3/9/2016
The Role of the Clinical Liaison as an Infusion Sales Strategy
Peter E. Herrschaft
Vice President of Sales
Infusion Services
Focus Rx
Cathy Daley, RN, BSN, CRNI®
Infusion Care Transition Nurse
Heartland I.V. Care
Lecia Snell‐Kinen, MSN, APRN‐CNS, CCTN
Vice President, Care Management Services
BioScrip
2016 NHIA Annual Conference & Exposition
1
3/9/2016
Speaker Disclosures
• The speakers for this presentation have no conflicts of interest to disclose.
• Off‐label and/or investigational drug uses will not be discussed during this presentation.
2
2016 NHIA Annual Conference & Exposition
2
3/9/2016
Identifying Market Opportunities & Implementing a Plan Peter E. Herrschaft
Vice President of Sales, Infusion Services
Focus Rx
3
2016 NHIA Annual Conference & Exposition
3
3/9/2016
Identifying Market Opportunities
• Hospitals & Hospital Systems
• All hospitals
• Base need
• Need for expertise
• Keeping up or competitive advantage
• Access to “closed” hospitals
• Clinician permission
• Access level
• Assessment of therapy mix
• Volume
• Type
• Payer mix
4
2016 NHIA Annual Conference & Exposition
4
3/9/2016
Identifying Market Opportunities • Making the Case to the Institution
• Transition of care capabilities
• Ease of process
• Clinician to patient/family teaching‐ complex therapies
• Relationship management
• Cost savings to institution
• Safe, timely discharges
• LOS reduction
• Readmission abatement
5
2016 NHIA Annual Conference & Exposition
5
3/9/2016
Implementing a Plan
• Sales support
•
•
•
•
Fit
F/T onsite or float‐ urban & suburban
Buy‐in
Incentive structure
• Clinical/ops support
•
•
•
•
Fit
Buy‐in
Liaison role & responsibilities
Cost savings
6
2016 NHIA Annual Conference & Exposition
6
3/9/2016
Implementing a Plan
• Legalities
• Formal or informal
• Permissions
• Can & cannot do’s
• Financial/market impact
• Cost/benefit analysis
• Market penetration
• Status at institution
7
2016 NHIA Annual Conference & Exposition
7
3/9/2016
Hiring, Management, and Performance Measurement Strategies
Lecia Snell‐Kinen, MSN, APRN‐CNS, CCTN
Vice President, Care Management Services
BioScrip
[email protected]
2016 NHIA Annual Conference & Exposition
8
3/9/2016
When to Hire
• Hire in places you need the business?
• Hire when the business is there?
9
2016 NHIA Annual Conference & Exposition
9
3/9/2016
What kind of CL do you need?
• What is your goal?
• Clinical vs non‐clinical
• RN vs. LPN, Non‐clinical vs. RN, Dietitian vs. RN
• Geographical area to cover
• One hospital
• Four hospitals
• Large region
“If you chase two rabbits, both will escape” 10
2016 NHIA Annual Conference & Exposition
10
3/9/2016
Characteristics of a Successful CL
• Clinical license (preferred)
• RN, LPN, Social Worker, Dietitian
• Strong clinical experience; home infusion experience preferred
• Excellent interpersonal, verbal & written communication skills
• Strong organizational and critical thinking skills • Ability to work independently and demonstrate leadership.
• Exceptional internal and external customer service skills
• Demonstrate company nursing competencies
• Solid knowledge of company policies and procedures
• Knowledge of local, state, federal, and other regulations applicable to the industry.
• Knowledge of accreditation standards and requirements
11
2016 NHIA Annual Conference & Exposition
11
3/9/2016
Characteristics of a Successful CL
• Ability to foster a cooperative work environment.
• Strong negotiation skills • Knowledge of infusion pharmacy reimbursement: state, federal and commercial.
• Knowledge of marketing strategies, processes, and available resources.
• Ability to develop, plan, and implement short‐ and long‐range goals.
• Ability to assume flexible work schedule. Ability to travel between locations during the business day as necessary to fulfill the job duties described herein. • Displays a neat, clean, professional appearance and demeanor at all times.
12
2016 NHIA Annual Conference & Exposition
12
3/9/2016
Increasing Core Referrals
• The Face of your team
• Develop trust • Internally and externally
• Streamline communication
• During discharge process
• Throughout length of therapy
• Expert recommendations
• Ownership of referral
• Orchestrate the patient experience
13
2016 NHIA Annual Conference & Exposition
13
3/9/2016
Collaboration for Clean Intake
• Owning the intake process
• Directing the Medicare qualification process
• Use your resources!!!!
• Effectively educating patients AND referral sources on patient benefits
• Understanding your Financial Hardship Processes
• Communicating financial responsibility
14
2016 NHIA Annual Conference & Exposition
14
3/9/2016
Cost Reduction/Increasing Profitability
• Customize patient supplies
• Coordinate most cost‐
effective initial delivery
• Manage referral source specific supply requests
• Assure supplies will match drug delivery selected
• Manage inpatient med administration schedule for conduciveness to initial home start and schedule • Teaching and hook‐up of med
• Personal supply stock
15
2016 NHIA Annual Conference & Exposition
15
3/9/2016
Positive Patient Outcomes
• Strategies to reduce avoidable readmissions
• Establish baselines
• Written and verbal hand‐
offs
• HHA and other post‐acute care partner relationships
• Training
• Confirmation of ability to start
• Shared visits, as appropriate
• Patient FU to providers
16
2016 NHIA Annual Conference & Exposition
16
3/9/2016
Other duties as assigned
• Round on pending patients daily; provide FU to branch
• “Be present”‐‐‐‐out of sight, out of mind
•
•
•
•
•
•
Provide updates on existing patients to clinical teams
Visit referral sources
Provide timely written clinical updates prior to MD appt
See patient in clinic while waiting for MD appt
Sit in busy, prominent areas of the hospital
ASK FOR THE NEXT REFERRAL!
• Plan and present CEUs with the sales team
• Obtain signatures on outstanding DWOs
• Selling activities with sales team
17
2016 NHIA Annual Conference & Exposition
17
3/9/2016
Interviewing for a Top Performer
18
2016 NHIA Annual Conference & Exposition
18
3/9/2016
Management Considerations
• Report to operations or sales?
• Part of call schedule?
• Utilize as field nurse?
• Commission or bonus structure?
• Providing Supervision
19
2016 NHIA Annual Conference & Exposition
19
3/9/2016
Measuring Success • Success measures need to be tied to any commission or bonus plan
• Increase sales
• Reimbursement
• Patient outcomes
• Internal and external satisfaction
• Cost reduction
20
2016 NHIA Annual Conference & Exposition
20
3/9/2016
A Clinical Liaison Case Study
Cathy Daley, RN, BSN, CRNI®
Infusion Care Transition Nurse
Heartland I.V. Care, St Paul, MN
2016 NHIA Annual Conference & Exposition
21
3/9/2016
Clinical Liaison/Care Transition Nurse
• Hired 6 years ago to be a clinical resource for home infusion, home care and hospice with primary responsibility for infusion the last 4 years
• Received sales training related to all 3 product lines
• No formal clinical orientation for my role although there is now company training offered for Clinical Liaison/ CTN
• Well received by both sales and clinical teams
22
2016 NHIA Annual Conference & Exposition
22
3/9/2016
Minneapolis Market
• Started position in 2010 after spending 25 years in home infusion in another state
• Had no established contacts in the market
• Prioritized meetings with new referral sources and patients prior to discharge
• Established quick response time, trust and expertise regarding home infusion
• Well received by case managers and social workers as a value added service
23
2016 NHIA Annual Conference & Exposition
23
3/9/2016
Typical day/week of a Clinical Liaison
• No day is the same!
• Organize/prioritize day by pending referrals/hospitalized patients throughout the Twin Cities
• Typically in 2‐4 Hospitals/day and 2‐4 Transitional Care Units/day
• Support sales team working to grown infusion by participating in sales calls, meetings and inservices
• Provide training to our clinical team and outside agencies
24
2016 NHIA Annual Conference & Exposition
24
3/9/2016
Transition of Care from Hospital/TCU
• Provide insurance benefits/costs back to referral source • Meet with patient/family prior to discharge to discuss coverage
• Provide preliminary teaching to ensure that patient/caregiver willing and able to learn
• Answer questions and decrease anxiety regarding home infusion
• Gather appropriate clinical information needed to bring patient onto service and relay any updates via email
25
2016 NHIA Annual Conference & Exposition
25
3/9/2016
Gaining momentum…
What did it take???
• Passion and commitment to transition the patient to home
• Thinking outside the box when dealing with a complex patient
• Finding a reason to get in front of referral sources to provide value/education and updates
• Gain access to hospital systems electronic medical record to decrease their work load
26
2016 NHIA Annual Conference & Exposition
26
3/9/2016
Case Study
• MK is a 50 year old male that was admitted to a LTAC post discharge from hospital for rehab and long term antibiotic administration
• Patients left arm was partially paralyzed and he suffered traumatic brain injury and BK amputation of right leg following an airplane crash
• Call from SW to see if patient would be able to go home in time for the holidays.
• Requested daily visits for RN to administer antibiotic as patient lives alone
• No agency able/willing to staff daily visits for extended period
• Liaison met with patient and worked on safe self administration of IV push antibiotic using adaptions • Patient d/c to home and completed coarse of therapy independently with initial teaching and intermittent follow up by pharmacy and nursing
27
2016 NHIA Annual Conference & Exposition
27
3/9/2016
Questions?
28
2016 NHIA Annual Conference & Exposition
28