Beyond Physician Satisfaction: Using Marketing Research to Drive Physician Outreach Strategies

1. Beyond Physician Satisfaction: Using Marketing Research to Drive Physician Outreach Strategies Presented by: Julie Pokela, Ph.D. Market Street Research and Cori Grant, M.S., MBA Methodist Le Bonheur Healthcare

2. Workshop Objectives To understand: • How to use marketing research to understand why physicians send patients to specific hospitals. • The key drivers for physician referrals. • How to translate research results into strategies that meet the needs of physicians and their patients, and increase referrals. 2

3. Importance of Physician Outreach Strategies • Physicians are key gate-keepers for specialists and hospitals. • Self-directed consumers are in the minority. • Even self-directed consumers seek advice from their physicians in selecting specialists and hospitals. 3

4. CASE STUDY: LE BONHEUR CHILDREN’S MEDICAL CENTER 4

5. Background on Le Bonheur • Based in Memphis, Tennessee • Leader in pediatric clinical care and research • Teaching facility for the University of Tennessee Health Science Center • 225 beds and 45 medical sub-specialties • Treated nearly 130,000 children in 2008 • Largest pediatric brain tumor program in the U.S. • One of the most advanced pediatric epilepsy centers in the country • The only pediatric cardiovascular program in the region 5

6. Marketing Research 6

7. Context for Research • In 2006, Le Bonheur unveiled plans for $451 million in new construction and renovation • With this expansion, Le Bonheur needed to strengthen its position in the regional market • Because of the key role physicians play in directing referrals, Le Bonheur wanted to understand how it was perceived by referring physicians. 7

8. Research Methodology • Phase 1: • Qualitative exploration of major factors driving pediatric referrals in region • In-depth telephone interviews with 10 referring physicians • Phase 2: • Quantitative analysis of referring physicians’ behaviors and attitudes • Telephone interviews with 50 referring physicians • Error rate ±8.1 to 13.4 percentage points 8

9. Key Drivers for Physician Referrals • Physicians strongly prefer to refer pediatric patients to a children’s hospital rather than a pediatric department in a larger hospital. 9

10. Key Drivers for Physician Referrals (cont.) • Relationships with specialists: • “They could try to get to know the primary care doctors better—make an effort to meet people and make it easier to make an appointment with them.” • Communication with specialists: • “Communication is poor—they don’t return phone calls.” • Ease of making referrals: • “Make it easier to refer—make sure we get follow-up on referrals . . . and numbers we can call directly to get an appointment and to see them in a timely manner.” 10

11. Key Drivers for Physician Referrals (cont.) • Availability of appointments: • “There is a long waiting period of less complicated cases—the wait is too long.” • Speed of receiving discharge summaries: • “I never receive feedback from physicians regarding patients. Also, when I finally receive feedback, it is too late.” 11

12. Use of Hospitalists • Referring physicians prefer to refer pediatric patients to hospitals with hospitalists. 12

13. Use of Physician Liaisons • Referring physicians who met with a physician liaison are highly satisfied with their experience. 13

14. Le Bonheur’s Strengths • Advanced technology and equipment. • Reputation and qualifications of its specialists. • Reputation for treating complex pediatric medical problems. • Reputation for providing sensitive, child-friendly care. 14

15. Le Bonheur’s Weaknesses • Communication from specialists. • Inconvenient location for patients and their families. • Ability to get appointments in a timely manner. 15

16. Use of Research Findings To Drive Referrals 16

17. Goals Deriving From Research • Expand geographic presence. • Facilitate more timely appointments. • Improve communications with physicians. • Develop hospitalist program. 17

18. Expand Geographic Presence • Opened Le Bonheur Community Outreach clinic in Tupelo, MS. • First use of Le Bonheur brand in a off-campus site. • Families can get consults from a variety of sub-specialists. • Provides increased convenience for area families. • Invasive procedures are done at Le Bonheur Children’s Medical Center. 18

19. Facilitate More Timely Appointments • Developed new transfer center for children who need hospitalization. • Physicians used to call physician services to admit the child and the transfer center to arrange transport. • Physicians can now call one number to arrange for admission and transport of children who need hospitalization. 19

20. Facilitate More Timely Appointments (cont.) • Developed PACES program (Patient’s Access to Excellent Care and Service) to improve access to sub-specialists. • Le Bonheur took ownership of process for making appointments with sub-specialists. • A referring physician faxes a form indicating the patient’s problem and insurance information. • Le Bonheur will get back to the referring physician within 24 hours with an appointment. • The program started in 2007 with 5 physicians booking about 65 appointments a month. • Currently, 38 to 40 physicians use PACES each month to book 250 to 300 appointments 20

21. Facilitate More Timely Appointments (cont.) • Expanded access to Physician Services. • Physician Services were offered during standard business hours. • Referring physicians can now contact the Transfer Center after 5 PM, and on weekends and holidays to receive immediate assistance. 21

22. Facilitate More Timely Appointments (cont.) • Developed partnership with independent practices to recruit new physicians. • The biggest barrier to timely appointments is lack of capacity. • Le Bonheur now partners with independent practices to offer expertise in: • Developing profiles for new physicians. • Working with recruitment firms. • Interviewing potential candidates. 22

23. Improve Communications with Physicians • Developed systems to ensure timely follow-up and discharge information. • Improved systems for identifying referring physicians • Now identify referring physician on EMR • Proportion of records missing referring physician identification went from 16.2% in 4/2009, when the program was started, to 7.2% two months later. 23

24. Improve Communications with Physicians (cont.) • Developed systems to ensure timely follow-up and discharge information (cont.). • Discharge information can now be auto-faxed to the referring physician. • More physicians can now access patient records at Le Bonheur online. 24

25. Improve Communications with Physicians (cont.) • Developed new systems to strengthen relationships with referring physicians. • Physician liaison takes new sub-specialists to meet with referring physicians. • Developed new monthly publication for referring physicians. • Was quarterly • Now more topical • Information about new sub-specialists • Information about educational programs • Send quarterly postcards from new sub-specialists 25

26. Developed Hospitalist Program • Referring physicians in the immediate area of the hospital preferred hospitals with hospitalist programs. • Le Bonheur currently has hospitalist coverage 10 to 12 hours per day, and will be expanding to 24 hour coverage. • Referring physicians have responded very positively. 26

27. Summary • Le Bonheur was increasing its capacity and needed to understand how it was perceived by referring physicians. • A survey of referring physicians showed that Le Bonheur has a strong image among referring physicians, but needed to increase its geographic access, access to appointments, and communication with referring physicians. • Le Bonheur was able to implement concrete strategies to address referring physicians’ major concerns. 27