Susan Worthy

In today's competitive environment, servicing and defending your physician referral base is no easy task. Building relationships in the face of growing examination volume, and with a shortage of staff, presents a daunting challenge for most radiology groups and imaging facilities. To facilitate contact with physicians and create competitive differentiation, many imaging facilities are relying on web technology, and on results distribution in particular. The speed with which results can be delivered to referring physicians through web-based access can improve service levels and enhance quality of care.

The anywhere, anytime access provided by the web is very appealing when compared with the slow pace of a film-based, paper-based operation. Although ubiquitous access to images and reports implies convenience, convenience alone is usually not enough to motivate referring practices to adopt the technology.

A web service only brings value to a practice when physicians are using it. With this in mind, a web distribution plan must be combined with marketing and execution strategies for success.

There is no doubt that web-based distribution offers many benefits to radiology. It has the potential to reduce the costs associated with the production and delivery of second originals and duplicate films. It also decreases the inefficiencies associated with faxing and mailing paper-based reports.

From the referring physician's perspective, however, the benefits are not quite as obvious once initial enthusiasm for the web fades. Proactively getting online to gain access to a result is actually an extra step that is not needed when a film simply arrives via courier. A faxed report requires no effort except picking it up and reading it. This work-flow reality should not be overlooked as an enterprise makes the decision to implement web-based results distribution. As the organization develops its plans for rollout, it should clearly define the value proposition to its customers. This benefit message should be loud and clear as a market launch begins.

WORK-FLOW CONSIDERATIONS

Many radiology groups focus their marketing efforts on physicians, but it is usually the the office personnel of the referring practices who order examinations for their patients and correlate results when they become available. If the target market is office-based, the work flow of these practices should be considered. In this setting, access to results is not "stat." Rather, office staff will often gain access to the result online, then print the report with associated images, if pertinent, and add the information to a paper-based chart. This information is then given to the physician for review. If the work list is hard to navigate, referring office staff will not use the solution. As the institution makes decisions about its web technology, it should be sure that the client access screens are easy to use. Practices should be able to find the information that they need quickly, and they should know at a glance whether a study has been ordered and read, as well as whether the resulting report has been completed.

Many of the image-distribution solutions available today are image-centered and are aimed at specialists or hospital-based clinicians. As a rule of thumb, 80% of the referring physicians for outpatient imaging facilities are likely to be primarily interested in reports. Full image sets with sophisticated imaging tools just get in the way for these practitioners. The organization would be wise to consider a web-based solution that is flexible enough to serve different users' needs with user-based viewing. Primary care physicians should have access to information using report centered viewing, while specialists should be presented with image-centered viewing with image manipulation tools.

Referring physicians access web-based reports with key images.

WEB SITE INTEGRATION

By combining image and report access with a marketing web site and/or physician desktop, a well-reinforced brand identity results. To access results, practices use the imaging facility URL address, and the website then becomes the portal for results access. A link for secure log-in to the imaging results server is only available for authorized users. Consequently, each time a referring physician accesses the desktop to review images and reports, he or she first experiences a coherent presentation of the values, services, and credentials of the radiology group or imaging center. New services are easily promoted to these users, and existing or underutilized services can be highlighted. The most painful words to a marketing professional are, "I didn't know you could do that." A properly designed web site can help strike this phrase from the referring practitioners' vocabulary.

PLANNING FOR SUCCESS

Surveys. A careful plan is necessary before launching a web service. The best way to start is with a simple survey of the target audience. Opinion surveys can benefit an organization's efforts in a number of ways, and the survey process will provide valuable information about the targeted population. The survey could uncover concerns or misconceptions physicians have about web-based access, such as security.

The information gathered should be used to shape a launch strategy. Survey results can provide a better understanding of the benefits from the customers' perspective, and thus define the positioning of the web service. If referring practitioners see value in accessing results anywhere, anytime, web-based access can be positioned as a tool that can be used off-hours or from home. If their office staff will be the primary beneficiaries, information richness or fast access to information should be highlighted.

Most important, a survey will help determine which referring practice will be the key target for initial launch. For example, a practice that is already connected to the Internet would be a great candidate for a pilot program. For marketing purposes, the practice should create a list of targets that includes the highest volume referrers, the biggest film users, large practices with the greatest referring potential, and innovative leaders who are likely to become early adopters of newer technology.

Physician Involvement. There is no better way to gain acceptance of a web service than to include the top referring practices in the planning process. Consider scheduling preliminary one-on-one meetings with these groups to discuss the upcoming technology plans. Pre-launch luncheons or meetings are also an excellent way to introduce the concept to a group of practitioners at once. By including them in these early planning stages, a "focus group" of sorts is developed. Such meetings will bring to the surface any misconceptions or obstacles encountered at a very early stage and foster an atmosphere of acceptance prior to launching the service, as well as help define the documentation and training that will be required to ensure access to the system. The meetings also will help prepare these key practices for any necessity to upgrade or purchase PCs for their practices, or improve their Internet access bandwidth. In addition to fostering a spirit of partnership with referring practitioners, the practice can secure its position as an innovative leader among the physician community.

Training and Documentation. Training and documentation does not need to be complex for a web service, but they represent a necessary step to ensure an easy start for your referring practices. Simple documentation with instructions for getting logged on can help reduce any anxiety or confusion for first-time users. The documentation can include directions for results access, navigation instructions, definitions for key tool buttons, and clear instructions for contacting you in the case of a problem.

THE INTERNAL ROLLOUT

Prior to launching a web service to the outside world, it is advisable to have an internal launch. By keeping all staff members involved, the entire organization can support the competitive advantage the group will gain from the web service. The web can significantly change the way a practice delivers services to referring physicians and  patients, so it is important to educate everyone in the practice. This is a ground-breaking new project for the practice, an event that should be heralded. From receptionists to radiologists, each individual should be involved in the internal launch meeting. At the close of the meeting, provide everyone with a sheet that offers proposed answers to some of the frequently asked questions (FAQs) anticipated from referring practices and patients. This will prepare everyone to address concerns and discuss the advantages of the service.

Before launching a comprehensive rollout, start with a pilot to only one or two practices. Be sure to document all questions and issues that arise so they can be avoided or overcome in the future. This information also can be compiled into a comprehensive FAQ list for your full rollout. Within the first few weeks of launch, contact all pilot sites and ask them about their experiences with the service. When positive comments are received, ask permission to use these quotes in the marketing effort. These can become powerful testimonial quotes.

A worklist feature for radiologists tracks studies.

THE ROLLOUT

Once the plan is worked out, it is time to work the plan. A phased rollout is usually the best approach to prevent overwhelming the operation with too many new users at once. Marketing personnel visits are the best way to drive enrollment in the web service quickly. Prior to these visits, marketing personnel should use the service themselves and become proficient with very brief demonstrations. The goal of these short demonstrations is to show how easy web-based results access can be. Keep them simple and only highlight the key advantages of using the system. When the practice is ready to bring on several users at once, open houses and other events are excellent venues to rekindle relationships and educate the physician community about all the services offered.

Web access to studies provides greater flexibility for all physicians.

Because a physician has enrolled for web access, does not mean he/she will use it regularly. It is necessary to reinforce the benefits of the service through regular marketing contact. It also is a good idea to track orders placed by referring physicians and confirm that they are logging on for their results. Some systems offer usage reports and audit trails so that it is possible to regularly examine when and how often referring practices are using the service. To stimulate visits to a web site, a URL business card can be useful. Printed with the practice's web address, referring practices can present these cards to patients when they request further procedure and prep instructions, or any other information about the practice.

THE KEY TO SUCCESS

There are many advantages to web-based results distribution. It can reduce result turnaround time by cutting out courier and faxing time. The solution also can improve access to information for referring practices. For many practices, the primary reason for implementing a web-based results distribution solution is the reduction of film and courier costs. But it is important to remember that none of these benefits are achieved if the solution is unused. Planning is critical to the web service's success, and careful targeting of early adopters can create future "sponsors." By launching in phases you can avoid overwhelming your practice with too many new users. A carefully planned and executed launch will make the web service a successand secure the practice's market position as an innovative leader.

Susan Worthy is director of marketing for eMed Technologies, Lexington, MA.