The secret to healthcare business success? Listen to the doctors

LAS VEGAS - It was dire stat. Physician satisfaction was 1 percent at Lafayette General Health in Lafayette, Louisiana.

But after a years-long project to improve physician satisfaction, the health system managed to drive that up to 58 percent for its 68 employed and 1,700 non-employed physicians.

According to Amanda Logue, MD, chief medical informatics officer, a lot of the troubles stemmed from technology.

“IT was the first, at the bottom,” Logue said at the Business of Healthcare Symposium at HIMSS18. “We could only go up from there.”

According to Edwina S Mallery, assistant vice president of information systems, “Our physicians were requesting additional technology. They wanted to see radiology on their iPads.”

EHR troubles also plagued the system.

The focus became integrating the patient record and portal into one single view and experience. It was extended into the medical community, including the independent doctors, to include the hospital, primary care physicians, specialists, lab results and more.

“We have one record, one patient portal,” Mallery said. “We engaged physicians for a stronger alignment.”

Alignment, standardization and telehealth added the capacity for physicians to see one to two additional patients per day in their clinics.

In 2013, the system formed a clinical transformation committee. Members included the CEO, CMO and CFO. They found service lines to align and several have received the centers for excellence designation.

Service lines include advanced primary stroke, joint replacement knee, joint replacement hip, joint replacement shoulder, stroke rehab center, bariatric, breast imaging and maternity care distinction.

“For population health and utilization we came up with practical ways for disease management,” Logue said.

This has resulted in reducing avoidable ED visits and admissions, the latter by $2.9 million. Physicians can see the stats, and have a healthy discussion amongst themselves to find a solution, she said. Many times the data can be drilled down to an individual provider. Peer pressure can be a motivator.

As with many new starts, Lafayette suffered setbacks. The system originally had a physician dedicated help desk staffed by internal analysts, that had a high level of recognition and customer support.

They outsourced the help desk two years ago, with disastrous results.

“They were answering phones quickly but the level of relationship was non-existent,” Logue said.

In 2017, Lafayette brought back the internal help desk staffed by analysts, who have said they’re learning a lot by taking the calls for physicians.

Since 2013, physician satisfaction is measured each June.

There’s staff “roundings,” a 20-minute one-on-one interviews with the top 200 practicing physicians, asking key questions about what’s going on in the organization.

“The major thing we did was to act on those results,” Logue said. “We shared the results with the clinical transformation committee.”

Physicians serve on the board of directors and also on the network executive committee. Most are not employed by the system.

The physician satisfaction survey results have plateaued at about 82, 83 percent, but they’re still working towards a goal of 90 percent.

It’s an ongoing mission, according to Logue.