Navigating Hospital Sales

2013. Technology Access Partners LLC.
All Rights Reserved

Mastering the Economic Sale
2013. Technology Access Partners LLC. All Rights Reserved
Issues uncovered in the HAMF
1. Champions that lack power to influence others including materials
management.
2. Lack of collaborative/team relationship with all the key clinical
champions
3. Establishing the product as a protocol vs. out-of-site; out-of-mind.
4. Unsure about committee capital processes.
5. Capital constraints and other budgeting issues.
6. Limited clarity of detail behind status of where proposals are in the
review process.
7. Clinical heavy sales and lack of access to other stake holders or
interest in targeting of non-clinical people (besides materials
management)
8. Dealing with materials management/purchasing scrutinizing the cost
and potential product usage.
Navigating Stakeholders
Other
Resources
Management
Salesperson(s)
CNO
Marketing
VAC Comm
CFO
CEO
Physician
QA
Who cares?!?!?-------Key Stakeholders
C-Suite
Chief Executive Officer (CEO)
Chief Financial Officer (CFO)
Chief Medical Officer (CMO)
Chief Nursing Officer (CNO)
Chief Operating Officer (COO)
Chief Information Officer (CIO)
Service Line Management
ICU Administrator
Administrator of GI/Surgery
Senior Management
VP, Marketing/Public Relations
VP, Managed Care
VP, Program Development
VP, Supply Chain
Clinical
Champion(s)

Value:
Information & Access
Micro-Map Hospital
Organization
Process Steps
& Roadblocks
Information,
Access & Endorsement
Initiatives, Budgets
& Approvals
Other Stakeholders
Issues, Concerns & PIP
(Politics, Influence & Power)
Committees
Policies & Procedures
Explore and Amplify
EXPLORE RESULTS AMPLIFY
Vision, Issues &
Concerns
Partnering With Your Clinical Champion
Degree of Collaboration
Validator Advocate Partner
Clinical Champion Collaboration
A Predictive Model
VALIDATOR ADVOCATE PARTNER
A Clinical Champion that Validates
the clinical need for your product
or technology.

! Confirms that they have a
patient population that would
benefit.
! Does not confirm that other
physicians feel the same need.
! Is not willing to champion with
other physicians or hospital
administration.
! Is not able to address the
economic impact to the
hospital.
A Clinical Champion that validates
the need but is also willing to take
your information and Advocate for
it.

! Although they are willing to
Advocate for your product they
are unwilling to accept your
assistance.
! They ask for your clinical and
economic data and wish to
bring it to others.
! They may or may not seek
input from other clinicians.
! They often tell you that they
have comsidered all aspects of
hospital process and dont need
your assistance.
A Clinical Champion that validates
your product, is willing to advocate
for it and also recognizes your
value to the sales process.

! They facilitate meetings where
you will both be present.
! They are willing and able to
micro-map their organizations
to identify other key
stakeholders.
! They are willing to discuss
potential roadblocks to success
and strategize with you to
overcome those roadblocks.
Clinical Champion Exercise
Identify a critical value
proposition and the issue that
it fixes for your Clinical
Champion. Write a few
sentences that amplify the
issue.
Clinical
Champion(s)

Value:
Micro-Map Hospital
Organization
Process Steps
& Roadblocks
Information,
& Approvals
Other Stakeholders
Committees
Explore and Amplify
Vision, Issues &
Concerns
Micro-Mapping Stakeholders
?
?
?
New York Presbyterian Hospital
Quality Assurance
Ian Hatch
(Quality Systems Manager)
Technology
John Paul Triculis (Manager Information
Technology)
Alicia Williams (Healthcare IT Project
Manager/Medication management specialist)
Purchasing
Matthew Joki
(Dir Clinical Sourcing)
Anand Joshi (Corporate Dir., procurement &
strategic sourcing
Executive offices
Phyllis Lantos MS
(CFO)
Steven Corwin MD
(CEO)
Robert Kelly MD
(President) Laura Forese MD
(CMO)
Richard Liebowitz
(CMO)
Wilhelmina Manzano MA
(CNO)
Finance
Dov Schwartben
(Svp Finance)
Vascular Service line
Lisa Mainieri
(Dir Vascular serv. line)
Surgeons
Karl Hemingway Krieger MD
(Chairman CardioThoracic Surgery)
Mathew Williams MD
Dr. Mehmet Oz
(Attending surgeon CardioThoracic)
Emile Bacha MD
(Chief of surgery CardioThoracic)
Marketing
Nida Shekhani
(Dir service line strategic planning &
Business dev,) Rosemary Cortez
(Program admin dir. HealthOutreach)
Karen Wish
(Dir Marketing)
Andrea Dacquino
(Dir. Intern. Bus Dev.)
Harry Sherman
(corp. dir web marketing)
Cardiac service line
Jessica Melore
(Program manager, outreach)
Lisa Morris
(Chief Cardiac Sonographer)
Eileen King
(Transplant Admin)
Stephen Moore/Kristin Johnson
(Cardiac social Workers)
Bernadette Miesner
(Cardiac Serviceline Director)
LeeAnn Glozman
(Sr staff Nurse)
Maria Moreno
(Cardiac outreach coordinator)
Martha Mijes
(RN cardiac catch lab)
NY Presbyterian Hospital
Micro-Mapping Exercise
Select a key hospital account
and map as many
stakeholders as you can.
Partnering With Key Stakeholders
Key Stakeholder Exercise
Identify three key stakeholders
that you would like to
incorporate into each hospital
campaign.
Committee Members as Stakeholders
Capital Expenditure Committee
New Technology Committee
Value Analysis Committee
Budgeting large permanent equipment
requiring physical plant adjustments
Devices, implants, smaller clinical
equipment, non-disposable clinical
equipment
Supplies, disposables and
commodity items

Clinical
Champion(s)

Value:
Micro-Map Hospital
Organization
Process Steps
& Roadblocks
Information,
& Approvals
Other Stakeholders
Committees
Explore and Amplify
Vision, Issues &
Concerns
Roles, Responsibilities & Concerns
! What are the primary roles and responsibilities of your key
stakeholders?
What does the title mean?
What are the individuals primary responsibilities: Budgetary, Supervisory,
Clinical, Regulatory, Quality Assurance
! What are the primary concerns of the stakeholder?
What are their Management By Objectives (MBOs)
What keeps them up at night??????
! How many of these key stakeholders do you currently call
upon?
Key Stakeholder Exercise
Identify the roles,
responsibilities and concerns
of your assigned stakeholder.
Chief Financial Officer
Concerns

The CFO is the individual responsible for
overseeing the fiscal health of the organization.
His responsibilities include:
Overall revenue and expense management.
Monitoring cash flow and ensuring the ability for
the organization to meet its liabilities.
Manage the relationships of the organization
largest payers.
Monitor, plan and react to changes in health
policy and reimbursement.
Short and long-term financial planning and
implementation.
Roles and Responsibilities

The top five concerns of the CFO are:
Ensuring that the organization stays cash
flow positive.
The ability of the organization to meet short
and long term financial liabilities.
Maintaining appropriate patient revenue and
procedure volume.
The fiscal operations of the department such
as billing and coding.
Supervision of the administrative and clinical
support staff
Chief Medical Officer

The Medical Director or Chief Medical Officer is
the individual responsible for overseeing the
quality of the healthcare services delivered by
the organization. His responsibilities include:
Management of the Quality Assurance,
Utilization Review and Discharge Planning
staff.
Liaison between the Medical Staff and
Administration.
Monitor the clinical performance of the
Medical Staff and oversee benchmarking
programs.
Ensuring consistent and high-quality
medical care.
Concerns

The concerns of a Medical Director or
Chief Medical Officer are:
The availability of high-quality clinical
programs that meet the needs of the
surrounding community.
Maintaining a collaborative relationship
with the Medical Staff.
Implementing and enforcing hospital
policies and procedures as it relates to
the Medical Staff.
Payment and reimbursement by private
and governmental payers (e.g. Medicare
and Medicaid)
Market share as compared to the
hospital's competitors
Vice President of Quality

! Responsible for quality management, hospital
compliance with regulations/standards using
surveys and tracking.
! Coordinate the education and consultations with
the CXO, Medical Staff and department heads;
manage and direct the Quality Management
activities and Medical Staff Services functions.
! Coordinate and oversees the organizational-
wide evaluations and activities for performance
improvement.
! Directs and oversees the development,
implementation, and refinement of the
organization-wide quality improvement plans and
program.
! Coordinate and prepares Performance
Improvement reports for the Quality
Improvement council, Medical Executive
Committee, and Board of Directors.
Concerns

The concerns of a VP of Quality are:
The development and management of
clinical improvement projects that
positively impact and improve patient
outcomes, cost, and operational
effectiveness in care delivery.
Developing, implementing and tracking
practice guidelines, policies, and
methodologies patient care.
Ensure the data for Surgical Care
Improvement Project Data (SCIP) and
the National Healthcare Safety Network
(NHSN) is accurate and consistent.
To learn more visit ahqa.org
Administrator Gastroenterology

The Administrator is responsible for the
administrative functions, financial management/
planning and operational affairs of the GI service
line. Their responsibilities include:
Developing and directing the long-range
strategic business plan; preparation of
business analyses, proposals,
implementation plans for new programs, and
the design and implementation of changes to
existing programs.
Implementing policies and procedures for
faculty, classified staff, professional staff,
residents/fellows, temporary staff and other
personnel.
Managing the department's operating
expenses.
Concerns

The concerns of the Administrator are:
Ensuring that the department
operates efficiently and within
budget.
Maintaining a collaborative
relationship with the clinical/
physician staff.
Managing the fiscal operations of the
service line.
Developing and implementing high-
quality, cost-effective clinical
programs.
Director Critical Care

A Director of Critical Care develops programs
and processes targeted at improving the
speed and quality of health care services.

In addition to increasing efficiencies and
reducing costs, directors of critical care
evaluate staff performance and create systems
for measuring departmental and practice
goals.

Consistently monitors Patient Satisfaction
results and develop plans to improve scores
measuring outcomes.
Concerns

The concerns of a Director Critical Care are:
Maintaining excellence in clinical practice
within the unit for all patient care.
Monitoring patient care on the unit level to
consistently enhance patient satisfaction.
Managing human, fiscal and other
resources needed to provide and maintain
quality care.
Assures adequate staffing to provide safe,
quality care.
Developing, monitoring and maintaining
budget for quality and efficient use of
personnel, equipment and supplies.
Value Analysis Committee
The VAC is responsible for evaluating, analyzing and ensuring that
medical supplies and services are purchased and delivered in a
cost effective manner. This evaluation typically applies to new
medical products and services brought to the hospital as well as
replacement for existing products and services. The goals of a
VAC can vary by hospital but generally:
Accomplish cost savings and cost reduction through process
improvement.
Function as the hospital "Gatekeeper" of new products &
services.
Determine whether new medical supplies and services meet the
hospital's clinical
Many hospitals heavily focus VAC efforts on physician
preference items also called PPIs. Hospitals can generate cost
savings if it can standardize many of the PPIs it utilizes.
Technical Questions
Personal Questions
Structural Questions
Political Questions
Focused Questioning
Technical Questions
Focused Questioning
Political Questions
Focused Questioning
Structural Questions
Focused Questioning
Personal Questions
Focused Questioning
Focused Questioning Exercise
List two Focused
Questions, from any
category, you would ask of
your assigned stakeholder.
Medical Dir
CEO
CFO
Department
Administrator
Clinical Financial Strategic Quality Awareness
Stakeholder Concerns Vary
Targeted Messaging
(For Training purposes only)
Quality
Clinical
Strategic
Economic
Awareness
Over 30 randomized controlled trials and several meta-analysis have demonstrated the
superiority of hemodynamic optimization over standard fluid management to decrease
renal, gastro-intestinal, respiratory and infectious complications, as well as the overall
morbidity rate.
Decrease in post-surgical morbidity obtained with hemodynamic optimization was
shown to be associated with a decrease in hospital length of stay ranging between 1
and 2 days.
With the Companys Case Study iPad app we can provide you with the analytics to
show you the outcomes with your PGDT implementation in comparison to your historic
data.
Company has been treating the critically ill patient for over 40 years.
Ease of use and application can result in earlier initiation of flow directed goal-directed
therapy, which in itself has been shown to provide better patient outcomes.
Targeted Messaging Exercise
1. Create a Targeted Message
for your assigned
stakeholder.
2. Identify the appropriate
message category.
Clinical
Champion(s)

Value:
Micro-Map Hospital
Organization
Process Steps
& Roadblocks
Information,
& Approvals
Other Stakeholders
Committees
Explore and Amplify
Vision, Issues &
Concerns
Broadening Stakeholder relationships
Other
Resources
Management
Salesperson(s)
CNO
Marketing
VAC Comm
CFO
CEO
Physician
QA
Leveraging influence and power.
Overcoming road blocks and building consensus.
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Stakeholder Value (SV) Provide Information
" Budget Map (Hidden Money)
" How to reach higher level stakeholders
" Power Map versus an Organizational Chart
" Budget Process
" Competitive Information
" Corporate Vision and Issues
" Departmental Vision and Issues
" Corporate Direction (COE, service line priorities,
etc.)
" Organizational Chart
PI
Stakeholder Value (SV) Provide Access
" Trusted Advisor to Key Stakeholder. Influences their
Budget Allocations
" Has Access to Others Calendars and Ability to
Schedule Meetings for You
" Send an Email Introducing You to Another
Stakeholder and Copies You in the Email
" Shares Information on Key Stakeholders and
Allows You to Reference Them.
" Provide Information on Other Stakeholders But No
Introduction
PA
Stakeholder Value (SV) Provide Endorsement
" Endorse Use of Aggregate Hospital Budgets based
on Perceived Value of Your Solution
" Access to Departmental Budget and Ability to
Endorse Contribution of Budget to Solution
" Higher-Level Veto or Endorsement Based on Fit
Between Your Solution and Departmental Initiatives
" Delegated Due Diligence of Your Solution to
Provide Technical Endorsement
" Technical Veto or Approval
PE
Hospital Analysis
Decisions, processes and relationship structures
Name
Lead
Name
Title
Name
Title
Name
Director of
Infection Control
Novation or
other GPO
Name
Title
Name
Title
Name
Title
Competitor 1
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CB/PI Sector:
Name
Title
Name
Title
Name
Director of Contracts
Name
Director QA
Name
VP Marketing
Name
VP Business
Development
Name
Chief Medical Officer
Name
CFO
Name
VP Purchasing
Name
CEO
Competitor 2
Stakeholder Intelligence and Access Exercise
Use a key stakeholder
within one of your target
accounts and place them
on the CB/PI Matrix. What
value (PI, PA, PE) can
they provide to your sales
campaign?
Hospital Account Evaluation and Planning
Interrogating account
reality
Hospital Account Debrief
What top 3 questions about a
hospital opportunity do you find
most critical when evaluating
an opportunity?
Hospital Account Mapping Components
Stakeholder
Segmentation
Navigation
& Evaluation
Target
Account
Hospital Account Mapping Process

1. Using the Enhanced Surgical Recovery Program (ESRP) process, at what stage of ESRP would
you place this hospital account? Sell, Assess, Align, Apply, Measure
2. What are current revenue and/or unit sales at this account?
3. What are the revenue and/or unit goals for this account?
4. Over what period of time are you expected to achieve the new revenue goal (e.g. end of Q2 or
end of fiscal year)?
5. Are there any historical challenges between your company and the hospital account that impact
your ability to achieve your revenue goals at this account?
6. Which companies are your primary competitors at this account?
7. If other companies are competitors in this account, identify several of their strengths and/or
weaknesses.
8. If the competition has stalled here please explain?
9. Are there any historical relationship challenges that you have with any hospital stakeholders that
impact your ability to achieve your revenue goals at this account?
10. Are there any historical product issues that impact your ability to achieve your revenue goals at
this account?

Hospital Account Segmentation and Goals

1. Which stakeholders do you persistently interface with? (Names & Titles)
2. For each stakeholder tell me about your relationship with them? How much influence do they have over
product usage? Are they willing to introduce us to other people?
3. What are each of their personal operations issues and concerns? What is impact of these issues?
4. What are the departmental issues? What is the impact of these issues?
5. How can we address these issues with our solutions?
6. What are the challenges each of the stakeholders we know are having with our company, products,
solutions? Why?
7. Who else in the hospital is involved in decision or is impacted in any way by our products; that we have
not met? (Names & Titles)
8. What do we know about them? How do we know of them?
9. Who can help us get info about them? Get to them? (If nobody, then how can we get to them?)
10. Who else do we know that is part of this decision and we have not leveraged the opportunity in a past
meeting to get to know them further? Why?
11. What do we know about them? How can we get back in touch with them?
12. What is each stakeholders position on competition? Are there positions we can leverage?
13. What are 2 to 3 focused questions and targeted messages we would use for each of these stakeholders
when we meet them?
14. Are there any other initiatives (departmental & corporate) that we are competing with? (time, resource,
money)? What? Why?

Stakeholder Segmentation, Navigation and Evaluation
Clinical
Champion(s)

Value:
Micro-Map Hospital
Organization
Process Steps
& Roadblocks
Information,
& Approvals
Other Stakeholders
Committees
Explore and Amplify
Vision, Issues &
Concerns

1. Is this hospital considered a Center of Excellence for GI/Colorectal?
2. Is there a long-term business plan for the COE service line?
3. If not a COE is GI/Colorectal a primary service line for the hospital?
4. How many GI/Colorectal procedures does this hospital perform each year?
5. What is your clinicians payer mix?
6. Which payers represent the majority of the clinicians revenue?
7. What is the hospitals overall payer mix?
8. Which payers represent the majority of the hospitals revenue?
9. What is the hospitals payer mix for cardiovascular procedures?
10. Have you determined if the product will need to be reviewed by hospital committees? New
Technology, Value Analysis Committee (VAC) or a Capital Budget Committee?
11. Have you obtained hospital committee policies, procedures and timelines?
12. Have you identified the individual members of the Committees?
13. Have you, or will you be meeting with each individual?
Hospital Account Navigation
Hospital Account Mapping Process

1. Who are the main challengers/roadblocks. What are their concerns?
a. Details of above?
2. Have we reviewed these blocks with our champions? Their response?
3. Are these challengers critical to our account success or can they be circumvented?
4. Can we overcome these blocks? Why/why not? Plan for overcoming?
5. What resources in the form of people, presentations, proof and deliverables will you need?
6. Is there Targeted Messaging we can use with the non-advocates to reframe their perspective?
7. Are there other stakeholders that have political clout with the challengers?
8. Who are they and what type of influence or power do they have?
9. Stakeholders we can leverage in order to get information or access to these other
stakeholders?
10. What messaging will resonate with the additional target stakeholders?
Navigating Hospital Account Roadblocks and Challenges
Rules for Deal Coaching

1. There are only two answers to each question: the
information obtained from the stakeholder or I did not
ask.
2. You can always go back to a stakeholder to get
clarification.
3. The goal of deal coaching is to interrogate reality not the
salesperson.
4. What we dont know will cost us deals.

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2013. Technology Access Partners LLC.

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