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Motivating Change: Best Practices for Primary Care Provider Outreach
WebinarFebruary 23, 2016
Presenters
Meagan Shallcross, MPHPhysician Outreach Coordinator
Assuring Better Child Health & [email protected]
Mindy Craig, PA-C, M.S.Director of Physician Outreach
Assuring Better Child Health & [email protected]
Review
• Last time we discussed:– Current climate in
primary care– Why it’s necessary to
engage primary care providers (PCPs) in your LAUNCH Together work
– Barriers and incentives for PCP engagement
Objectives
Review the principles of effective provider outreach approaches
Understand the components of an effective key message
Understand methods for handling PCPs’ objections and addressing barriers to engagement
Medical Office Staff
Practice Manager
Front Desk
Medical AssistantNurse
Support Staff
Approaches to PCP outreach
Academic detailing
• “Interactive educational outreach to physicians to provide unbiased, non-commercial, evidence-based information about medications and other therapeutic decisions, with the goal of improving patient care” 1
• Effective in bringing about small to moderate changes in practices related to prescribing or screening and improving the care provided to patients 2
1. Farrell S, Fischer M, Avorn J, et al. Introductory guide to academic detailing. Boston, MA: National Resource Center for Academic Detailing and Alosa Foundation, 2011.
2. O’Brien MA, Rogers S, et al. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000409.
Academic detailing
• Main characteristics of academic detailing 3– Building rapport and credibility– Fostering change– Using explanatory materials– Maintaining change
• The National Resource Center for Academic Detailing (NaRCAD) is a great resource – www.narcad.org
3. Clow PW, Dunst CJ, Trivette CM, Hampby DW. (2005). Educational outreach (Academic detailing) and physician prescribing practices. Cornerstones, 1(1), 1-19.
1-2-3 Approach
• The 1-2-3 Approach to Provider Outreach1) Make initial contact 2) Conduct the outreach visit 3) Follow up– Used by the CDC to market chronic disease
interventions to PCPs– Pilot testing demonstrated effectiveness 4
• In general, in-person contact is most effective 5
4. A pilot test of the 1-2-3 Approach to Provider Outreach for marketing arthritis self-management interventions. [Unpublished CDC Report.] Submitted by Westat, 2012.5. McGettigan P, Golden J, Fryer J, et al. Prescribers prefer people: the sources of information used by doctors for prescribing suggest that the medium is more important than the message. British Journal of Clinical Pharmacology. 2001;51(2):184-189.
Gaining Access
Gaining Access
Questions you may have…
• When are the best times to contact the practice?
• How should I make contact with the practice?
• What should I say or ask for during my first contact with the practice?
• Who can I expect to talk to during this initial contact? Who might help direct me to the “right person”?
Gaining Access
• When to call or visit– Normal business hours– Avoid lunch hour, Monday
mornings, Friday afternoons
– In ABCD’s experience, first thing in the morning is often a good time to make contact
Gaining Access
• Mode of contact– Phone calls or in-person visits tend to be most
effective– Consider making a drop-in visit with outreach
materials– Email may or may not be effective– Mailing information not typically very effective
• However, after a few attempts, consider mailing a packet of information with a note introducing yourself and business card
• Follow up with a call or visit and reference the materials you mailed
Gaining Access
• Leverage existing relationships or affiliations– Ask providers you already know if they could introduce
you to PCPs who may be able to provide input about the local landscape of early childhood services
• Gatekeepers– Build rapport with front office staff and practice
managers– You may have to talk with a few different people until
you find one who can help you get through to the PCP
Gaining Access
Your message:• Prepare a script for your call and track your calls• Introduce yourself and your organization• Briefly describe LAUNCH Together • Briefly describe the environmental scan and ask
if a PCP at the practice might be willing to participate– Be ready to explain what participation would entail (an
in-person interview, a phone call, a written survey, etc.)
Gaining Access
• Scheduling– Get on meeting
agenda– Schedule one-on-one
meeting with PCP
• Be flexible and willing to visit outside of the 9-5 work day hours
Gaining Access
Engaging different practice models
Hospital based HMO model
Multiple practices
combining
Small, independent
practices
Concierge practice
Gaining Access
Example:
Call and receptionist
answers
Give brief introduction and ask to speak with the practice
manager
Transferred to practice
manager’s voicemail
Leave voicemail and follow up in a
few days
Gaining Access
Example:
Work with the practice manager to schedule a time with a PCP for 7:45am on a weekday, before patient appointments.
Practice manager answers. Repeat your introduction and ask if there are any PCPs who you might be able to meet with for 10-15 minutes to provide input for the environmental scan.
Give brief introduction and ask to speak with the practice manager.
Call and receptionist answers.
Your Pitch
Your Pitch
Key components of your message:• Who you are• What LAUNCH Together is and
what groups are involved• How this work will benefit the
community• Why you’re there/what you’re
asking of the PCP• How engaging with your work
will benefit the PCP
Your Pitch
Describing LAUNCH Together:• It supports communities in promoting the wellness of
young children and families by addressing the physical, social, emotional, and behavioral aspects of development
• It is not a community program where a family would receive “LAUNCH Together” services
• It is a privately-funded initiative focused on enhancing existing evidence-based and promising practices AND improving our community’s system of supports
• It will take partners across sectors working together to improve child outcomes
• We are currently creating a list of resources and programs that serve children in the 5 strategy areas
Your Pitch
Address opportunities for engagement during the implementation phase and beyond• View the environmental scan process as an
opportunity for data collection as well as a time to establish lasting partnerships
• Introduce the idea of the PCP engaging with the work during the implementation phase– Consider scheduling another time to talk with the PCP
about what this might look like
Your Pitch
• Respect the provider’s time
• Check that he or she is willing to talk – Be willing to come back
another time if that would be better
• Bring materials with your business card to leave behind
Your Pitch
Example:
• Introduce yourself and your organization
• Give some background on LAUNCH Together: the organizations involved and the five strategies
• Explain you are working to conduct an environmental scan and the PCP’s input on the environmental scan will provide a valuable perspective and will help inform the work
• PCP’s engagement provides an opportunity to shape work that will strengthen early childhood systems and promote social-emotional health of young children across the community
Handling objections
Handling objections
• Anticipating PCPs’ objections to engagement is crucial– Have responses to potential objections ready
• Acknowledge concerns and reflect what you’re hearing the PCP say
• Keep barriers from last webinar in mind
• Consider how practice model might affect barriers to engagement
Handling objections
Example:I just don’t have time to do an interview or survey right now.
Is there another provider or person
in your practice who might have
time?
Can I leave the questions for you
to think about and follow up with a
phone call?”
PCP
Your response
Handling objections
Example: I’m probably not the best person to talk to about that. I’m not very
familiar with the early childhood systems in the community.”
It would be actually still be great to get your input, if you’re willing. It may help us identify what some of the
barriers are to PCPs being connected with these systems and find ways to build PCPs’ awareness and familiarity of the systems & services in the community. Identifying gaps
is an important part of this environmental scan.
PCP (Family Practice)
Your response
Summary & Follow-up
Summary & Follow-up
• At the close of your visit:– Thank the PCP for his/her time– Ask if he/she has further questions– Ask if he/she would like to be updated on the
work and participate in the future– Establish the best mode of contact for the PCP
Summary & Follow-up
• If the PCP is interested in staying in the loop:– Keep lines of
communication open– Follow up with
updates– Determine the level
of engagement that would be the best fit for the PCP (full participant vs. advisor)
Final thoughts
Please contact Molly Yost at [email protected] if you need additional
support or technical assistance.
Questions?
Thank you!
For more information visit LAUNCHTogetherColorado.org
