Pitching a Healthcare Blogger Part II: Don't Burn Your Bridges

Even if you give the best pitch in the world, sometimes you're gonna get singed. Guy Kawasaki recently received this email reply from a reporter.

Last week I blogged a response to a PR pitch by Houston Neal, Director, Business Development for Software Advice. Houston wanted me to cover a corporate blog entry exploring the EMR/EHR nomenclature debate.

The email was blech, blog entry was ok, but the site itself was more interesting.

Any HIT firm connecting providers to eHealth resources with a revenue-generating business model not based on ads should be of interest to Health Management Rx readers.

Rather than just deleting the email, I posted this entry, which earned me a phone call from Houston, who had indeed actually read the coverage.

That led to the interview with his CEO, Don Fornes, which is published below. It's a behind-the-scenes look at how one firm is helping docs research EHR purchasing decisions. Medical Software Advice's goal? To move providers from the 'learning' to 'buying' stage - pronto.

Although this is a bit of a departure for HMRx readers, docs who need some help moving quickly from the research to the buy phase of EHR purchasing may find Software Advice useful.

I don't know for sure, as I'm not a doc, and so wouldn't generate a qualified lead (grin).

I'm hoping one of you, dear readers, will give it a try and report back. And healthcare bloggers - sometimes reading those pitch emails yields unexpected fruit.

"And most of the time, all the marketing sounds the same." -– Medical Software
Advice website


Q: Jen: This story begins in an unusual way for a business interview...I was contacted, as were several other bloggers I know, by Houston Neal, your Director of Business Development, who sent an email with a link to a corp. blog entry discussing the difference in the EMR/EHR terminology. I followed the link, and was unimpressed by the initial pitch, but interested in the company.

I used Twitter to ask colleagues what they would do - delete the email? Take time to 'educate' the PR contact? Many suggested the former, but I chose the latter.

Instead of emailing Houston back, I posted a reply on my blog, which included ways to improve his pitch to healthcare bloggers. I invited him to respond to the blog entry, and if he did, I'd spend more time learning about Software Advice.

Houston was good enough to read a very tough bloggers' review and respond in a professional manner, which allowed us both to carve out time for this interview today. So, how do you feel about Houston's results (not method), and has your strategy for contacting bloggers changed at all as a result?

A: Don: Yes, I think our strategy will be refined, but I don't think it will change. I'm very metric driven. We have to contact a certain number of relevant blogs to get a certain amount of relevant coverage. So we'll probably continue to contact the same number of blogs.

Houston learned that those contacts (email or phone) have to be more personalized and to the point. We had our weekly one- on- one meeting the Friday before you posted your blog post and some of the comments you had were the same comments I had.

It's hard. Houston's a pretty good writer, and business communication is very difficult for a number of people; getting to the point, making the ask, and getting to the point where you tell them the ask. So we'll continue to work on making those communications better, but we're not shy. We are very assertive in going out and trying to get our name out there. And we'll continue to do that.

We'll just try to do it better and make sure that people like you know we are talking just to them - not that we're not spamming every blogger out there. And that impression is rooted in us digging deep into the blog and understanding the angle the blogger takes.


Q: Jen: Now let's get down to business. Tell me more about Software Advice, and your service for physicians. What are you doing? And why do it for free?

Your site says you're a "Matchmaker between software buyers and vendors."
Do you want to be the Consumer Reports of EHR systems for docs?


A: Don: So my whole career before starting this company was in software and market analysis and research. I was an M&A (mergers/acquisitions) banker working with software companies. (Jen: Don also has a degree in Economics from Princeton). I realized big companies can go to a Gartner group and pay them tens of thousands to build a short list of products.

Small organizations don't have anywhere to turn. We started looking at how to use the web to do their initial research - not make their final selection. So I built that website and then I had to figure out a business model. And it became clear that it had to be referral based such that we would be paid for making referrals.

We've learned a lot about making referrals. We were originally doing that without human involvement; however that automated process leads to bad referrals though because people don't make the right decisions on the web - as you know they skim, they don't read.

So we got on the phone and started talking to people to see what was going on. We found that phone call started to really help us understand buyers’ requirements and help develop quality referrals - talking through features, deployment options, which specialty are you in? What's the size of your practice? Etc.

Q: Jen: So what's the business model? Are you paid by the EHR/EMR companies? You list 11 companies here including Abraxas, eClinicalWorks, iMedica, Practice Partner, etc.


A: Don: Yes, we're paid per referral, but it has to be a quality referral. We give the software vendors the flexibility to decide if it is a quality referral.


Q: Jen: Is there a limit to that free consultation call with the physician? Do you have people abusing the free call and calling back several times?


A: Don: There's no limit to the call, but there is a limit to how much we can help them...so if it gets to the third call, they're so deep in the analysis that we can't help them. We can't make the final decision for them, but we can help them get down to the final 3-5 options.

We don't make the final decision FOR a provider because that gets down to subjective assessments of 'what's easier' to use. That last decision is very tough, but as matchmakers, considering the level of knowledge that we have, it wouldn't be prudent or useful for us to make that final decision.

I would say less than 5% of the time we are asked for that opinion. We decline to offer it.


Q: Jen: So what's the goal of that first call?


A: Don: We have a specific quantitative goal - to help the provider narrow options to 3-5 providers on that first call.


Q: Jen: How many vendors are you working with?


A: Don: We're currently working with about 50 software vendors in medical, and about 150 across our other two industries. We are aggressively every day trying to profile more products and partner with those software companies.


Q: Jen: Software advice works in other sectors (construction, retail) correct?


A: Don: Yes, we work in construction and retail as well.


Q: Jen: Does Software Advice gather and share reviews/feedback from physicians using the service?


A: Don: We get feedback usually on how the sales process went (from vendors) - we don't often talk to people, you know, 6 months in. We'd love to know more about how vendors are performing for people, but we don't want to get into the position where we're liable for one negative physician review.

There are lots of stories out there about software failures - but I really think the buyer of the software, regardless of the industry, has to take a fair bit of responsibility for their own success.

Sometimes they buy software expecting it to solve all of their problems - make my bed, make my dinner - simply by paying for and installing the system.

But they totally overlook change management - making sure they are using the software to its full potential.

Q: Jen: Right now it's obvious your marketing strategy includes some social media outlets, including those in the health/medical blogosphere - how else does Software Advice communicate with potential customers?


A: Don: Our biggest focus is the search engines. So if you google OB/GYN EMR software or cardiology EMR software you'll see us ranking very highly. EMR software we bounce back and forth...so we're not in the top spots that we're aiming for, but we’ll get there. We're always working hard to achieve strong “organic” rankings (Google, Yahoo, and MSN Live).


Q: Jen: Which blog reviews would definitely help you with?


A: Don: Of course.


Q: Jen: Tell me what differentiates Software Advice from other resources docs might use to evaluate EHRs. What do you see as the firm's place in the Health 2.0 ecosystem?


A: Don: It's really the phone conversation. So what you see on the website is fairly simple - there's no complex functionality on there, but if you were to see the back end system that we look at, we have a lot more filters, including specialty, size of practice, do you want web- based, web- enabled, number of users, bidirectional lab integration, eprescribing, integration to ECHOs, etc.

The amount of sophistication in the filters that our Customer Advocates have access to is very powerful, and so we're able to perform a consultation that is very helpful in narrowing down that short list, whereas if the physician were left to their own devices on the web, it's a lot of sorting through marketing content and other data.

Our system almost brings us to the point of being a consultant, but we're not. We don't work through the process of installation and implementing the software for them. It's valuable if you can afford to hire a local IT consultant for that, but we don't serve that need. We just narrow down the options.

I don't want to stretch things so far and say we're Health 2.0 - it’s a hot phrase, but we are what we are.

Having said that, it's exciting to talk to some of the younger physicians who are starting new practices and want to extend information to patients via a patient portal, scheduling online, integration with a PHR, etc.

That's a fun part of our job - to start talking about some of those cutting edge technologies.


Q: Jen: So how many of the providers who call are asking for patient-directed or consumer-centric features like emailing a patient, PHR integration with Microsoft or Google, etc.?


A: Don: Less than 5 percent are asking this - more are asking for integration to lab, pharmacy, and hospital health systems.


Q: Jen: Walk me through the process for a customer call? Do you facilitate the end purchase via link, etc?

A: Don: It's a dynamic conversation. We do train our Customer Advocates on a script to make sure they're asking the right questions - who are you and what do you do?

This helps us know how to walk them through the process. So we might learn: The buyer is a physician in a 6 cardiologist practice with a staff of 12 in medical records and billing.

Then we ask what do you need? And we might hear: “I need a complete system that includes an EMR, medical billing, and scheduling, and I want them it all in one system. Currently my charts are all on paper and I have DOS-based 15 year old practice management system (Jen: Yikes!), our hardware's failing."

And we'll say ok we know which apps/modules you need. Let's drill down into some features. Are you interested in cardiac templates? eprescribing? Do you need this to be certified by CCHIT? And we get those answers and we can check them off in our system and the list of products is narrowing as we do that.

Our Customer Advocates, while very intelligent, don't need to know everything - they just need to ask the right questions. Then we look at the overall functional map for the provider as we move onto deployment questions. Do you want it on premise? Do you want web-based access? Access at home? At the hospital?

There are other things we can get into in terms of functionality and integration...for the most part that helps us narrow it down.

Then we'll talk budget; have you thought about how much you want to spend? Have you gotten any pricing information? Obviously that can be a big deal.

Our goal is to have buyer start with functional/tech needs and then compare prices. We don't do anything with pricing – just ask questions. We know enough to eliminate some of the choices and or point them in another direction.

Finally, we make our recommendations: "Based on what you told me, I'm going to recommend the following products - I can recommend two to five, so what's your appetite to digging into the a short list? OK, here are the ones I suggest and here's why."

We can pass on the notes from our call and your contact info and a rep will contact you to walk you through a live demo like a WebEx.

We're very careful to get confirmation; this that is what qualifies makes a good referral. So they say sure, we confirm we have permission - then we ask what is a good time for the vendor rep to call? Is there a better phone number? Do they have preferences with regard to phone or email?

At this point it's critical that we have them bought into the process, that they're ready to roll up their sleeves, get serious with the software vendors, otherwise it's not a high quality referral. We don’t make connections that don’t benefit both the buyer and the seller.


Q: Jen: Ok, so you're much more geared towards moving physicians from the EHR research stage to the EHR system buy stage than I anticipated reading the website.

It appears to be just this free helpful research service, but you really want me to be ready to buy. It seems a bit like Consumer Reports or the Blue Book - I don't pick up those resources and spend time on the short list until I'm really ready to buy a car.

So what's the attrition, or rate at which physicians drop off? How many go through the call and aren't ready to buy?

A: Don: Attrition rate is probably 5% - 10%.

We call it “taking our advice and running” with it. We know it's gonna happen, it's not ideal, we get really bummed out and sad, but that buyer was probably not ready to engage the software vendors.

So we're far less sensitive to it than we used to be. But at that point we've already put in the cost and effort and everything that goes into making that recommendation but we didn't make any money. Frankly, that is fine. That was not a qualified referral.

From the outset keep in mind it's a 20 minute phone call, 30 minutes if it's a talkative physician - so we start by understanding needs and acting as a reference for them. The best thing we can do is demonstrate that we really know what we're talking about during that call. People are amazed they're able to accomplish so much during that phone call in so little time.

We've compressed 2-3 weeks of research down into that brief call.

Q: Jen: Are your Customer Advocates physicians? How do you pick them? What are their qualifications?


A: Don: We're picking them for their charisma and their ability to relate to people on the phone, similar to the type of person that a software vendor might hire for their inside sales, but we don't look for closing skills because we don't need to sell anything. So maybe they're a little less aggressive but a little more thoughtful or consultative in that they need to understand a wide range of products and a wider range of buyers.

But these are not physicians, nor do they need to be.

Do they know as much about EMRs as a consultant that has years and years of EMR software experience? Maybe not, but they're a lot better organized and empowered by the tech we've built.


It was myself and Austin doing this until recently for most of our existence, so we had two people who really care about the business. We just hired two new Customer Advocates. The biggest challenge as a company is how we'll scale.


Q: Jen: Give me an idea of call volume.


A: Don: Well, there are two ways to contact us (800 number or form) - so we've got inbound and outbound inquiries. In a few weeks we'll do a new release of site, where users will be able to ask specific questions and request a free consultation in multiple different ways.

If you add up all the inbound calls and forms on website it's between 50-80 a day.


Q: Jen: Of those 50-80 inquiries/day, how many turn into software referral for a vendor?

A: Don: I'd say 35-40 percent.

Another 20 we're unable to help for one of many reasons - they're overseas, looking for tech support, students doing a term paper, etc. Another group of people we can't help or they need custom system, or they want home health care and we're not there yet, long term care, we're not there yet.


Q: Jen: I like to open with a tricky question and close with a trickier one. Everybody hates this one, but final thoughts about where you think healthcare in the US is going?

A: Don: I'm going to have to think about that one a little bit, but as a small business that just got healthcare coverage for all of its employees, the challenges are clearer than ever for me personally.

One thing I believe is that tech can really help create efficiencies. If you look at the manufacturing industry and the way worker productivity has increased over last 20 years,those macro stats demonstrate the value of IT in that industry.

We haven't seen that in physician practices - they have been too slow to adopt. I think that providers/physicians have so many other demands in terms of what they do and focusing on their own very arduous educational development that they haven't been able to focus enough on work flow and process to wring out all the gain all the efficiencies technology can bring.

I can't answer the question about whether or when that kind of process innovation will happen but I hope it will.


Q: Jen: Don, it's been a pleasure. Thanks very much to Houston, for coordinating this talk. I know it was tough for him, and he should be applauded for his response.