navigating hospital sales

2013. Technology Access Partners LLC. All Rights Reserved

Mastering the Economic Sale


Issues uncovered in the HAMF

1. Champions that lack power to influence others including materials management.

2. Lack of collaborative/team relationship with all the key clinical champions

3. Establishing the product as a protocol vs. out-of-site; out-of-mind. 4. Unsure about committee capital processes. 5. Capital constraints and other budgeting issues. 6. Limited clarity of detail behind status of where proposals are in the

review process. 7. Clinical heavy sales and lack of access to other stake holders or

interest in targeting of non-clinical people (besides materials management)

8. Dealing with materials management/purchasing scrutinizing the cost and potential product usage.


Navigating Stakeholders

Other Resources

Management

Salesperson(s)

CNO

Marketing VAC Comm

CFO CEO

Physician

QA


Who cares?!?!?-------Key Stakeholders

C-Suite Chief Executive Officer (CEO)

Chief Financial Officer (CFO)

Chief Medical Officer (CMO)

Chief Nursing Officer (CNO)

Chief Operating Officer (COO)

Chief Information Officer (CIO)

Service Line Management ICU Administrator

Administrator of GI/Surgery

Senior Management VP, Marketing/Public Relations

VP, Managed Care

VP, Program Development

VP, Supply Chain


Clinical Champion(s)

Value: Information & Access

Micro-Map Hospital Organization

Process Steps & Roadblocks

Information, Access & Endorsement

Initiatives, Budgets & Approvals

Other Stakeholders Issues, Concerns & PIP

(Politics, Influence & Power)

Committees Policies & Procedures

Explore and Amplify

EXPLORE RESULTS AMPLIFY

Vision, Issues & Concerns


Partnering With Your Clinical Champion


Degree of Collaboration

Validator Advocate Partner


Clinical Champion Collaboration A Predictive Model

VALIDATOR ADVOCATE PARTNER

A Clinical Champion that Validates the clinical need for your product or technology.

! Confirms that they have a

patient population that would benefit.

! Does not confirm that other physicians feel the same need.

! Is not willing to champion with other physicians or hospital administration.

! Is not able to address the economic impact to the hospital.

A Clinical Champion that validates the need but is also willing to take your information and Advocate for it. ! Although they are willing to

Advocate for your product they are unwilling to accept your assistance.

! They ask for your clinical and economic data and wish to bring it to others.

! They may or may not seek input from other clinicians.

! They often tell you that they have comsidered all aspects of hospital process and dont need your assistance.

A Clinical Champion that validates your product, is willing to advocate for it and also recognizes your value to the sales process. ! They facilitate meetings where

you will both be present.

! They are willing and able to micro-map their organizations to identify other key stakeholders.

! They are willing to discuss potential roadblocks to success and strategize with you to overcome those roadblocks.


Clinical Champion Exercise

Identify a critical value proposition and the issue that it fixes for your Clinical Champion. Write a few sentences that amplify the issue.











Explore and Amplify




Micro-Mapping Stakeholders

?

?

?


New York Presbyterian Hospital

Quality Assurance

Ian Hatch

(Quality Systems Manager)

Technology

John Paul Triculis (Manager Information

Technology)

Alicia Williams (Healthcare IT Project

Manager/Medication management specialist)

Purchasing

Matthew Joki

(Dir Clinical Sourcing)

Anand Joshi (Corporate Dir., procurement &

strategic sourcing Executive offices

Phyllis Lantos MS

(CFO)Steven Corwin MD

(CEO)

Robert Kelly MD

(President) Laura Forese MD

(CMO)

Richard Liebowitz

(CMO)

Wilhelmina Manzano MA

(CNO)

Finance

Dov Schwartben

(Svp Finance)

Vascular Service line

Lisa Mainieri

(Dir Vascular serv. line)

Surgeons

Karl Hemingway Krieger MD

(Chairman CardioThoracic Surgery)

Mathew Williams MD

Dr. Mehmet Oz

(Attending surgeon CardioThoracic)

Emile Bacha MD

(Chief of surgery CardioThoracic)

Marketing

Nida Shekhani

(Dir service line strategic planning &

Business dev,)Rosemary Cortez

(Program admin dir. HealthOutreach)Karen Wish

(Dir Marketing)Andrea Dacquino

(Dir. Intern. Bus Dev.)

Harry Sherman

(corp. dir web marketing)

Cardiac service line

Jessica Melore

(Program manager, outreach)

Lisa Morris

(Chief Cardiac Sonographer) Eileen King

(Transplant Admin)

Stephen Moore/Kristin Johnson

(Cardiac social Workers)

Bernadette Miesner

(Cardiac Serviceline Director)

LeeAnn Glozman

(Sr staff Nurse) Maria Moreno

(Cardiac outreach coordinator)

Martha Mijes

(RN cardiac catch lab)

NY Presbyterian Hospital


Micro-Mapping Exercise

Select a key hospital account and map as many stakeholders as you can.


Partnering With Key Stakeholders


Key Stakeholder Exercise

Identify three key stakeholders that you would like to incorporate into each hospital campaign.


Committee Members as Stakeholders

Capital Expenditure Committee

New Technology Committee

Value Analysis Committee

Budgeting large permanent equipment requiring physical plant adjustments

Devices, implants, smaller clinical equipment, non-disposable clinical

equipment

Supplies, disposables and commodity items











Explore and Amplify




Roles, Responsibilities & Concerns

! What are the primary roles and responsibilities of your key stakeholders? What does the title mean? What are the individuals primary responsibilities: Budgetary, Supervisory,

Clinical, Regulatory, Quality Assurance

! What are the primary concerns of the stakeholder? What are their Management By Objectives (MBOs) What keeps them up at night??????

! How many of these key stakeholders do you currently call upon?


Key Stakeholder Exercise

Identify the roles, responsibilities and concerns of your assigned stakeholder.


Chief Financial Officer Concerns The CFO is the individual responsible for overseeing the fiscal health of the organization. His responsibilities include: Overall revenue and expense management. Monitoring cash flow and ensuring the ability for the organization to meet its liabilities. Manage the relationships of the organization largest payers. Monitor, plan and react to changes in health policy and reimbursement. Short and long-term financial planning and implementation.

Roles and Responsibilities The top five concerns of the CFO are: Ensuring that the organization stays cash flow positive. The ability of the organization to meet short and long term financial liabilities. Maintaining appropriate patient revenue and procedure volume. The fiscal operations of the department such as billing and coding. Supervision of the administrative and clinical support staff


Chief Medical Officer

Roles and Responsibilities The Medical Director or Chief Medical Officer is the individual responsible for overseeing the quality of the healthcare services delivered by the organization. His responsibilities include:

Management of the Quality Assurance, Utilization Review and Discharge Planning staff.

Liaison between the Medical Staff and Administration.

Monitor the clinical performance of the Medical Staff and oversee benchmarking programs.

Ensuring consistent and high-quality medical care.

Concerns The concerns of a Medical Director or Chief Medical Officer are: The availability of high-quality clinical

programs that meet the needs of the surrounding community.

Maintaining a collaborative relationship with the Medical Staff.

Implementing and enforcing hospital policies and procedures as it relates to the Medical Staff.

Payment and reimbursement by private and governmental payers (e.g. Medicare and Medicaid)

Market share as compared to the hospital's competitors


Vice President of Quality

Roles and Responsibilities ! Responsible for quality management, hospital

compliance with regulations/standards using surveys and tracking.

! Coordinate the education and consultations with the CXO, Medical Staff and department heads; manage and direct the Quality Management activities and Medical Staff Services functions.

! Coordinate and oversees the organizational-wide evaluations and activities for performance improvement.

! Directs and oversees the development, implementation, and refinement of the organization-wide quality improvement plans and program.

! Coordinate and prepares Performance Improvement reports for the Quality Improvement council, Medical Executive Committee, and Board of Directors.

Concerns The concerns of a VP of Quality are: The development and management of

clinical improvement projects that positively impact and improve patient outcomes, cost, and operational effectiveness in care delivery.

Developing, implementing and tracking practice guidelines, policies, and methodologies patient care.

Ensure the data for Surgical Care Improvement Project Data (SCIP) and the National Healthcare Safety Network (NHSN) is accurate and consistent.

To learn more visit ahqa.org


Administrator Gastroenterology Roles and Responsibilities The Administrator is responsible for the administrative functions, financial management/planning and operational affairs of the GI service line. Their responsibilities include: Developing and directing the long-range

strategic business plan; preparation of business analyses, proposals, implementation plans for new programs, and the design and implementation of changes to existing programs.

Implementing policies and procedures for faculty, classified staff, professional staff, residents/fellows, temporary staff and other personnel.

Managing the department's operating expenses.

Concerns The concerns of the Administrator are: Ensuring that the department

operates efficiently and within budget.

Maintaining a collaborative relationship with the clinical/physician staff.

Managing the fiscal operations of the service line.

Developing and implementing high-quality, cost-effective clinical programs.


Director Critical Care

Roles and Responsibilities A Director of Critical Care develops programs and processes targeted at improving the speed and quality of health care services. In addition to increasing efficiencies and reducing costs, directors of critical care evaluate staff performance and create systems for measuring departmental and practice goals. Consistently monitors Patient Satisfaction results and develop plans to improve scores measuring outcomes.

Concerns The concerns of a Director Critical Care are: Maintaining excellence in clinical practice

within the unit for all patient care. Monitoring patient care on the unit level to

consistently enhance patient satisfaction. Managing human, fiscal and other

resources needed to provide and maintain quality care.

Assures adequate staffing to provide safe, quality care.

Developing, monitoring and maintaining budget for quality and efficient use of personnel, equipment and supplies.


Value Analysis Committee

The VAC is responsible for evaluating, analyzing and ensuring that medical supplies and services are purchased and delivered in a cost effective manner. This evaluation typically applies to new medical products and services brought to the hospital as well as replacement for existing products and services. The goals of a VAC can vary by hospital but generally: Accomplish cost savings and cost reduction through process

improvement. Function as the hospital "Gatekeeper" of new products &

services. Determine whether new medical supplies and services meet the

hospital's clinical Many hospitals heavily focus VAC efforts on physician

preference items also called PPIs. Hospitals can generate cost savings if it can standardize many of the PPIs it utilizes.


Technical Questions

Personal Questions Structural Questions

Political Questions

Focused Questioning


Technical Questions

Focused Questioning


Political Questions

Focused Questioning


Structural Questions

Focused Questioning


Personal Questions

Focused Questioning


Focused Questioning Exercise

List two Focused Questions, from any category, you would ask of your assigned stakeholder.


Medical Dir

CEO

CFO

Department Administrator

Clinical Financial Strategic Quality Awareness

Stakeholder Concerns Vary


Targeted Messaging (For Training purposes only)

Quality

Clinical

Strategic

Economic

Awareness

Over 30 randomized controlled trials and several meta-analysis have demonstrated the superiority of hemodynamic optimization over standard fluid management to decrease renal, gastro-intestinal, respiratory and infectious complications, as well as the overall morbidity rate.

Decrease in post-surgical morbidity obtained with hemodynamic optimization was shown to be associated with a decrease in hospital length of stay ranging between 1 and 2 days.

With the Companys Case Study iPad app we can provide you with the analytics to show you the outcomes with your PGDT implementation in comparison to your historic data.

Company has been treating the critically ill patient for over 40 years.

Ease of use and application can result in earlier initiation of flow directed goal-directed therapy, which in itself has been shown to provide better patient outcomes.


Targeted Messaging Exercise

1. Create a Targeted Message for your assigned stakeholder.

2. Identify the appropriate message category.











Explore and Amplify




Broadening Stakeholder relationships

Other Resources

Management

Salesperson(s)

CNO

Marketing VAC Comm

CFO CEO

Physician

QA

Leveraging influence and power. Overcoming road blocks and building consensus.


Collabora've*Behavior/Poli'cal*Inuence*Matrix*

Informa'on *Access *******Endorsement*

Poli'cal*Inuence*

Valid

ator

********A

dvocate***********Partner****

Collabo

ra'v

e*Be

havior*

Descrip(on+1+

Descrip(on+2+

CMO*

High*CB/High*PI*High*CB/*Low*PI*

Low*CB/High*PI*Low*CB/Low*PI*

COO*

CEO*

CFO*

Prgm**Dev*

Doc*

Mktg*

Admin*

CB/PI MatrixTM

A ""B "

""C "

""D "

""E "

""F "

G "

1 *2 *3 *4 *5 *6 *7*

High

er*Collabo

ra'v

e*Be

havior*

Higher*Poli'cal*Inuence*


Stakeholder Value (SV) Provide Information

"Budget Map (Hidden Money) "How to reach higher level stakeholders "Power Map versus an Organizational Chart "Budget Process "Competitive Information "Corporate Vision and Issues "Departmental Vision and Issues "Corporate Direction (COE, service line priorities,

etc.) "Organizational Chart

PI


Stakeholder Value (SV) Provide Access

"Trusted Advisor to Key Stakeholder. Influences their Budget Allocations

"Has Access to Others Calendars and Ability to Schedule Meetings for You

"Send an Email Introducing You to Another Stakeholder and Copies You in the Email

"Shares Information on Key Stakeholders and Allows You to Reference Them.

"Provide Information on Other Stakeholders But No Introduction

PA


Stakeholder Value (SV) Provide Endorsement

"Endorse Use of Aggregate Hospital Budgets based on Perceived Value of Your Solution

"Access to Departmental Budget and Ability to Endorse Contribution of Budget to Solution

"Higher-Level Veto or Endorsement Based on Fit Between Your Solution and Departmental Initiatives

"Delegated Due Diligence of Your Solution to Provide Technical Endorsement

"Technical Veto or Approval

PE


Hospital Analysis Decisions, processes and relationship structures

Name Lead

Name Title

Name Title

Name Director of Infection Control

Novation or other GPO

Name Title

Name Title

Name Title

Competitor 1

High*CB/High*PI* High*CB/*Low*PI* Low*CB/Low*PI* Low*CB/High*PI*CB/PI Sector:

Name Title

Name Title

Name Director of Contracts

Name Director QA

Name VP Marketing

Name VP Business Development

Name Chief Medical Officer

Name CFO

Name VP Purchasing

Name CEO Competitor 2


Stakeholder Intelligence and Access Exercise

Use a key stakeholder within one of your target accounts and place them on the CB/PI Matrix. What value (PI, PA, PE) can they provide to your sales campaign?


Hospital Account Evaluation and Planning

Interrogating account reality


Hospital Account Debrief

What top 3 questions about a hospital opportunity do you find most critical when evaluating an opportunity?


Hospital Account Mapping Components

Stakeholder Segmentation

Navigation & Evaluation

Target Account


Hospital Account Mapping Process

1. Using the Enhanced Surgical Recovery Program (ESRP) process, at what stage of ESRP would you place this hospital account? Sell, Assess, Align, Apply, Measure

2. What are current revenue and/or unit sales at this account? 3. What are the revenue and/or unit goals for this account? 4. Over what period of time are you expected to achieve the new revenue goal (e.g. end of Q2 or

end of fiscal year)? 5. Are there any historical challenges between your company and the hospital account that impact

your ability to achieve your revenue goals at this account? 6. Which companies are your primary competitors at this account? 7. If other companies are competitors in this account, identify several of their strengths and/or

weaknesses. 8. If the competition has stalled here please explain? 9. Are there any historical relationship challenges that you have with any hospital stakeholders that

impact your ability to achieve your revenue goals at this account? 10. Are there any historical product issues that impact your ability to achieve your revenue goals at

this account?

Hospital Account Segmentation and Goals



1. Which stakeholders do you persistently interface with? (Names & Titles) 2. For each stakeholder tell me about your relationship with them? How much influence do they have over

product usage? Are they willing to introduce us to other people? 3. What are each of their personal operations issues and concerns? What is impact of these issues? 4. What are the departmental issues? What is the impact of these issues? 5. How can we address these issues with our solutions? 6. What are the challenges each of the stakeholders we know are having with our company, products,

solutions? Why? 7. Who else in the hospital is involved in decision or is impacted in any way by our products; that we have

not met? (Names & Titles) 8. What do we know about them? How do we know of them? 9. Who can help us get info about them? Get to them? (If nobody, then how can we get to them?) 10. Who else do we know that is part of this decision and we have not leveraged the opportunity in a past

meeting to get to know them further? Why? 11. What do we know about them? How can we get back in touch with them? 12. What is each stakeholders position on competition? Are there positions we can leverage? 13. What are 2 to 3 focused questions and targeted messages we would use for each of these stakeholders

when we meet them? 14. Are there any other initiatives (departmental & corporate) that we are competing with? (time, resource,

money)? What? Why?

Stakeholder Segmentation, Navigation and Evaluation











Explore and Amplify





1. Is this hospital considered a Center of Excellence for GI/Colorectal? 2. Is there a long-term business plan for the COE service line? 3. If not a COE is GI/Colorectal a primary service line for the hospital? 4. How many GI/Colorectal procedures does this hospital perform each year? 5. What is your clinicians payer mix? 6. Which payers represent the majority of the clinicians revenue? 7. What is the hospitals overall payer mix? 8. Which payers represent the majority of the hospitals revenue? 9. What is the hospitals payer mix for cardiovascular procedures? 10. Have you determined if the product will need to be reviewed by hospital committees? New

Technology, Value Analysis Committee (VAC) or a Capital Budget Committee? 11. Have you obtained hospital committee policies, procedures and timelines? 12. Have you identified the individual members of the Committees? 13. Have you, or will you be meeting with each individual?

Hospital Account Navigation


Hospital Account Mapping Process

1. Who are the main challengers/roadblocks. What are their concerns? a. Details of above?

2. Have we reviewed these blocks with our champions? Their response? 3. Are these challengers critical to our account success or can they be circumvented? 4. Can we overcome these blocks? Why/why not? Plan for overcoming? 5. What resources in the form of people, presentations, proof and deliverables will you need? 6. Is there Targeted Messaging we can use with the non-advocates to reframe their perspective? 7. Are there other stakeholders that have political clout with the challengers? 8. Who are they and what type of influence or power do they have? 9. Stakeholders we can leverage in order to get information or access to these other

stakeholders? 10. What messaging will resonate with the additional target stakeholders?

Navigating Hospital Account Roadblocks and Challenges


Rules for Deal Coaching

1. There are only two answers to each question: the

information obtained from the stakeholder or I did not ask.

2. You can always go back to a stakeholder to get clarification.

3. The goal of deal coaching is to interrogate reality not the salesperson.

4. What we dont know will cost us deals.

navigating hospital sales

Documents

technology access partners

clinical need

lack of access

rights reserved issues

clinical champions value

key clinical champions

clinical heavy sales

access endorsement initiatives