are “somewhat pessimistic or very pessimistic about the future of the medical profession.”

1973: 85% had no doubts about their career choice. 2008: 6% “described their morale as positive.”

Doctors today are more likely to kill themselves than are members of any other professional group.

Problem: No Time

Today’s system: RVUs, 8 Minute Appointments, Paperwork (processing forms, negotiating with insurance companies, reviewing labs, EMR documentation, consults, Rx visits)

Physicians in non-hospital medical practices in the U.S. “spend 10X as many hours on nonclinical administrative duties” as their Canadian counterparts do, Danielle Ofri, an internist at New York’s Bellevue Hospital, reports in What Doctors Feel.

Time Wasted, Patient Wasted

Why This Work is Needed Now

Annals of Internal Medicine: 1 refers to 229 other MDs

NYT: MDs receive up to 45% of new patients by referrals.

Average health system: 70% of patient referrals from MDs

ACO, Shared Savings, Population Health, ROI

Smartest marketing dollars you can invest. Creating a trusted relationship with the most important customers– that you rarely see.

Despite consumer involvementin decision making, physiciansare still the key drivers of volumes, and as such, cannot be ignored. Healthcare Strategy Alert, 2008

Physicians remain the single most powerful lever in hospital volume growth. Advisory Board. 4/14/06

Physicians are the key stakeholders. Hospitals would not be in business without them. The cultivation of referral relationships is mandatory to market development. Healthcare Financial Management, May 2007

New Challenges= New Thinking

You must establish a Physician Referral Program now

How can we improve the health and well-being of our physicians?

How can we communicate more effectively with physicians to build engagement, trust and lasting relationships?

How can we help ensure an exceptional physician referral experience?

How can we stop wasting time and money with inappropriate visits?

How can we better apply resources, data, analytics, and metrics to grow volumes, revenue and relationships?

Baystate Health, Springfield, MA

Baystate Health, a Top 15 Integrated Delivery System of five hospitals, including Baystate Medical Center, the largest hospital outside Boston. Baystate is the health care leader in Western Massachusetts with 5 hospitals, an insurance plan (HNE w 160,000) and one of the largest employers with 500 employed physicians/providers, 12,500 employees and 1,500 independent physicians in a 100 mile radius.

2006: MD Communications Issues“Referral process and admitting procedures both are in need of improvement.”

“ Scheduling is a source of frustration – physicians are sending patients to other hospitals because they find it easier and quicker to get into a competing hospital.”

“ Physicians feel less connected to the hospital since Hospitalists were hired.”

“Don’t see benefit in the new EMR system. No time savings. Training efforts are lacking.”

“Leadership is viewed as distant and not engaging these physicians in dialogue about the direction of the organization.”

“ Medical education attendance is down. Programs lack innovativeness. Looking not only for new things to learn but also for new ways to learn.

“ Half (53%) would recommend Baystate to colleagues with some reservations. This lack of complete advocacy can erode other physicians’ confidence in Baystate. Patient migration to other hospitals could be a problem over time.”

“ Most of these physicians see their admitting/referring patterns with Baystate staying the same over the next couple of years. Much of the opportunity to gain more patients from these patients is in the control of Baystate.”

Rob Klein, Klein & Partners, 2006

2011: New CMO Arrives

Growth & Financial Stewardship

Listen, Learn for Loyalty (L3 model)

#2 FILTER

Solicited Thoughts from Referrers• Common themes during initial evaluation (Aug 2012)– Long waits to see providers (variability by area, specialty)– Difficulty navigating referral processes– Poor communications back to primary providers– Insufficient data/analytics re: competitive environment

• Leading practice shows the value of:– Toll-free number for referring physicians experiencing

challenges– BH liaisons to develop long-term, positive relationships with

referring physicians– Database and metrics to monitor progress

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Solicited Internal FeedbackWith Chairs, Chiefs and Regional CMOs

General Feedback• Our success will be determined by our ability to differentiate ourselves on service• Continue to focus on operational issues: OR block time, Access Services, capture

referring physician as mandatory field for auto-sending reports to referring physicians

Feedback on Office of Referral Services:• Staff should facilitate coordinated recommendations for complex patients and

physician-to-physician conversations• Build on existing internal processes including “Go To People” for questions/issues

Feedback on Physician Liaisons:• Should focus on re-establishing relationships with physicians who are dissatisfied with

Baystate Health• We need relationship-based field staff and a sales force, with

- Collaboration among reps even though serving different functions- Formalized, systematic approach to meeting with physicians- Standardized training for sales and customer service staff across Baystate Health- Centralized reporting through Crimson Market Advantage database

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Researched Leading PracticesU Mass Memorial

Physician Referral Services Center

Tufts Medical CenterPhysician Network

Services & Physician Liaisons

Dartmouth-Hitchcock Physician Connection

Center

BI DeaconessCare Connection

Emory Physician Consult Line

Call Center Staff

Manager & non-clinical schedulers

Manager & non-clinical schedulers

Manager & Nurses Manager & Nurses

Primary Objectives

“One call, red carpet service.” Resolve scheduling challenges, provide missing documents

Schedule appts for ED patients and second opinions for health insurers & patients

Initial point of contact for problems & solve simpler ones

Schedule appointments and coordinate multiple appointments on same day

Closed medical staff: do not deal with problems/ issues

Doctor to doctor line: calls from physicians concerned about care of complex patients

Set post discharge appointments for some inpatients

Provide high level clinical thinking to provide most appropriate referral

Advice: “don’t become a complaint line…”

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Strategy: Physician Relationships

• Develop approaches that are “value added” for referring providers– Provide one “point person” in the field for ready access,

response – Provide support for navigating the referral process;– Expedite consults/appointments – particularly for new, complex

and/or acutely ill patients;– Consistently communicate back to the referring physician and

primary providers

• And as a result, retain current referrals and earn additional referrals

1) Physician Relationship Database • Analyst reports to VP, Strategic Planning & Business Development • Provide database training, data reporting and analytics support

2) Office of Physician Referral Management• Director reports to Chief Physician Executive for high-level issue resolution

and 2.0 FTEs responding to calls

3) Physician Relations Liaisons • 2 FTEs report to VP, Marketing & Public Affairs to ensure integration of

growth and retention efforts• Each has a territory with a maximum of 300 physicians

• Springfield and Northern Region (BJ)• Springfield and Eastern Region (Kevin)• Hand offs to other sales reps (BRL, BRI, BVNA&H, IR&S, HNE, etc)

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3 Pronged Structure