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    Referral Management Solution Deployment: The 6 P's of Success

    By Daniel Palestrant, MD • July 5, 2018

    When we launched par8o almost six years ago, we thought we had a great idea and exceptional technology. The market would soon validate both those things, but it would also show us that great technology is necessary but not sufficient. That’s when we started to appreciate a pattern that we now refer to as the 6P’s.

    Pre-launch there are three P’s:  People, Process, & Platform.

    During launch there are two more P’s: Personalities & Politics.

    Post-launch: There is one more P: The Panera Circuit.

    We can actually go on and on with this: ‘P’ for patient, for payer, for provider. Or even a ‘P’ for par8o and maybe one for Palestrant!

    The only thing there isn’t a P for is Pixie dust. Implementing a successful referral management solution takes hard work and unfortunately, we haven’t invented any pixie dust for that - yet.  But understanding the impact of the ‘P’s’ at various stages of a referral management project can help ensure success.

    Pre-Launch: The 3 P’s

    One of the mistakes I see repeatedly among investors, executives, and even entrepreneurs is a lack of awareness about how their technology will impact the users within the organization that purchases the product. Unlike direct-to-consumer technologies where the purchaser is the user, in healthcare IT, and certainly in referral management, it is unusual for the actual users to be the same people who make the decision to purchase the technology.

    Because of that, organizations and vendors tend to overlook the change management that's required for successful adoption. For par8o, we quickly learned the benefits of carefully documenting the People, Processes, and Platforms that will need to use the par8o platform for a successful launch. 

    A methodical approach to proactively considering, ‘OK, who are the people who will be using the technology?’ will help identify potential issues while establishing the front-line support necessary for a successful deployment. Patient referral management is rarely successful when it is purely top-down. Each one of those people likely has a process that they currently use for referrals. These processes are rarely the same from location to location and they are almost never what senior management thinks they are.

    Going into the offices and documenting the actual referral process can confirm or (more often) dispute perceptions that people have around existing workflows. One tip: take care to learn from the people that are on the frontline. They often have the best insight and know the strengths and weaknesses of the current approach. If you listen carefully and build trust, in most cases, people are willing to show you where the yellow sticky notes and Excel spreadsheets are - which are primary tools most offices use for referral management.

    And of course, there is the ‘P’ for platform. What are the different platforms, EMR, registration, EMPI, etc. that need to be considered. Not necessarily in terms of actual integration (please read When EMR Integration Doesn't Matter to learn if integration is right for your implementation), but what are the other platforms that users interact with?

    Often this inclues unusual/unexpected data sources, such as credentialing offices (provider directories), payer sites (eligibility), marketing sites (contact information), pharmacy (340B participation) and so on. Beyond functional integration, these platforms often provide key points of information that need to intersect with the workflow.

    During Launch: Personalities & Politics

    “In so much as healthcare is a business, referrals are the currency of that business”...such were the sage words of one of my early professors at Duke.

    Referrals are important and tinkering with the way they flow through the healthcare system often raises anxiety levels. In many organizations referrals are either poorly organized or poorly executed (which is why you might be interested in referral management and therefore reading this blog!), so it is completely understandable that people will express interest when it starts getting fixed.

    I find that emphasizing three things tends to help dissipate provider concerns:

    1. This will not cause you more work or duplicative work. In most cases it will eliminate work)

    2. It will be transparent (par8o score cards have been hugely successful).

    3. It will enhance patient care.

    I continue to be impressed by the frequency with which our biggest antagonists often turn into our biggest advocates, once they see the impact of an effectively deployed referral management system. 

    Post Launch: 'The Panera Circuit'

    Having covered all manner of technology, platforms, politics, and personalities, the honest truth is that every single one of these deployments comes down to successfully engaging with people on the frontlines.

    Most offices are hectic places.  Asking them to do something different is always a big deal. It helps when we can point out that more effective referral management will improve patient care (it does), or that it is critical for the organization's overall strategy (it often is), but it always comes down to building a relationship with the office staff where they support that vision and will support the launch.

    This usually takes a couple of meetings and a few training sessions... and that is where the final ‘P” comes in: "The Panera Circuit". We believe that asking office staff to spend some of their lunch break learning about a new technology platform is a big ask…and we’ve learnt nothing says thank you like Panera.