Una Hutton Newman, MBA, MA

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Rx for Healthy Physician-to-Physician Sales

• Una Hutton Newman, MBA, MA
• Chief Marketing Officer
• Woodruff Health Sciences Center
  HealthConnection
• Lori McLelland, RN, MSN
• Executive Director
• HealthConnection Marketing
• April 24, 2009

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Assessing Strengthening Relations and the
Program

• Overview of Emory Healthcare
• Importance of Referring Physicians to Emory
• Database Analysis to Learn About Your Customer
• The Sales Program
• Organization
• Sales Objectives
• Reporting
• Goals/Success criteria
• Physician Consult Line interface
• What are we hearing and how do we communicate to
  administration
• Sales And Marketing Working Together
• Q A

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1. Overview of EMORY HEALTHCARE

• EMORY HEALTHCARE is the largest and most
  comprehensive health system in Georgia drawing
  patients from throughout the Southeast.
• We are a component of Emory University and
  Woodruff Health Sciences Center (WHSC)
  responsible for the
• education of health professionals
• research affecting health and illness
• patient care, and policies for prevention
• treatment of disease
• EMORY HEALTHCARE is the clinical arm of the WHSC,
  including those components dedicated to patient
  care.

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Overview of EMORY HEALTHCARE

• EMORY HEALTHCARE facilities include 4 hospitals
  totaling 1,310 beds.

• Emory University Hospital
  
  573 licensed beds located on the Emory University
  campus

• Emory University Hospital Midtown
  511 licensed beds located in
  Midtown Atlanta

• Wesley Woods Geriatric Hospital 100
  licensed beds nations first geriatric hospital

• Emory University Orthopaedics  Spine Hospital
  126 licensed
  beds first university-affiliated surgical
  facility of its kind in Atlanta

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Overview of EMORY HEALTHCARE

• In addition to hospital facilities, EMORY
  HEALTHCARE includes large physician practices.

• The Emory Clinic
  Multi-specialty practice
  with 1,200 faculty practice physicians in
  multiple locations across a broad geographic area

• Emory Winship Cancer Institute
  
  Multi-disciplinary cancer facility offering
  medical, surgical, radiation oncology and
  diagnostic imaging by more than 200 faculty
  members

• Emory Children's Center
  Largest pediatric multi-specialty group practice
  in GA comprised of 100 School of Medicine faculty

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Overview of EMORY HEALTHCARE

• Over 48,500 hospital inpatient admissions
• Approximately 2 million outpatient encounters
• Annual revenues of over 1.6 billion
• Diverse multi-ethnic/multi-national work force of
  almost 10,000
• Payor mix
• (inpatient and
• outpatient)

Data reflects FY2008
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Overview of EMORY HEALTHCARE

• Service Line Mix

The top three service lines generate 49 of
total service line inpatient volume.
Market Share by Service Line EHC ranks 1 in all
service lines except Ortho and Spine where it is
3.
Data reflects FY2008
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Overview of EMORY HEALTHCARE
EHC is 1 when measured by wallet share and had
the most significant change between the two
methodologies (3.0 points)
Source GHA Patient Level database
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2. Importance of Referring Physicians to Emory
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Majority of Prior Physicians Suggest Emory

• With the exception of neurosurgery and neurology
  patients, the majority of PCPs suggested that the
  patients should visit Emory for treatment.
• Interestingly, the majority of neurosurgery and
  neurology specialists did suggest Emory.
• More research should be done to determine why
  PCPs do not see Emory as a place for
  neuro-related conditions.

(n160 PCP

n399
Specialist)
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3. Database Analysis to Learn About Your Customer

• 12,050 referring physicians
• 7,798 of these are within
• Metro Atlanta

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Fine Tuning Referral Data

• Quantities of referrals alone do NOT paint an
  accurate picture of referring physician value
• Next Step Work with the data analyst to
  determine the best scoring methodology to create
  a tool to more effectively target referring
  physicians
• Geographic efficiencies
• Benchmark data

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Physician Scoring Methodology

• Referral score calculated by combining all
  referral files and creating one unique record for
  each doctor.
• IDX Financial and Referral Data
• HealthConnection Caller Data
• Scores were assigned in four categories
• Payor Mix
• Total Charges
• Specialty to which referring
• Number of Referrals
• The total score represents the sum of these four
  categories, for a maximum possible score of 16.

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State-Wide Analysis By County
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Applying the analysis to the referring physician
data narrowed the physician targets but did not
identify a clear cut off point in determining
actual physician accounts. A score of 10 could
indicate EITHER a high number of referrals with a
poor payer mix to a low capacity for growth
product line. OR A score of 10 could indicate a
moderate number of referrals with a desirable
payer mix to a high capacity for growth product
line.
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Additional Refinement Creation of Tiers

• To better target loyal and high potential
  physicians, we created a system of tiers within
  our scoring system.
• There are nine tiers

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What Do We Do With This Information?

• Narrowed liaison scope from 2500 physicians to a
  targeted list of 200.
• Liaisons now cover their geographical area more
  efficiently because physicians are better
  qualified.
• Each liaison developed individual sales
• plans based on the new target list.

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4. Sales Program

• Organization
• Sales Objectives
• Sales Targeting
• Reporting (Sales Logix)
• Tie in with Emory Consult Line

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Sales Territories
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Success Criteria

• Sales Plan
• Liaison maintains  up-to-date sales plan with
  specific goals and tactics appropriate to the
  market
• PreCall Planning
• Sales Logix Visit notes contain
• Complete documentation of visit type, referring
  MD specialty, meeting topic, and collateral
  distributed using the pick list in the designated
  field
• Notes include headings to indicate Met with,
  About (topic), Feedback, and Follow-up
• The feedback description clearly summarizes the
  situation, reflecting an accurate identification
  of the problem.
• Collateral distributed follows a progressive
  order to create the sale funnel
• Follow-up plans includes a logical to do list
  that supports next steps
• Sales summary
• Sales summary form (attached)

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Success Criteria

• Communicates well with leadership and peers,
  providing appropriate information at and between
  meetings.
• Analyzes situations to determine basic problems,
  rather than symptoms, and offers realistic,
  alternative solutions
• Functions as an effective member of a work group,
  gaining the respect and cooperation of others
• Maintains a communication style which is open to
  constructive suggestions
• Demonstrates collaborative working relationships
  with multiple clinical sections and physicians
• Arrives on time and prepared for meetings (list
  meetings)
• Meets deadlines (list assignments)
• Quarterly HealthConnection listen in completed
  on (list dates)
• Is a good steward of corporate resources (budget,
  supplies and equipment)

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Sales Targets
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Sales Objectives
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Designing the Tools
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Sales Reports
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5. Culture ChangeMarketing and Sales Working
Together

• Organization (Marketing and Physician
  Liaison/HealthConnection)
• Developing a B2B mentality
• Sales training with Kris Barlow (Marketing and
  Physician Liaisons)

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Developing an Integrated Customer Strategy

• For the select product line
• What is the Business to Business Strategy?
• Marketing Plan?
• Sales Plan?
• How will the team operate? How will Marketing
  support sales and visa versa?
• Goals? Accomplishments?
• Who are the target physicians?
• Competition
• Operations what needs to change?

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First Understand Your Product

• In what areas are you trying to grow your
  business? Why? Are those areas of strength that
  you want to continue building upon on areas of
  weakness where you need to recapture volume?
• Tell me why a physician would want to send their
  patient to Emory for X procedure/test/treatment
  instead of to competition?
• What are your areas of weakness? What are you
  doing operationally to overcome those barriers?
  What can marketing and sales do to help you
  overcome those barriers?
• How does a patient come to you for X
  procedure/treatment/test? If you were to
  document a flow-chart of a patients travel from
  complaint to diagnosis to treatment to follow-up
  care, what would it look like?
• Do you have a clinical operations meeting that I
  can attend to meet your clinical leaders and to
  better understand your clinical operations and
  issues?
• What are your biggest areas of research and how
  do they or will they relate to patient care?

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Creating Solid Messages

• Division of Vascular Surgery Endovascular
  Therapy
• Treatment specialties offered by the division
  include All procedures are performed at EUH.
• Surgical and endovascular treatment of abdominal
  and thoracic aortic aneurysms
• Endovascular treatment of aortic dissection
• Carotid artery surgery and stenting
• Renal artery surgery, angioplasty and stenting
• Peripheral arterial surgery, angioplasty, and
  stenting
• Treatment of deep venous thrombosis
• Dialysis access surgery
• Minimally invasive and laser treatment of
  varicose
• Differentiation of the Service (i.e. outcomes
  data) Offering less invasive and simpler
  treatment options for vascular disease,
• including a variety of new, minimally invasive,
  catheter-based endovascular procedures. These
  treatments include stenting of
• the carotid artery, endovascular repair of
  abdominal and thoracic aortic aneurysms,
  atherectomy and angioplasty devices used
• to clear lower extremity arteries of plaque and
  less invasive therapies for varicose veins such
  as endovascular laser ablation.

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Identifying Differentiators

• Be objective about what differentiates the
• practice (by audience group)
• Develop questions to better understand
• the practice
• Understand what the referring physician
• wants and needs
• Being first doesnt always last
• Bring value to the table (know your
• product)
• Have a dialogue dont just sell

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Case Study Emory Radiology

• One of the largest academic radiology practices
  in the
• country
• 11 Subspecialty Divisions
• Abdominal, Breast, Cardiothoracic, Community,
  Emergency,
• Interventional Radiology Image-Guided Medicine,
  
• Interventional Neuroradiology, Musculoskeletal,
  Neuroradiology,
• Nuclear Medicine Molecular Imaging, Pediatric
• 130 physicians 600 FTEs cross-cutting
  clinical care, research, education and spanning
  School of Medicine and Emory Healthcare

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Situation Analysis Emory University Hospital
Midtown Radiology

• 40 of Emory University Hospital Midtown
  medical staff is
• private practice
• No required commitment to use Emory Radiology
• 100 Top Private Practice Physicians at EUHM
  account for
• 50 of all outpatient MRI volumes
• 20 of all outpatient CT volumes
• December 2007 EUHM loses 50 of radiologists
  to local and national competitors
• Forces rapid transition from community to
  academic- based radiology practice
• Referring MDs unhappy with communication and
  transition
• Express feelings and fear that EUHM will become a
  closed hospital and they would be forced out
• Will dissenters start referring to competitors?

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Strategy for Driving Radiology Volume

• Build Infrastructure to support The Emory Clinic
  (TEC) referring physician communication
• Lotus Notes update
• Intranet site
• Develop referral forms, prep instructions,
  patient education collateral
• Focus on loyal referring physicians
• Top 100 Emory University Hospital Midtown (EUHM)
  private practice physicians
• Facilitate communication about EUHM transition
• Insure The Emory Clinic referrals (WCI TEC
  outreach)
• New Business
• General external internal medicine, family
  practice
• Cardiac imaging cardiologists, CT surgeons
• Musculoskeletal imaging orthopaedists,
  podiastrists, sports medicine, rheumatology,
  rehab, collage and professional sports team
  physicians
• Interventional OB/GYN, oncologist

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Strategy For Driving Radiology Volume

• Work in tandem with Operations to grow volume of
  core modalities CT, MRI,
• PET
• Appointment of Dr. Small as EUHM Radiology Chief
  of Service
• Administrator and COO meet with key dissenting
  MDs
• Communicate target service levels to referring
  MDs
• RadNet Conversion
• New MRI PET/CT CON approved
• PACs conversion

Dr. William Small Chief of Service EUHM Radiology
Dr. Carolyn Meltzer Chair Emory Radiology
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Competitive Environment Emory University
Hospital Midtown Radiology

• MRI of Georgia 1 block away
• Atlanta Medical Center 1 mile
• Piedmont West Imaging Center 4 miles
• Piedmont Hospital 6 miles
• Resurgens has own MRI in MOT
• Competitors are marketing to and visiting MDs
• at their EUHM offices

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Tactics

• Liaison Visits
• Office and MD luncheons with
• radiologists/administrator
• New EUHM MD Announcement
• Quick Reference Guide
• Meet Your Radiologists event
• Radiology Portfolios distributed at
• new MD orientation
• Web (internet and intranet)
• Sales Blitz

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Results Emory University Hospital Midtown
Radiology
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QUESTIONS ANSWERS