Leveraging PRM Systems To Get Real Results From Physician Relationship Management Programs

By Dann Lemerand, Director, Healthcare Industry and Solution Strategy, Infor

Hospitals and health systems often use physician liaisons to strengthen the ties that bond. Part salesperson, part customer service agent, and part consultant — physician liaisons are charged, in part with establishing and maintaining good relations with the cadre of physicians working in their communities. As such, these liaisons often visit with physicians to provide updates on hospital services and to ensure they are satisfied with the hospital’s level of service. It’s part of a strategy that goes a long way in not only keeping physicians happy with the hospital or health system; it also leads to business growth.

This work has been acknowledged as a crucial component of a healthcare organization’s success for many years now. As the industry continues to evolve under health reform, however, these relationships are more important than ever. With increased demand for coordinated care, new organizational structures, and value-based payment models, strong physician engagement has become a non-negotiable imperative. Building strong physician engagement is critical for health organizations to achieve the triple aim: quality, cost, and population health initiatives.

The upshot? Hospital leaders now need to make it possible for physician relationship management programs to go beyond just physician satisfaction and focus on actually producing measurable bottom-line results. In essence, leaders — from chief marketing officers to directors of business development to vice presidents of planning and strategy and others — are striving to develop and implement physician relationship management initiatives that will result in a demonstrable return on investment by attracting more patients, improving the payer mix, and enhancing overall physician loyalty.

Start With A Plan

To elevate physician engagement initiatives to this higher level, healthcare leaders need to start with a strategic plan. Indeed, instead of simply looking to establish cordial relationships with physicians in the hope of increasing referrals, a physician relationship management plan should include a detailed roadmap as well as a variety of defined and measurable objectives.

For example, the plan should spell out goals in relation to physician retention, physician leakage (the term used to define the amount of business that a physician takes to other hospitals or systems) or missed opportunity, the growth in patient referrals, the growth of specific procedures or service lines, and the growth of referrals from key providers.

With goals clearly defined, organizations can use a physician relationship management (PRM) system to more strategically move from vision to reality. Such systems are used to plan, analyze, and manage physician interactions using data to improve relationships and drive growth. By using claims analytics in conjunction with the right PRM system, healthcare organizations can gain a comprehensive view of every physician and their patients in their organization as well as in their markets. This combination will enable hospital leaders to strategically develop sound strategies that empower physician liaisons to maximize the impact of each interaction.

In fact, hospitals and health systems can get a more substantial return on investment from their physician outreach initiatives by leveraging PRM systems to develop and implement the following seven strategies.

1. Proceed with intelligence. With a PRM solution, hospital leaders can create an informed approach, specifically designed to meet their goals. For example, a PRM system that includes claims data can identify where to focus outreach efforts. The data could reveal that, of all patient access points located in a hospital’s service area, five account for 80 percent of the total outpatient orthopedics. Not only would the hospital be able to identify the specific access points, they would also know which physicians were tied to those sites and what precise types of care were being rendered. As such, a hospital leader could then focus outreach efforts on these providers, as well as look to other access points where there is an opportunity for growth, thereby increasing the potential return on investment for the effort.
    
2. Target the right physicians. While it may not be possible to reach all physicians in a market, data from a PRM solution can help to strategically identify which individual physicians represent the most relevant opportunities for growth. Such information can provide insight into the specific level of business that physicians are doing with your organization — as well as the business physicians are conducting outside of your organization. Commonly referred to as “leakage,” this missed opportunity is the amount of business a provider could send to your organization, but is sending to other organizations. That difference — big or small — impacts everything from patient outcomes to the hospital’s bottom line.

For example, if hospital leadership has embraced increasing the number of hip replacements each year as a goal, the PRM system could identify specific orthopedic surgeons to target.

By tapping into this data, you could see that orthopod Carl and orthopod Katherine do not use your surgical suites at all for hip replacements. The data would show you, though, that Carl does a half million dollars’ worth of hip replacements per year but Katherine does 25 million dollars’ worth of these procedures. So, the business development leader might then instruct a physician liaison to work on developing a relationship with Katherine and not Carl.

3. Empower liaisons to make physician visits more meaningful. Information in a PRM system not only provides insight on which physicians to target but could also offer an understanding of how physician liaisons should structure their visit. Physician liaisons could transform their meetings with physicians from not only producing good relations to producing real results as well.

For example, intelligence from the PRM could reveal that an ophthalmologist is performing most of his eye surgeries at a surgery center across town, where they recently installed a precision laser system for cataract surgery. So, when the physician liaison meets with the ophthalmologist, the liaison could go beyond simply “checking-in” and steer the conversation toward technology needs. The examples below illustrate how a typical physician liaison to physician conversation could differ from one that is empowered by PRM data:

The typical visit: When the physician liaison arrives, he talks about last night’s championship basketball game and asks the ophthalmologist about her children. The liaison then asks the physician how things are going at the hospital — and the ophthalmologist says everything is fine but doesn’t offer much more. The meeting — pleasant as it was – ends and business as usual ensues.

The PRM-informed visit: When the physician liaison arrives, he talks about last night’s championship basketball game and asks the ophthalmologist about her children. He then mentions that he heard about a new laser technology that is being used in cataract surgery. The ophthalmologist lights up and starts talking about how valuable the technology is. In fact, the doctor reveals that she would most likely do a lot more eye surgery at your hospital if the technology was available. The meeting ends – and the physician liaison can now inform hospital leadership of exactly what it would take (new technology) to get this ophthalmologist (and perhaps others) to perform more surgeries at the hospital.

4. Pinpoint the right patients. Through PRM data, hospital leaders could discover that a certain physician is referring a large number of patients; however, further analysis might reveal that the provider is not sending a favorable payer mix. The physician liaison could then approach the provider and discuss the possibility of referring more patients with specific insurance that results in more favorable reimbursement and, therefore, a better return on investment for the organization.
    
5. Identify areas in need of improvement. A PRM system also can help identify what a hospital or healthcare organization needs to do to increase physician loyalty. For example, as physician liaisons meet with doctors, they could populate the PRM with information about various physician concerns. In this sense, the conversations with doctors can be used to identify trends.

The physician liaisons can keep track of the concerns and over time this information can be analyzed to identify trends and make changes. For example, the data might reveal that the hospital simply is not accessible to patients due to a lack of parking. The hospital could consider adding a valet parking service to enhance physician loyalty and increase patient referrals. Additionally, the liaison team can track which actions lead to better outcomes.

6. Judiciously leverage staff resources. A PRM system with claims analytics could also help a hospital leader determine how many and what types of liaisons are needed to produce the greatest return on investment by making it possible to most cost effectively leverage staff resources.
    
7. Track the impact of touchpoints and interventions. With a PRM system in place, hospital leaders can track not only what types of contact their physician liaisons are having with physicians but also the impact derived from these various initiatives. In essence, the system will provide insight into the impact from e-mail communication vs. in-person meetings vs. continuing education events, and so on — making it possible to track the return on investment of various initiatives.

By leveraging PRM systems to create and support more strategic physician outreach, hospitals can ensure that their programs bring in bottom-line results. Leaders should realize, however, that not all PRM solutions are created equal. You want to deploy a system that offers access to real-time claims data and provides the intelligence that could help organizations respond more effectively to changes in the market. It’s also important to select a PRM system that uses very specific clinical data, like procedure codes or diagnostic categories, and is capable of simultaneously tracking cost, quality and outcomes.

With the right PRM solution in place, healthcare organizations can transform their physician relationship management programs from “nice-to-have” community building efforts to strategic initiatives that ultimately bring in bottom-line results in terms of increased patient referrals, an improved payer mix and enhanced physician loyalty.