Using KPIs for Tracking and Monitoring Physician Relationship Management

As healthcare organizations strive to build meaningful relationships with referring physicians and serve as a trusted partner when a referral need arises, it is essential to have a clear understanding of how effectively their needs are being met. That’s where Physician Relationship KPIs are invaluable.

Given the multivariate factors that influence referral decision-making, it is necessary to designate key performance measures (Physician Relationship KPIs) that reflect goals for building referring physician relationships. Physician Relationship KPIs provide a comprehensive view of the activities and outcomes of the physician outreach strategy and activities. Nevertheless, they are only relevant and useful if they measure the right information and are easily accessible to those that impact results.

Start with a Data Management Plan

Creation of a Data Management Plan is foundational step to ensure data is accurate and well-organized so that Physician Relationship KPIs can be monitored. The plan identifies key data sources, definitions, data and process owners. It should include a quality control process and provide for training and continuing education programs for analysts involved in the process of physician outreach reporting activities. Although initial development of this plan can be time-consuming, it is critical infrastructure that leads to an efficient and accurate understanding of your referral base and tracking of Physician Relationship KPIs.

Data Management Plans should include:

• Streamlined reporting to provide the most meaningful data to executive, clinical and departmental stakeholders.
• Optimal implementation of relevant reporting and business intelligence tools to gain the most comprehensive understanding of the physician referral base.
• Integration of PRM generated data into the analysis and reporting of physician referral activity
• A ROI methodology for physician outreach activities

Ensuring that the data is accurate and complete will require the team to access several organizational information systems and data repositories. Accessing these systems requires collaboration with groups such as Information Technology, Hospital Operations, Finance and the Medical Staff Office. Guidance from Compliance professionals may be necessary if any patient protected health information is to be accessed and/or utilized the data management process.

The following represent examples of the most common data and information systems that may need to be accessed as part of the data management plan and process:

Organizational Database(s) and Data Warehouse:

• Repository for all informational data on patients including medical, appointment, financial, diagnostic, and procedural data contained within your organization’s electronic medical record system (EMR).
• Relational data tables relating to all aspects of the patient’s care, including referring physician and other external providers allowing the analysis and reporting of related datasets that are gathered from various databases across the institution.

Physician and Provider Database(s)

• Primary system for collection and maintenance of external physician / provider information.
• May also provide for the digital association between external providers and the organization’s patients.

Identifying Physician Relationship KPIs

After the data is ready to use, it will enable tracking of Physician Relationship KPIs. KPIs should be tied to outreach and growth goals and serve as a catalyst to make changes or take actions that will improve performance. Although there is no “one size fits all,” there are four types of Physician Relationship KPIs to consider for managing referring relationships.

1. Referral Development:

Physician referral activity data should be used to track the success of the physician liaison team, measure overall contribution to service line growth plans, define territories, locate potential referring physicians and medical group practices, and monitor overall referral trends.

Examples include physician referral volumes and revenues, able to be filtered by individual referring physician, physician specialty (PCP vs. various specialists), hospital service line, geographic service area, liaison territory (individually and as a team/program), office visit activity, event attendance at medical society and professional conferences (CME).

2. Operations:

Referral related information is tracked to identify opportunities for improving operational efficiency related to processes and systems with which referring physicians interact. This data is also used to understand how various interventions and improvements are impacting the physician referral base, shifts in physician vs. self-referrals and satisfaction with access and communications processes.

Examples include referring physician satisfaction with patient access processes and clinical communications, physician practice calls into the call center by specialty and type of call (e.g. referral, patient transfer, requests for information, requests and ability to speak to a physician, problems and service recovery issues), wait time from referral to first appointment, provider database accuracy and completeness, proportion of duplicate / inaccurate records, physician portal registration and utilization (referrals, secure messages to clinical staff, medical record information viewed/accessed).

3. Physician / Market Intelligence:

Your physician liaison team provides first-hand insight into physician referral relationships and current market dynamics that affect the likelihood of future patient referral opportunities. The liaison team will also evaluate physician and market intelligence that increases organizational knowledge and understanding of referral decision factors and influence overall growth planning and physician relationship strategy development. Feedback received while quantitative in nature, can be categorized and documented in the liaison team’s Physician Relationship Management (PRM) system.

Examples include: Physician feedback about problems and issues by type, changes in practice affiliation and employment, health plan influences on referral decision making, definitions for priority / targeted physician segments, physician demographic information, etc.

4. Strategic:

Highlighting relevant trends and key information for executive and clinical leadership teams regarding the health and growth of your organization’s physician referral base. This knowledge and information assists in demonstrating the strategic importance of physician referral relationships to the success of your organization and provides insight into the performance and contributions of various physician outreach programs and initiatives.

Examples include physician reputation (US News), Return on Investment (ROI) and Return on Relationship (ROR) determinations, quantifying high value physicians, benchmarking, referral leakage, referral source dynamics (physician vs. self-referral, employer, international, health plan) and by channel – phone, fax, email, text, portal.

Translating Information to Action

Where many healthcare organizations fail to get the most value from data and KPIs is accessibility. It is critical that both leadership and those who can affect change in their day-to-day activities are able to easily access, understand, and monitor performance, including physician liaison activities.

There are some low-cost ways to focus on KPIs – such as boards in staff common areas that highlight performance, or consistently including them as an agenda item to review in team meetings. However, as something that can be access regularly and as-needed when most relevant, dashboards that integrate data and highlight KPIs are a useful tool.

Effective Physician Relationship KPI dashboards should allow you to view information such as referral volume trends, satisfaction scores, and outreach activities. These can be segmented by key audiences – such as service line or geography. Dashboard systems use various platforms, including mobile apps that liaisons can use while in the field to track, document and report physician office visit activity. Creating workflows to escalate problems to identified team members provides an avenue for immediate service recovery when a referral relationship is at risk.