Developing and Implementing a Data-driven ReferralDevelopment Strategy

Carol Marshall, Executive DirectorReferral Marketing & Customer InsightsApril 14, 2015

University of Chicago Medicine

Chicago Market• Population 2.7 million• Extremely competitive healthcare market

- 5 Academic Medical Centers- Large community systems providing

tertiary care- Competition from other regional

centers

• The University of Chicago Medical Center- Center for Care and Discovery- Bernard Mitchell Hospital- Comer Children's Hospital- Duchossois Center for Advanced Medicine

• University of Chicago Pritzker School of Medicine• Biological Sciences Division

- Knapp Center for Biomedical Discovery- Gordon Center for Integrated Sciences

Operating Revenue $1.34 billion

Avg Beds in Service 568

Admissions >26,000

Patient Days >157,000

Outpatient visits >420,000

Emergency Visits >75,000

Employees 9,037

Attending physicians 815

Residents and fellows 975

Nurses 1,644

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Marketing & Communications Team Evolution

3

Transactions

Analysis

Influencing

Analysis

Influencing

Transactionsto INFLUENCING

Do less butgenerate moreWork Smarter& moreefficiently

Influence decision-making at theExecutive Level thru Analytics

Transactions

Analysis

InfluencingInfluencing

Move from DOING

Direct to Referring Physician Strategy

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Referring Physician Voice of CustomerReferring Physician Voice of Customer

Four Part Strategy to Grow Referral Relationships1. Grow the Base - Build loyalty of existing referrals

2. Redirect referrals from competitors3. Expand Regionally - Create new relationships

4. Create Demand

Four Part Strategy to Grow Referral Relationships1. Grow the Base - Build loyalty of existing referrals

2. Redirect referrals from competitors3. Expand Regionally - Create new relationships

4. Create Demand

Physician Relations TeamReferring Physician Visits

MD:MD MeetingsField intelligence gathering

Physician Relations TeamReferring Physician Visits

MD:MD MeetingsField intelligence gathering

University of Chicago MedicinePhysician Connectand EPIC Care Link

University of Chicago MedicinePhysician Connectand EPIC Care Link

Other MarCommDirect Mail, National Physician

Meetings, Inspired Magazine, ReferralDirectory, Digital - Social Media andWeb, “Trade” based earned media

Other MarCommDirect Mail, National Physician

Meetings, Inspired Magazine, ReferralDirectory, Digital - Social Media andWeb, “Trade” based earned media

Physician Education“Learning @ the Forefront”

Online ChannelLive CME Events

Physician Education“Learning @ the Forefront”

Online ChannelLive CME Events

Content and Participation from UChicago Medicine FacultyContent and Participation from UChicago Medicine Faculty

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Our Journey toward Data-driven Outreach

Phase IPhysician Relations

Activity Management2012

Phase IPhysician Relations

Activity Management2012

Phase IIReferral Analysis

2014

Phase IIReferral Analysis

2014

Phase IIIAdvanced Integrated

and ROI Analysis2015

Phase IIIAdvanced Integrated

and ROI Analysis2015

• Build accurate PRMdatabase– Referring Physician data– Group Practice affiliation– Hospital affiliation

• Capture other data– MD to MD interactions– $ spent per physician– Issues resolution with

workflow• Define & build

management reports

• Integrate Claims Data– Ability to report by service

line and referring physician– Encounters, procedures,

charges, payor mix, etc.• EPIC Integration

– Capture Referring Physicianin EPIC

• Influence OperationalEnhancements thruReferring Physiciansurveys

We are finallyhere……

• Data-driven Strategy– Service-line reporting by

program combining claimsdata and EPIC data

– Group Practice data• Targeted opportunities• Trend analysis

– Changes in referralpatterns

Data is Power!

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Engage your Physicians

Transform your Outreach Team

Influence your Organization

How accurate is your

Referring Physician data?

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Resolving Issues with EPIC Referral Data• Service Lines have up to 900 different individuals scheduling appointments in EPIC, with 83% of encounters

referencing Internal faculty as the referring physician.

• Held Kaizen with cross-functional representation (EPIC, Service Line Operations, Scheduling Team, etc.)

• Process and system enhancements underway, which include simplified communication back to referring MD

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Int MD % Int46,649 83%

2203 64%2665 99%1472 68%955 65%

1166 98%1168 100%1262 100%1282 98%742 64%975 72%419 40%861 97%608 67%932 94%883 98%335 65%726 84%187 24%671 98%828 97%884 99%677 98%572 99%

Cancer Outreach Activities FY15 Q2

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Activity by Program Focus

Highlights:• Hematology Oncology Group’s VIP visit to campus included a tour of the CCD and

meeting with network development, Dr. Bishop and the BMT team. They would liketo work more closely with our physicians and establish a direct referral relationship.

• Dr. Choi presented on pancreatic cancer for the Northern Indiana EducationalFoundation (NIEF), which is the credentialing organization for NW Indiana.

• Lung Cancer CME event in Rockford resulted in three referrals for procedures withDr. Murgu in December.

• CME dinner featuring Drs. Rubin and Patti with XYZ Medical Group resulted inredirected esophageal referrals to Dr. Patti from a competitor.

• Women’s Health symposium was attended by 50 referring physicians. The physicianpanel highlighted our multidisciplinary treatment approach. Drs. Yamada,Jaskowiak, Chang, Chmura, Hoffman, Kulkarni and Sennett represented cancer atthe event.

• A series of Post-ASH CME dinners are being held in different regions featuring ourBlood Cancer and BMT specialists.

Participating Faculty

Activi ty Q2 FY14 Q2 FY15 Variance FY14YTD FY15 YTD Variance FY15 Goal % of Goal

Vis i ts 319 377 18% 540 621 15% 1175 53%

MD to MD Encounters 113 281 149% 163 492 202% 45 1093%

Faci l i tated CME 2 7 250% 2 12 500% 16 75%

Year to Date ActivityBloodandBMT

GU GI ThoracicOther

Cancer Total

Referral Marketing

MD:MD Encounters 82 52 64 39 255 492

CMEs 2 - 3 2 5 12

Learning at the Forefront - 1 3 1 9 14

CANCER MD MD ENCOUNTERS - FY15Participating MD Blood/BMT GU GI Lung Other Total

Angelos, Peter 8 8Artz, Andrew 3 3Bales, Gregory 1 1Bishop, Michael 28 28Choi, Eugene 5 5Chmura, Steven 3 3Blair, Elizabeth 8 8Chang, David 18 18Eggener, Scott 3 3Haraf, Daniel 8 8Hoffman, Philip 10 10Hogarth, D. Kyle 3 3Jakubowiak, Andrzej 2 2Jaskowiak, Nora 12 12Kline, Justin 2 2Kulkarni, Kirti 2 2Kulkarni, Swati 61 61Larson, Richard 2 2Langerman, Alex 8 8Lengyel, Ernst 25 25Lee, Nita 72 72McCall, Anne 17 17Murgu, Tim 10 10Odenike, Olatoyosi 2 2Patti, Marco 30 30Posner, Mitch 8 8Portugal, Louis 8 8Salgia, Ravi 11 11Sennett, Charlene 6 6Shalhav, Arieh 12 12Smith, Sonali 12 12Song, David 2 2Suh, Grace 31 31Tenney, Meaghan 6 6Umanskiy, Konstantin 2 2Villaflor, Victoria 8 8Vokes, Everett 5 5Yamada, Diane 27 27Zagaja, Gregory 11 11Total MD-MD 82 52 64 39 255 492

Source: Evariant PRM System

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Unique Patient Referrals – All Territories

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Source: EPIC (unique patients referred by External MD zip code)

As expected, UCM Cancer Programs draw physician referrals regionally and beyond. The map showsareas of opportunity to build the base, redirect from competitors and build regionally.

Build regional referrals

Build regional referrals

Build the Base

Redirect referrals

Opportunity to Redirect Referrals

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Four Part Strategy to Grow Referral Relationships1. Grow the Base - Build loyalty of existing referrals

2. Redirect referrals from competitors3. Expand Regionally - Create new relationships4. Create Demand with new technology & treatments

Four Part Strategy to Grow Referral Relationships1. Grow the Base - Build loyalty of existing referrals

2. Redirect referrals from competitors3. Expand Regionally - Create new relationships4. Create Demand with new technology & treatments

StateTotal Cancer

Care MDsNon-

Competitors% Non-

Competitors Competitors%

Competitors

Current Baseof Non-

Competitors*% Current

BaseRedirect

Opportunity% RedirectOpportunity

IL 606 343 57% 263 43% 188 55% 155 45%IN 326 214 66% 112 34% 127 59% 87 41%Michigan 491 289 59% 202 41% 34 12% 255 88%Wisconsin 334 227 68% 107 32% 37 16% 190 84%Total 1757 1073 61% 684 39% 386 36% 687 64%

Group Practice Profile: Group Practice A

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Advanced HF has been a focus for outreach over the past year. FY15 projections show a major growth in Advanced HeartFailure referrals from Group Practice A from FY14. A 12-month sampling of claims data shows UChicago Medicine as thepreferred AMC, followed closely by AMC2 and AMC3. A closer relationship presents an opportunity to redirect many of thesereferrals.

Source: EPIC

Top Referring MDs & Specialties

Source: Evariant

H&V Referrals to Competitors (Claims Data)

Program FY14FY15

Annualized % ChangeOthers 37 36 -3%Structural Heart 27 22 -19%Vascular 25 26 4%Heart Failure & Tx 24 62 158%Electrophysiology 11 14 27%

124 160 29%

Referring MD 1 Internal Medicine 17Referring MD 2 Interventional Cardiology 16Referring MD 3 Internal Medicine 13Referring MD 4 Geriatric Medicine 13Referring MD 5 Cardiovascular Disease 13Referring MD 6 Internal Medicine 12Referring MD 7 Cardiovascular Disease 12Referring MD 8 Internal Medicine 11

TotalUnique

ReferralsReferring MD Referring MD Specialty

Service Line and Referred-to OrganizationTotal

Referrals %CARDIOVASCULAR 605 100%

Referred w ithin Group Practice A 101 17%Group Practice A Community Hospital 1 37 6%THE UNIVERSITY OF CHICAGO MEDICAL CENTER 18 3%Group Practice A Community Hospital 2 14 2%AMC 2 14 2%EMERGENCY MEDICINE 1 11 2%Group Practice A Community Hospital 3 11 11%AMC 3 10 2%Community Hospital 4 9 1%EMERGENCY MEDICINE 2 9 1%Community Hospital 5 9 1%EMERGENCY MEDICINE 3 8 1%Community Hospital 6 8 1%Surgical Practice 1 4 0.7%AMC 4 4 0.7%Community Hospital 7 4 0.7%HOME HEALTH 3 0.5%EMERGENCY MEDICINE 4 3 0.5%AMC 5 3 0.5%

2%

Drilling Down to Develop Targeted Strategy

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• Identify physicians within a group practice by highest to lowest referring• Identify programs to which they refer, highest to lowest

Source: EPIC

Target lowreferringMDs withhelp from

top referringMDs

CERT with IBD

IBD with Esophageal

CERT 125Liver 16GI Cancer 13Pancreas 11Colorectal 5IBD 5Esophageal 3Celiac 1Gen GI Nutrition 1Bariatric -Peds GI -Total 180

DD ProgramGI Group Practice AReferring MD 1 51Referring MD 2 38Referring MD 3 30Referring MD 4 25Referring MD 5 11Referring MD 6 11Referring MD 7 9Referring MD 8 3Referring MD 9 2Referring MD 10 -Referring MD 11 - Total 180

GI Group Practice BReferring MD 1 33Referring MD 2 19Referring MD 3 17Referring MD 4 15Referring MD 5 10Referring MD 6 9Referring MD 7 9Referring MD 8 6Referring MD 9 5Referring MD 10 3Referring MD 11 3Referring MD 12 2Referring MD 13 2Referring MD 14 -Total 133

IBD 58Liver 21GI Cancer 18Colorectal 8Esophageal 7Celiac 6CERT 6Pancreas 6Bariatric 2Gen GI Nutrition 1Peds GI -Total 133

DD Program

Pair high referral programswith lower referring tointroduce program andfaculty

Results?

Immediate referrals tothe introduced program

Getting to ROI

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• We will now be able to measure FY15 against FY14• Metrics: Outreach Visits & MD:MD Encounters resulting in increased referrals

and revenue• Preliminary analysis: BMT (FY14 & first 8 months of FY15)

Top 5 Tips and Tools for Data-Driven Outreach

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1. Work toward complete and accurate data captureof Referring Physician in your EMR

2. Make sure financials are readily available andlinked to your data

3. NPI# is the lynch pin – make sure it is included inall data systems

4. Invest in Claims Data but also invest the time toconfigure it correctly – service lines, DRGs,competitors, etc.

5. Invest in a really good Analyst!

Thank You!

Questions?

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