Step one should be the collection and analysis of consumer data from all possible sources.  This helps all who communicate with customers know the content of that communication and potential next steps.  This central repository helps an organization personalize the communication and track the process.

For a tool, you have a wide choice of options.  You can use something as simple as Access.  Or off-the-shelf options include GoldMine and ACT!  There are many other software tools that can help you collect data, monitor communication and transactions and they range from simple on-tool tools (HighRise) to more complex, enterprise wide options.

Having a database of information for your consumer allows you to focus on the needs and preferences of your “customers.”  Understanding what your customers want will help you work toward their needs and develop relationships.  You can organize and analyze the data that you collect to determine preferences and drive your efforts toward responding to those needs.

Customer relationship management as a tactical technology tool can help you gain insight into the behavior of your customers.  This can ensure physicians and patients are served in the best possible way. Customer relationship management helps organizations recognize and pay attention.  Keep in mind that while a technology tool can help collect and analyze this kind of information, it is the overall strategy and culture of the organization that puts energy behind this information and creates a responsive process.

Step two should be using your insight to improving communication with your consumer. Targeted communication that gets in the hands of your potential customer as they need it versus sending blanketed mailings to everyone with no particular focus hoping something will appeal will save the organization money and will improve the relationship with the individual target.  They will not feel bombarded with non-focused communication.

No surprise that different customers prefer different communication channels.  Certainly newer digital channels and social media tools offer greater opportunities to directly personalize messages.  But don’t throw out traditional methods which may appeal to a sector of your market.  The message is to carefully segment your market for both message and channel.  That new mom might find information on your FaceBook Fan page really helpful as she deals with the adjustments of having a baby in the house.  The grandfather who can’t finish a golf game without visiting the restroom several times might find a post card about your prostate services more helpful.

Working out the above is a matter of re-prioritizing your internal communication approach based on the insight you garner from data collection – the following are basic but sound steps to employ:

• Communicate to the customer based on their needs; avoid silo approaches.
• Use customer information from the entire organization and centralize it to make customer profiles and develop a more in-dept understanding of your customer.
• Segment your market.
• Communicate with the various segments as one entity – do not overwhelm your target with multiples communications and messages.

Whether you are focusing on your physician relations program or want to have  a more targeted approach with potential patients,  the need to track and measure nurturing activities is a basic outgrowth.  The information flow works in both directions so that significant market intelligence is collected as these relationships are cultivated.  The more individuals working on a specific relationship, the more navigation is required so that the target is not overwhelmed by a disorganized flow of information from various sources.  Technology can serve the process by easing the management and integration of information.  Use technology to enhance your developing relationships by being more focused in your communication and more aware of what your individual customer wants and needs.

Cleveland Clinic

“Patients are the purpose of our work, and Cleveland Clinic has embarked on an ambitious plan to examine and improve every facet of the patient experience. This effort encompasses every point of contact between patient and provider, from parking to prescription pick up.”

Johns Hopkins Health System

“Our quest for excellence isn’t limited to the treatments we provide. Several initiatives are under way at Hopkins to help physicians, nurses and staff to deliver the best possible service to customers.”

Gettysburg Hospital

“Gettysburg Hospital is ramping up its commitment to patient satisfaction with the aid of a qualified specialist. Tracy Lee joined the hospital last September as director of patient experience. Lee tracks patient satisfaction survey results and develops strategies for improvement.

Lee explained that many health systems have placed renewed emphasis on patient satisfaction in recent years.  A federally mandated consumer survey known as HCAHPS—the results of which are available to the public—has driven that trend.

“We all know what it’s like to either be a patient or have a loved one in crisis, and I enjoy helping make that experience a better one,” she said.”

These three organizations could not be more different from one another. And yet is placing special emphasis on the patient experience.  Each of them are defining that experience as beyond taking care of a patient clinically:

• “…every point of contact between patient and provider.”
• “Excellence isn’t limited to treatments we provide.”

When a patient visits the hospital or a doctor’s office, that individual experiences a series of events that often overshadow the actual contact with the medical provider. On a recent medical visit , I spent 15 minutes with the physician and 45 minutes “in process” once I entered the office – time at reception, time in the waiting room, time with the med technologist, time waiting in the exam room and time checking out after the visit.  It is easy to see how a good interaction with the physician can be overtaken by less than stellar service interactions.

You have heard me say that service is the marketing and that phrase is so true when it comes to the patient experience.  If you patient leaves happy, they will consider the experience positive and likely share that with their friends and family.  They will probably want to be your patient for a long time and will refer others to you. Their positive experience will create a long-lasting relationship value for them.  If your patient leaves grumpy, none of these good things happen.  In fact, a patient is more likely to share bad service news than good news and in telling their friends and family, you are on your way to a poor reputation.

So, think about, how high is your patient experience bar?

Top 10 Health Industry Issues for 2010, PricewaterhouseCoopers’ Health Research Institute

I like this quote. It sums up the vast pressure points in the healthcare industry in one sentence. What I don’t like is the ominous sentiment. Of course, it is not just PricewaterhouseCoopers that takes that warning tone. You can open just about any trade journal and find looming doom and gloom advisories. All of this is fine as long as the warning creates positive action versus paralytic analysis and no-action. Dissecting the quote further makes me consider what is controllable?

You can be a voice in the continuing healthcare reform issues, but your solitary efforts are not likely to foment change in the exact manner you prefer. But what about consumer demands? There is a rushing tide of changing American consumers especially when it concerns healthcare demands. Consumers are more informed, more connected, and more emboldened. Control elements center on the consumer and not on the provider. While it is essential to be tuned in to the healthcare consumer and to provide services they seek, there is little that can be done to alter the changing nature of our consumers.

The only part of the quote that we can effectively engage is the first part about relationships: squeezing the most value out of new and existing relationships. The word “squeezing” implies that we have already pressed our relationships and there is not much left to attain. This is a point of consideration – where do relationships stand with our patients, our referral sources – our consumers?

Have we squeezed the value? Is there more that can be done? As you face the new year and the new decade, why not create a new focus, call it what you will, but put your energies into those consumer relationships: maybe not to squeeze them of value but to enhance them with an outward and invigorated attention. See your practice, your habits, and your organization through the eyes of your consumers. To get you started, here are five push points that merit careful consideration and most likely some adjustments as you work to create more value in those important relationships:

• Do you treat all of your consumers the same?
• How does your service treat your consumer differently that your competition’s?
• How high is your satisfaction bar for the patient experience?
• How well do you employ technology to assist you in developing your consumer relationships?
• Literally sample your workflow through the eyes of your consumer (patient or referring physician), what adjustments can be made to signal your consumer that you are working to better the relationship?

So where should you start?

The Hospital

Seems like it would be a “no-brainer” for the call center and marketing department at your affiliated hospitals to be disseminating your information but this is sometimes an overlooked area. Think about that call center operator and imagine how much more enthusiasm they might provide a newcomer to the area if they have actually met you – the physician? Taking the time to introduce yourself to call center personnel and the individuals in the marketing departments helps them put a real face on their work and also lets them know you respect and appreciate the work that they do. Along these same lines, make sure that the individual charged with the hospital’s website has your information. Ask them if they engage in any social media platforms like Twitter and find out what kind of information they like to have from medical staff members. And, of course, make sure that the public relations teams has a good sense of your services and find out if they have a speakers’ bureau they promote to local organizations. Can you and your service be one of the topic areas of interest?

Practice Partners or Former Colleague

If you are taking over a practice for a retiring physician, make sure there is a hand off between the former provider and you. Letters mailed to all existing patients about the practice changes help prevent leakage and provide you with a solid and respected introduction into the community. This communication process also works well if you are joining a practice. Your new colleagues can send a letter to their existing patients about the new provider/new specialty.

The Medical Community

Go beyond simply providing an announcement to the members of the medical community and get personal. Face to face introductions make a huge impression. Take the time to arrange introductions. Consider who will be most likely to refer to you and get out to meet those individuals on their turf – their offices. You can also introduce yourself to office personnel for in most cases, they will handle the mechanics of the referral and it helps them to really know who you are.

Ask the medical staff leadership to introduce you or call or drop by on your own. And of course, make sure you do send out those announcements to all potential referrers and to any non-physician referring sources as well. To reinforce your presence, send out the announcements first and follow-up with the face to face contact. And then, send out a letter to those contacts thanking them for their time and reiterate the services you offer. This in an ideal time to include a rolodex card with your contact information. In a short period of time, you provide three “touch” points and demonstrate your communication abilities.

Outreach Tasks

You have covered the basics – hospital promotion centers and the medical community. But don’t stop there! In order to develop relationships, you have to be out in front of people. Help them get to know you by some of the following actions:

· Offer an Open House in your new office for referral sources.

· Offer an Open House with a health twist for the community – free screening or healthy check-list.

· Participate in CME lectures.

· Partner with a fitness center or health spa and provide a service screening.

The Real Basics – Don’t Overlook

Once you start getting referrals from providers, make sure you are worthy. Worthy? This goes beyond provide good care for these patients. You need to make sure you provide easy and convenient access for your referral sources. If they need to talk to you, make it easy for them to do so. Instruct your office staff to be warm, friendly and HELPFUL. One unpleasant conversation with you or a staff member can turn a referral source into a non-source and they won’t come back.

Close the loop once the patient has been seen. This is an easy quid pro quo (this for that) that must be done. If a referring provider sends you a patient, be sure to call them/email them/fax them and tell them what happened with THEIR patient. Make sure they are the first to hear the news. Make them feel like a partner in the care and tending of THEIR patient.

In this post, I just want to provide some examples of what some health care organizations (mostly hospitals) are doing:

The American Cancer Society is on Twitter (@AmericanCancer). Their updates center on the latest cancer news and research. You can also catch the Lance Armstrong Foundation on Twitter (@livestrong). Cancer survivors are sure to follow LiveStrong and discuss and celebrate their news.

Many hospitals and health systems also are on Twitter. Some provide health updates. Here is an example from Beth Israel Deaconess (@healthwithbidmc) in Boston:

HealthwithBIDMC:

1. Obama Administration May Recommend 3 Flu Shots for Americans This Fall. http://bit.ly/103yfdabout 23 hours ago from web
2. Swine Flu Likely to Return to U.S. Next Winter. http://bit.ly/r6rq0about 23 hours ago from web

Henry Ford Hospital is experimenting with various social media outputs – they recently transmitted the robotic procedure for the removal of a cancerous bladder by satellite to the International Robotic Urology Symposium and they also provided updates on Twitter. Physicians “tweeted” directly from the operating room in a detailed description of the procedure. Physicians also answered question “tweets” about the surgery. The hospital indicated they hoped to provide awareness of the hospital’s new surgical capabilities

The Henry Ford health system has utilized YouTube and podcasting as well, offering medical advice, educational updates and a variety of health information.

Some organizations are experimenting with FaceBook accounts. Scripps Health in California has a Facebook account where they provide information about their organization and health tips. Here is a recent post:

Sneak peek! See the online version of the Scripps 2008 Annual Report, complete with video. This year’s edition, “A New Era of Medicine,” focuses on the many exciting medical advancements that Scripps employs or is helping to develop.

Mayo Clinic’s penetration into social media was recently detailed in the Star Tribune:

These days, Lee Aase of the Mayo Clinic is a walking, talking, blogging, Twittering, Facebooking, YouTubing force who’s blasting Mayo into the social networking world faster than you can say “Mayo Brothers.”

Aase says Mayo is simply spreading its reputation as it always has: through word-of-mouth. In fact, Mayo spends very little on advertising. It has had the same logo — three overlapping blue shields symbolizing research, education and clinical practice — for years.

The Web, however, seemed a natural move to Mayo executives. “As we see people communicating in new ways, we want Mayo Clinic to be part of the conversation,” said Dr. Thoralf Sundt, chair of Mayo’s marketing committee. “We know the conversations are happening out there. This is a chance for us to join.”

Does any of this actually get patients in the door?

Several patients with rare diseases have told their doctors at Mayo they came after watching another patient’s video on the Sharing Mayo Clinic blog. But numbers are hard to pin down, Aase said. What he does know is people are watching.

What this produces in patients and revenue remains to be seen, said Bevolo. But since Web tools are free, he added, “the risk of it is so little.”

In my next post, we will look at what medical practices and physicians are doing in the social media realm.

Specialists do have the dual customer responsibility but in most cases, the patient will return to the primary care physician to resume their long-term relationship. While many primary care physicians report that they jointly decide with the patient where to refer patients, the bulk of referrals still remain the responsibility of the primary care physician. Because patients are both accustomed to the advice of their primary physician and his/her knowledge of the medical community, their main concerns are how long before they can obtain an appointment and will the specialist take their insurance?

In terms of outreach and practice growth, knowing how the referral process works between patient and primary care physician informs us that the specialist should be paying very careful attention to the primary care physician as the customer. In our work in network and referral development, we repeatedly hear from primary care physicians that the things they care most about when referring is access and communication.

Access and communication sound simple enough but in practice they are apparently difficult. Often primary care physicians will indicate that if they did not receive appropriate feedback, they will drop the specialist from their referral list. One area that causes significant frustration is when a secondary referral occurs without discussion with the primary care physician. Physicians refer to those who send the patients back, don’t refer the patient elsewhere and communicate promptly and directly with the referring physician.

Developing a relationship with your referral sources takes time. If you practice in a personal community hospital environment, it is easier to get to know your referral sources through less formal connections. With more hospitalist programs, however, those informal interactions are less likely to occur in the hospital. Efforts have to be more systematized in an academic medical center to understand the needs and expectations of the referring physician.

Consider keeping a database contact list of your referral and potential referral sources. Specifically ask them about their expectations and communication preferences. Note the names of their office manager/practice assistant who typically will be charged with facilitating the referral. If you provide more customer service to your referral sources, they will continue to refer patients to you and they will share their positive results with their primary care colleagues.

Your customer is always your patient but the way to more patients is through the referring physician.

We recommend to our clients that this step happen before they get excited about a particular program so that the principles of what is required to be successful leads the thinking. It is surprising about how many different thoughts exist for some of these issues so it is wise to discuss them first and make criteria for selection:

• How will the data be housed and the implications especially if within a multi-hospital system
• Data security
• Access to the system – how and where users and managers will access the system and what type of access will they have?. While end-users need to input and navigate on the account level, will they also require report-writing/viewing capabilities? Will there be different access features for management?
• Access to the system beyond the department. Are there ancillaries or clinical areas that will require viewing or input capabilities? How will system reports be shared?
• If you have more than one hospital in your system, will you share access on all of the accounts? Are there reasons to have some limitations?
• Will the program be web-based or installed with the hospital’s technology architecture? How facile will this be for the end-users?
• If you currently have a rudimentary or old system, should the historical data be imported into the new system? What elements in that data are absolutely necessary to transfer? Would there be an objection to this data being transferred internally or with manual mechanisms if cost is prohibitive?
• What kind of data will be required for the system? Where will this data come from – this is especially important to discuss if you are initiating a new system but have multiple data pools within the organization.
• Will other departments/functions integrate in the future, i.e. will your call center share some functionality or require data feeds?

There also needs to be one person who is responsible for the system and is considered the “go-to” person for all first line issues. We recommend that this individual have enough technical abilities to generate reports and do basic system problem-solving but also be sensitive and aware of the needs/demands within physician relations.

Okay, once you have completed these three preliminary steps outlined in the four parts to this multi-post, you are ready to start comparing vendors and begin the selection process. Feel good about taking the time to do this preliminary planning for it will make the next steps toward execution all that much easier and your team will be more adroit in the selection process. Following these steps make it more likely that you will select a better fit between your organization’s needs and the system’s abilities.

Use your hospital’s publications to pass on information with a personalized note. Personalizing information makes people feel more important. The note may be about a service the new physicians will find useful or reinforcing a conversation you had about the changes in the lab.

Be a conduit of information – connecting people, information and the like. Maybe the new doctor tells you his wife is feeling isolated since both children are at school. This is information you hold on to and share with the nurse manager in pediatrics because she is the co-chair of the PTO at that same elementary school. You want to get connection points moving on their own but you are giving them some social adrenaline to move forward faster.

Asking for information should be a standard in your approach. You’re supplying a service, so call the physician or her office staff and conduct a mini-survey to see how things are going. Ask about what’s working and what needs improvement. Something as simple as, “I am following up on our monthly outcome reports. Is the information helpful to you?” can launch a meaningful discussion.

Another area of outreach is simply asking how things are going and if there is anything you can help them with — truly listen to what they have to say. Their answers may be surprising. Don’t try to be a problem-solver all the time Too often, physicians have no place to go with their business concerns and sometimes just being able to talk is invaluable to them.

Cultivate these new relationships with service and attention. The flow of business will move in your direction and you will find that retention issues are solved in an on-going manner versus in a crisis moment. This type of relationship building takes organization and patience. Set up a consistent system to provide attentive service. Soon, it will become a natural part of your business approach, you’ll position yourself well and your physicians will feel the difference.

]]> http://fortepartnersllc.com/2009/04/building-physician-relationships-a-long-term-process-that-takes-planning-and-focus-part-ii/feed/ 2 http://fortepartnersllc.com/2009/03/developing-relationships-isnt-new/ http://fortepartnersllc.com/2009/03/developing-relationships-isnt-new/#comments Mon, 30 Mar 2009 15:34:37 +0000 Suzanne Dewey http://fortepartnersllc.com/?p=169 Okay, you need to know up front that my hair is graying and I am a Baby Boomer – on the tail end of the demographic swath, but a Boomer all the same. I tell you this because I am going to complain about another comment I just read about on-line marketing. The writer was singing the virtues of in-bound marketing. And, there are many virtues, I agree! But, let’s not fall into the all or nothing trap.

Take hospital marketing as a tricky example. It is very important that hospitals have a significant on-line presence. I also think hospitals should be trying to develop community hubs on their websites and utilize a lot of what social media has to offer. But, an organization would be remiss if they did not integrate inbound and internet tactics with more traditional (yes, “old”) methods.

As I suggested…hospitals are tricky examples. Why? First, the “sales force” are typically physicians who operate their own small businesses (independent practices) and are not on the hospital’s payroll. Physicians guide their patients to particular services and particular hospitals. When a physician needs to send a patient somewhere, they don’t Google the service, they don’t use the Yellow Pages, they go where they have easy access and they go where they have a relationship. Yup, a relationship.

Developing that relationship with the physician starts during recruitment. But don’t let it stop there. There is a lot to be said and done in developing relationships that I will save for future posts. However, it is wise to use formal and informal mechanisms to work on that relationship development. And use both old and new methods to communicate. Just because the hospital recruited an excellent orthopedic surgeon after months of searching doesn’t mean your primary care physicians are even aware of the addition. And this is where using a variety of tools comes into play. Use your website, use formal direct mail announcements, send an email or a fax blast, set-up rounding opportunities, have a welcome event – do whatever it takes to make sure referral sources are aware of the good news and on the path of physician-to-physician relationship development. While Twitter can be one of the avenues for the announcement, don’t stop there. Don’t be caught up in the new thing that you neglect the old thing – or the thing that might get the message received.