Practices are finding innovative approaches to boost their referral base, including the use of sophisticated modules within their EMR, while others are using conventional approaches like consultants and event hosting. But there are many other untapped ways that practices can employ to generate new revenue.
Using the EMR
While many cardiology practices implement an EMR in the hopes of achieving the stimulus dollars available for meeting the meaningful use criteria under the HITECH Act, referral management software also can be added to their EMR to boost revenue.
For example, tracking quality outcomes of specific conditions can help alert cardiologists to certain comorbidities like hyperlipidemia, hypertension or diabetes, which in turn leads to better patient management. Such attention to advancing the delivery of care can sucessfully build outside referrals, says Daniel J. Marino, president and CEO of consulting firm Health Directions in Chicago.
Implementing alerts can help facilitate the care continuum between the cardiologist and the referring physician through the EMR. The system can help cardiologists set up appointment reminders that are sent directly to the primary care physician. Referring doctors often don’t know if a patient has been seen or the results of an exam, says Marino. Creating these types of consultation notes within the EMR that provide a timely alert to the referring physician can help close the loop.
A good referral management program can add anywhere from 5 to 20 percent additional revenue to the practice, says Marino. However, this can be an expensive task. In fact, implementing a brand new EMR can cost upwards of $15,000 to $30,000 per physician in the first year alone.
If practices are considering using the EMR as a means of building referrals, Marino urges them to:
- Understand what functionality exists, and how the program will fit into their business model and clinical workflow.
- Identify key criteria and successes of the practice to help choose the best EMR to fit the practice.
Have EMR technology in place to begin tracking quality indicators. In the future, payors will begin contracting with providers on the basis of clinical outcomes data, not just the number of patients being seen or tests being performed.
Starting as an initiative to enhance patient satisfaction and a way to differentiate themselves from the competition, the 14 cardiologists at Pikes Peak Cardiology in Colorado Springs, Colo., began using the Pocket EKG clinical-based marketing program (Cardiomark) in 1997. Since then, placing a simple laminated card the size of a credit card in the wallets of patients has helped boost word-of-mouth referrals by 22 percent annually, and has decreased unnecessary hospitalizations by 45 percent.
The card, which presents patients’ baseline 12-lead ECG results on one side and vital patient information—blood type, cardiac conditions, allergies and medications—on the other, not only promotes practice loyalty, but boosts referrals, says Ronald D. Blonder, MD, DO, a cardiologist at Pikes Peak.
In addition to the laminated card, which is helpful during emergency situations when patients are out of town, the marketing program also includes Pocket EKG Patient Satisfaction Surveys, which are distributed to patients to help the practice better understand patient satisfaction and concentrate on areas in which it can improve.
The survey asks patients questions such as: How long did you wait in the waiting room? How were you treated by the front office staff or nurses? How long did you wait in the exam room and were you happy with the physician? The answers are then documented into pie charts and bar graphs by Cardiomark, which distributes results back to the practice on a quarterly basis.
“The survey gives an objective cross-section of the practice’s results so that we can identify problems early,” says Blonder, adding that the marketing program focuses on the three P’s of cardiovascular marketing: patients, payors and primary care physicians.
Hiring a welcoming committee
In 2008, Associated Cardiovascular Consultants in Cherry Hill, N.J., performed 3,433 cardiac catheterizations and 2,526 peripheral vascular interventions. For the seven-office, 31-cardiologist practice, serving five hospitals in the region, their numbers have increased steadily since 2002 when the practice hired a part-time sales consultant to visit referring doctors and inform them about the practice’s