Your Patient Pipeline on Autopilot!

June 25, 2018 Practice Administration 0

If you missed my interview with Fred Pira of ProNex Inc., I’m adding it to my blog today!

You are in for a treat today.  I have for you on the line Fred Pira. He is the CEO of ProNex Inc, which is a company that provides the tools that Bariatric Surgeons and Bariatric Programs desperately need. I know this because, not only do I run a busy Bariatrics Surgery Practice, but when I talk to and consult with Bariatric programs all around the US, it’s one of the most common concerns that they have. Fred Pira produces the tools in order to do this. I’m not going to steal his thunder, but I’m going to introduce Fred and let him tell you a little bit about his background and how he’s built his business and career around these tools to help Bariatric Surgeons and Bariatric Programs succeed. Fred, if you can tell us a little bit about your story, that would be great:

Fred: Thanks you so much Karol.  What a pleasure it is to be here with you today and have a chance to share our story with your audience. I appreciate that very much. We started 18 years ago. I had been working for a very large soft wear company. I had been working out like a mad man.  I was frustrated on how I was feeling. I probably had been logging 180 miles of aerobic activity a month. I was OK. I was faced with the challenge of keeping my weight off, but I just wasn’t feeling right. So, I went to go see a doctor who ran some tests and said I was insulin resistant. We started out talking to the certified nutritionist. My assignment was to meet with her once a week. I thought there could be a better way. I was selling soft wear to the large organizations like Eli Lily, Walgreens, Caterpillar, John Deere that would track just a multitude of tasks and so forth. I would be able to do that in a very seamless way leveraging technology. When I reached the point of total frustration I thought there has to be a better way to provide this information. I had no intention of building a soft wear company whatsoever. I went out to search for a better way and could not find it. That was the ability to capture information and share it seamlessly with the health professional at the other end. At the time .net was not really developed too much. We started it out with a vision. I met with a group of certified nutritionists that were very interested in what we were doing. We got lucky and collaborated with the University of Chicago Bariatric Department.  We began to build the soft wear tool that went way beyond what we had. It actually turned into an EMR for Bariatric Surgical Practices. That brought us to where we are today having patient flow and referral flow. Patient flow is a very strong tool that solves a problem. So, we’re talking to a number of Bariatric Surgical Practices. We have proven that the tool works. It’s patient relationship management at its very best. It helps to remove all the obstacle that are in the continuum of care the bariatric surgical practice is facing.

Karol:  I’m going to let you share a few things about patient flow, but can you tell me a little bit about what differentiates your program from some of the other things that are out there?

Fred: Sure. One of the key parts of the value proposition that we have to vet out almost from the very beginning is having a very clear process that we go through. We generate interest, we have a conversation with the interested party, we provide an assessment that allows us to see scoring, and then we put together a demo based on that. So, that’s the very beginning. The second part of that process that differentiates us from everyone else is our ability to go ahead and be very interoperable friendly. We do not encourage that they change their EMR or get another EMR unless they’re completely dissatisfied. We encourage a very detailed plan to evolve into a statement of worth that provides a very high level of interoperability in multiple systems, that allows a seamlessness to take place and allows the practice to eliminate all their excel sheets and provide them with soft wear with a click of a mouse. The can get reports, they can find out what their surgery conversion rate is, and they know where the payers are. So when you look at this in its entirety, and how seamless it is, that’s one of the key differentiators and a huge part of our value proposition when we’re presenting to Bariatric Surgical Practices.

Karol: I like the fact that it’s more customized. It’s not just one single thing. The other thing is that you show how a return on investment is realized. Some practices get too involved in the marketing aspect. But for me I thought it was so exciting that you can actually track your return on investments for your marketing. You can track where all your leads are coming from. It’s very different from all the things that I’ve seen.  I’ve seen just about everything. If you don’t mind I was going to see if you might be able to demonstrate a few of those aspects.

Fred:  Absolutely. Here’s our screen.  This is our dashboard. We typically have a conversation around what you see on the left, and that is our key performance indicators. We also share that we’re about 80-85% already baked off the shelf.  What is very unique about what we do is that we take 15-20% of the product to the customer and we begin to ask a lot of questions to develop a statement of worth that provides a very customized, specific application with reports and so forth. That shouldn’t scare anybody away. It allows them to have a deliverable that brings a great deal of satisfaction. We think that it’s important to dig deep in an assessment from the very beginning to be able to provide a deliverable that’s going to make them very happy. These key performance indicators track the leads that come in every day. On any given time you can pull up reports on that.  You can pull up the surgeries and where they are on the continuum of care. In the pipeline how long does it take them from the moment that they fill out information? And how long does it take to get the initial consult and move on to a scheduled surgery? As you can see in this one are, we have the ability to track what the referral source is, what the count of family and friends is, and referral sources from the internet and TV. So it gives very specific ways to determine cost of acquisition of the patients. The cost of acquisition could be very high, so at the end of the day when you get the reimbursement, if you’re not able to take your expenses out to determine what your net is, it’s just revenue coming in to the practice. It’s not a bad thing, but it’s important to measure that. Secondly, we can drill down on the pay per click. You want to take a look at any of the activity in terms of your various locations that you’re doing marketing (website, google, FB). We’re able to measure the count and what percentage of those leads come in. And we’re also able to measure the ability to determine what the cost of acquisition is and to determine what point in time they are scheduled for surgery and post-surgery.

Karol: This is so important.  I’m a big numbers girl. So making sure they can track where all their leads are coming from, are they getting a return on their marketing, once they come in what’s their conversion rate, which ones aren’t converting, which ones do you need to pay more attention to? This is so exciting. I’ve never seen anything available that can show you that. A lot of practices might look at this and think, “That looks really great but we’re really crazy busy and I don’t have time to add another element into our practice.” Talk a little bit about the timeframe for having this become live and making it happen in a practice.

Fred: Sure. I think that if more practices have the mind set of integrating best practices in terms of business they’ll be able to yield more from the reimbursements and not get frustrated and say, “I’m going to sell it to the hospital.” I am really very passionate and have an enormous interest in entrepreneurs who set out to try and build an organization. If the right tools are brought to the table, they could be very successful because they’re measuring the right things. We have an acronym: Measure, Analyze, and Improve. If you can capture the information, analyze it, you can measure it, you can improve on it. So with the continuum of care, each step needs to be analyzed. IT’s very important to take a look at that data, and to be able to do it by clicking a mouse for a report. This product has been in development for the last five years. We just decided to bring it to the marketplace because we saw an enormous problem. We’ve been hearing about it for quite some time. What we’ve seen is a very high level of frustration when they get to a certain level of surgeries they try to do the best they can with the tools they have (using multiple Excel sheets), but during peer-to-peer meetings it’s very difficult getting that information out. It’s really not productive. It causes a high level of frustration. So we didn’t just go create a piece of soft wear to go sell. We identified a problem that had a need that we have brought this solution to. One of the key things that we do upfront is use a patient flow simulator (calculator). You can see it on the Pronex website under patient flow. The purpose of this is to determine if we’re the right fit for you or you’re the right fit for us. You may only be doing 50 surgeries a year and we may not be the fit for you. Those considerations are made. We take in a very careful group of assumptions that allow us to determine what a potential ROI is.  When we open up this calculator and we show this to practices, it’s hard to believe how many efficiencies we can drive to their bottom line. They are very surprised.

Karol: If you think about that whole pipeline, and how often people get lost in the shuffle, or delayed because of something like a psychological evaluation, the process gets delayed if you don’t have that streamlined process. The other thing I see is that a lot of practices have a lot of marketing campaigns going, and they put a lot of money into those marketing campaigns. Yet, it’s really hard to get those numbers, unless you have someone in the practice dedicated to that. But that’s unrealistic as well. There certainly does seem to be a lot of ways to streamline that process. You and I are both very committed to the patients’ outcome. It’s the most important thing obviously. What’s the impact for the patients when the practice is using this system?

FRED: That’s a great question. Understanding the emotional part of the process and the decision-making process is something you have to consider. It’s not just the bariatric surgical procedure.  There are so many different areas that you have to be focused on. You have to be available, whether it’s leveraging technology or taking a phone call for the patients.  Let’s face it.  The staff at these bariatric surgical practices only have so much to work with. It only makes sense to leverage technology so you can be in contact with the patient.  How do we become more efficient and help to reach out to them so that we can move them through the continuum of care in a very comfortable way? The behavioral change process and the educational processes all have to be in play in a very seem less way. How do we do that? We know we’ve cracked the code on that. We know that we can provide the soft wear that helps in that effort. I’ll give you an example. We had a customer that put out a marketing campaign for a balloon.  They got 600 leads in. They had a need to inquire about how the follow-up was going. They weren’t getting the results they had expected. We ended up having a conversation with him. I asked him if he pulled up the report.  He asked, “What report?”  I asked when the advocate had gotten back to him. We found out that the average time that they got back to these potential prospects /patients (which is considered leads), was 45 days! Because of the price point on the balloon and the ability to go shop that, 600 leads were very perishable, and a lot of them had fallen through the cracks. They really saw the value and the power of being able to drill down on the data that they’re collecting, analyze it, and then make the changes.

Karol:  As you said, you need to respond to them very quickly and help nurse them through that decision-making process. They’ll either decide it’s not for them or they’ll go find another provider.

FRED: Absolutely! We see that happening all the time.  We ask clients how many patients they think have fallen through their pipeline. The response it, “ohh… a lot!” We ask them if they know where they are at any given time.  The client’s response is, “Some of them.”  We ask them if they know what their conversion rate is. As we walk through the key performance indicators we find out that they are really good at compliance, and they’re really good in other areas. But they’re not good when it comes to following that patient through the continuum of care and having the ability to text message them, e-mail them, and contact them. Everyone is looking at their I-phone.  So why not leverage that? Contact these people, which show them that you really care. What better relationship to have with health care than the doctor or healthcare staff member that can talk to the patient or have some kind of conversation with them?

Karol:  The bottom line is you and I both know their heart is in the right place. They want to be able to communicate with people and have the right tools to be more efficient and make it so it’s not a burden on their staff. That’s really important.

FRED: They’re a very passionate group of people in health care. I was brought up by a health care family (doctors, surgeons, hospital executives).  I said there would be no way that I’d ever be involved in that because just going to see my Dad in the hospital was painful enough. So, I got a big surprise! I’m now calling on them. I gotta tell you. I always wanted to be rock star. But there is nothing else that I’d rather be doing than building this company and serving this particular population.  With these people, once you’re in, you’re in. If you do a good job and you have a good deal of respect for what they do for the patients, and how these lives are changed, it’s such satisfaction.

KAROL: Yes, we’re totally on the same wavelength there. Tell me about what you see for the future as health care continues to evolve.

FRED: We’re positioned to provide services but I do think the whole are of patient relationship management is absolutely key.  There are so many other services that bariatric surgical practices can offer to their patients, and even extend that out further. Keep in mind that the patient should be at the very center of everything we do. Then, take the technology and be able to make it very friendly so they can access information like a Google search. The ability to have that kind of connection is critical. Another area that is going to be absolutely critical is this whole area of interoperability. We’ve seen practices change 3 or 4 different EMR’s. That’s just not necessary. We know that’s there’s no one Holy Grail out there. There’s no system that’s going to provide everything.  IT’s a multitude of tools that come together for your personal tool box. If you have the right guidance and the right business practices and the best methods, you can put together a pretty powerful tool box that could generate additional revenue that help keep you focused on your patient and help you to avoid additional full-time employees. Use leverage technology to the point that you need it and when it’s time to hire another full-time employee, and then bring them on.

KAROL: I agree that patient engagement is really important and adding additional revenue streams. I think leveraging technology while still maintaining that personal touch is important. It differentiates practices, one from the other.  Those were really good points. There are a lot of different people that listen to the podcasts. Some are established practices. Others are just starting out their practice. What would be the one piece of advice you would give to those people just starting out their practice?

FRED: This is how I started:  think big, start small, move fast. I think that mantra has served me very well. I can’t boil the ocean in a second, but I would be very laser focused on what you do well. Be aware of the competition. Try to drive efficiencies into the business. A lot of health professional are very good at the relationship between the patient and the doctor. Sometimes that can be to a detriment. I think you have to take into consideration the business part, the corporate part, human resources, and most definitely take a look at the relationship of the patient. You may start out small. The things that you’re doing, Karol, with the Profit centers are absolutely critical. Sometimes it just takes up so much time to just take care of the day-to-day. Have conversations with vendors. Consult with people that have been very successful. Take a look at what they’re doing and then adapt to it. It’s that time frame for adoption when you first start out. I talk to a lot of bariatric surgeons and physicians and when they first start out there’s a resistance and hesitation to move forward with tools that are going to be healthful. They think they can do it all themselves. As we know, you can’t do that. Surrounding yourself with wise counsel and the right team is absolutely critical. Also, identify what the core competencies are of each one of them so you can be successful at growing your practice. The last thing you want to do is invest for 5 years and then decide it’s not for you and go work for someone.

KAROL: That’s great advice. One of the things I’m really big on is personal development because as you grow yourself throughout your career it can bring great success or it can bring problems. I’m wondering from your perspective if you could share some of your personal habits that have made you a success.

FRED: Well, golf is definitely one part of it!! Smoking a cigar is the other part of it! No, I surround myself with people who have like-mindedness. In terms of the business, I’m engaged in discussions in how we can get better at what we do. I love collaboration. If you pressed me and asked me what the one thing it would be tenacity. It’s a determination to set aside anything else other than living out your passion for a particular subject, a business, or something that your heart really beats for. I wake up early in the morning and I can’t wait to begin my day. Yes, it’s filled with challenges and so forth. But at the end of the day I know I’m doing something that’s going to have an impact on people’s lives. If you can align yourself with what your passion is, that’s great. I had a conversation with a friend of mine that runs a company a few days ago. He has to go in for eye surgery. I began to think about how somebody has dedicated their entire career to doing surgery on the eye! Removing the cornea and replacing it with another cornea, or doing bariatric surgery is serious stuff! These people have committed their entire life to this.  You’ve got to ask the question, “What is it about that?” The one thing that surfaces to the top is tenacity, a balanced life as much as you can accomplish and loving what you do. If you can find out what you love to do and you can stick to it without worrying about the money, the money will follow.

KAROL: Good advice! You have shared some very inspirational thoughts today and offered some great business advice which I really appreciate. One of the things I like about you is your passion and your integrity. I was wondering if you could share a little bit about how people can ask additional questions or have an evaluation in their practice. How might they get a hold of you?

FRED: You can find me on Linked In. Fred Pira. My company is PRONEX, Inc. You can go to our website and look under our solutions and there are a number of places that offer an opportunity to have a discovery call or have an assessment done.  Simply go to:
you can go to either one of those locations and someone from the team can reach out to you.

KAROL: Well, that’s exciting.     I just really believe in your services. I guess I see the immense value of the services you are offering. I’m also stoked about the fact that your patients can interact basically with any EMR that somebody has in place.  So that’s pretty cool too.

FRED: I might add one more thing on that note Karol. Whether you’re an independent practice or part of a hospital system, we are very appealing and helpful to any of those types of organizations.  So it’s not just the independent surgical practice that finds our tools helpful.  It’s also hospital systems.

KAROL: Right. Both large or small-making that integration very easy. So if I’m out there and I find something that a great valuable resource I feel it’s my duty to share it with people. I’m really excited to get to know you and your products better. I really appreciate you taking the time out of your busy schedule to share your advice and share what you have going on in your corporation. I really appreciate it, so thank you so much.

FRED: Thank you Karol.  We appreciate it too. It’s been a pleasure.

KAROL: Have a great week everybody. Keep doing all the awesome things that you do for your patients. I look forward to hearing from you. If you have any questions about what we discussed today or about the 5 profit engines e-mail me at: