About Cardiomark

CDM Review JCM How to Market
Gateway Strategic Partner JCM EKG Benefits

The Journal of Cardiovascular Management
How to Market
a Cardiology Practice

Laura M. Keledjian, MA
Cardiomark, L.L.C. (Formerly Health Tech Enterprises)
Fresno, CA

Introduction
In todays competitive healthcare environment, marketing is becoming increasingly more important to the success of medical group practices. This case study discusses how one cardiology practice implemented a new marketing program called Pocket EKG. The implementation process; the perception of the program from the physicians, administrator, staff, and patients; as well as the marketing outcomes will be examined. Pikes Peak Cardiology, LLP is made up of 9 cardiologists and located in Colorado Springs, Colorado.

The senior partner, David Greenberg, M.D., brought the idea to the group, "I saw the clinical value of the Pocket EKG Card for the patient as well as the potential marketing value of the service for our practice." The group decided to begin the service in January of 1997.

Outline of Pocket EKG Marketing Program
The Pocket EKG Marketing Program is based around the Pocket EKG Card that is a heart identification card the size and shape of a credit card designed to fit in a patient's wallet. On the card front is the patient's complete cardiac history, as well as the sponsoring organizations name, logo, address, and phone number; and on the card back is the patient's baseline EKG.

The marketing value of the card is to enhance word of mouth referrals and link patients to the physician practice. The clinical value for a patient to have their baseline EKG at all times is documented. "There is a 54% reduction in unnecessary hospitalization when a physician has access to a prior ECG."

Journal of General Internal Medicine, Volume 5, 1990

According to the American Journal of Medicine, 79% of physicians find a baseline ECG to be extremely valuable when making diagnostic and treatment decisions for heart patients.

Along with the card, there are a variety of services included in the Pocket EKG Marketing Program aimed at promoting the physician practice:

Patient satisfaction survey in compliance with HEDIS/NCQA Guidelines

Customized slide kit designed for community education

EKG Screening Kit for use at local health fairs

Media kit to distribute information about Pocket EKG and the physician group to the local media

Patient education materials

Goals and Objectives
Pikes Peak Cardiology wanted to differentiate themselves from the competition by not only providing the highest quality of medical care, but also by adding value to their medical practice with the Pocket EKG Card and services. PPC had three goals when they began this program. First and foremost was the Patient Satisfaction Survey. When a patient receives a Pocket EKG Card, the survey is included. Cardiomark, L.L.C. then collects the data from the returned surveys and issues a quarterly report that is both physician specific as well as a cumulative report for the entire practice.

"This material is valuable for two reasons: it is reported by an objective third party which adds credibility; and it is also in compliance with HEDIS/NCQA Guidelines that payors are looking to when contracting with physician groups." Emerson Smith, Ph.D., Medical Sociologist

A second consideration was to provide a clinical service to pateints that promoted rapid and accurate treatment. According to James M. Glass, M.D. with Pikes Peak Cardiology, there have been numerous incidences where a patient with an abnormal EKG presented to the emergency room with a Pocket EKG Card and was saved from being unnecessarily admitted to the hospital.

The third reason for implementing the Pocket EKG Marketing Program was for patient retention and recruitment. Colorado Springs includes many seniors that are migratory and travel to warmer climates during the winter. The Pocket EKG Card adds to their sense of security if they have to present it to the emergency room far from home.

The 3 P's of Cardiology Marketing

Pikes Peak Cardiology wanted to increase their patient volume. The design of the Pocket EKG Marketing Program focuses on the 3 Ps of marketing cardiology:

Patients

Payors

Primary Care Physicians

1. Patients
The patient's needs would be met with the Pocket EKG Card itself which links the patient to the practice.

"Patients feel a sense of security and peace of mind when they have their card with them-the consumer component of the card is tremendous." William M. Mantia, MBA CEO, Pikes Peak Cardiology

2. Payors
In order to better market the group to the payors, Bill Mantia, administrator of PPC, felt that he needed the data supplied by the Patient Satisfaction Survey Report that was included in the program. With this information, he has valuable data when contracting with the payors.

3. Primary Care Physicians
When promoting the practice to their referring physicians, PPC sent out a letter announcing the availability of the Pocket EKG Service. There is a place on the card front that highlights the referring physician as well as the cardiologist by name and phone number. Through the Pocket EKG Card, this sort of medical care partnership is formed.

Budget
The cost of this program is $15 per Pocket EKG Card with a one-time enrollment fee of $500. PPC began tracking their ECG service more closely and used the reimbursement from the ECG to offset the cost of the Pocket EKG Card. By capturing all the patients requiring an ECG, the group found that the cost for the Pocket EKG Marketing Program was at a break even point. Also, according to Ronald Blonder, MD of Pikes Peak Cardiology, "The satisfaction data gathered from the patients enrolled in the program is information that wouldn't otherwise be available to us without incurring a considerable cost. Combining the survey process within a program that enhances clinical care delivery is cost effective for the group."

Implementation
To implement the program, management has to not only say this is what is going to happen but also provide the means to make it happen. For this reason, a floater person was hired at $7.50 per hour to assist in the actual implementation of the Pocket EKG Program. For a patient to receive a Pocket EKG Card, there is a simple, one-page patient data form that is filled out to generate the information on the card front.

This form is attached to an ECG printout. The patient form and ECG are mailed to Cardiomark, L.L.C. where the card is manufactured and mailed back directly to the patient along with the patient satisfaction survey. A Pocket EKG Protocol was implemented to streamline the delivery of the service. The following criteria is used to identify and issue a Pocket EKG Card.

1. New patient
2. Recent intervention - PTCA, Stent, or Rotoblator
3. Recent permanent pacemaker or ICD implantation
4. Recent CABG, MIDCAB and/or Valve replacement/repair surgery
5. Recent MI
6. Patients identified as having an arrhythmia

Some of the inefficiencies with the implementation were found in the completing of the medical history portion of the patient data form. This information needed to be completed by a nurse and was sometimes found to be too time consuming. Also, when a patient needed to have their EKG performed, the availability of a place to do the test as well as staffing to perform the test were obstacles at times. This is where the staff floater person was of great assistance.

Outcomes
Pikes Peak Cardiology has seen three major outcomes since implementing the Pocket EKG Marketing Program: First and foremost was an increase in new patients seen in the office. There has been a 13% increase in new patients for two consecutive years since the implementation of the Pocket EKG Service.

According to Rosalie Forsythe, Clinic Supervisor and Program Coordinator for the Pocket EKG Program, our office has never been busier. The practice is growing, adding one new cardiologist in 1998, and 2 more cardiologists in 1999. Pikes Peak Cardiology also opened a Cardiac Cath Lab in August of 1998.

Secondly, having the data from the Pocket EKG Patient Satisfaction Survey Reports when contracting with payors is a definite advantage. According to Bill Mantia,CEO, the payers are surprised that a physician group not only has this data available, but the fact that the data was compiled and reported by an objective third party entity makes the information even more compelling.

A third outcome is the tremendous sense of security that the Pocket EKG Card gives to patients. "I think the Pocket EKG is a valuable tool for both the patient and the physician. It is an extra safety precaution to have. I keep it in my wallet right next to my drivers license." Irene Bello, cardiac patient.

"The Pocket EKG Card is seen as almost a status symbol to our patients. It is through building long term, loyal relationships with customers that determines the success of any business." David Greenberg, M.D., Founding Partner of Pikes Peak Cardiology, LLP

For more information about the Pocket EKG Marketing Program, call Cardiomark, L.L.C. at (800) 589-4949, fax (559) 275-9378 or visit www.pocketekg.com.

CDM Review JCM How to Market
Gateway Strategic Partner JCM EKG Benefits