Brand Loyalty Reigns

PACSman: In an “Oh, by the way” moment Tim Tebow, the University of Florida’s stellar quarterback, announced yesterday that he was staying to play at UF through his senior year. Thirty-five thousand people let out a collective sigh of relief waiting to hear the Douglas MacArthur - like words that were music to every Gators’ ears - “I’m coming back”- and then Ben Hill Griffin stadium erupted in cheers about his triumphant return. Everyone one wanted him back- and rightfully so. Here is a guy who had a chance to go to the NFL, but instead comes back to play college football for another year saying, “I just feel loyal to this place. I feel like a role model. A lot of times today, people start things and don’t finish them. I don’t want to be like that. I wanted to be loyal to the university and finish what I started and play another year…” So what does this have to do with PACS? As it turns out, quite a bit.

Only one out of four PACS vendors would be welcomed like Tebow was if they announced, “Oh, by the way, let’s do it again. I’m coming back.” Most clients would say “Thanks, but no thanks. Maybe you should try the NFL after all…” It is a sad reality, but nearly three out of every four replacement PACS goes to a new vendor rather than the incumbent. Why is their no customer loyalty to vendors?

The biggest reason there is no customer loyalty to vendors is there seems to be no vendor loyalty to customers. I’m reminded of the scene from the movie Hitch where the guy in the “power suit and power tie” tries to elicit Hitch’s help to “hit it and quit it” with the love interest of his dreams. That is the way too many vendors approach their clients any more - hit it and quit it. Hitch said no thanks, that’s not how he works, that his clients actually like women…and well….watch the movie to see how it goes from there…

Think about the last time you got a call from your sales rep when it was anything but to see what else they could sell you as an add-on or to collect on an overdue bill. That long huh? Ever had a vendor just call to say hi and not sell you a thing? I do that all the time, with clients, just saying hi and seeing how things are working out for them. They also call me with questions they have when they have them….and I always answer them - for free. I also do that with people who aren’t even clients yet - people who just have a PACS-related question they need answered. That approach has led me to get both more new and follow-up business than I ever imagined, with about half my business follow up on contracts from existing customers. It may not be next week, next month, or even next year, but it eventually almost always comes my way…

What fascinates me is the facts on existing customers are irrefutable. According to the statistics I’ve found, it costs five times more to acquire a new customer than to keep a current one. The probability of selling to an existing customer is 60 -70 percent. A 10 percent improvement in customer retention results in a 30 percent increase in the value of the company. And a 5 percent increase in customer retention can increase business profits by 25 - 125 percent. How can you improve on that?

Customers also need to feel that they are getting value from their relationship. I had one client who, with my help and after much haggling with the vendor, who cut their annual service costs in half and actually got better service than they had before…Too many companies also go with flat rate costs for installation, training, service, etc. without considering the clients needs. Some might actually need more than is being offered, but the vast majority often need less. And service? Most of that cost is pure profit….with more exemptions than you can shake a stick at…

So what incentives are needed for a client to re-up with a vendor? Feeling like they matter to the vendor, that they are more than a “hit it and quit it” account, and that the vendor is listening to their needs…Price is a consideration especially in these economic times, but value wins out over price almost every time…

Winning the deal is like bringing home flowers or taking the wife out to dinner after not doing that consistently for years. The same holds true for her providing you with your annual quota of lovin’ in a single month. Something’s up for sure….By regularly “courting” your clients, providing them with a value add and doing something for nothing, you can have a win-win situation - and maybe even put yourself in a three-peat situation like the Gators are no doubt poised to be in next year…

Ms. PACS: PACSman, that reminds me of what I keep hearing about radiologists creating value so that they do not become a commodity and end up just another service provider.

The question for PACS people is how to create that value, which you addressed pretty thoroughly. The fact is, creating value for the radiologist goes beyond PACS and here is where PACS vendor’s can tune in…a sophisticated ‘PACS consultant’ goes beyond the reading room and addresses the radiologists’ needs across the whole process because by improving the whole process, the radiologist can build value, and grow his or her referral base…and continue to buy PACS.

Where does value building start? Internally. In an interview I conducted yesterday with Paul Chang, M.D., who is now vice chairman of radiology informatics and medical director of pathology information at University of Chicago Medical Center, he couldn’t stress enough the importance of taking a holistic view of radiology workflow. Dr. Chang is working on a "closed loop imaging" research trial in collaboration with Philips. As he pointed out, radiologists
need to create value by improving efficiency and quality of care, and this takes more than just a good PACS in the reading room; it is done by looking at “the total information throughput,” as he called it. Dr. Chang explained that total information throughput involves efficiency in the imaging suite, in how exams are ordered and how reports go out. “You have to be efficient but also optimize quality. The whole purpose of closed loop imaging is to optimize the entire sequence, not just the one’s in the radiology reading room, not just the one’s in the scanning suite but the whole process.”

Next is building awareness externally. In an article that David A. Dowe, radiologist at Atlantic Medical Imaging, published in American Journal of Roentgenology,* he discusses how radiologists should create value amongst patients and referring physicians by boosting awareness of the radiologist’s role in the care cycle.

While Dr. Dowe was specifically addressing CT angiography and the ‘turf wars’ between radiologists and cardiologists, the need to build value goes beyond cardiac CT, especially with growing numbers of nonradiologists purchasing imaging systems. Some of these doctors send the images to radiologists to interpret, while others read the scans themselves.

Dr. Dowe emphasizes that radiologists should show the images and discuss future care with patients before they leave the office. He said, “Nothing is more effective anyway than your face-to-face meeting with patients and physicians and your images.” The same principle goes for PACS vendor-client relations. If you think you can ask someone to pay $250K for a computer program – and never see them again - either you’re either a con man or a ‘made’ man. No, you need to continue to foster the relationship.

Here is the quality part. Dr. Dowe stressed, “It is mission critical to go to the scanner and optimize image quality.” Yes, good image quality would help the cause. Plus, Dowe encourages radiologists to share the images with everyone – that means give patients and referrers the images on a CD and include “only images that they will understand and that tell the story that is your report.” He added, “Coronary CTA images are breathtaking and they sell themselves.” For PACS vendors, that means offer some kind of personal giveaway. Remember, as more patients catch on to the idea of personal healthcare records, these images will be sent electronically and patients will get their hands on more information. At that point, they morph from passive patients into what Dr. Chang calls ‘healthcare consumers’ - and we know how aggressive consumers can be.

Finally, the radiologist needs to educate the community. Dr. Dowe suggests hosting free public forums to discuss CCTA with patients and patient groups, and meeting with referring doctors - in person. For PACS vendors, it is known as advertising. Of course, if you’re clever enough to pitch a bylined article or pose as a public speaker, you might get your Ad for free.

Maybe PACS vendors and radiologists alike should take a closer look at Dr. Chang’s holistic view and Dr. Dowe’s dao on creating value – which works nicely with the Dalai’s dogma on PACS (doctordalai.blogspot.com). All of this Eastern philosophy comes down to one basic principle…it is hard to put a price on the true value of human relationships.


Reference:
Dowe, David A., How to Win the Coronary CTA Turf War. AJR 2006; 187:849-852. www.ajronline.org/cgi/content/full/187/4/849

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