Healthcare · Discovery Call
Discovery Call Questions for Healthcare: A 25-Minute Playbook for CMIO and Clinical Ops Calls
You have 25 minutes with a CMIO who blocked the time between a governance meeting and an in-basket cleanup session. She already knows your one-liner — that's why the invite exists. If you spend the first two minutes on logos and funding, she'll be polite, she'll answer in short sentences, and she will not take the second meeting. The people who buy in healthcare are diagnosticians by training. They will notice immediately whether you're taking a history or reading from a script.
The surface symptom will land in the first two minutes and it's almost always the same one: pajama time. Ninety-plus minutes of after-hours EHR time per provider per day in the audit log, chart closure sliding past 72 hours, two family medicine docs who just went to 0.8 FTE. That's layer one and it's worth almost nothing — every vendor on their calendar this month heard the same sentence. What you're after is the mechanism (which specialties, which EHR workflow, who's actually touching the note between the visit and the lock), the cost (turnover at 10–15% where every point is six figures, downcoded E&M levels, HCC conditions that never got recaptured), and the stake (what the Chief Medical Officer promised the board, and by when).
This playbook gives you the clock, the discovery call questions for healthcare buyers that actually open people up, the objections you will hear from an Epic shop with a scribe vendor in the graveyard, and a close that survives an EHR governance committee that meets monthly. Read it, write the five time markers on your notepad, and dial.
The discovery call script
Say it in your own words. The structure is the part that matters.
- 1
0:00–2:00 — The frame (do not re-pitch)
"Thanks for the time. I'm not going to re-explain what we do — you saw that already, and I'd rather spend the 25 minutes on your shop than on mine. When we traded emails you said [their exact phrase — 'our primary care docs are drowning in the in-basket' / 'we're at 15% no-show in behavioral health'], and that's the thing I want to dig into. Fair warning on how I run these: I'll ask a lot of questions for the first fifteen minutes and I won't show you anything. I'd honestly rather tell you this isn't a fit than burn a demo slot on your calendar and mine. Still good for 25? And before I start — is there anything you want to make sure we cover, so I don't run us out of time?" If they say "mostly I want to know how you handle Epic integration and whether you sign a BAA" — write it down. You now know this call ends with a technical follow-up, not a business case, and you should plan minute 20 accordingly.
- 2
2:00–6:00 — Layer 1 to layer 2: get inside the workflow
Open one thread. One. - "Walk me through what a Tuesday looks like for one of your family medicine docs — from the first rooming to when the last encounter locks." - "You said pajama time. When you pull the audit log, what's the actual number per provider per day, and how spread is it — is it everybody at 45 minutes or a handful of people at two hours?" - "Which specialties are worst? I ask because ortho and behavioral health usually look nothing like primary care on this." Then the three follow-ups that get you the mechanism: - "Where in the visit does the note actually get written — during, between patients, or all at night?" - "Who else touches that note before it closes? Is there a scribe, a coder query, a CDI review?" - "What's the workaround your best documenters have built? There's always one person who's figured it out." Do not say "we automate that." Not yet. If you kill the thread at layer one you'll leave with eight symptoms and no deal.
- 3
Minute 6 — "So what do you actually do?" (the trap)
It always comes here and it's a fair request. Give 30 seconds tied to what they just said, then hand the ball back. "Short version — we take the note off the physician's hands so your family medicine docs aren't reopening charts at nine at night, and it launches from inside Epic rather than as a separate window. But whether that's actually useful to you depends on something I don't know yet: [next question]." If they push a second time, they genuinely need orientation. Give a clean 60 seconds — mechanism, integration path, where you're live in production — then: "Can I go back to the thing you said about the in-basket? That's the part I'm not clear on." Almost everyone lets you.
- 4
6:00–11:00 — Layer 3: the cost, and "how do you know?"
- "How many providers are we talking about across the group, and how many are in the worst cohort?" - "What's your chart closure rate inside 72 hours right now? And is that trending anywhere?" - "What's your physician and APP turnover looking like this year? Everyone I talk to is somewhere in the 10 to 15% band and every point of that is six figures by the time you count recruiting and the ramp on the panel." - "When a family medicine doc leaves, how long does the seat sit empty — recruiting plus credentialing?" Then the beat most reps skip: - **"How do you know?"** Ask it flatly, not challengingly. If they can cite the audit log, the exit interviews, and the Press Ganey provider communication scores, you have a buyer who can build a business case. If they say "honestly it's anecdotal, it's what I hear in medical staff meeting," that's a finding too — it means your first job is helping them instrument the problem, and your pilot needs a baseline measurement built in. If revenue cycle is in the room, run the parallel thread: "What share of your denials are documentation-driven versus prior-auth? And where's your first-pass clean claim rate sitting?" Then: "Who owns the downcoding conversation — is that RCM, or does it land back on the CMIO as a burnout issue?" That question tells you whether you need two sponsors.
- 5
11:00–16:00 — Layer 4: the stake
This is the layer that moves deals. Slow down. - "Who's feeling this most right now — is there a specific site or a specific division chief who's escalating?" - "Whose number does this show up in at the end of the year? Yours, the Medical Group President's, the CNO's?" - "What did you commit to the board or to medical staff leadership, and by when?" - "If it's still exactly like this in twelve months, what's the conversation you're having?" Then **count to three.** Do not fill the silence. The sentence that matters — "we lost two of our four physicians at the west clinic and I'm not sure the third is staying" — arrives in the gap you leave.
- 6
16:00–20:00 — Qualify the path (weave it, don't recite it)
- "If you decided this was worth doing, what actually happens next in your world? Does it go to the EHR governance committee, or is there a clinical informatics review before that?" - "When does that committee meet, and what have they approved or rejected in the last two cycles? I'd rather know what they said no to." - "Who owns third-party risk here, and how long did the last clinical vendor take to get through security review? We sign the BAA as standard, I just want to start that clock in parallel rather than after." - "Have you tried to fix this before? What happened?" — the scribe vendor in the graveyard is your real competition. - "What's forcing the timing — a contract year, a medical staff commitment, a MIPS deadline, a recruiting cycle?" If nothing is forcing it, you have a pleasant conversation, not a deal. - "Is this a line item that already exists — clinical informatics, physician retention, RCM — or would it have to get created?" Far more useful than "what's your budget." - "What happens if you just keep doing it the way you're doing it?"
- 7
20:00–23:00 — Targeted relevance (90 seconds, only what they raised)
No tour. Speak to exactly the two things they named. "Two things from what you described. First, the toggling problem — this launches from inside the chart via SMART on FHIR, so it's in the same window, no second login. Your informatics analyst will want to see the build; I'd rather show them than argue it with you. Second, the adoption question, because you already lost a year to a scribe vendor. We measure weekly active use per provider during the pilot and we'll agree the threshold up front. If we're under it at day 60, we pull it out — I'd rather that than be the second vendor your medical staff stopped trusting." Stop. Let them respond.
- 8
23:00–25:00 — Playback and the dated next step
**Playback, three sentences, their words:** "Let me make sure I've got it. Your primary care and behavioral health providers are averaging about 90 minutes of after-hours EHR time a day, and the reason is that nothing gets documented during the visit because the in-basket eats the between-patient gaps. Two docs have already gone part-time and you told the Medical Group President you'd have a plan before the fall recruiting cycle. Did I miss anything, or get anything wrong?" **Then prescribe, don't offer:** "Based on that, the useful next thing isn't a demo for you — it's 45 minutes with your Director of Clinical Informatics and whoever owns the security questionnaire, where we walk the Epic build and start the BAA and vendor review in parallel. Then a separate 30 with you and your Director of Revenue Cycle, because the downcoding piece is half the business case and you only own half of it. I've got Tuesday at 2 or Thursday at 8. Which one, and who should I put on it?" Send the invite before you hang up. Confirm out loud: who's attending, what you'll show, what they'll bring — a de-identified audit-log export of after-hours time by specialty is the single most useful artifact for call two.
- 9
What goes in the CRM
Their words, verbatim. Not your paraphrase. - "Audit log says 94 minutes average after-hours, worst cohort is family medicine at the two south clinics, over two hours." - "Lost Dr. [name] in March, seat still open, credentialing is 100+ days here." - "Epic shop. Governance meets first Tuesday. Rejected a symptom-checker tool in Feb because nobody from medical staff sponsored it." - "CMIO said: 'I don't need it to be perfect, I need it to still be running in month four.'" That last quote is your entire second-call strategy, your business case framing, and the first line of your follow-up email.
How the call actually sounds
Prospect on the left, the rep on the right.
Rep
Thanks for the 25. I'm not going to re-explain what we do — you already saw that. When we emailed you said your primary care group is "living in the in-basket." That's what I want to dig into. Before I start, anything you want to be sure we cover?
Buyer
Two things. We're an Epic shop, and Epic has ambient documentation on their roadmap. So mostly I want to understand why I'd sign a contract for something my EHR vendor says is coming. Also I've got a hard stop at the top of the hour.
Rep
Both fair. I'll get to the Epic question directly, I just want to earn it first. Walk me through a Tuesday for one of your family medicine docs — from the first rooming to when the last encounter actually locks.
Buyer
Twenty-two on the schedule, fifteen-minute slots, double-booked twice because of no-shows. They don't write notes during the day. They write them at night. That's the whole story.
Rep
When you pull the audit log, what's the actual after-hours number per provider per day — and is it everyone at 40 minutes, or a handful of people at two hours?
Buyer
Group average is around ninety minutes. But it's not evenly distributed. Family medicine at our two south clinics is well over two hours. Ortho is fine. Behavioral health is its own disaster for different reasons.
Rep
So the between-patient gaps that should absorb documentation — what's eating them?
Buyer
Results, refills, patient messages. The in-basket. And prior auth chasing, because our referral coordinators are short-staffed and the docs end up doing peer-to-peers themselves. So the note is the thing that gets deferred, every time.
Rep
That's useful. What's chart closure inside 72 hours looking like as a result?
Buyer
Not where it should be. Look, I've heard this diagnosis from four vendors. I don't need help identifying the problem. We tried a scribe service two years ago and half the physicians stopped using it inside a month. So what's different?
Rep
Before I answer that — what actually killed it? Turnaround time, note quality, specialty coverage, or was it just optional?
Buyer
Turnaround, mostly. Notes came back the next morning, sometimes two days. By then the doc had already written it themselves. And it was optional, yes. Nobody was going to make medical staff do anything.
Rep
That's the diagnostic answer, thank you. Different question — what has this cost you in people? What's turnover looking like across the physicians and APPs?
Buyer
About thirteen percent last year. Two family medicine physicians went to 0.8 FTE, which doesn't show up in the turnover number but costs us the same in panel coverage. One left outright. That seat's been open since March.
Rep
How do you know the charting is why?
Buyer
Because it's what they said in the exit interview, verbatim. And because I sat with one of them and watched her open her laptop at 8:40 at night with her kid on the couch. That's not a survey finding.
Rep
…Who's feeling that hardest right now, besides you?
Buyer
Our Medical Group President. He committed to the board that we'd have a burnout intervention in place before the fall recruiting cycle, because we can't recruit into a group where the story on the street is that everyone charts till nine. And our Director of Revenue Cycle has her own version — she thinks the rushed notes are why we're getting downcoded on E&M and missing HCC recapture. She calls it a coding problem. I call it the same problem.
Rep
That's the whole business case in one sentence, and it's yours, not mine. On Epic — they will ship it, and it'll be solid for an average primary care note. The question is what your south clinic docs do for the next eighteen months while it's in early adopter release, and how it handles behavioral health, which is usually where native tools are thinnest. Do you know which release your instance is on the roadmap for?
Buyer
No. Our Epic TS would have to tell us, and I'd guess it's three releases out for our footprint. That's a real point, I'll concede it.
Rep
Then here's what I'd propose, and it's two meetings, not one. Let me make sure I have it first: ninety minutes of after-hours time on average, two-hours-plus in south family medicine, driven by the in-basket and prior auth eating the between-patient time. Thirteen percent turnover, one open seat since March, and the Medical Group President has a board commitment before fall recruiting. Downcoding and HCC recapture is the revenue cycle half. Did I miss anything or get anything wrong?
Buyer
You missed governance. Anything touching clinical workflow goes to the EHR governance committee, they meet the first Tuesday, and they will not approve a vendor who shows up without a physician sponsor in the room.
Rep
Then let's build the packet for that meeting rather than pitch it. Forty-five minutes with your Director of Clinical Informatics to walk the SMART on FHIR build and hand your security team the completed questionnaire and BAA so that clock runs in parallel — Thursday at 8. Then thirty minutes with you and your Director of Revenue Cycle on the downcoding half. And before governance, I'll get you a reference call with a CMIO on Epic who took this through the same committee. Does Thursday at 8 work, and is it [name] I should invite?
Buyer
Thursday at 8 works. Send it to both of us. Bring the security questionnaire — if that stalls, nothing else matters.
Objections you will hear
What they say, and what you say back.
| Objection | How to answer it |
|---|---|
| “If it doesn't live inside our EHR, clinicians won't touch it. They're not toggling to another window in a 15-minute visit.” | Agree immediately — anything that adds a login is a dead product. Then be specific enough that they can check you: name the mechanism (SMART on FHIR launch, sidebar embed, whatever yours actually is), name the health systems on their EHR where you're live in production, and offer to walk their Director of Clinical Informatics through the build on a technical call rather than debating it with the CMIO. Then flip it: "What's the last third-party tool that actually got adopted inside the chart here, and what made that one work?" Their answer tells you the real integration bar, which is almost always cultural rather than technical. |
| “Patient data. Legal will need a BAA, and we'll have to run you through a full security review.” | Never resist this — it's a qualification signal, not a stall. "Of course. We sign BAAs as standard, here's the SOC 2 Type II and our HITRUST status, and here's the completed vendor security questionnaire we've already submitted to two other systems on Epic." Then ask the question that actually moves the deal: "Who owns third-party risk review here, and how long did your last clinical vendor take to get through it?" If the answer is 90 days, you've just learned your close date — and you can start the review in parallel with the pilot conversation instead of after it. |
| “Our operating margin is under two percent. There's no budget for anything that isn't billing or compliance.” | Stop selling software and start selling a P&L line they already own. Two levers work here. Physician retention: "You said turnover's around thirteen percent and one open family medicine seat since March. What did the last replacement cost you all-in, once you counted recruiting, credentialing, and the ramp on the panel?" And throughput: "If a provider gets 45 minutes back a day, that's one to two more visits — what's your contribution margin per encounter?" Make them do the arithmetic out loud in their numbers, not yours. The business case has to be in their handwriting to survive the CFO. |
| “We tried a scribe vendor two years ago. Half the docs stopped using it after a month.” | Ask what killed it before you defend anything — turnaround time, note quality, specialty coverage, or that it was optional. It's nearly always one of those four and the answer is diagnostic. Then reframe adoption as something you own jointly: name your weekly active-use threshold, propose measuring it every week of the pilot alongside after-hours EHR time and chart closure rate, and offer an exit clause — if you're below the threshold at day 60, you pull it out. Physicians trust a vendor who volunteers an exit more than one who promises success. |
| “Anything touching clinical workflow has to go through our EHR governance committee, and they meet monthly.” | Don't route around it — get on the agenda and get your sponsor to co-present. Ask three things: what has the committee approved and rejected in the last two cycles and why, what goes in the submission packet, and who on the committee is the skeptic. Then arm your champion before the meeting with the one-pager, the pilot measurement plan, and a completed reference call with a CMIO who went through the same gate. Deals die in governance because the sponsor walked in alone holding a vendor deck. |
| “Our EHR vendor says they're releasing something like this natively next year.” | The honest answer beats the defensive one: "They will, and it'll be fine for the average primary care note. The question is what your south clinic family medicine docs do for the next eighteen months while it's in early adopter release." Then ask which of their instances is actually on the roadmap and when — usually nobody knows, or it's three releases out. Then ask about specialty coverage. Native tools tend to launch strong in primary care and thin in ortho, derm, and behavioral health, which is exactly where the after-hours charting is worst. |
| “We'd have to get patient consent to record, and our state is two-party consent.” | Have this ready before they raise it: the standard consent language other systems use, whether it's verbal at rooming or written into the intake packet, and exactly what the product does when a patient declines. Offer to share how two or three comparable systems operationalized it — most handled it as a one-line addition to the existing consent-to-treat and the front desk barely noticed. It's usually a legal reflex rather than a blocker, but only if you don't fumble it on the call. |
Questions reps ask about this call
- What are the best discovery call questions for healthcare buyers like a CMIO or VP of Clinical Operations?
Start with one workflow thread and follow it three levels down rather than asking five surface questions. The highest-yield openers: "Walk me through a Tuesday for one of your family medicine docs, from first rooming to encounter lock." "When you pull the audit log, what's the after-hours EHR time per provider per day, and how is it distributed by specialty?" "Who else touches the note before it closes?" Then the cost layer — turnover rate, chart closure inside 72 hours, open seats and credentialing time — followed by "How do you know?" Then the stake: "What did you commit to your Medical Group President, and by when?"
- How do I get past layer one when every healthcare prospect opens with "our docs are burned out"?
Burnout is the free answer everyone gives. Convert it into a number and a location in the workflow. Ask which specialties and which sites, ask what's eating the between-patient gaps (usually in-basket volume and prior auth chasing), ask who's already found a workaround. The mechanism is where the deal lives: a CMIO who tells you "family medicine at the south clinics is over two hours because the referral coordinators are short and the docs run their own peer-to-peers" has just given you the pilot scope, the sponsor, and the business case.
- Should I ask about budget on a healthcare discovery call?
Not as "what's your budget" — with operating margins commonly in the 1–3% range, that question invites a no. Ask instead whether the line item exists: "Is this something that would come out of clinical informatics, physician retention, or RCM — or would it have to get created?" Then size it against a number they already own: cost per replaced physician, contribution margin per encounter, or denial rate on documentation-driven claims. You want their arithmetic, not your pricing page.
- How do I qualify the buying process when the EHR governance committee only meets monthly?
Treat governance as the deal path, not an obstacle. On the discovery call ask: when does the committee meet, what has it approved and rejected in the last two cycles and why, what documentation does the submission packet require, and who on it is the skeptic. Also ask who owns third-party risk review and how long the last clinical vendor took to clear it — that number, plus the committee cadence, is your close date. Start the BAA and security questionnaire in parallel with the pilot conversation, not after it.
- Why do healthcare deals need two sponsors, and how do I find the second one on a discovery call?
Because the problem is split across org lines. The CMIO owns after-hours EHR time and physician turnover; the Director of Revenue Cycle Management owns denial rate, first-pass clean claim rate, and downcoded E&M levels — and those are the same rushed note. Surface the second sponsor with one question: "Who owns the downcoding and HCC recapture conversation here — is that revenue cycle, or does it land back on you as a burnout issue?" Then book them separately. A single-sponsor deal in healthcare tends to stall the first time the CFO asks who else validated it.
- What's a strong next step to close a 25-minute healthcare discovery call?
Never "I'll send some information." Prescribe two dated meetings based on what you heard: 45 minutes with their Director of Clinical Informatics to walk the SMART on FHIR build and hand over the completed security questionnaire and BAA, and a separate 30 minutes with the Director of Revenue Cycle on the documentation-and-denials half. Offer two specific slots, name the attendees out loud, ask them to bring a de-identified audit-log export of after-hours time by specialty, and send the invite before the call ends.