Estimated reading time: 136 minutes
Table of contents
- How can you get more patients?
- How do you create your medical marketing plan?
- How can your medical practice show up on google search results?
- How a medical practice can show up as more trustworthy to patients by getting patient reviews
- Improve patient access with near instant online appointments
- Growing your healthcare business via physician referrals
- Understanding the healthcare referrals process
- What are physician referrals?
- How is a physician referral made?
- “Notepad” physician referrals – how do these work?
- How are healthcare referrals via “Referral Pad” handled?
- Phone call from referring provider to specialist office
- What happens when a patient referral is faxed over?
- How about referrals sent using a physician referral software?
- What information do referring providers need to send you a referral?
- How about specialist office approval?
- Is a referring provider obligated to make a referral?
- Referral management and HEDIS
- What are the stages of a physician referral?
- How does using Referral management software help?
- Understanding the healthcare referrals process
- How to add new referring physician partners per month
- How to create a list of referring physician prospects near your practice location(s)
- How to use a simple CRM with referring provider data
- How to market to referring providers via faxes, calls, emails
- How to send marketing faxes to doctors and medical practices at scale
- How to market to referring providers via physician liaisons
- Separating hunters (physician liaisons) from farmers (referral coordinators)
- What does a physician liaison need to do their job? Understand this well and you will succeed !
- How to target the right contacts at your prospect referral partners
- What does a referral coordinator need to do their jobs?
- How to empower your physician referrals team with the data and the tools they need to be effective
- How to create a great physician referral marketing team
- Closed Loop Physician Referral Management – why
- How to market to your existing patients
- Asking patients for referrals
- How to increase patient visit volume by mining your PMS / EMR
- How many return patients do you need for this campaign to break even?
- Get daily reports for no-show patients
- Identify the people, processes and technologies for your campaign
- Define your “no-show patients” campaign
- Define at least a few dispositions before you get started
- Define max attempts to be made
- Prepare campaign data
- Enhance your spreadsheet (if you are not using a healthcare CRM)
- Execute your campaign 🙂
- Monitor your campaign
- Now, here’s one more way that we use.. cold calling patients.
- How to run community outreach with a patient contact center
- How to increase patient volumes by calling patients that never showed up
- Combining all the above – marketing to patients and referring providers. Telehealth Marketing!! Let’s see how to market telehealth services 🙂
- Patient Retention – how to do it right
- Patient engagement journey and ways to improve it, be part of it.
- Patient Experience – Ways to improve and the value it brings to your medical practice
- Do not confuse patient engagement with patient experience.
- Patient Satisfaction – Do not confuse patient experience
- Importance of patient satisfaction surveys, questions to ask, and available free tools
- How to create and run patient satisfaction surveys
- Available Free Tools to create Patient Satisfaction Surveys
- The case for Patient Relationship Management In Healthcare
- Finding your niche/specialty to help medical marketing
- Want us to help? Reach out to sales
How can you get more patients?
Take a moment to think this through. You get patients from
- B2B (business to business) marketing – aka marketing to other physicians and businesses (whether you are scoping out physician referrals or marketing with payers or doing direct deals with employers etc)
- B2C (business to consumer) marketing – aka marketing to prospective patients directly (whether you are doing digital marketing, print and media advertising, workshops, community outreach events etc)
Medical marketing to businesses
Healthcare, in many ways, is like a retail business. Unless you have ventured into telemedicine or started using telehealth as a potential patient acquisition strategy, your patients are local to you most of the time.
So, what kind of businesses can you market to?
- Other physician practices
- Businesses around your medical practice location(s)
- Senior living centers
- Home healthcare agencies
- Many more…
Medical marketing to people
Regardless of whether you are marketing to other businesses or not, you need to establish a direct marketing channel to draw patients to your practice. You could be doing very well based on other physician referrals, but please do not ignore this direct-to-patients marketing channel.
There are several ways you can market directly to patients
- Digital marketing
- Print and advertising
- Community outreach
- Joint marketing campaigns with payers, other providers promoting health
- Health awareness seminars held at your office or other locations
- Many more…
How do you create your medical marketing plan?
This is where most folks get stuck. They either get overwhelmed by the entire marketing process, read up too much information or attempt to do too much at one time.
We have also encountered practice leaders that set out in a year deciding to “market the practice” without having a marketing plan.. Nor do they set up marketing goals. This inevitably sets them up for disappointment and thereby leads them to drop the marketing plan altogether.
A marketing plan doesn’t have to be an extensive document or a powerpoint presentation at all. It simply has to be written down and referred to throughout the year. That’s it. Commit to doing just that.
Take a simple approach. First figure out what you want to achieve and make sure that it is achievable. It’s perfectly OK to aim for something specific (examples below):
- I want to add 20% more NEW patients per month OR
- I want to add one new referring physician partner per month
- I want to add 20% NEW patients from google – that makes it even more specific
- I want to add 50 new patient reviews each month
- I want to add 50 new patient reviews each month on google reviews
- I want to add 50 new patient reviews each month on Facebook reviews..
Do you see the point here?
- You are being very Specific about your goal
- You are setting a goal that is Measurable
- Once you write it down on paper, you are setting something that is Attainable
- Your goal is now Realistic
- Your goal is time bound (each month, each week etc)
And that’s it.. You have now set up S.M.A.R.T goals.
Now, for the plan.. Here’s an example of how you can achieve your SMART goal “I want to add 20% more patients per month from google”.
Let’s break this down. How would you achieve that?
First and foremost, you would need to show up in google local search results when patients are searching for a practice like yours. You need to show up in the first page itself or, preferably, in the google local pack results (that small set of 3-4 search results that google shows at the top of the page).
Once you do show up in google local search results, your practice needs to show up as being more “trustworthy” than your competitors that are also showing up in those search results. This necessarily means that you have as many positive reviews as possible and have a higher review rating than your competitors
After prospective patients deem you as more trustworthy than your competitors in google search results, they need to be able to book an appointment with you ASAP. Whether they “text” your business for an appointment or call you from your google search result listing or click on BOOK NOW button or go to your website and request an appointment.. Whatever that method might be… they need to be able to do so IMMEDIATELY.
So, your high level plan would be to
- Show up on google search results via paid ads or SEO
- Show up as more trustworthy to patients by getting patient reviews
- Leveraging various technologies / software to enable near instant bookings from patients.
Implement your patient acquisition ideas
How do you take your high level marketing plan and create actionable steps out of it?
You will have your own set of goals, plans and accompanying steps to take. Let’s walk through the example shared before. Follow this example as a framework to set up your own marketing goals, plans, actionable steps yourself (as a team).
Here’s what we had before
- Show up on google search results via paid ads or SEO
- Show up as more trustworthy to patients by getting patient reviews
- Leveraging various technologies / software to enable near instant bookings from patients.
How can your medical practice show up on google search results?
You have two options to show up when people search for doctors.
- Paid ads on google / PPC (pay per click)
- Search engine optimization/SEO
A quick primer on PPC
PPC is expensive, is getting more expensive and competitive by the day. However, done properly, they give you instant results. The day you stop spending on PPC ads, your results stop. This doesn’t mean that you just put up an ad on google and you’ll start showing up on the first 3-4 ad results. You have to work hard to show up on the top paid ad results. If your ad doesn’t get clicked on, google will slowly stop showing your ads.
SEO does not give you instant results but it does give you long lasting results. It takes dedication and daily/weekly work to show up for google search results (especially on the first page). However, as you keep working on it, the results are longer lasting. This does not mean that once you show up / rank higher on google search results, you’re forever going to be there. You still have to keep working on SEO to stay on the first page of search results.
Either way, it’s a lot of work and you need to put in the work needed. This is where most medical practices fail. They don’t realize that they need to work really hard towards achieving their goals, continue working on it even after they’re beginning to see results. They give up too easily.
No one said marketing is easy or a one time effort.
Paid ads / PPC on google
DO keep in mind that in many markets you’re going to be competing with ZocDoc’s ads. They spend quite a bit on paid ads, so make sure you understand that.
However, they won’t show just your medical practice’s name when they show their ads. They place ads to show up for term searches – eg “eye doctor Bronx” or “eye doctors near me”. Their ad will show up and if a patient clicks on their ad, they will be shown ALL eye doctors – not just you.
If you do want to attempt to have your own PPC ads, make sure you understand PPC well. You can easily spend a lot of money on PPC ads. Make sure you work with people that know how to utilize your ad budget properly. Either hire your own ppc expert in house or hire an agency or freelancer that has rock solid experience in running medical campaigns.
Levers to pull in paid advertising
There are small levers in PPC that can make or break your budget and campaign success. Make sure you hire folks that understand those levers.
As an example, if you’re located in Jackson heights / queens, you know that there’s no point showing ads to folks in Brooklyn or Bronx. Patients are not going to travel that far. That means, your PPC campaign has to be leveraging geotargeting / geofencing to avoid wasting money on ads shown to the wrong people. Make sure that whoever you hire, knows small things like these.
Another example is where you can use retargeting ads (RLSA) on people that have already visited your web page or website. Many digital marketers forget that. Retargeting ads are dirt cheap compared to ads for broader search terms and gives you a very easy way to brand yourself plus stay on top of your patient’s mind.
Keep one thing in mind – the biggest challenge you’re facing is that your prospective patient doesn’t even know that you exist. If they did, they’d book you directly.
Also, understand that your patient isn’t googling your services for fun everyday. By the time they have started to google, they’re ready to book you (or your competitors).
When your patient is on google, your competitors stand a chance to win your business (you have the same benefit as well).
Your goal is for the patient to think of your medical practice’s name when they need your services.. and not go to google.
In other words, you need to be “known” to the patient long before they actually need your medical services. Keep this in mind (aka branding) to decide your budget on getting your name out there as well.
So, divide your paid ads budget into
- Competing for patients ready to book now
At a minimum, these should be the ones you consider from the get go.
Facebook paid ads
Think of Facebook paid ads a bit differently from the way you’d think of google paid ads. On Facebook, patients are not actively searching for doctors or your medical practice per se.
Facebook is unique in the sense that it does give you much deeper insights into their users’ likes, dislikes, interests etc. You can very well use this information available to you via Facebook ads and target these users for your goals.
Targeting Facebook users for branding works well. What you’re really trying to do is to get your name out there and get people to click through and come to your website.
Once someone has visited your website, you can pretty much follow them around the Internet and retargeting ads work extremely well for these purposes.
You could also allow people to book appointments using your Facebook page “book now” button as well. However, always keep in mind that patients are not really actively searching for your medical services on Facebook.
One thing that works very well on Facebook is to get reviews from existing patients. Facebook allows you to upload your customer list (you can provide as little information as needed, to avoid violating PHI related concerns) and create a custom audience out of your customer list.
Once you have this custom list, you can boost (pay) your ads to get reviews from your existing patients. Keep in mind that google shows Facebook reviews when they show your practice search results on the right hand side of google search results.
So, as a recap, if you want quick results, start paying for Google and Facebook ads to get immediate results with calls from patients.
A quick primer on SEO
Most medical practices (even larger groups) are told that you need a website, a blog, multiple social media channels etc etc.
We’re not contesting that you should, someday, have all those. But, here’s the reality – any online presence that you have, you need to put in a lot of work for it to generate any return on investment (ROI) for you.
What does this translate to?
Let’s say that you don’t have a website and a medical marketing agency or even your in-house marketing hire tells you that you need a website… they’re only partially correct.
Just having a website does NOTHING towards marketing your medical practice. The day you purchase the domain name and create a website – it’s just that. Only google knows about it.. because your team submitted the site map to google for indexing.
That’s about it. You are just one tiny sapling in an Amazonian jungle. Even your next door neighbor wouldn’t be able to find you on google unless they specifically type your business name and your business domain name on the browser.
Don’t get your hopes up nor skew your expectations just based on the fact that you now have a website.
You could have the most beautiful website or you could have the ugliest website.. it doesn’t matter to google unless it finds your website trustworthy enough to show your website pages in search results.
That’s the part most doctors don’t understand, nor do marketing agencies tell you.
So, would you not have a website?
That’s not what we’re recommending. Our point is that if you have a website of even one page, that’s better than not having one at all. But, what’s more important is that you have something to say, a point to make, something to give to your patients… without that, you’ll only be found when someone searches for your doctor’s names, or searches for your practice by name…
That’s really just branded searches 🙂 you aren’t being discovered by someone that doesn’t know about you at all.
Ok, so this does sound like a lot of work. Is there no way to even hope to win this game?
There certainly is!!! And the best part is that the bar is set really low in healthcare. You only have to do a tiny bit better than the next guy to win this game over them.
So, what are the immediate steps to take?
Definitely have a website created. You don’t have to spend a fortune on custom design for the website unless you really want to have your brand look and feel a certain way.
Create complete profiles for each provider in your practice. In the beginning, most of the google searches will be for provider names as they have “some” brand name with patients. Start being found for those doctor name searches.
Create location pages on your website plus have the google map of that location on the web page itself. This will help you being found for queries like “near me” for whatever specialty you’re in.
Have your business listed in relevant directories. Complete your profile on those business directories (listed below)
What to write on the website?
Here’s the tricky part. Most hospitals completely miss this. They are sitting on a goldmine of patient queries and patients’ chief complaints. They are sitting on a treasure trove of patient stories. They are sitting on a gold mine of patient (user) generated content.
Use those. Create patient stories with consent from patients. Create video testimonials/interviews.
Patients find you after having gone through a process of self education about their own disease. Find their journey, write about their journey, about their cure, about their experience with you, about their experience after they were cured by your providers.
You are sitting on the best content generating machine in the world and you don’t even use it!!
Next we can look at how a medical practice can show up as more trustworthy to patients by getting patient reviews
Business directories that helps medical marketing / SEO
Here are some directories to keep in mind and get listed on
Claiming a listing online verifies that you’re the owner of a valid business (your practice) and are authorized to maintain its presence on the web. Each online local business index has its own claiming process with unique steps to verify your listing.
Moz has a great step by step process and dos and don’ts in detail (read here)
By doing these things, at least you’re on the map.. These also help you to be found in local google searches. That’s critical.
How a medical practice can show up as more trustworthy to patients by getting patient reviews
One of the biggest contributors to being found near the top of search results, in google search results “local pack “ and also to compete effectively with the several other choices that patients have – PATIENT REVIEWS.
You can, of course, choose to have reviews on various websites like zocdoc, ratemds, healthgrades, caredash , Yelp etc, but in our opinion, nothing trumps google reviews and Facebook reviews. That’s our opinion.
Most doctors do believe that they are providing great, quality patient care. We don’t doubt that. If you are very sure about this, go right ahead and implement the ideas we share below to start collecting patient reviews.
If you have any doubts about how your medical practice is viewed by patients, take some time to go through patient satisfaction surveys. Even if you are doing extremely well on patient reviews, you should, from time to time, engage in patient satisfaction surveys – just so you are in touch with reality and can identify issues that might have come up in your practice without you being aware of the same.
Getting patient reviews is so, so easy – JUST ASK !!
Few steps you can take today to get patient reviews
At the end of each patient visit (yes, we said EACH patient visit), ask them if they are happy and ask them to leave a review for you. It’s as simple as asking “If you get some time, would you please leave us a review on Google or facebook? We would greatly appreciate your feedback”. SIMPLE. That’s it – and it takes 30 seconds. Granted, most patients will forget it as soon as they leave your practice, but at least you will get SOME reviews.. That’s more than what you currently have ! And it is worth it.
If you don’t feel comfortable asking for patient reviews, you can very easily hand the patient a “Thank you for visiting” card which also has your practice’s google or facebook details. On the back of this card, you can very easily ask “Please leave us a review. We would greatly appreciate your feedback”.
If you do not want to spend money on postcards (yes, the costs do add up), then you can very easily email patients each day. You could have your staff set aside 30 mins at the end of the day to send our emails to all the patients of the day with something as simple as “How did we do today? Please leave us your feedback on Google or Facebook . We would appreciate your feedback”. This does require your front desk to collect patient emails diligently.
If your front desk staff is not good at collecting patient emails, you could very easily send patients SMS asking for reviews. A simple SMS like “Hi Sally, Could you please give us your feedback on Google or Facebook ? We really appreciate it!”
Trust us – you will start seeing results and you will eventually want to automate collecting patient reviews by leveraging technology (here are some key features to look for). Here are some tips and tricks on how to get more patient reviews.
Now that your patient is finding you online, do not lose their attention. This is your moment to shine. Make it SUPER easy for them to book an appointment with your providers. PLEASE, Oh please do not make them jump through hoops to get an appointment.
Improve patient access with near instant online appointments
Patients have changed the way they shop for healthcare. They have changed the way they look for doctors. Patients have very little patience these days.
When a patient is looking for a doctor and your business listing does show up, you need to allow your patient to request an appointment online – while they are searching.
Trust us – after requesting an appointment with your practice, these patients are moving on to your competitor’s listing and requesting an appointment online with them.
That’s how fickle patients are – they have very little patience for waiting.
Let’s talk about two of them here
- Google book now
- Facebook book now
How to use Google book now button to get patient appointments
You can enable Google book now by following these steps here and here. Keep in mind that it does ask you to sign up with one of their approved scheduling partners. If you don’t have an account with one of the partners, you should sign up. There aren’t many partners that actually support HIPAA compliance, so be careful about the ones you choose.
You can also use our free booking tool that works with Google Book Now button as well.
Another way to enable booking is via Google messaging. Read more about it here. Do keep in mind that to enable this, you have to turn on Google messaging. Here’s how you do it (read this link) and keep in mind that you do need to respond within 24 hours of receiving a message from a customer (or potential patient).
There is no risk to enabling the book now button nor any risk in enabling google messaging. Just because a patient asked for a specific appointment date/time doesn’t force you to agree to that date/time. You can always call the patient and reschedule based on an available appointment date/time. It’s that simple.
How to use Facebook book now button to get patient appointments
Facebook is not far away in this game either. You can enable Facebook book now button quite easily – all you have to do is to set up your availability, list the “services” that you cater to (e.g. retinal surgery, glaucoma, Primary Vision Care, Allergy Eye Care, Cancer Care, Cataract Surgery, Corneal Surgery etc) and just set up the patient reminders..
Facebook also allows you various options with the Book Now button. You can direct patients to your website, use one of their scheduling partners or set up (as mentioned above) your schedule on Facebook itself.
Facebook has messaging features similar to what Google has as well. Your patients can send you facebook messages via the Facebook messenger. This does not necessarily mean that you or your staff have to sit around with the facebook messenger tool open all day long. Unlike Google Messaging which has not opened its messaging API yet, Facebook integrates via tools like zapier to email or SMS you those messages. This makes it really useful because Facebook messages can be integrated directly into your daily workflow.
Wasn’t that easy?
Growing your healthcare business via physician referrals
This is a topic that’s often looked over by even the most experienced practice managers. Either they are too shy to do this or they are too proud to ask for referrals.
Physician referrals are a gold mine and your healthcare business can grow tremendously if you execute on this strategy well.
You do need a team to do this properly but it pays off extremely highly. Let’s see how to go about this.
Understanding the healthcare referrals process
Understanding the healthcare referrals process well will help you market your practice and grow faster than your competition.
Understand the healthcare referral process well. If you are a referral coordinator – This will help you be better at your job. If you’re a physician liaison – this will help you manage referring partner relationships better. If you’re a healthcare marketer – this will help you make your quota. Most of these are automatically taken care of by our healthcare CRM software when you use it for referral tracking and referring provider relationship management
What are physician referrals?
We are all patients and see various specialists (e.g. cardiologists, ENT doctor) and also our primary care physician (general practitioner, PCP). When the provider diagnoses or suspects that a patient of theirs needs further diagnosis from a specialist physician, they refer the patient.
How is a physician referral made?
When one doctor refers a patient to another doctor, here’s how they do it:
– tell the patient to see a specialist of the patient’s choosing. This usually happens in the referring provider does not have an established relationship with the specialist.
– If the referring provider already knows of a specialist that they have had good experience with, tell the patient to see that particular specialist.if the referring provider already knows of a specialist that they have had good experience with, tell the patient to see that particular specialist.
The referring provider can send the report patient via a couple of ways:
– Write the referral on a notepad or a piece of paper and hand it to the patient.
– write the referral on a referral pad that the specialist might have provided the referring providers office.
– Send the referral to the referred specialist using a third party referral software.
– call the referred specialist office to make an appointment for the patient.
– Send a referral instruction to the referred specialist via fax.
– Send a referral order to the referral specialist directly from their EMR. When the referral order goes from the EMR, it can reach the referred specialist either via DIRECT email communication (EMR to EMR email) or fax from the EMR.
“Notepad” physician referrals – how do these work?
The referring doctor or doctor’s staff writes down the name and number of the referred doctor on a notepad or piece of paper and gives it to the patient.
In this case, the referring doctor knows that they referred the patient but the referred to doctor doesn’t know that they were sent a referral.
It is up to the patient to call the doctor they were referred to and make an appointment.
Research has shown that 50+ % patients do not call to make that appointment.
How are healthcare referrals via “Referral Pad” handled?
Many doctors advertise themselves to other doctors in their neighborhood. When they advertise, they leave their referral pad with these doctors.
Here, the referring doctor or doctor’s staff writes down the name and number of the other doctor on the referred to doctor’s referral pad and gives it to the patient.
In this case, the referring doctor knows that they referred the patient but the referred to doctor doesn’t know that they were sent a referral.
It is up to the patient to call the doctor they were referred to and make an appointment.
Research has shown that 50+ % patients do not call to make that appointment
Phone call from referring provider to specialist office
Referring doctor office staff calls the specialist / referred to doctor office to get an appointment for their patient.
If they connect with the staff at the referred to doc’s office, they try to set an appointment for the patient (rarely happens) ASAP.
Typically, If they don’t connect, they leave a voicemail with the referred to doc’s office AND write down this referred to doc info for patient and ask them to call the doc’s office themselves.
In this case, the referring doctor knows that they referred the patient. The referred to doctor also knows that they were sent a referral.
What happens when a patient referral is faxed over?
In this case, the doctor or doctor’s staff writes down the name and number of the patient, some more patient related information and sends a fax to the referred to doctor. They tell the patient that the referred to doctor’s office will call the patient to set up an appointment.
Here, the referring doctor knows that they referred the patient. The referred to doctor also knows that they were sent a referral.
How about referrals sent using a physician referral software?
In this case, the doctor or doctor’s staff uses a product (e.g. referwell.com, getreferralmd.com, mdreferralpro.com, www.smartmd.com, jointhenetwork.com, Werq.com etc) to send the referral to referred to doctor. This works when the referred to doctor is also using this software. Otherwise, the sSpecialist office gets a fax or an email that they have a referral. The specialist office that needs to provide a code from the fax or the email to retrieve the referral.
The referring provider staff enter the name and number of the patient, some more patient related information and send the referral to the referred to doctor. They tell the patient that the referred to doctor’s office will call the patient to set up an appointment.
In this case, the referring doctor knows that they referred the patient. The referred to doctor also knows that they were sent a referral.
What information do referring providers need to send you a referral?
The very first thing that the referring provider office will check is the patient’s insurance. This is important because the insurance companies want to make sure that the referral is clinically needed.
Each plan from each payer might have specific referral requirements. This is why the referring provider office sometimes requires additional time to determine which specialist would be an appropriate fit for the patient to be referred to.
While referring providers office’s staff determines the insurance plan fit, they also find out whether an authorization is required for the referral or not.
If a prior authorization is required the referral center will submit an authorization request for the referral. This, sometimes, can take up to 14 days.
How about specialist office approval?
Just because the referral is submitted to a specialist office, does not mean that the specialist office has accepted the referral. Many times specialist providers have a referral process of their own.
Many a time the specialist provider office will ask for supporting documentation for the referral to determine its clinical necessity. The supporting documentation may include the patient record ( CCDA) and possibly supporting reports (lab reports, x-rays etc.)
Sometimes the specialist office will require the patient to take some additional tests. These tests might require prior authorization from the patient’s insurance.
Is a referring provider obligated to make a referral?
Ethically – yes. Technically – not quite.
Most referring providers will, however, make a referral due to their HEDIS/ MIPS related concerns.
Referral management and HEDIS
Understand this part and the relationship between physician referrals and HEDIS measures. This will help you understand why referring providers behave the way they do and how you can keep them happy.
HEDIS makes it possible to compare the performance of health plans on an “apples-to-apples” basis.
Data is reported to NCQA every June of the reporting year (e.g. June 2019) but that report is for the prior year ( eg 2018) for providers.
E.g. one of the HEDIS measures is Comprehensive Diabetes Care (CDC) – Retinal Eye Exam for patients with Diabetes type 1 or 2.
What is required to achieve good marks for this measure?
A note or letter from an ophthalmologist, optometrist, PCP or other healthcare professional indicating that an ophthalmoscopic exam was completed by an eye care professional, the date when the procedure was performed and the resultsThe primary care physician / doctor has a patient come in with diabetes types 1 or 2.
Here, the PCP notices that the patient needs a referral to an eye doctor.
They immediately refer this patient to the eye doctor (ophthalmologist).
However, they need this “note or letter” before they can claim to the healthcare payer that they met this measure and should be given high marks.
So, unless referred to doctor’s office returns the visit notes “note or letter” – the referring doctor cannot meet this measure.
What are the stages of a physician referral?
When a referring provider refers a patient to a specialist doctor using fax or referral software, the referral goes through the following referral stages.
1. Pending/Not Scheduled referral
When an appointment request (referral) is received, the referral is in “Not Scheduled” or “Pending” status.
This is called the “Request backlog” for the referral managers and referral coordinators of the referred to doctor’s office. It is their job to call and convert these patients into appointments.
Sometimes this is outsourced to a call center.
unless someone is using a referral software to track all these referrals, or using a spreadsheet to track these (like a CRM), it is nearly impossible to manage how many referrals came in, how many are in pending status etc.
On top of this, the referring provider also wants to know “what’s the status of my referral”.. So they have to be called/emailed/faxed for updates (patient didn’t pick up the phone or patient declined to make an appointment or patient phone number is wrong or patient line was busy etc).
2. Scheduled Referral
The specialist/ Referred to doctor’s office calls patient to try and set an appointment.
If the patient picks up the phone, the specialist office makes an appointment for the patient. This is when the referral gets to the Scheduled status.
Only 30% patients actually pick up the phone. So, if in 1 day, you get 100 referrals, only 30 patients pick up the phone.
So, the next day, you have to call 100 patients of next day + 70 patients that didn’t pick up the phone the last day.
On top of this, the referring provider also wants to know “what’s the status of my referral”.. So they have to be called/emailed/faxed for updates (scheduled).
3. Referral No Show
After a patient makes an appointment, the patient needs to be reminded to keep the appointment.. If they don’t show up, the referred to doctor would lose that time slot and won’t make money for those 15 mins (each appointment is usually 15 mins).
To make sure patients show up, the doctor’s office staff (sometimes a call center) send SMS appointment reminder to the patient 1 week before, 2-3 days before etc. This can typically be done via the EMR or PMS as well.
One challenge is that not all patient phone numbers are mobile numbers. So, appointment reminder text messages are not always delivered.
Some practices, call the patient the day before the appointment and if they cannot reach the patient, they call the patient on the day of the appointment as well.
If the patient does not show up for their appointment, this appointment/referral gets to a No Show status.
Every day about 10-35% of the patients do not show up. These patients are now in the “Request backlog” for the staff to call again and try to set up another appointment with them.
So, now, every day, you have to call much more than 100 patients.
Every day the patients have to be called and reminded to come in for their appointment. This also adds to the patient call/request backlog. On top of this, the referring provider also wants to know “what’s the status of my referral”.. So they have to be called/emailed/faxed for updates (no-show).
4. “Patient seen” Referral status
When the patient actually shows up for the appointment, the patient referral is marked as Patient Seen.
At the end of the day or asap, the doctor that saw the patient will write up the encounter / visit / consult notes in their electronic medical record software (e.g. EPIC, eclinicalworks, Modernizing Medicine, CareCloud, Cerner, AthenaHealth, Allscripts, CureMD, GE Healthcare, Practice Fusion).
This note needs to be sent back to the referring doctor.
Every day, if you are seeing 100 patients, you will have to send 80+ visit notes back to referring doctors (not all patients are from referrals).
Someone needs to keep track of who is sending these visit notes back to the referring providers or not.
Some people send faxes and some people mail these visit notes (postal mail) and some email them (not HIPAA secure).
Someone needs to keep track of whether mailing these visit notes or faxes is actually happening or not. This is an arduous task to keep up with using paper or spreadsheets.
How does using Referral management software help?
There are a few things to remember/understand when practices/providers are using referral software.
If the Referring doctor is using a referral software, their referral recipient partner also has to use that software (not always the case, but most of the times, this is the case).
If the specialist office does use the software, then the referring office sends the patient referral using the software.
Few things can happen here since the referring office & the specialist office both store the patient information separately in their own separate EMRs (e.g. one could be using PracticeFusion and another could be using eClinicalWorks).
The referring office might have connected their EMR to the referral software so the patient information is automatically transferred to the referral software.
The specialist office might have connected their EMR to the referral software so the patient information is automatically transferred to the referral software.
Both of these provider offices could have connected their EMR to the referral software so the patient information is automatically transferred to the referral software, however practice 1 wants to connect their EMR to the referral software using HL7 interface and practice 2 wants to connect their EMR to the referral software using Secure Direct Messages.
Neither one of the practices might have connected their EMRs to the referral software. In this case, staff from either side has to manually transfer patient information back and forth between the referral software and their EMR (usually people forget to do these things)
How to add new referring physician partners per month
Here’s an example of how you can achieve your SMART goal “I want to add one new referring physician partner per month”.
Let’s break this down. How would you achieve that?
- Create a list of physicians near your practice location(s) to market to. If you do not actively market to physicians around your practice locations, you need to fix that asap. Physician referrals are a rock solid way to add new patients to your practice on a weekly/monthly basis.
- Create a simple CRM with this database you gather.
- Hire or deploy your existing physician liaisons to visit these potential referring physician partners OR
- Send faxes/letters to these physicians on a regular basis introducing your practice to them OR
- Call these practices and introduce yourselves to them on a regular basis
- Work with your scheduling team / front desk to ensure that patients referred by these referring partners get appointments quickly
- Follow up with the referring physician office with visit notes to close the loop and to ensure their patients are happy PLUS the referring physician is happy.
How to create a list of referring physician prospects near your practice location(s)
First and foremost, you need to create a list of all potential referring physicians. As you know, the primary care physician is the biggest source of all referrals. However, for specific population health conditions (e.g. diabetes), certain groups of specialties also are a target. As an example, for diabetic patients ophthalmology, podiatry, endocrinology, nephrology, dieticians… they all get involved in the same patient’s care. Do not forget to market to such “associative” practices !
Creating a list of all such providers is not as easy as it sounds. However, there are some ways you can achieve this
- NPI database that is distributed by CMS and updated weekly
- ZocDoc or healthgrades or rateMDs or vitals.com etc
- Best of all – payer provider directories
Finding referring physicians from NPI Database
CMS distributes this publicly available database here. Keep in mind that CMS updates this with a “Full Replacement Monthly NPI File” each month and also publishes a “Weekly Incremental NPI Files“ each week.
While this does contain comprehensive data, unfortunately, the addresses of providers in this database are not always accurate. Bear that in mind when you are creating medical marketing lists of your own. We have noticed that sometimes the addresses reported by the NPPES database file are completely incorrect.
Although, if you are marketing via fax or phone, this might not be an issue for you as we have found that the fax numbers are usually pretty accurate. Phone numbers do tend to be pretty accurate as well, although they are not as accurate as the fax numbers. While every listing is going to have a phone number, fax numbers are not always a guarantee.
Finding referring physicians from Google
You can always turn to google maps for a listing of providers around your location as well. This is a bit of a painful process. You need to use google maps and start searching for specialties by name .. e.g “podiatrist” or “ophthalmologist” or “optometrist” and collect the google map search results for providers around your location(s).
Google also faces the same challenge – the data you get is not really accurate.
Finding referring physicians from business listing websites
While NPPES and Google don’t always provide accurate information, on the other hand, business listing websites do provide more accurate information (for profiles that have been claimed by medical practices). You need to be careful about trusting data of practices that have been claimed by the medical practice – that’s when the data is actually more accurate than what you find via Google or NPI database.
If the medical practice has NOT claimed their business profile then you are, in all probability, looking at the same inaccurate data as you would find via the NPI database or Google search results.
Finding referring physicians from payers’ provider directories
This is quite possibly the best source of the most accurate information of providers. By law, each payer is supposed to maintain a correct, updated provider directory. This helps you in many ways.
You already know which payer plans you accept and know well that you do not actually want to see patients whose insurance you do not accept (leads to billing issues). So, the best way to do this is to simply take a list of your payers and then google + provider directory (e.g. “healthfirst provider directory”).
Most, if not all, payers have their provider directories available on their website or as a PDF. You can simply create your own database of providers to market to by collating this information.
Instead of going about this in a haphazard way, we recommend using an age old technology called CRM (customer relationship management) software.
How to use a simple CRM with referring provider data
Many practices make the mistake of not being organized about their physician marketing program. They gather information here and there, download PDFs, print them out, then sort of mark the providers their rep has visited or the ones they have called to introduce themselves.
That is not the way to approach marketing. You can certainly start that way, but very soon you are going to forget who you contacted, who you didn’t, how many times you contacted someone etc.
Marketing (and sales) is a game of numbers. You need to show up, rain or shine, on a regular basis for people to remember you. It’s as simple as that.
You don’t even need to invest in any CRM (physician relationship management) tool to begin with. All you need to have is (at a minimum), a spreadsheet where you have all this provider data, the name of the person(s) from your office that is marketing to that provider, notes, date(s) you reached out to that provider.. That’s about all you need to track on a regular basis.
Trust in the process. Keep showing up and keep at it. You WILL see the results over time.
Of course, should you choose to invest in a basic, simple CRM – life becomes a lot easier and things get a lot easier to manage. Most CRMs send you reminders, automatically log calls and emails to help your team avoid spending time in data entry.
If you choose to invest a little bit of money in this – go with Badgermaps (Route Planner for Field Sales) or you can also use our free provider CRM software as well.
Don’t want to do either? At the very minimum, use a google sheet or a spreadsheet!
Here’s a sample spreadsheet to use
Don’t want to do either? At the very minimum, use a google sheet or a spreadsheet!
Here’s a sample spreadsheet to use as a spreadsheet based provider CRM. For daily reporting, feel free to use a sample like this.
Just doing this alone will help you and your call center team keep track of physicians to reach out to.
|FirstName||LastName||Degree||Gender||RoleName||NPINumber||phone||fax||Address||City||State||Zipcode||Zip4||County||Call Date||Comment||Disposition||Open||New Patient||History & Physical||Faxes Sent||Email Address||New info|
|Mohammed||Rahman||MD||M||Primary Care Provider (PCP)||1194811521||7186746222||7186746233||8834 161st St||Jamaica||NY||11432||4040||Queens||05/18/2020||06/04/2020||Dr ofc closed||No Answer|
|Moisey||Delman||MD||M||Primary Care Provider (PCP)||1982665261||7182752669||7182752686||9508 Queens Blvd Ste 1E||Rego Park||NY||11374||1151||Queens||05/18/2020||06/04/2020||Dr ofc closed||No Answer|
|Orrin||Lippoff||MD||M||Primary Care Provider (PCP)||1225038664||7183316600||7182590094||8210 18th Ave||Brooklyn||NY||11214||2901||Kings||05/20/2020||06/05/2020||Dr ofc closed||No Answer|
|Qazi||Haider||MD||M||Primary Care Provider (PCP)||1184793846||7188860355||7188860311||14014 Cherry Ave||Flushing||NY||11355||3025||Queens||05/21/2020||06/05/2020||Dr ofc closed||Voicemail|
|Robby||Mahadeo||MD||M||Primary Care Provider (PCP)||1407996135||7183221111||7183221506||12910 Liberty Ave||South Richmond Hill||NY||11419||3120||Queens||05/21/2020||06/05/2020||Dr ofc closed||No Answer|
|Robert||Pintauro||MD||M||Primary Care Provider (PCP)||1942393343||7186524647||7186527862||2460 Mickle Ave||Bronx||NY||10469||6240||Bronx||05/21/2020||06/05/2020||Dr ofc closed||No Answer|
|Roberto||Zambon||MD||M||Primary Care Provider (PCP)||1326147778||2122811677||2122811589||1854 Amsterdam Ave||New York||NY||10031||1714||New York||05/21/2020||06/05/2020||Dr ofc closed||No Answer|
|Sandra||Robinson||MD||F||Primary Care Provider (PCP)||1366528812||7185272850||7189771089||1545 Atlantic Ave Ste 108||Brooklyn||NY||11213||1122||Kings||05/22/2020||06/08/2020||Dr ofc closed||No Answer|
|Shiu||Tang||MD||M||Primary Care Provider (PCP)||1952319022||7184788500||7184788508||8708 Justice Ave Apt 1I||Elmhurst||NY||11373||4576||Queens||05/26/2020||06/08/2020||Dr ofc closed||No Answer|
|Sultan||Khan||MD||M||Primary Care Provider (PCP)||1740364504||7186457105||7186457110||1602 Quentin Rd||Brooklyn||NY||11229||1250||Kings||05/27/2020||06/09/2020||Office closed||No Answer|
How to market to referring providers via faxes, calls, emails
It’s pretty basic and simple, however, your team does need to be regimented about it.
Of course, if you are serious about physician marketing, please use a healthcare crm
Here’s what you need to do:
- Set aside a few hours per day, every single week or have a person dedicated to this function.
- Have a marketing one pager that introduces your practice / medical services ready to go with some stats/numbers to speak of.
- Make sure you have a target number to hit every day (e.g 100 calls per day or 200 faxes per day or 150 emails per day).
- Do not stop until you have made those number of calls or sent those numbers of faxes/emails.
- Every time that you do make a contact with someone at the practice, ensure that you glean some additional information about the practice staff or doctors and add that to your notes in the CRM or spreadsheet.
- Make sure that you team up with your practice folks that schedule appointments and ensure that they capture the referring physician information for each patient.
- Make sure that you get a list of all appointments created in your EMR from the day before, identify all the patients that came in from referring providers that you are targeting. The next time you reach out to them, you would be calling to thank them.
- Make sure that your appointment scheduling team also captures the primary care physician information for each and every appointment.
- Make sure that you get a list of all appointments created in your EMR from the day before, identify all the patients that came in from primary care providers (PCPs) that you are not targeting. Add them to your list of folks to call / establish a relationship with (within your CRM or the spreadsheet that you are using). Even if the PCP has not really referred the patient to you – this gives you the opportunity to add new PCPs to your roster, call them to let them know that you are co-managing the patient’s care and would be sending them the visit notes asap after the patient’s appointment.
- Every single day, after each call or faxes/emails blitz, update your CRM or spreadsheet with the latest activity data (e.g. last contact date, outcome etc)
- Follow this process every single day – rinse, repeat.
- You will probably be touching each contact only about 1-2 times a month. Do not repeat your outreach to more than twice a month per contact / practice.
- Each time a practice sends their first patient(s), mark that practice account as a “customer” instead of a “prospect” and handle the account accordingly.
You will notice that after 6-7 contacts / touch points with the same practices, you do start getting referrals
How to send marketing faxes to doctors and medical practices at scale
Faxes to doctors and medical practices do work well – when done correctly. You could be marketing your medical devices, pharma, your healthcare services, software or even trying to market your practice to potential referral sources.
If you are using our HIPAA compliant healthcare CRM, these are available quite easily (pre-built). If you are not using NisosHealthCRM, here are the steps you can follow to do the same manually.
- Get an account with decently priced broadcast fax providers like openfax, clicksend etc. Try to keep your bulk fax pricing near 3 c/page.
- Prepare a few versions of “one sheeter” for whatever marketing material you want to fax.
- Prepare your list of provider offices you are marketing to. Ensure that your fax numbers are correct format (e.g. +11231231234) as some vendors need the country code as well.
- Make sure that you have a google sheet or spreadsheet that will help you keep track of the bounced fax numbers.
- Make sure you have a google sheet or spreadsheet to keep track of the “opt out” fax numbers.
- Have a spreadsheet or google sheet to keep track of which faxes you have sent on which data to which providers, with which version of the one-sheeter marketing template. Finally, you might want to add a column to capture the leads generated per set of marketing faxes sent (to measure the ROI).
- Make sure that you have a phone number set up that doesn’t make the callers jump through hoops to get to you (or your team).
Medical Marketing One sheeter
If you are in marketing, you already know about A/B testing. You are aware that you should be testing out your marketing copy before you automate or scale anything.
This is why we advocate creating multiple versions of your one sheeter (PDF or word document).
If you don’t live in the world of faxes, you should know or be aware that faxes don’t’ look as pretty as your word document or PDF. By the time someone receives the fax, it does look quite “ugly”.
Don’t try to cram too much information into one fax.
Do not use small fonts – aim for font sizes of at least 14 and higher.
Avoid the use of fancy fonts – God only knows what that will look like when it arrives at your prospect’s fax machine.
Don’t use fancy images – they come out looking pretty bad at a fax machine (and do use up quite a bit of ink).
Whatever you do – do NOT forget to include an “opt out” fax number, phone number or email address. You need to be in compliance with TCPA. There are “Disclosure & Opt-Out Requirements” that you need to adhere to.
If you are going to be sending personalized or mail merged faxes, then make sure that you are preparing your one sheeter with the appropriate variables that you want to “mail merge”.
Below are some fax one sheeter examples – feel free to edit and use them. There are several one-sheeter templates in NisosHealthCRM for you to edit and use for your convenience as well.
Healthcare Marketing list preparation
As any good marketer, you are going to need your marketing list prepared. If you use NisosHealthCRM, you already have several lists to choose from. If you are a paid subscriber, you can create custom searches and build your own marketing lists.
Prepare a google sheet or spreadsheet with your marketing list. It would look something like this (below). As we have discussed previously, you can get this information from CMS’ NPPES database, from provider/hospital/dialysis centers etc compare databases or from PECOS databases as well. There are several public databases for you to build your marketing lists from – however, do keep in mind that these public data sources are notoriously unreliable/outdated.
Here’s a sample of a spreadsheet that you might want to use
Doctors Marketing list cleaning
If you have been in marketing for any length of time, you are well aware of the list cleaning tasks 🙂 It’s a necessary evil that we all need to get done each day. Of course, if you are using our NisosHealthCRM, this is taken care of, on your behalf.
Each time you send a batch of faxes, you are bound to get some bounced faxes / faxes that didn’t go through. Keep track of each of the fax sent statuses because not all “undelivered” faxes are wrong numbers. Sometimes, faxes bounce because of “no answer” or “wrong number” or “blocks” or “busy” signals etc.
For many such undelivered faxes, you can retry sending the faxes at a later date/time. Each fax broadcast vendor will also give you a list of fa numbers that failed during delivery.
You might also want to add numbers to your global “blocked list” to avoid re-sending marketing faxes to folks that have “opted out”.
Before you hit send on your faxes, you are going to need to rid the sheet or spreadsheet from duplicate data as several locations of a practice might end up having a centralized fax number/fax server.
Now you are ready to send marketing fax broadcasts.
Sending the marketing faxes to doctors or practices
This part is entirely up to you – whether you want to send the fax as a mail merge (to personalize it) or whether you want to send the faxes in a generic blast fax batch. Each has its pros and cons – and is not mutually exclusive.
Make sure that you update your marketing / fax tracker spreadsheet with the list you sent faxes to, which version of the fax template you sent, date you send the faxes.
Here’s an example fax log spreadsheet that you can use
If any of your prospects showed any interest, make sure you update this spreadsheet with leads and the source campaign being “faxes”.
Each time a fax broadcast finishes, you will get a report on how many succeeded, how many failed and typically, the fax vendor will send you a broadcast report.
Again, all these are available out of the box in NisosHealthCRM.
Personalizing your marketing faxes
If you are doing mail merges or personalizing your marketing faxes, follow these steps if you are not using NisosHealthCRM.
- You can use your fax broadcast provider to mail merge and send faxes on your behalf. OR
- You can create those mail merged faxes yourself (more control) and there after, send those faxes via Fax api calls.
If you are using your fax broadcast provider to get it done, then follow the steps that your provider tells you to follow.
If you are merging PDFs to fax yourself, then follow these steps below.
Install Autocrat for google sheets. Once you install it, the addon will show up like this
If by chance you do not see the add on, then refresh your google sheet and then try again. It should show up.
Hopefully you have already stripped your marketing list of some “not so personal” names like P.A, PA, INC, L.L.C., LLC, M.D., MD , O.D, OD, etc. If not, go ahead and do that first as they don’t really look “good” for personalized faxes 🙂
Make sure you use the google sheet or spreadsheet built in function to remove duplicates as well – there’s no point sending 2 faxes (each fax costs money, as you already know).
Prepare your template file with some variable names e.g. (see below)
These are the variables that will be replaced by Autocrat from the spreadsheet that you have the variables in.
Next, launch Autocrat and create a job.
Next, go through the steps and make sure that you merge the columns appropriately. Specify the folder where you want Autocrat to place the mail merged files (pdf or google doc). Make sure you see a “PREVIEW” with the first mergeable row (Autocrat has this function built in).
If you have done correctly, you will see a preview (based on the variables mentioned above) like this:
For the following data
Now, fire away. Run the job for all your mail merge data. This will take a while based on the number of rows your spreadsheet has.
All the PDFs will be created in the folder you specified in your Autocrat job. These PDFs are now ready for you to fax them.
How to market to referring providers via physician liaisons
Physician referrals are a gold mine – we all know that. There are very few industries outside of healthcare where referral networks can work so well and can be so effective in business growth.
Over time, we have noticed that the practices that grow rapidly are the ones that take physician referral networking and physician referral partnerships seriously… very seriously.
It actually is very easy to do so if you master the individual components of this growth strategy.
The things to look at:
- Marketing to physician offices near your office/practice locations
- Following up with physician offices and reminding them of your services regularly
- Taking care of patients referred by your referring physician partner by seeing them asap, treating them well and ensuring that the patients are happy
- Keeping your referring physician partner office(s) in the loop constantly about the referral they sent over
- Closing the loop with your referring physician partner by sending out consult/visit notes ASAP and transitioning care back to your partner
- Touching base with your referring physician partners regularly to ensure satisfaction, addressing any issues they might have, keeping them abreast of the latest about your practice and the co-managed patients.
How we have seen it being done
Most practices that we have worked with, make the mistake of having physician liaisons do the following:
- Market to referring physicians with/without giving them the proper tools to do their jobs
- Follow up with physicians to make sure they send referrals
- Follow up with the practice management staff to find out whether the referring physician sent any patients or not
- Follow up with the referring physician practices to update them about the referred patients’ appointment status
- Follow up with the practice management staff to find out if the consult / visit notes are ready or not
- Follow up with the referring physician practice to drop off consult notes
- Find out issues from referring physician practices and relay them back to the practice management staff internally
- Follow up with referring partner practices on whether issues have been addressed or not
This is too much for physician liaisons to handle. They simply cannot be effective if they are handling hunting, farming, customer satisfaction, practice management staff coordination etc.
How we feel it should be done and how we have succeeded
We have always had success with teams that are laser focused on a singular task. This allows us to hire, train, set proper KPIs, MBOs for, measure, learn, fine-tune better. That’s at least, our approach to running a practice management business.
Separating hunters (physician liaisons) from farmers (referral coordinators)
Our first advice is to break down these functions into:
- Hunting – folks out in the field hunting down new referring partner accounts to close (or rather, “open”). You need to equip this team with the proper training, collaterals, account information (aka referring practice locations), account intelligence (aka physician specialty, clinical interests, number of procedures if possible, procedures performed, expertise, payer mix etc). These are your “field sales reps” or “physician liaisons”.
- Farming – Once the hunters have hunted and the referring partner has sent their first few patients, it’s the job of the farmers to expand that “account” into getting more referrals. The only way this is going to happen is if your farming team is “on top” of referred patients, patient satisfaction, patient coordination, keeping the referring partner up to date on patient appointment status, reverting back with consult notes and transitioning care to ensure referring partner satisfaction. This is much more of a coordinator role (aka referral coordinator).
Our earnest advice is NOT to mix these two roles as they require different personalities and have a very different focus.
What does a physician liaison need to do their job? Understand this well and you will succeed !
We have seen that for most smaller practices, IT is a challenge and physician liaisons are thrown into the field with little to no tools nor correct data to hunt.
Imagine yourself in a physician liaison’s role. What do you need to be successful? You need:
- A clearly defined territory – i.e. exact boundaries of where you should be hunting for referring physician partners
- A clearly defined list of accounts in your territory – i.e. a list of all practices, their specialties, their locations – and if a practice has multiple locations, a clear indication of this association of multiple locations to the same practice.
- A well defined list of contact information for your accounts (fax, phone numbers are a must have, websites are a nice to have)
- A clearly defined list of contacts within your accounts – i.e which physicians practice at the account, front desk person(s) name(s) (if possible), referral coordinator’s name (if possible)
- A well defined list of contact information for these contacts within your accounts (fax, phone numbers and emails if possible)
- A well defined list of availability information for these contacts if possible. Many times, liaisons waste time going to practices expecting to be seen by a doctor – only to find out that the doctor only comes in twice a week on such and such day(s) of the week
- Provider/Account intelligence – if possible, a list of information that tells you more about the practice, the kind of plans they accept, the kind of procedures they do, the number of medicare/medicaid patients they see etc.. These require a little bit more legwork by your IT staff but are well worth your time
- A complete history of contacts / touch points and activity history with that practice (e.g. rep 1 has visited 3 times, rep 2 has called 5 times, rep 1 has faxes 3 times, doctor A had sent referrals before but stopped sending 2 years ago, doctor B just sent a new referral etc)
- Training on your own practice’s strengths, weaknesses, areas of opportunities, threats to your practice
- Marketing collateral that can be used for conversation starters, drop off / leave behind material at the practices, key differentiators between you and your competitor
- Referral pads or an even easier way for these partners to refer patients to you. You cannot dictate how this referring physician would send referrals – whether they call in, send a referral via P2P or their own EMR, whether they send via fax, your referral pad or whatever fits within their workflow. You need to prepare your farmer / referral coordinator team with that information
- To be able to add account intelligence while you are out in the field and are going door to door. These could include newly discovered staff name, numbers, details on the staff .. or the same with doctors that you discovered when you visited the practice
- To be able to add reminders to yourself about following up with a practice on specific dates/times
- To be able to check in/check out of the practices you visit so that you don’t constantly have to report back to your boss manually
- To be able to define your route for the day intelligently (i.e. optimized to minimize driving times) without having to be a google maps wizard
- To be able to communicate with your practice staff instantly while you are at the practice you are visiting
- To be able to have a clear idea about the practice and the patients they have referred to your practice over the past year (at least) as soon as you enter the practice – so you are not caught off guard while you’re there
- More to be added based on your own unique ways of hunting
How to target the right contacts at your prospect referral partners
More often than not, we see that physician liaisons are being told to “call high”.. Aka, don’t leave without meeting the doctor.
Truth is that this is not accurate, depending on the practice you are hunting into. Many times, we have noticed that doctors actually do NOT make the referral decisions. There are many times where the referral coordinator (or even the front desk that doubles as a referral coordinator) is responsible for sending referrals out and is the one that’s responsible for deciding who (which specialist) the referral is sent to.. And they do so purely based on the path of least resistance and the most responsive partners.
Understand that and let that sink in.. while you are aiming to connect only with the doctors, referral decisions are being made by front desk or referral coordinator staff that are tasked with “sending” the referrals out the door. They don’t care about the “best doctor” for the patient (they are not clinically trained to know that much).
What do they really care about?
A couple of things ..
- Which referring partner responds to me the fastest, so I can update my boss on the status?
- Which referring partner gets my patients appointments the quickest, so my patients don’t complain to my boss, the provider?
- Which referring partner keeps me updated about the appointment status – so that my patient doesn’t come back to see my provider without having completed the referral visit or the referral notes?
- Which referring partner closes the loop on the referrals I sent via a visit note, so that I can update the same on my EMR and thereafter can report back to our payers about the referral being `complete”?
- Which referral partner offers me the path of least resistance? Aka.. I just send referrals the way I used to, without having to jump through any new hoops or having to learn a new referral process/software or something else?
The underlying theme here is.. What makes the job of your referring partner’s lives easier?
Sure, in many cases, doctors themselves are responsible for the referrals. We are not saying that you shouldn’t try to see the doctor.
But you should also keep in mind that you need to train your physician liaisons in a different way to be able to gain audience with the doctor.
And once they do gain an audience with the doctor, they should be able to have a powerful impact in the 5 minutes that the referring doctor gave them.
In other words, the physician liaison should be able to bring something to the physician’s table that only the physician could appreciate.
Something that the physician liaison could not leave behind or train the front desk or referral coordinator on.. Something that the doctor themselves would be able justify spending their 5 minutes on..
Keep that in mind when you are persistent about being given an audience with the “doctor”.
Don’t expect a physician liaison to be able to figure this stuff out themselves.. Train them, empower them, guide them..
And you will reap rewards..
What does a referral coordinator need to do their jobs?
Understand the critical role of the “farmer” or “referral coordinator”. Imagine yourself in a referral coordinator’s role. What do you need to be successful? You need:
- To be a true partner with your physician liaisons / hunters – you need to know which accounts they are hunting and who you are aligned with, to support them in their efforts
- To monitor all incoming channels of referrals (referral websites, faxes, emails, phone calls)
- Always accept referrals from multiple channels (whatever your referring partner prefers) but always report back on one single channel (fax or website is usually easiest to do). Do not force the referring partner to change how they send referrals, but dictate how you report back to them
- To be in sync with your appointment scheduling team (inbound or front desk) to ensure that they capture referring physician information for each patient appointment
- To be able to call patients for whom the referring physician information is not captured and ensure that you at least capture their PCP information – this will truly help your team grow the referring partner base. Trust us on this one – even if the PCP did not send you the patient, if you get back to them with the appointment visit notes, you establish a (potentially) new referral partner. This at least gives you a reason to get in touch with the provider
- To know the referring providers of each practice – to keep an eye out for any new patients referred. You need to be on high alert for this information. Keep in mind that when the inbound team / appointment scheduling team schedules a new patient, they might only get the referring provider information. You need to be able to figure out which practice this patient was sent from. Sometimes, you will find that the same provider is practicing at multiple different practices – in those cases, you would need to call the patient to find out which practice location the patient typically visits. Or, alternatively, call each such listed practice location asking about the patient – one of them will confirm that they are the custodians of that patient 🙂
- Call the referring partner upon receiving the first few referrals to cement the referral relationship. Keep them up to date on the patient appointments, no-shows or cancellations. Make sure the referring partner office hears your practice name and your name a few times. Give them your email / contact info (direct line, not the practice main phone number), your direct fax number if possible. All these little things really do end up making a big difference.
- Collaborate with your practice management team or your IT team to get a list of all referrals received in the last week and the status of each referred patient appointment. Ask your team for a spreadsheet with this information.
- On a weekly basis, call the referring provider office to “tally up referrals sent vs received vs patient appointment information”. For the first few weeks, resist the push back from the referring practice to “just fax over this information”. It takes only 10-12 mins to get this done per practice. Get into the habit of doing so. Each day, you should be able to cover 25-30 practices. Make it a habit to call at the same date/time each week so that the referring practice staff get used to hearing from you.
- As the relationship is cemented, you can even be friendly enough to pick up the phone and ask the referring partner why you haven’t received any referrals in the past week.. Whether they are happy with your practice, if they need you to do something else.
- Always keep your hunter/physician liaison team up to date on each referring partner account details.. They need details on partner satisfaction, referrals received per week, if referral volume went up or down etc.
- As you advance your relationship with the referring partner, start transitioning them to a fax based weekly update – with the same spreadsheet format that you have been sharing with them on a weekly basis. This way you can focus on the newer referral relationships that your physician liaison team has hunted down
- Send thank you notes to your referring practices during holidays and other notable days each year. You can do this more effectively if you establish a good rapport with the stakeholders on their side.. Get to know them better and get to know their birthdates / special life events.
- ALWAYS, always try to understand (probe) if the referring partner is sending referrals only to you (loyal) or whether they are a splitter (sends to multiple specialists). Try to understand why that’s the case. You might find out that several of their patients are from a certain neighborhood where you don’t have offices. You might find out that several of their patients are not in the age group that you typically treat. Always bubble up these information to your manager
- Always keep an eye out for and probe for referring partner satisfaction.. Always ask what their referred patients said about your provider and your practice. Incorporate these notes in your weekly reports to your management.
- Feel free to add your own twists to what you do and how you feel it works better for you and your practice
Over time, if you don’t see the referral volume increasing from any particular referring partner, it is time to have a meeting with the 2 practices – preferably involving physicians and key practice management staff on both sides.
How to empower your physician referrals team with the data and the tools they need to be effective
Let’s go through each item one by one
Basics – provider and practice data for your physician referrals team
Your physician referrals team is going to need accurate provider and practices data. There are several companies that do this for a living. Some of them are the big guys that most of us cannot afford – e.g. definitive healthcare, LexisNexis, integratedmedicaldata (more so on email lists), IQVIA etc.
OK, so you cannot afford it – now what? Keep in mind that you can always fall back to the basics and get the data from the CMS NPI database. This data is updated every month and you also get incremental data updates weekly.
However, this data is bad – REALLY bad.. We have used this before and have pretty bad luck with this. You can read more about how inaccurate this really is on Fierce Healthcare.
If you want to depend on the government provided data, do keep in mind that you have to merge / munge the following data sets
- National Plan and Provider Enumeration System (updated weekly)
- Medicare Provider of Services Files (CLIA and all other HCPs, updated quarterly)
- Physician Compare (updated annually)
- List of Excluded Individuals and Entities – LEIE (updated monthly)
- Physician Patient Demographics (updated annually)
- Dialysis clinic information (updated quarterly)
- Long-Term Care Hospital (LTCH) Quality Reporting (updated quarterly)
- Medicare data (parts A-D)
- Hospital Service Areas (updated annually)
- Hospital Consumer Assessment of Healthcare Providers and Systems – HCAHPS (updated annually)
- Hospital Compare (updated annually)
- Medicare Shared Savings Program Organizations (updated annually)
- Sunshine Act – General + Research + Hospital + Physician Payments (2013 – 2017)
Look up Carevoyance – they do this as well.
You can use Google to do the same research. E.g. you can go to google maps, search for your location (or be at one of your offices), then search for physicians, specialists (by typing each specialty) etc.. Sure you can do that – but that is also REALLY bad data.
You can also go to zocdoc.com, vitals.com, healthgrades.com and try to find providers and practices – good luck with that 🙂
Anyways – here’s something else you can do… and data you can trust. Payer provider directory. By law, payers are supposed to keep accurate provider directories (it is not updated in real time but it’s as close to real time updates as you can hope for).
Simply create a spreadsheet with all the payers you accept. Then, google payer name + provider directory to find the results
E.g. 1199seiu provider directory – this gives you a link here
Or aetna provider directory – this gets you to here and you can get (e.g.) all PCPs around Brooklyn
If you cannot purchase the data from the companies mentioned above, you can hire freelancers from upwork.com and get them to create a spreadsheet with all the provider and practice info. At a minimum, you are going to need the following information to help your physician liaisons or healthcare marketing folks
- Practice Name
- Provider names — all providers that practice there
- Provider credentials for each provider
- Specialties – e.g. Pediatrics; Emergency Medicine
Now, at least, you have started empowering your physician liaisons with data to be effective.
Software for your physician referrals team
Your physician liaisons can surely not use any technology if you truly do not want them to. But don’t be surprised that they are spending time each day updating their notes, spreadsheets that you might be asking them for, reports you ask them for etc. Also, be fully prepared that they would be wasting valuable time printing maps, spreadsheets of information, trying to figure out how to optimize their routes, finding parking etc..
We always recommend field sales operations CRM software that allows you and your reps to:
- Upload your target accounts with full contact data and account intelligence
- Create and assign territories to your reps
- Create routes and plans for each day of the week that is optimized for driving time
- Create reminders for themselves that ties into their calendars
- Check in and check out of accounts AND the ability to not be able to check in when they are not at or near the target account location
- Take notes while they are at the prospect, to add contacts they discovered at the practice, leave notes for your inhouse sales enablement teams to help them further
- Ping anyone at the practice to help them out with specific questions while they are at the practice
- Be able to pull up account level information so that they know in as real time as possible the total referrals and names of referred patients from each practice
- Be able to see their weekly performance of new referrals they have driven to your practice, how many patients have been scheduled, not scheduled, seen, billed etc
- Be able to order referral pads or other marketing materials when the referral partner tells them that it is needed.
Territory of your physician referrals team
Let’s talk about territory – if you’ve ever run a sales or marketing team before, you know you have laser focus on your territory and the quirks of each territory. E.g. upper west manhattan – it’s a heavy Spanish neighborhood .. and a Dominican or a Hispanic liaison is going to be most effective here. Or, e.g. the Jamaica or Jackson Heights neighborhood – it’s heavy on Bangladeshi.. A Bengali speaking physician liaison is going to be more effective here.
Divide your target accounts into territories and try not to have overlapping territories and accounts. It only leads to headaches with commissions and account ownerships.
You can choose to have territories defined based on geography or based on specialities or based on specific lines of businesses you want to promote – that’s really something you need to figure out based on what makes most sense to your practice.
In general, it’s always best if you do not have multiple reps reaching out to the same practice with mixed messaging. It’s always best if you have a rep manage a relationship with a referring partner.
In general, we always advocate hunters to be hunters and for farmers to be farmers.. Keep it that way.
Account level information for your physician referrals team
You’re going to have to clearly define a list of accounts in your territory and enhance each account with account level information so that your reps can be most effective when they are knocking on doors.
We recommend that your territory have a list of all practices, their specialties, their locations (and if a practice has multiple locations, all locations should be handled by a single rep), a clear indication of this association of multiple locations to the same practice.
You will need a well defined list of contacts within your accounts – i.e which physicians practice at the account, front desk person(s) name(s) (if possible), referral coordinator’s name (if possible), how many times your reps have visited the practice etc.. On top of this, try to provide account level information that tells your reps more about the practice, the kind of plans they accept, the kind of procedures they do, the number of medicare/medicaid patients they see etc.. Gathering this kind of data does get expensive but is well worth it.
In addition to this, you are going to need to provide a well defined list of contact information for your accounts (fax, phone numbers are a must have, websites are a nice to have).
Over time, you will notice that your reps are gathering deeper information about each account.. How many times a doctor visits the offices, which days or times they come in, new contacts in a practice, who seems to be a champion in that referring practice for your own practice, who can guide them within your referring partner practice etc..
Crucial parts that your software vendor should solve for your physician referrals team
The following is where we have seen several practices fail. They do provide training on their own practice’s strengths, weaknesses, areas of opportunities, threats to their practices. Some of them even provide decent marketing collateral that can be used for conversation starters, drop off / leave behind material at the practices, key differentiators between their practice and their competitor’s practice etc..
However, they typically don’t provide software robust enough where their reps could spend more time in networking rather than reporting to their managers on their daily performance / activities.
Your reps should be able to create daily route maps, know which accounts haven’t been touched in a while (aging), be able to add reminders to themselves about following up with a practice on specific dates/times, be able to check in/check out of the practices they visit.
The biggest issue that most software vendors do not solve is to allow the reps the ability to have a clear idea about the target referring practice and the patients they have referred to your practice over the past year (at least) as soon as you enter the practice. Many times reps have visited a practice several times and the partner might even have sent patients over already – but the reps do not know.
Make sure that your field sales CRM software is 100% mobile and 100% integrated with your EMR (or at least someone on your IT team updates the account information with such crucial referral information)
How to create a great physician referral marketing team
You referral coordinators + your physician liaisons should be your A team.
While your physician liaisons go hunt every day, your referral coordinators should be taking care of the “house” per se. They are your farmers and every door your physician liaisons open, every account they “land”.. Your referral coordinators expand.
First things first – NEVER assume that you can change the way your referring partners send you referrals.
Make it the path of least resistance for referring partners to send you referrals. Whether they choose to send you referrals directly from their EMR to your fax, using your Direct address, faxing you directly, using P2P (jointhenetwork) or any other 3rd party referral software.. Accept them ALL.
The ONE thing you can control is how you report back to your referring partners on referral status, patient appointment statuses, visit notes. And we suggest that you DO control and influence this part of the game.
This allows you to centralize “closing the loop” with your referring partners, showing them historical information of all referrals sent, showing them data on referral volumes, how quickly your co managed patients are getting appointments, how many attempts you are making per patient to get those patients to come in, how you are handling no-shows, cancellations etc..
This reporting aspect tied to the fact that your referring partners can look up their patients at any point is KEY to cementing your relationship with them.
For this, you are going to need some help from your IT team or do some spreadsheet magic.
First of all, you are going to need to help your referral coordinators monitor all incoming channels of referrals – namely
- Referral websites emails
- Referral website faxes
- Referral emails
- Inbound referral phone calls
- Patients calling in to make appointments based on the referral pad your referring partner might have given their patient
- Direct faxes from EMRs
- Situations where you acquire a new patient that wasn’t a referral but you captured their PCP information – this is KEY and a GOLDEN opportunity for you to open even more doors.. DO NOT IGNORE THIS CHANNEL.
For inbound calls – you are going to enable your referral coordinators to be in sync with your appointment scheduling team (inbound or front desk) to ensure that they capture referring physician information for each patient appointment.
- Even a simple spreadsheet that captures the following will help:
- Facility Name — where the patient came from
- Facility Location — which location the patient came from
- Referring Physician with NPI — this is crucial and inbound agents should always capture this info
- Facility Number — nice to have the referring location phone number
- Facility Fax Number — if possible
- Patient Name — of course 🙂
- Patient DOB — of course 🙂
- Patient Phone no. — at a minimum, this will help your call center to call patient back to find out additional information
- If Referral, Call from — whether patient called after being referred or the referring physician called directly to get an appointment.
Trust us – being diligent about collecting this information really does help. This at least gives you a reason to get in touch with the provider.. Hey, open more doors !!
Maintain daily spreadsheets of this information..
The next important thing to do .. without fail…
Call the referring partner upon receiving the first few referrals to cement the referral relationship.
Keep them up to date on the patient appointments, no-shows or cancellations. Make sure the referring partner office hears your practice name and your name a few times.
We do this on a regular basis and we continue even after we keep receiving referrals from them. The policy we follow is that if we’re not calling them or calling on them, someone else is.
Each day when you wake up, know that someone is going to knock on your referring partner’s door to gain their business.
Your job is to protect what you worked so hard to get.
We recommend that you give the referring practice admin or referral coordinator your direct email / contact info (direct line, not the practice main phone number), your direct fax number if possible.
Do whatever you need to, to make it easy for them to reach you and get appointments for their patients.
You’d be surprised at how many practice staff don’t care and take referrals for granted.
Get on weekly update calls with your referral partners – even for 10 mins. Get into the habit of calling at the same time, each week. This establishes a routing and a pattern.
For this, you’ll need to collaborate with your practice management team or your IT team. Try to get a list of all referrals received in the last week and the status of each referred patient appointment. Ask your team for a spreadsheet with this information.
Next, add a few columns to your spreadsheet.. date called, remarks – that contains what transpired on the call.
On a weekly basis, we call the referring provider office to “tally up referrals sent vs received vs patient appointment information”.
We actually resist the push back from the referring practice to “just fax over this information”.
As the relationship is cemented, you can even be friendly enough to pick up the phone and ask the referring partner why you haven’t received any referrals in the past week.. Whether they are happy with your practice, if they need you to do something else. More often than not, you’ll be happily surprised that they’re quite candid with you and give you valuable feedback for the entire practice – things like “patients said it takes too long to get an appointment “ or “we don’t get visit notes back quickly” or “your staff gives up calling these patients too easily” etc
Always, always escalate this information to your management and get together as a team to figure out how you could do better together as a team.
Get into the habit or creating a cumulative summary of referrals per practice. This really does help you and your physician liaison get a better handle of your referrals portfolio.
Always keep your hunter/physician liaison team up to date on each referring partner account details.. They need details on partner satisfaction, referrals received per week, if referral volume went up or down etc.
As you advance your relationship with the referring partner, start transitioning them to a fax based weekly update – with the same spreadsheet format that you have been sharing with them on a weekly basis. In fact, right from the beginning, you could get into the habit of calling with updates, plus following up that conversation with a fax with the same info you just discussed.
It’s so easy to send a fax via the web these days… you don’t even need to walk over to the fax machine. Just “print + save to file “ the spreadsheet as a PDF and fax it over.
Once you know your top referring providers week to week, month over month … create a list for thank you notes. Send thank you notes to your referring practices during holidays and other notable days each year.
You ALWAYS, always have to try to understand (probe) if the referring partner is sending referrals only to you (loyal) or whether they are a splitter (sends to multiple specialists). Of course, you cannot ask this right from the beginning of your relationship.
First “give, give, give” and then “ask” after you’ve helped them out.. a lot..
Try to understand why that’s the case.. if they’re splitting their referrals between you and your competition.. a competitor that you might not even be aware of.
You might find out that several of their patients are from a certain neighborhood where you don’t have offices. You might find out that several of their patients are not in the age group that you typically treat.
Always keep an eye out for and probe for referring partner satisfaction.. you’re going to do that on the phone anyways, but if your referral network is as large as ours, you’ll want to systemize and formalize this a bit more.
You can very easily create satisfaction surveys using a simple combination of google forms and google sheets. This is great information to share with your manager and your practice management staff.
Always ask what their referred patients said about your provider and your practice. There are so many patient review software these days that this is really not a big deal to take on.
We recommend that you send out a patient survey after each visit. Then you ask the patient to post it on a social media channel of their choice. Simple.
Give your patients multiple options – let them post on Facebook or google or yelp or health grades etc.. whatever is convenient for them.
While you obviously don’t have access to the same kind of survey results as Press Ganey provides, whatever you can collect yourself is a great start.
You can do this in a low tech way by simply using google forms and email or SMS! Really easy to do.
Overall if you follow these strategies, you’re already way ahead of the game.. and it reaps BIG rewards in the long run.
Closed Loop Physician Referral Management – why
Closed loop physician referral management is an amazing way to get new patients. As you already know, being adept at physician referral management and patient referral management can grow your medical practice tremendously. We have covered this in our medical practice marketing course as well. Learn how to grow your medical practice.
Whether you manage physician referrals via spreadsheets or use some healthcare referral management software or solution – you do need to have a plan for this. The is the only way to ensure solidifying your relationship with a referring partner is to close the referral loop with them.
Just taking good care of patients is not enough. Use our healthcare referrals management software to do this better.
Understand the following a bit further and you will know why closing the loop is so important.
- Each provider gets paid by payers.
- Each payer gets paid by members (i.e. people like you and me).
- Members get insurance from (mostly) their employers.
- Employers choose insurance plans available to their employees based on price (quoted by the insurance plans) and also based on HEDIS ratings – Employers and individuals use HEDIS to measure the quality of health plans. (see this link of NCQA)
- For Medicare/Medicaid, people use STAR Ratings (As an FYI, The Centers for Medicare & Medicaid Services (CMS) uses a five‐star quality rating system to measure Medicare beneficiaries’ experience with their health plans and the health care system. This rating system applies to all Medicare Advantage (MA) lines of business: Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). It also applies to Medicare Advantage plans that cover both health services and prescription drugs (MA‐PD).)
- So, based on how NCQA rates plans (see this document), point #2 is for clinical measures “Rates for Clinical Measures: The proportion of eligible members who received preventive services (prevention measures) and the proportion of eligible members who received recommended care for certain conditions (treatment measures).“.
- How do plans prove it? By proving that members got those services. How is that proven? By documenting visit notes and closing the referral loop.
- So, plans expect PCPs to refer patients out for preventive and treatment measures. PCPs are expected to prove to plans that they did send those patients out by providing visit notes. Specialists need to provide PCPs these visit notes – that’s where you have the power to help your PCPs do better with their plans. This helps the PCPs help their plans do better with NCQA. That gets them higher ratings, which in turn helps the plans be chosen by more employers.. It’s a cycle.
Once you understand the above, you know you need to ensure that:
- You keep your referring partner office in the loop about patient no-shows.
- After the patient is treated, you need to send the visit notes to referring partners within 24-48 hours.
This alone will keep you on top of mind with ALL your referring providers. (HINT – this is very easy to do with our healthcare CRM software)
Most provider offices are really bad about getting these done, so the bar is REALLY low.
Take care of this aspect and your referring partners will reward you with all referrals.
In the above section, we worked through marketing to referring providers.
Next up, let’s look at generating more business from our own existing patient database. The “low hanging fruits”
How to market to your existing patients
This is an area that provider groups do not do well either. Here are a few things to do to market to your existing patients, bring them back to the practice and at the same time, provide “managed care” even if you are not a PCMH.
There are a few areas that we typically recommend:
- Asking patients for referrals.
- Regimented re-appointing of no show patients
- Regimented re-appointing of patients that cancel appointments
- Reactivating patients that have fallen out of care
Asking patients for referrals
Most provider office staff are not comfortable asking a patient directly for patient referrals. You are not alone in this.
But, you need to get over it.
You will never get anything unless you ask for it – so what’s the harm in doing so? Are you afraid that the patient will see you as “too commercial”? Are you afraid that your patient care is not good enough to justify a referral?
For all you know, your patients are already referring other patients to your practice – you just don’t know it yet because you do not have a way to capture the referral source.
First, put a process in place wherein you capture where a patient came from.
E.g. in Carecloud, in the patient demographics screen itself has a place to enter the REFERRAL SOURCE. Use it. As an administrator, you can also customize the REFERRAL SOURCE and add “PATIENT REFERRAL” to it (if you would like to).
Next, make sure that your call center agents, your front desk staff AND your technicians ask at least once – “How did you find out about us? Did a friend or a doctor recommend you to us? We would like to thank them.”
Start capturing the source of where your patients are coming from. Each day, report something as simple as
|Total appts created||New pt appts created||Provider referral||Pt Referral||Other sources.. Add columns…|
That’s it. It’s that simple
Now that you have this process in place, you can start asking patients to refer you to their friends and family members.
Each email that you send (hopefully you send “stay in touch” emails to patients) should include a single sentence to “Do you know anyone that could benefit from seeing our doctor? Please forward this email to them”
Each appt confirmation SMS that you send should include “Know someone that should see your doctor? Fwd this sms to them”
Each patient review SMS that you send should include “Know someone that should see your doctor? Fwd this sms to them”
Each thank you and welcome package that you send to patients should include “Know someone that should see your doctor? Tell them about us”
You could also incentivize patients for giving you referrals. E.g. “For each patient referred, get a $5 metrocard” (or something similar). As long as you do not waive the copay, you are not getting into trouble with the payers. Go ahead and think of things you can offer your patients to refer patients to you.
Before you can go ahead with our recommendations, you do need to understand that you will have to :
- Employ patient engagement techniques to stay in touch with your patients
- Enhance patient experience to have happy patients that recommend other patients for you
How to increase patient visit volume by mining your PMS / EMR
We all struggle with no-show patients. Here’s how you can re-appoint patients per month simply by mining the data in your EPM.
In the following steps, I will be using CareCloud as the sample EPM (you can substitute with your EMR/EPM).
Life is a LOT easier if you attach a healthcare focused CRM to your EMR. This works well if you are willing to put a little bit of time and effort into it.
How many return patients do you need for this campaign to break even?
Make sure that you know how many patients need to show up from this campaign per month before you breakeven. Do not start without defining this.
Get daily reports for no-show patients
Try to be diligent about calling your no-show patients in the same week as their appointment. At a minimum, you can start with exported reports of daily no-show patients. If you want to take this initiative seriously, consider using a healthcare focused CRM that helps you with outbound dialing and is always in sync with your EMR. If you do not have a dedicated team to make these calls, hire a BPO team that does the calling and reporting for you.
Identify the people, processes and technologies for your campaign
Your first step is to identify the right staff, the processes you are going to follow to run the campaign, monitor the campaign, the outcomes you are expecting from this campaign and also the technologies you are going to deploy in the campaign.
Keep in mind one very important point – the older this data gets (i.e. the longer it has been since your patient was a no-show), the harder it is to get these patients back to your door. So, make plans accordingly and staff your team accordingly.
A simple math that you can follow is thus:
– Typically, every day, an agent is going to be able to call about 200 patients once.
– Out of these 200 patients called, they are able to connect with about 20% (i.e. 40) patients.
– Out of the patients they talk to, about 70-80% agree to be re-appointed (about 30+)
– So, effectively, out of 200 patients, you win 30 back, lose 10. This means that you are left with 160 patients to add to the next day’s workload.
– Do the math accordingly and size your team correctly. The benefits are tremendous if you multiply each patient visit with your revenue per visit.
Define your “no-show patients” campaign
This means that you need to decide whether you are going to consider all patients that didn’t show up in the last one week or one month or six months as “no-show” patients. Our recommendation is that you define a campaign with patients that did not show up in the last 2 months (max) – No more than that.
We discovered that after the 2-month period, patients tend to forget that they ever made an appointment with your provider.
We all have situations where patients did not even show up for their first appointment. In our experience, we noticed that patients like these need to be treated a little differently than the patients who usually do come to see our providers but simply did not turn up for the last appointment.
For such patients that never showed up for their first appointment. we recommend that you consider them for a “no encounter” campaign instead.
You are also going to need to define the various legends that you are going to use in your campaign.
As an example, what are the various outcomes that you are going to accept from your calling team?
Define at least a few dispositions before you get started
We use the following (you can have your own):
DONE – this means that the patient was re-appointed
NOANS – this means that the patient did not answer the phone. I recommend that your team calls them back next week (i.e. it goes into next week’s backlog)
LVM – this means that the agent left your patient a voicemail. This is a bit tricky because if the patient calls back and books an appointment, usually another agent answers the call. You need to ensure that this agent also updates the spreadsheet with the fact that the patient now has an appointment hence should be removed from your no-shows campaign.
WNUM – this means wrong number. Yes, it happens ALL the time.
CBACK – this means that the patient has asked for a call back at a certain date/time or both. The agent needs to be able to set a reminder for themselves to call the patient back.
LOST – this means that the patient has either found another doctor or has decided that they do not want to come in for an appointment (i.e their need has been met). Usually, I put these patients in another campaign to try and win them back.
DCONN – this means that the patient’s phone number is disconnected. The patient population that my clients work with tends to have this happen to them (obamaphones).
UNAVLBL – this means that for whatever reason the patient is not available, but the phone number is correct (e.g. someone from their family picked up the phone but your agents are not allowed to book appointments unless they speak to the patient directly)
HUNG UP – this also happens wherein a patient simply hangs up. Don’t call them back immediately but try reaching out to them the week after.
DNC – this happens (for whatever reason) when the patient does not want to be called any longer. They tell your agent to not call back again – these are a separate category of patients that are lost. DNC is something that I consider as non-recoverable, where as LOST patients is something that I consider as LOST for now, but will try to win back later.
RECONFIRMED – sometimes due to data errors, the agent runs into situations where the patient has already called in and made an appointment to come back, but the agent’s spreadsheet does not reflect this new appointment. In that case, the agent simply confirms the new appointment date/time.
DUPLICATE – happens all the time where the patient record is a duplicate in the spreadsheet they are working off of.
Define max attempts to be made
You also need to make sure you define the maximum number of attempts your team is supposed to give towards reappointing a patient before they mark that patient record as unrecoverable.
We have typically defined this as five(5) – ie our BPO team should call the patient at least five times before they give up on that patient.
Prepare campaign data
Export the patients marked no-shows/cancels in carecloud (reports/analytics section) as a CSV and save it somewhere that you have designated as HIPAA compliant. We include patients that “canceled” in this campaign primarily because most healthcare staff that we work with, did not seem to follow the same process of marking a patient as “no show” versus “canceled”. So we never know for sure whether the patient really wanted to cancel or was simply a no-show.
Enhance your spreadsheet (if you are not using a healthcare CRM)
Enhance your combined spreadsheet with some columns to “sort of” make it like a CRM (this allows your staff to be laser focused on working the list). I tend to include columns like these (yours can be different to suit your needs).
Assigned Date – the date this patient account was assigned to the agent. I want to monitor if they are actively working the accounts given or not.
Disposition – outcome of the call
Call date – 1st call date
2nd call date – self explanatory
3rd call date – self explanatory
4th call date – self explanatory
5th call date – self explanatory
Notes in carecloud – whatever be the outcome of the call, the agent puts this in carecloud as an after call work.
The following, you will get from carecloud exported CSVs anyway.. Some (not all) of these are needed for your agent to be able to effectively talk to your patient when they do answer the phone…
Nature of Visit
Now that you have a defined spreadsheet, schedule a Carecloud report every day (end of day) of all patients that were deemed no-show/cancelled. This data will be added to the sheet you prepared in the step above.
Execute your campaign 🙂
You can decide to set aside a few hours each day, start dialing, dispose the call with an outcome, notes and follow up if any required. Since our clients work with at least 3-4,000 patient appointments per month, this usually requires multiple full time employees.
Keep adding to the list, keep working the list (never ending process). Understand the basic math as mentioned above. In one week, the backlog of calls to be made does add up significantly.
Do not let patient data get stale.. If you need more agents to add to this team, do so and you will reap the rewards.
Monitor your campaign
Monitor the performance of your efforts and fine tune calling times if needed. We have noticed that certain kinds of patients tend to pick up the phone early in the morning, around lunch time and then again around 4 PM onwards. Another set of patient demographics seems to pick up the calls throughout the day.
We have also experienced that the conversion rate seems to decrease as the total number of calls to the same patient increases (just our observation). This means that if the patient picks up the phone in the first try, the chances of reappointing them are close to 100%, if they pick up at the second try, the chances go down a bit to around 70% or so, if they pick up on the 3rd try, it reduces further etc..
Fine tune the number of calls to be made before you give up on that patient. We have vacillated between 3-5 calls, but we don’t ever truly give up on a patient. We simply move patients from campaign to campaign – if they have not rebooked within 3 calls, then we might move them to a completely different campaign altogether.
Play with power dialers (not robocalls) vs dialing manually – you can achieve a lot more calls per day but it does increase your phone bills significantly.
Good luck with this – keep at it and you will see HUGE monetary rewards. If you need any help, let me know.
In addition to no-shows, use this method to recall patients fallen out of care (more than 3-4 months)
Now, here’s one more way that we use.. cold calling patients.
There are 2 segments that we break this down into.
- Community outreach cold calls
- Calling patients that never showed up
How to run community outreach with a patient contact center
You can do most of these “automatically” if you are using our healthcare CRM and our patient communication software. Our patient contact center does community outreach for our healthcare customers. Basically, this breaks down into a few campaigns – mailing postcards, voicemail drops, sending SMS (to mobiles) and a voice call from agents for the last mile (i.e. patients that just don’t respond). We use a healthcare CRM to focus and organize our efforts.
Set up the community outreach process workflow
Our customers send us a file with prospect names each month OR we buy prospect / people data from InfoUSA.com for the same. Some of them want our patient contact center team to start dialing those numbers immediately. Meanwhile, some clients prefer to start with sending postcard mailers first. Some customers prefer to start with sending SMS to mobile numbers and call / leave a voicemail to prospects.
Regardless, the workflow is adjusted per customer’s wishes. You can also follow something as below for your own community outreach initiatives.
Set up the pre-requisites
- Set aside a team to concentrate on patient engagement.
- Set up your Amazon Web Services account – it doesn’t take more than 5 mins to do so. This ensures that all SMS, voice numbers that you provision and use during the community outreach stay in your account. You would need this because you might choose to hire an external patient contact center team. If they are no longer engaged with you, the numbers they’ve been using, should remain with you.
- Getting new phone numbers is dirt cheap with providers like Amazon (around $1 per month). Set aside a separate SMS number for patient outreach. This is done in Amazon Pinpoint. Keep in mind that in the USA, the same Amazon Pinpoint number (long code) can handle SMS and Voicemail drops.
- Next, set aside a separate voice number for patient outreach cold calls in Amazon Connect Contact Center. Note that if SMS and voice originate from the same number, it might jeopardize both numbers being marked as SPAM by patients unwittingly. It happens – sometimes patients mark numbers as spam unwittingly.
- Then, you set up a cloud based IVR (Amazon Connect Contact Center) for this initiative.
- You do need a separate patient CRM instance for patient outreach. It gets a little hairy trying to do this with spreadsheets (trust us – we have been there, done that).
- 7. Make sure you obtain or designate separate EMR login credentials for the outreach team (for creating new appointments)
- 8. Set up or get a confirmation on the scheduling process (block times for new appointments vs ad hoc appointments) and visit types.
- Figure out if televisits are acceptable as a way to introduce your practice to the patients.
- Make sure that you set up escalation point of contact for both parties (outreach team and the scheduling team)
- Prepare and get sign off on calling scripts and SMS scripts. Make sure that all parties understand the outreach frequency.
- An outreach frequency could be that you send patients postcard mailers, then the next week you send those patients an SMS, the week after you do voicemail drops for those patients, the week thereafter, you send them an SMS again or call them.
- Set up weekly calls for progress updates between the stakeholders and the outreach team. There must be a mutual agreement on dispositions of calls because you will be reporting on the daily activities and outcomes.
- Finalize the handover protocol from the outreach team to the scheduling team (e.g. mark new appointments with Chief Complaint / HPI or just “new appointment” etc).
- If the outreach team also does appointment reminders, then finalize the cadence of the same (e.g. 7 days before, 2 days before and day of appointment or some other cadence that you all can agree on).
- If the outreach team also handles no-shows, then finalize the no-show cadence / modalities. Make sure that all parties agree to it.
- Finalize cancellation cadence / modalities if your outreach team is going to handle cancellations. Keep in mind that these prospects are cancelling before their first visit, so they are treated “almost” like a cold call (not a warm call).
- Before you get started, find out if your upper management / stakeholders want to enrich prospect data with social data or not. If so, finalize whether social data should be mined and social outreach should be made (e.g Facebook, Twitter etc)
- Are you going to have your outreach agents also handle incoming website chats? If you are going to do that, then make sure that you set up a protocol to delineate who handles what for existing vs new patients. Among new patients, figure out whether the new patients are from outreach or whether they are just patients that discovered your practice. Make a decision on how you would handle both.
- Decide on whether you are going to create and send monthly / weekly/ quarterly campaigns based on patient/prospects’ segmented data. See below – an example for a primary care practice.
- Last but not the least – make sure that you finalize your patient journeys. This means that you need to figure out the journey that your prospects would take, the brand touch points they would face before they become your patients.
Create a set of patient segmentation led campaigns (examples below)
For a primary care business, you have MULTIPLE reasons to reach out to a prospect / patient. Some of these can be the initial outreach itself and some can be after the prospect has become a patient of your practice.
- (CDC) COMPREHENSIVE DIABETES CARE
- (CBP) CONTROLLING HIGH BLOOD PRESSURE
- (COA) CARE FOR OLDER ADULTS
- (COL) COLORECTAL CANCER SCREENING
- (BCS) BREAST CANCER SCREENING
- (CCS) CERVICAL CANCER SCREENING
- (CIS) CHILDHOOD IMMUNIZATION STATUS
- (IMA) IMMUNIZATIONS FOR ADOLESCENTS
- (W15/W34/AWC) WELL-CHILD AND ADOLESCENT WELL-CARE VISITS
- (ABA) ADULT BMI ASSESSMENT
Finalize your workflow (recommendation below)
- Monthly – Import each month’s file as an audience into Amazon Pinpoint. Read this guide on how to import endpoints into Amazon Pinpoint.
- Once you have imported endpoints / audiences into Amazon Pinpoint, segment them based on whatever your campaign criteria are. See here for help on creating segments.
- Run the Amazon Pinpoint PhoneNumberValidate feature to figure out which numbers are mobile vs non-mobile. For the mobile numbers, you are going to send SMS. For the non-mobile numbers, you are going to drop a voicemail.
- Daily (or any regular schedule / cadence you decide upon), send outreach SMS to mobile numbers received. Since you are using Amazon Pinpoint, this also allows for A/B testing of messaging to various segments.
- Daily (or any regular schedule / cadence you decide upon), send outreach voicemail drops to non-mobile numbers received. Since you are using Amazon Pinpoint, this also allows for A/B testing of messaging to various segments. Here’s some help on how to send voice messages to prospects.
- Daily (or any regular schedule / cadence you decide upon), make outreach calls to landline numbers received (allows for A/B testing of messaging). These calls need to be made from Amazon Connect.
- On a regular basis, update your community outreach tracker / CRM. Read below on how to use a community outreach tracker/CRM using Amazon HoneyCode. Here’s a guide on how to get started with Amazon Honeycode
- For patients that pick up the call, we recommend that you ensure capturing the patient’s mobile number. This allows you to have another contact point with the patient in addition to being able to contact the patient throughout the day (vs being stuck with a home phone number).
What to do when you connect with patients
If patient agrees to an appointment
- Create the patient in the EMR
- Make an appointment
- Dispose the call and update patient status based on agreement, in the community outreach tracker.
- Send appt confirmation SMS immediately (same SMS as where the outreach went from)
- Send SMS appointment reminders based on agreed upon cadence
- Call patients for appointment reminders based on agreement
- Call no show and cancelled patients based on agreement
- Send SEEN patients review requests based on agreed upon messaging
- Respond to patient reviews based on agreed upon messaging
For patients that did not agree to an appointment
- Send practice info immediately via SMS
- Dispose call and set up reminder to follow up next month
For patients that did not pick up the call but have voicemail set up
- Leave VM with agreed upon messaging, asking for a callback at your phone number.
- Dispose the call as agreed upon in the community tracker CRM and set up a reminder to follow up next month with next month’s messaging
For patients that did not pick up the call and do NOT have voicemail set up
- Dispose the call and set up reminder to follow up at agreed upon cadence
Callbacks and inbound calls
Arguably, there will be callbacks and inbound calls (maybe even from postcard mailers sent out to prospective patients).
- For each incoming call, dispose the call appropriately so it can be reported on
- For each inbound call, if the patient wants an appointment, create the patient in the EMR, then create the appointment based on your agreement.
Rinse, repeat, report
- Daily – repeat outreach from last month’s reminders, dispose according to agreement (modalities and frequency)
- Weekly – consolidate and send week’s efforts, inputs from lessons learnt to your stakeholders 🙂
How to increase patient volumes by calling patients that never showed up
We have all had situations where patients had made appointments with our providers, but never really showed up for their first appointment (where we can bill as a “new patient visit”).
This is a whole lot easier if you use a healthcare CRM and an automated communication solution like ours. We have all had situations where patients had made appointments with our providers, but never really showed up for their first appointment (where we can bill as a “new patient visit”). These were patients that were not really familiar with our client’s practice, nor did they really know about the amazing bedside manners or the skills of our providers.
So, this was almost like a “cold call” with a hope that the patients might remember their first appointment. When we started, we had hoped that patients would recall making the first appointment.. But alas, the older the data was, the more we found our that the patients didn’t even know who the provider was nor who our client’s practice is/was.
The patients didn’t remember when their PCP had referred them to our specialists. When they did pick up the call, they asked the agents “OK, tell me who my PCP is”.. Unfortunately, our client’s staff wasn’t very regimented at capturing the referring PCP information, so more often than not, the agents could not answer this directly – however, choosing the right agents that could handle these questions with a slight change in the script helped iron things out.
Prepare your team properly (not easy)
If you have a call center team that is willing to make “cold calls” or “sort of cold calls” – this campaign can produce very good results. Again, dig into your EMR to find all patients that never showed up for their first appointment, remove the patients that might already be part of a no-shows campaign and get running with this. Your agents will have to have laser focus and not get disheartened at the rates of conversion, but that’s also why you need hard core agents with sales skills and the thick skin to take rejections all day long for this campaign.
Identify and train the team
You are going to need the right people / staff with the right skill set for this. Most of our call center staff do have decent sales skills, but this was a different breed – we staffed this with folks that have cold calling experience. It worked very well as that’s precisely what was required.
Your team’s job is going to be to make patients understand that despite the fact that the referring PCP info is not always available with them.. There was a reason why their PCP had referred them to your practice… and to have the patients agree to coming back in to you see your provider(s).
Use some kind of a CRM
We started with spreadsheets, but ended up moving to our own healthcare focused CRM (life was hellish before that).
You are going to need to have a team that knows excel spreadsheets well enough – even then, managing the volume of data is on the hard side.. If you use a healthcare focused CRM, it does get easier (my experience).
Use the same steps as above (do the match, prepare the data, monitor the campaign, execute the campaign etc)
Combining all the above – marketing to patients and referring providers. Telehealth Marketing!! Let’s see how to market telehealth services 🙂
There’s a reason we left this discussion until now. It’s because you are going to market telehealth services to both patients and referring providers. You are going to market to pretty much every provider in the city. You are going to market to every patient – existing and new. There are no boundaries. You are going to use PPC and SEO. All channels. Everything. no boundaries. At all.
The beautiful thing about telemedicine is that it doesn’t have any boundaries around office locations (unlike the services you offer at your offices, telehealth can be delivered to anyone residing far away from your locations as well).
Offering telehealth services and beginning to market telehealth services are just the first steps of creating a line of business around telemedicine. As with any other service offering, you need to have a plan around generating new patient appointments, retaining patients and generating more revenues via recalls etc. i.e. the same medical marketing rules apply here.
First things first, add this line of service on your website. Make sure that on your website’s contact us form, you allow patients to select televisit appointment as one of the appointment choices.
Trust me – Just because you have added telehealth as a service offering today, doesn’t mean that you will be flooded with appointment requests before you are ready. It takes time for google to “catch up”. Add it today.
Send a fax or email to ALL the providers in your city letting them know about your services. For in office visits, you could only market your practice to providers near your office locations.
But, for telehealth, there are no boundaries. Market to everyone in the city. Who cares? Even if 10% of them refer patients to you, imagine how many new patients you can acquire that way! BTW, you are going to need to use a healthcare CRM that allows you to track referring physicians.
Send a personalized fax to all your referring provider partners letting them know that you are available to service their patients. Your current partners HAVE to know that they can now refer patients to you for televisits as well. If you want to send a fax blast instead of sending individual faxes, you can use providers like openfax.com. These guys will even allow you to send personalized faxes (some limitations there).
Hopefully you are managing referrals and referring partners using a healthcare CRM like ours.
We advertise on Facebook and Google. Out of the two, we had better luck on Facebook. The most important thing to remember is that when you get an incoming appointment request from your paid ads on facebook and google, you HAVE to respond within a few mins. Make sure your team is ready to do so. We have noticed that if you respond after 30 mins or so, the patient has already decided on someone else. The same goes for zocdoc as well. You need to respond REALLY fast.
We are having HUGE success by posting regularly on Google my business. Posting on Google My Business alone has increased our traffic and interest from prospective patients substantially (for our healthcare customers).
We found that not many practices do this kind of community outreach. We have been doing this for our healthcare customers for almost 2 years now with decent success. Start community outreach initiatives via the phone or postal mail to all zip codes that you can afford to. For this, you need to buy people data from data providers like InfoUSA (if you want to call in addition to sending postcards). If you only intend to send postcards, you can also use USPS itself.
Start by sending postcards. We typically mail postcards, then the week after, we start calling. We alternate between leaving a voicemail and not doing so. Our approach is that a person should hear exactly twice from us each month. No more, no less.
Make sure that you use a healthcare CRM for this. Community outreach is a volume game, and you need to arm your marketing team with a healthcare focused CRM. You also need to arm your call center team with contact center software.
Prepare for community outreach calls – This is quite simple. Head over to data providers like infousa.com and simply purchase a list of patients that fit your criteria (e.g. people 40+, near zipcode of your choice etc). Before you start using their data to call patients you will have to register with the Do not call registry as well. There are a few, very simple steps to take before you can start a community outreach campaign. However, once you take those steps, you are good to go for an entire year (they will give you a SAN and ORG ID).
Hopefully you use a healthcare CRM as this becomes very easy to do if you use one. If you do not use one, then login to your EMR and search/filter for patients that had appointments within a specific date range of your choice (e.g. March 16th 2020 through April 30, 2020)
Call Patients from the resulting patient list.
Prepare your script(s) for calling patients with cancelled appts
Here’s a sample of a script we have used for one of our clients.
“Hello, I am calling from <your practice name>. Can I speak with… “
Then usual “how are you doing/feeling etc “ …small chat as usual.. ..
“Well, I’m calling because we had to cancel your appt recently and upon reviewing your chart, our doctor recommended that we set up a video call with you and our doctor. This will help the doctor determine your care plan.”
Call no-show and cancelled patients
Start calling patients that had cancelled in the recent past or have no-showed in the recent past. We typically start with a list of 2 months of such patients. What we find out is that many patients were a no-show or cancelled due to work reasons. Being able to do a televisit allows them to not have to travel and not have to take time off of work. This alone had allowed us to conduct 4,500+ televisits for one of our eye care customers.
Prepare your script(s) for calling patients with upcoming appts
“Hello, I am calling from <your practice name>. Can I speak with… “
Then usual “how are you doing/feeling etc “ …small chat as usual.. ..
“Well, I’m calling because you have an upcoming appt on < date time > and upon reviewing your chart, our doctor recommended that we set up a video call with you and our doctor. This will help us determine your care plan and next steps..”
COVID specific tactic
Start calling patients with future appointments to see if they would be better served by staying at home and offer them telehealth services. We started doing this because during COVID, our customers’ in-office appointments were at a premium. When you are doing televisits, you cannot run tests (most tests) on a patient. For this, you need to have in office visits. For some preventive care/maintenance visits, our patient contact center team works with our customers’ providers to identify patients that can be served via televisits. They, then call those patients and offer them televisits
Prepare your script for community outreach
“Hello, I am calling from <your practice name>. Can I speak with… “
Then usual “how are you doing/feeling etc “ …small chat as usual.. ..
“We are calling all members in communities around our offices in Bronx, Jackson Heights, Jamaica to let them know that we are still seeing all emergency eye care patients. In addition to that, our doctors are also seeing patients via video calls. If you know of someone that needs help related to eye care, could you please let me know?”
… answer questions etc etc..
The goal here is NOT to have the patient make an appointment with your provider, but rather, to be aware of your service offering.
So, while the patient is on the call with your agent, use this script
“Why don’t I send you an SMS with our locations and phone numbers so you can forward it to friends and family?”
“Sure, I can set you up with a video call appt with one of our eye doctors”
Prepare your script for when a patient agrees to a televisit appt
… Pt response… If they are good to go.. (not DECLINED) .. Explain how a televisit works and what the patient should expect before, during and after the video visit.
“Cool. The way video calls with our doctors works is this..”
First, I will get you an appt date/time that works for you and our doctor.
Then I will send you an SMS with the appt confirmation.. You will get a link where you can confirm your appointment, change or reschedule your appointment.. everything.
Of course, you can take the video call from your home computer or your phone that most have a camera
Next, our system will send you a reminder 30 mins before the appt and also 15 mins before your appt
At the time of your appointment, the doctor will start the call and you’ll get an SMS with the link to the video call web page. You just click on the link, enter your mobile number, your DOB and the doctor will see you.
If you face ANY problems, just call us at <your practice phone number> and we will help you.
When your appt starts, the doctor will ask your the regular diagnostic questions, specific questions about your vision, your problem, examine you the best they can over the video and after that, they’ll recommend next steps”
… answer any other questions..
Prepare your billers / medical billing team 🙂
This is pretty crucial – look at how to schedule and get paid for telemedicine .. just a few gotchas there.
Next up, let’s look at how NOT to lose the patients you already have!! Patient retention is so much easier than patient acquisition. You know it 🙂
Patient Retention – how to do it right
You do that by improving patient satisfaction and ensuring that the patient experience is absolutely top notch.
No two ways around it. Note – we are talking about patient experience and not patient engagement. However, you and your staff can be a part of all of this. Trust us. Your patients can benefit from it and so can your healthcare business. Let us show you how.
Patient engagement journey and ways to improve it, be part of it.
Patient engagement refers to an ideal healthcare situation in which patients are well informed about and motivated to be involved in their own medical care. It begins right from early education and awareness stage, moves to physician interaction and finally to appointment follow ups.
Depending on the patient population that your practice location(s) sees, this may or may not be the case. As an example, an ophthalmology group that we work with, has diabetic patients that despite all their efforts, simply do NOT engage in taking care of their health.
Patient engagement consists of 6 stages :
- Research – In this stage a patient performs self-assessment of conditions and symptoms, leading to online research and education, posting questions etc. You can be part of this stage with the SEO tips we shared above. This is where you and your brand are on top of patient’s mind.
- Appointment – First point of contact for help. This includes a patient’s initial contact with the health system via call center, email, mobile, etc. (i.e., Whom shall I contact? Where can I find it? How can I ask a proper question?). You can very much be a top contender here. Follow the best practices we have shared before about making it super easy to be in touch with you and your business.
- Diagnosis: Assessment of Health Condition. This is where a patient visits a medical facility to assess his health condition (physician’s office, hospital, etc.). This is very much in the hands of your providers and their bedside manners. This is also VERY much dependent on your staff. Be careful and train your staff (frontdesk and technicians).
- Treatment: This includes on-site and follow-up care (medications, physical therapy, etc.). This is very much in the hands of your providers
- Behavioral / Lifestyle Change: This refers to lifestyle change incorporated by the patient to reduce readmissions and promote proactive health. Patients take account of their own health such as dietary changes, exercise, taking medicines on time. This is very much in your hands and you can be part of this journey by simply staying in touch with the patient – there are many technological advancements that can help you do this at scale.
- Ongoing Care / Proactive Health: This refers to ongoing care management between patient visits, fostering engagement between the patient & physician and enabling the patient to better manage his/her own care. Again this is very much in your hands as well and you can be part of your patient’s journey with the help of technology.
We are not going to refer to acquiring patients in their research stage just yet – let’s look at how you can engage with patients in the rest of the steps (2-6). Below are some of the effective ways you can consider to improve patient engagement journey:
Using patient education to retain patients
A lot of issues associated with patient adherence to treatment plans stem from the lack of patient education. Patient education is the practice of informing patients about their health, wellness, treatment plans, potential outcomes, and other information critical to the patient experience.
Invest some time, effort and money into patient education. This also has added side benefits of patients being more involved in their own care.. Thereby adding to additional preventive appointments your existing patients make with your practice.
Patient education can be done by following ways – and none of them are very difficult to do. The best part is that whatever content you do end up creating for this exercise, can be reused on your practice’s website as well – thereby contributing to your practice growth even more.
Start by preparing free teaching tools organized by each clinical topic and upload either to the patient portal or on your website.
Next step is to provide access to patients to help find the best possible treatment and gain real knowledge.
If you do not have time to create patient education materials, you can leverage online libraries such as ‘iHealthSpot’, ‘Krames online’, that include a library of award-winning patient education related to your specialty. You can license the library for a small setup fee or monthly licensing fee and make it available on your websites. If you end up licensing the content, be aware of the distribution fees / agreement from these content providers as well.
You can very easily use tools such as informational brochures or other printed materials, Podcasts, YouTube videos, Videos or DVDs, PowerPoint presentations, Posters or charts, models or props, group classes, trained peer educators to achieve the same results as well. The HUGE benefit of doing these is that not only do they help with patient education, but they directly contribute to your practice’s reputation and credibility as well. This in turn, markets your practice beyond what you can personally do, plus generates new patient appointments from your existing patients (or patients they refer to your practice).
You can also send regular newsletters via the patient portal for the patient to stay up to date with their healthcare.
Patient Treatment / adherence for patient loyalty
Most patients experience “episodic care” and think of their relationship with you as “transactional”.. Because that’s exactly how you treat them. You see the patient, tell them what medication they need to take, send them their own way.
The trick is to stay in touch with your patients without adding a huge burden to your providers.
Medication / treatment plan adherence is painfully low. According to research “Typically, adherence rates of 80% or more are needed for optimal therapeutic efficacy. However, it is estimated that adherence to chronic medications is around 50%.3 Adherence rates can go down as time passes after the initial prescription is written, or as barriers emerge or multiply.”
You can affect this change in your patients and improve your own practice’s efficacy (and therefore, patient satisfaction) via use of medication-management apps. There are so many options available (including our free treatment plan management app).
Use one of these apps by integrating it with your EMR.
Give your patients the power to control their health through a mobile app. Help them and their family keep a track record of their health summary, their test results by using the existing free medical-management apps or use those available in their EMR/EPM.
Ongoing, proactive treatment and staying in touch with the patient
This is a secret weapon that most providers do not use because it requires investment of time in patient follow ups.
The best way to not lose your patients to your competitor is to stay in touch with them.
Patients have questions about their health – it’s not every day, but ever so often they do have questions about their health or about the medications they are taking. They have questions that require a simple (even a single sentence) answer from providers or healthcare technicians.
The easiest way to stay on top of existing patients’ minds is to allow them to get in touch with you securely. You can use the patient portal of your EMR to do so OR you can get one of the patient messaging apps as well.
There are several options in the market – including free software from us as well.
- Patient management app
Patient management app(s)
The concept is very simple. No patient really expects their doctors to be online all day. Patients just want to be able to get answers for their questions within a reasonable period of time (clinical and non-clinical). Staying in touch with them is as simple as how payers stay in touch with their members via a member management mobile app.
Our advice is to invest in patient management apps that allow you to stay in direct touch with patients on demand while not having to disclose your online status nor having to disclose your mobile phone number.
Most providers think of telemedicine as a tool to potentially use for patient visits and billing. Telemedicine and billing codes are tied to geography/ zip codes, areas that need care etc. There are laws per state (e.g. for NYC see here).
However, we think of telehealth as another medical marketing opportunity. Let’s walk through an example of how we helped an Ergonomist and Occupational Therapist working in the field of injury prevention for hi-tech, insurance and healthcare enterprises.
The basic idea was to do the following:
- Acquire – Generate more leads with a “foot in the door” offer, at a low cost of acquisition
- Convert – Provide tangible value to these new customers with this low priced offer. This is serviced with minimal effort from our client’s side.
- Nurture – Be in regular contact with these new customers, provide tangible value and aim for the larger business – being introduced to the companies these customers work for.
- Up-sell – Present these initial customers with a slightly higher priced service offering that isn’t a big ask from these new leads. For this, only two pictures were required from the customer to get a “paid consultation”. Again, this was also serviced with minimal effort from our client’s team.
This practice used a simple mobile app that allows their providers to achieve all of the above (it doesn’t necessarily need to be a mobile app)
The mobile app presents 4 paths to help someone with aches/pains (patient)
- Self assessment – the patient is asked a series of questions to help them with their aches and pains
- Solutions for body discomfort – wherein the patient can click on various body parts to identify self care and ergonomic tips.
- Help videos – helps the patient make immediate changes to their posture with self help videos
- Ergonomic equipment recommendation – helps the patient choose from various products to ease their aches and pains.
The app was then distributed to their patients.. Our findings showed that:
- Approximately 80% of people that downloaded the app used both the self assessments.
- Approximately 20% of these users also used the various solutions / suggestions that the app provides for body discomfort.
- About 35% of these users that downloaded the app also signed up to hear more directly from the practice
- About 20% of the users that answered various assessment questions, also signed up as a “lead” to hear more from the practice
To service this “foot in the door” offer, the practice owner and their team didn’t have to spend a single minute. These assessment questions and the solutions for various body discomfort were all canned responses.
In other words, the initial “foot in the door” offer was a raging success !
Everything after that was pretty simple and can be automated by leveraging technology.
People that signed up to hear more were sent personalized emails and were constantly nurtured with help videos.
When a patient is seen using the app within the past hour (i.e. they are actually active), a push notification is sent to remind the patient to take a 2 min break and stretch every 30 mins of sitting at their desk. This has a dual purpose. First, for people that are really using the app, it keeps them engaged and helps them achieve their goals. On the other hand, if someone hasn’t opened the app in the last hour, it doesn’t bother them at all. This helped keep the patients engaged with the app and therefore, with the practitioners daily.
Once we saw that people were interacting with the app and using the various self help and self assessment areas of the app, it was now time to up-sell these patients to a personalized recommendation / consultation. We called this “Ask an expert”. Of course, for their regular practice, this required an in-person visit from the patient or if this was being done at a contracted enterprise, the team would have to make in person visits to their offices. The patient could simply connect with the provider group and make an appointment.
At the same time, there was another option that patients could choose for – instead of coming in for an in-office visit. The patient was asked for a single side view picture – of them sitting at their desk (capturing the computer, keyboard and their feet). This allowed the practitioner to “virtually” see the patient and immediately recommend posture changes, recommend any changes to various equipment in use in addition to recommending any alternate desk/chair options. This was a very easy up-sell as the patient had just undergone self diagnosis, already obtained a lot of tangible value from the get-go.
This is just the start of the journey. There is so much more you can do with very little overhead.
Showcase & democratize your knowledge to folks that could be your future patients
Much like every other professional services firm, most patients reach out to you (providers) after they have researched you and are comfortable with your expertise. Most of this research happens without you even knowing it. Don’t miss out on this opportunity to share your knowledge. Does this mean that your patients would just solve their problems without consulting you? That couldn’t be further away from the truth. If that were the case, you wouldn’t have a business due to WebMD or google. Rather, patients would be connected ever closer to you and your business. When the time is right and when they feel comfortable with your expertise, you’d have a customer that already knows you and trusts you. This increases your visibility and increases your branding..
Patient Experience – Ways to improve and the value it brings to your medical practice
Across the globe, there are many patients who still continue to have a negative healthcare experiences. As per a recent research by Accenture on 10,000 patients in 5 countries US, UK, France, Germany and Brazil, patients are still looking for quality services throughout the patient engagement journey.
Below are the key findings from the research:
- 65% of all patients surveyed said that pretreatment is the most frustrating period for them.
- Less than one in five patients are aware of services available to them
- 58 % of patients use services when they are aware of them
- 79% of the respondents said that the services they used were “very” or “extremely” valuable
- 85% of patients wanted their healthcare professionals to be the point of contact for providing services to manage their condition
Do not confuse patient engagement with patient experience.
Patient engagement is a gauge of how engaged a patient is with their own healthcare. Population demographics typically play a big role into how engaged (or disengaged) a patient is or will be with their own care.
Patient engagement is not something that you can really force on a patient. You can certainly aim to utilize all available tools for your patients to be more engaged with their own health.. However, you cannot govern how your patient’s engagement in their own care is going to end up being.
Patient experience on the other hand is almost entirely in your hands. It starts from the moment the patient first comes in contact with your brand. This is not when the patient decides to make contact with your medical practice or health system. It begins when they first see your ad or business listing or brand post or ad..
Your patient experience (brand experience) starts way back then.
Think of the ads you see for Sloan Kettering. Do you currently have cancer? Hopefully not. But you have already started experiencing the brand of Sloan Kettering.
It behooves you to carefully design the patient experience of your brand. Here are a few questions you can ask yourself or your leadership team:
- What do you want your patients to experience before they even contact you?
- What do you want your patients to perceive of your medical practice or brand before they decide to make the first call / click on the first book now button / first “request an appointment” form submission?
- Think about how you want the patient to experience your call center or your front desk when they call to make an appointment
- What about the patient experience when they submit a “Request an appointment” on your website?
- What do you want them to experience when they do land on your website?
- What should your patients experience when they click on a “Book now” button on facebook or google?
- What should the patients experience after they book an appointment? Should they be asked to fill out their demographics information before they come into the practice? Should they fill that out in the waiting room?
- What would you like the patients to experience when they want to reschedule their appointment? Or cancel their appointment?
- What happens when your insurance eligibility team figures out that their insurance is not eligible on the date of visit? Do they cancel it or do they give the patients a heads up or do they work with the patient towards a middle ground or payment plan?
- How should the patient be treated / greeted when they come into your practice?
- How does the patient check in? Do they do it digitally or do they wait for the endless line at the front desk?
- What is to happen if the wait times are extending longer and the patient has another prior commitment?
- What happens when the patient does go into the work up room? Do they go through the techs asking them for all their medications history or can the patient update this information while they are at home, before coming into the practice?
- How long of a wait time should patients be asked to bear after they have been “worked up” by your tech?
- How much time should your providers spend with your patients? Should they be spending time looking at the EMR or should a scribe help them do so?
- How do the patients get an estimated cost of care so they can make decisions?
- How do the patients pay their copays? Do they pay cash or via credit card or can they avail care credit or other options?
- What happens to patients and what do they experience when there are patient bumps due to inevitable provider emergencies?
- Do patients get a satisfaction survey at the end of their appointment? Or are they asked to leave a review? How do they provide feedback to your practice?
- Do your patients automatically get a no show reminder to reschedule if they forgot to show up for their appointment? Do they have to pay if they cancel within 24 hours of the appointment?
- Do they get automatic recall SMS if they have not come in for a preventive check up for 6 months?
- Do they get a patient balance reminder if they have an outstanding balance due at your practice? Do they get a statement from you?
- How do they pay their balances? Do they pay via check or cash or credit card? Do they have to come in to the practice to pay or can they do so from their homes?
These are the things you need to think through when you are designing your patient’s experience with your brand and throughout their patient engagement journey with you and your practice.
When a patient is delivered an exceptional experience, they are more prone to:
- Stay engaged with your practice
- Stay engaged in their own healthcare decisions and make more preventive appointments
- Stay loyal to your practice
- Show up for their appointments
- Refer more patients to you
- Leave positive reviews about you online that would lead to your brand reputation and your getting more patient bookings
Do not confuse patient experience with patient engagement. As you can see above, they are two different things.
The VERY first thing you might want to look at is to improve patient access to appointments.
How to improve patient access to appointments
Make appointment scheduling easily accessible. This has been the biggest pain point for most patients, for a long time now. The sections above discuss this to some extent and we cannot stress this enough. Making an appointment with your medical practice shouldn’t be like pulling teeth.
You can use free online scheduling software and apps that will empower patients to book and reschedule appointments. If you take one step further, you should use a digital patient intake software to achieve these.
You can have a dedicated person / team (on shore or offshore) that takes care of this function for you. Net-net, patients should be able to call, text, submit an appointment request form on your website and be able to make an appointment within 5 mins. It shouldn’t be a crazy long process – just to get an appointment.
It doesn’t stop here. Patients are busy – much like you are.
Each patient has a hectic schedule – just like you do. Respect that.
- Make it easy for patients to add their appointments to their calendars.
- Make it easy for patients to get appointment reminders (see SMS texting here).
- Make it easy for patients to be able to reschedule or cancel their appointments.
- Make it easy for patients to communicate with your practice
- Make it easy for patients to recall themselves (i.e. set up the next appointment once they get a reminder contact from you)
- Make it easy for patients to update their demographics information and their insurances by using digital patient intake software technologies
- Make it easy for patients to pay their copays, balance dues etc
You don’t have to do these things manually. Make good use of your EMR’s patient portal to help you achieve the same results. A patient portal is simply a website that is connected to your EMR/EHR and is focused on patient access to health data. These tools will help give patients full access to their own data – including lab results, physician notes, their health hist, discharge summaries, and immunizations.
Most of your EMRs/EPMs already include a patient portal.
Use them..Patient portals typically include functionalities such as :
- Appointment Scheduling
- Viewing health information
- Bill pay/view
- Prescription follow-up
- Filling out pre-visit forms
- Medical history update
- Communicating securely with the provider / your office staff
- Digital patient intake
Why not use something that you are already paying for and at the same time reduce the communications overhead for your practice?
Patient Satisfaction – Do not confuse patient experience
Patient experience is something that you deliver to patients. Patient satisfaction, on the other hand, is entirely on the patient’s experience and their expectations.
You cannot diagnose potential issues with your practice, staff, reputation, providers unless you actively participate in soliciting responses from patients.
Patient satisfaction surveys help you do just that.
If you are starting out with all these initiatives, it behooves you to first begin with surveying your patients. It allows you to find out more about your own medical practice and about yourself. What’s working, what is not working, what the patients see as issues (some that you are aware of and some that you might not be aware of) etc.
Running patient satisfaction surveys are not very difficult to do. There are many software that are commercially available and help you run satisfaction surveys.
You can also use our free patient satisfaction survey tool as well.
If you do not want to use any survey tools, you can very easily run surveys all by yourself, with your team as well.
Importance of patient satisfaction surveys, questions to ask, and available free tools
Conducting patient satisfaction surveys can truly serve as a diagnostic tool for your practice and can help identify opportunities for improvement in care, reduce costs, monitor performance of health plans and provide a comparison across healthcare institutions. The goal of patient satisfaction survey is to assess your patient’s perception of the practice.
So why is it important?
By conducting patient satisfaction surveys, first and foremost you will be letting your patients know that their opinion is very important and their feedback will help you provide quality services.
It will help you provide better care and also ensure that the time your patients spend with you is as pleasant as possible
Next, it will help you compete with other healthcare providers and set your standards
It will help measure the overall rating of your medical practice and responsiveness of your staff. It will also help provide rewards and recognition to the staff at practice who are performing well, which in turn will increase the quality of care
It will improve quality of communication of doctors with patients which is a key to patient satisfaction
Gauging patient satisfaction and using the feedback to implement or build on quality improvement initiatives will help demonstrate a commitment to patient-centered care and improve overall medical service experience.
How to create and run patient satisfaction surveys
Step 1: Identify what you want to know
Before you begin creating your patient satisfaction survey, bring your team together and identify potential problem areas in your practice. Are patient wait times too long? Are patients getting enough time with the doctor? Can patients access their health information and get through to the office when they have questions or requests? This is a great opportunity to collaborate with staff members and share insights on how the practice could improve.
The goal of this first step is to make sure your survey is asking relevant questions that are solvable. Asking broadly about satisfaction (“How satisfied are you with our practice?”) doesn’t give you actionable information. Instead, try asking about specific elements of the patient experience, like “How satisfied are you with the length of time you spend waiting to see a doctor?”
Next, you must focus on whether you want to create a generalized survey or single experience survey. A generalized survey will cover all areas such as feedback on office premises, doctor’s visit and will give you a broader perspective, whereas single experience survey will only focus on the specific experience immediately after the patient visit to a doctor
Step 2: Create your survey
- Focus on common areas related to patient satisfaction
- Identify common questions related to patient satisfaction, for eg. Ease of making an appointment, waiting time, physician and staff interaction etc.
- Start creating the survey based on this approach and it will help you give a good foundation to your survey.
- Avoid Binary questions
- Avoid using ‘Yes’ or ‘No’ questions, as these don’t give you an exact result for your question. Instead, consider using multiple options such as “Extremely happy” “Neutral” “Needs Improvement” such options to help you better understand.
- Keep it short and simple – Too many questions and options may lead to no responses at all !
Step 3: Choose a platform to launch your survey
- Software based survey tools – There are several free and paid options for hosting surveys, such as SurveyMonkey, Jotform, and Snap Surveys. Some even offer built-in promotion tools and real-time result charts. Keep in mind that online surveys may be less ideal if your patients don’t have easy access to a computer or a smartphone with internet access.
- Telephonic Surveys – Since mobile phone penetration is around 81% and landline is around 53%, in the USA, phone surveys are a great way to get patients’ feedback. You can conduct them in-house with a staff member or by hiring a research firm to make the calls and run the data for you.
- Email Surveys – whatever you can do via software, you can do via email as well. You or your staff can quite easily email patients with a short list of questions to answer. As the responses do start coming in via email, your staff can collect/gather these information and assign scoring to the questions being asked to all patients.
- Mailed surveys may seem a little old-fashioned, but they’re estimated to be 50% – 150 % cheaper than telephonic surveys.
- Office Premises – Asking patients to fill out a survey at the end of their visit is a great way to get immediate feedback. You can have staff members hand patients the survey form when they’re checking out or place the forms and a collection box in your waiting room.
- Survey Kiosks – Patient satisfaction surveys can be conducted via patient intake kiosks that as well. These digital patient intake kiosks must be located in the main reception area of the practice and should let patients provide feedback using a touchscreen. The kiosk provides a convenient, quick and easy method for patients to give their feedback on service offered by the medical practice.
Step 4: Evaluate the results
If one uses an online option to create surveys, then it is easier to draw results and create charts. In case of telephonic, office or email surveys you have to manually note the results in a spreadsheet and then evaluate the results. It will help you know the areas your practice needs improvement, which in turn will result in providing better quality care to your patients.
Step 5: Make Changes
Next step is to work on the points of improvement. Plan and work on the changes suggested by your patients. Observe for a few months and again conduct a survey. If the outcomes of the service offered, shows positive alignment with patients’ happiness, you are on the right track.
Patient satisfaction surveys – Questions to ask
Here is the list of potential areas that must be considered in your survey:
- How easy was it for you to schedule an appointment with our facility?
- How convenient was it for you to reach our premises?
- How long did you have to wait before being affected by the doctor, post schedule?
- How satisfied are you with the cleanliness and appearance of our facility?
- Are you satisfied with the care you received?
- Was the staff courteous and information was clearly presented?
- Did the practice give you a brief guided tour of your paperwork and point out relevant lab results?
- Did the practice encourage you to teach back your lab results and your treatment details back to them?
- Did the doctor encourage the family members to know about your problem, home remedies?
- Were you comfortable throughout the visit?
- What could we have done better?
- Would you recommend the doctor to a family member or a friend?
- How would you rate the overall care you received from the doctor?
- Anything you would like to tell us about?
Available Free Tools to create Patient Satisfaction Surveys
- SoGo Software – SogoSurvey is a web-based application that makes it easy to create, distribute, analyze beautiful multilingual surveys, forms, and assessment within no time. It allows you to start from scratch, or choose a template from a survey bank. It also allows you to customize your survey appearance as per your branding. It allows you to create and store contact lists and then choose right distribution methods such as unique invitations, links from the website or social media, plus helps track participation instantly and send reminders to those who haven’t replied. Its powerful reporting capability allows you to run and customize reports as per your need.
- Survey Monkey – Survey Monkey allows you to design different types of surveys such as Customer Satisfaction surveys, Employee satisfaction survey, health care surveys, nonprofit surveys. It also allows to create custom themes, add logos, select fonts and build custom thank you pages
- QuickTab Survey – QuickTab Survey allows you to create, test, and publish your survey. Also allows you to collect and view responses.
- Typeform Survey – It is an online survey creator that is fast, free and fully customizable. It helps you conduct research, boost your brand and know your audience.
- Survio.com – It’s a powerful free survey tool that helps you create online health surveys. You can choose from 100+ templates and 70+ designs. Helps you create surveys that are easily adapted to any mobile device, allows you to view your result in real time. It provides automatically generated, easily understandable PDF reports in just one click. It also allows results to be downloaded as raw data in XLS, CSV, XML and HTML file formats.
- JotForm Survey
Some of these are free and some require you to purchase plans. Of course, you always have the option to use our survey tool as well.
As you can tell, all this leads up to really managing patient relationships well, in healthcare. The days of “doctor say, patient do” are gone. Over. Finished.
Healthcare consumerism is in. You need to be prepared and armed.
The case for Patient Relationship Management In Healthcare
Almost all of this really ends up pointing us in the direction of patient relationship management. While it sounds like a new buzzword that is used to generate revenue for consultants, product developers, and speakers – and for some, that may be the case; however, for a medical practice endeavoring to stand out from the competition – i.e., to attract the patients the practice owners want and to retain existing patients – patient relationship management is necessary.
It is certainly true – due to the nature of healthcare – that there is something unique about the provider-patient relationship; nevertheless, patients are – in the end – consumers that are looking for value when spending their healthcare dollars.
In the era of high-deductible health plans, increased cost sharing, and increased interest in concierge medicine it is more often the patient’s – not their employer’s – money that is being spent on healthcare. Despite the intimacy of the patient-provider relationship, patients do switch providers, and their propensity to do so is underestimated by providers.
There is a significant disconnect, according to the Altarum Institute’s study (cited above).
For example, nearly sixty percent of patients that responded stated that they would switch providers for quality or service reasons; whereas fewer than one-quarter of the doctor’s that responded felt that a patient would switch providers for those reasons.
The study’s results also showed that there was a disconnect between how satisfied that providers thought their patients were – they estimated that roughly three-fourths of patients were satisfied; whereas, patients themselves, when asked, stated a satisfaction of roughly forty percent.
The increasing consumerization of healthcare along with the strong disconnect between providers’ perception of a patient’s willingness to switch providers and their overall satisfaction indicates that there is a gap that is currently not being filled with existing patient management tools.
Currently, the primary tools that are used by providers are typically an EMR, a practice management system (often increasingly integrated with the EMR), and a patient portal.
The latter tool was often advertised as the only thing a practice needed to engage and manage patients
That, however, is not the case.
Portals themselves have limited functionality and – with some exceptions – often are only useful for tasks such viewing one’s medical record, sending notes to a practice, and requesting appointments
A notable exception is eClinicalWorks’ Healow product which has telemedicine built into it.
A CRM for Healthcare
To successfully manage a patient population – not merely document care that occurs during a visit – i.e., what occurs within an EMR – a tool analogous to a customer relationship management system – a patient relationship management system is needed.
Such a tool would be centered around the care plan for the patient and facilitate structured, pertinent communication between providers and patients.
It may also help the practice market its services to likely future patients.
It will also, as many portals do, allow patients to request appointments, pharmacy refills, and view their record.
In many respects, this ought to be the next evolution of patient portals – it will be a more interactive tool that does more than a few administrative functions; rather, to fully embrace patient relationship management, tools will be needed to better enable shared decision making which, as studies have shown, increases patient engagement.
Many initiatives such as Patient Centered Medical Homes (PCMH) and value-based payment arrangements have put a strong emphasis on shared decision making.
Logistical and scheduling issues make it difficult to keep having the patient come in for visits; moreover, patients are resistant due to higher cost-sharing and scheduling difficulties – e.g., work, transportation, etc.
A software tool that could engage patients in making collaborative decisions about with their health with their provider would likely increase their satisfaction and, furthermore, such a tool would likely increase the chance that the patient adopts and follows-through with the care recommendations made.
Two companies offer relatively comprehensive patient relationship management systems: HealthLoop and SolutionReach.
- HealthLoop, for example, offers solutions to help remotely monitor patients and to enable more efficient interventions to reduce complications. Their product line has shown effectiveness in numerous cases – especially in targeted scenarios such as orthopedic procedure where intelligent procedures and quick interventions can reduce readmissions and complication rates. As bundled arrangements continue to grow, this will be an increased focus within the patient-provider relationship.
- SolutionReach, however, takes a different focus and offers tools to allow a physician practice to grow their market and more effectively manage patient satisfaction. They have tools that allow for self-scheduling, waitlist notifications, patient-provider texting, appointment reminders, and care adherence – a tool that uses a patient’s preference to reach out to them for care reminders. SolutionReach also offers numerous marketing tools to help identify patients likely to provide positive reviews, e-mail management, and social media management.
Both tools – and there are others out there as well – offer practices with a different take on relationship management; for those that are more ambitious and ready to fully jump into patient relationship management, a tool such as SolutionReach offers a comprehensive suite of products to begin managing the process of retaining patients and acquiring patients that are likely to be satisfied with one’s medical practice.
For those looking more at this from a standpoint of only providing better care and would rather not engage in more marketing, a tool such as HealthLoop might work better.
Patient relationship management – starting small
A practice can start even smaller if they wanted (and it may make more sense to do so while the practice’s staff adapts to the cultural change).
Many practices have access to a significant number of patient e-mail addresses. These were likely collected for portal enrollment and to send reminders.
These addresses can be converted into a patient newsletter that focuses on engaging patients in their care.
For example, articles about the flu vaccine; when to call the on-call, use an urgent care, or go to the Emergency Room; positive reminders to get preventative screenings – e.g., depression, colorectal cancer, cervical cancer, etc… – or to remind patients that you have same day access (if it exists) and on-call availability.
Such reminders – even if the patient were told already – could help increase patient satisfaction and reduce unnecessary Emergency Room utilization which is probably tied to at least one incentive the practice is involved in. Also, existing staff can use simple online newsletter software such as Constant Contact to get started.
Patient Relationship Management is going to become increasingly necessary as patients demand better service from their healthcare providers and continue seek optimal value for their healthcare dollars.
Additionally, many employers and insurance companies are looking at patient satisfaction when determining either who to include in-network or who to incentivize.
It behooves any medical practice looking to succeed in the long term to begin adopting such practices now when it can be done in a deliberate, careful manner.
Finding your niche/specialty to help medical marketing
Marketing a medical practice (or marketing in general) is all about niching down and marketing the heck out of it. Mass marketing and marketing the same material to everyone is a classic way of wasting a LOT of money without much return on that investment.
Are you looking for a way to stand out from the 20 other PCPs within 10 blocks of you? Niche down … on something. Whatever your preferences are – niche down on something.
You’re probably saying that a practice’s niche is its providers’ specialty. That, however, isn’t probably the entire truth. Upon examination and reflection, providers and administrators will probably find that there are certain demographics and diagnoses where a professional aptitude or passion exists.
Some family physicians are interested in weight management, others are interested in diabetes prevention, and others have a passion for women’s health.
Moreover, some providers have an interest in working with senior citizens; whereas, others are passionate about treating whole families.
For a sole provider practice, finding one’s niche is extremely important. This will keep the provider engaged in the care that they are providing, and – equally important – patients will notice that the provider is passionate about the care they are providing and, thus, the patient will be more likely to retain the relationship.
In multi-provider practices, there may be a need – where passions and aptitudes are diverse – to layout the idea niche for each provider.
This individualization may evolve into separate patient acquisition plans for each provider. This can be both beneficial – diversity in the composition of patients/consumers can help offset some risk in over-specializing – and challenging as the practice will need to tailor marketing messages to different demographics.
There are additional benefits to identifying and pursuing a niche.
If, for example, one’s preference is to work with elderly patients, one can then target patient education material to that demographic, assist billing staff in specializing in working with Medicare and Medicare Advantage Plans, and focus one’s incentive coordinators on HEDIS measures that those plans incentivize heavily.
On the other hand, if a provider’s preference is to work with families, the educational material would change, and, perhaps, ancillary services would focus on whole family health – e.g., wise food choices, active lifestyles, and more sound family interpersonal dynamics.
In effect, finding a niche isn’t just about marketing in itself; rather, it encompasses everything from back-office staffing specializations to the general ambiance of the practice.
Once a niche has been identified, then the practice must define what differentiates it from competing practices – i.e., it must develop its value proposition. An accurate, concise, and powerful value proposition helps focus the practice team on what their strengths are, who their customers are, and helps to convert potential patients into satisfied patients.
For example, perhaps a practice is an internal medicine group with a focus on diabetic and pre-diabetic patients. The practice may, as a value proposition, perform A1C screenings and micro/microalbumin tests with onsite lab equipment to better convenience patients, and, there may be a registered dietician and care manager on staff that works with at-risk patients to either manage an existing diagnosis or prevent pre-diabetes from becoming diabetes; moreover, financial assistance staff would likely be trained in navigating through patient assistance programs for the major diabetic equipment manufacturers.
The goal is to demonstrate to patients – to retain them – and to potential patients within the practice’s niche that the practice provides optimal value for their current and future health needs and can offer them more value for their healthcare dollars than competing practices.
Don’t believe us? Look at Davita, Sloan Kettering for examples.. And learn from them. They didn’t get to where they are by serving everyone and everything in their specialties.