CRM in healthcare: A look inside its muddled world

When Susan Taylor, vice president at patient engagement platform provider Pegasystems, starts to despair at the slow pace of CRM in healthcare, she tries to keep one thing in mind: "It took Amazon 20 years to help me buy a dress," she said. And she might have something there -- by some estimates a 20-year journey to CRM in healthcare may not be that far off the mark.

At a time when consumers want more control over their health and are increasingly willing to shop around for care, how providers approach patient relationship management (what many call healthcare CRM) has never been more critical. But while a myriad of technical solutions exist, implementation is far from straightforward, and the challenges of defining the space and blasting through the back-end silos of information are immense. There is little agreement on a name or even a concrete definition of what CRM in healthcare should include. Not surprisingly, it can be a lot for providers to wrap their heads around.

Tech solutions aren't ready to support healthcare CRM

"The CRM market is mushy," said Brian Eastwood, an analyst at Chilmark Research. "We think of CRM as just one subset of patient relationship management." But as Eastwood was quick to point out, patient relationship management could include everything from follow-up care after a hospital visit, appointment reminders, shared communication across a health team, marketing to prospective patients, condition management, an interactive provider directory or almost any other service that helps tie a provider to a patient. That's a lot of ground to cover and, according to a 2017 survey from Klas Research, the tech solutions available just aren't stepping up.

Though half of providers surveyed by Klas said technology helps with wellness, the research firm said the vast majority of solutions available today are shallow. "We are still far away from an ultimate vision that is often talked about: a world where even healthy individuals are actively collaborating with providers to stay healthy," Klas analyst Colin Buckley said.

Silos hinder interoperability

That vision is far away because traditional CRM is simply not equipped to deal with the reality of how healthcare works, said Kyra Hagan, senior vice president of marketing and communications at Influence Health, a CRM provider focused primarily on prospective patients.

Kyra Hagan

"If you have a discharged patient without a primary care practitioner, you want to follow up on the same day and get them in to a PCP and establish a relationship," she said. Although that sounds like a straightforward problem, it isn't, mostly because the data to make that happen is located in different silos within the hospital setting and the information might not be clean or compatible. "Most CRMs can't handle that," she said. "The market today is in a very mixed state of aspiration vision. [Hospitals] have different teams and fragmented data sets. And for that we're under-teched and over-tooled."

Hagan's not alone in her rather dark vision. Aditya Bansod, co-founder and CTO of CRM platform provider Luma Health, thinks healthcare is just at the beginning of a very long journey toward interoperability and free-flowing data. "Our company's long arc to getting better is about 20 years long," he said flatly. "We may be about two years in to it."

Appointment reminders a boon for CRM in healthcare

Brian Eastwood

You wouldn't hear much disagreement from Robb Malone, system vice president at UNC Health Care in Chapel Hill, N.C., who has first-hand experience with siloed data. The UNC network includes hospitals, practices, teaching facilities and ACOs with a total of more than 5,000 providers. UNC had been using spreadsheets to manage the physician rosters, provider location data and credentialing information, but given the size of the network, Malone realized it was time to create an up-to-date provider directory. The goal is to eventually push that directory out to patients so they can take ownership of choosing a provider and perhaps even tempt independent providers to sign on, Malone said. "But this is so much more complex than we expected."

It's so complex, in fact, that in many provider organizations, the expectations have been dialed back. Chilmark's Eastwood and Klas' Buckley agree the biggest successes for CRM in healthcare to date are in the relatively straightforward area of appointment reminders. For Buckley the reason is obvious.  "The market goes where the money goes," he said. "On the provider side, we are just starting to learn how this might work through various value-based payment models. In the meantime, providers invest where there is the most obvious return, such as using appointment reminders to cut back on no-shows."

The CRM market is mushy.

That strategy worked for Pediatric Associates of Stockton, based in Stockton, Calif., according to Beth Bettencourt, operations manager. The Solutionreach platform lets her and her team easily remind patients via text or email a week ahead of time and then again one day before an appointment, she explained. "We would have a lot more no-shows without it," she said. But even though Solutionreach offers other features, including surveys and online appointments, her practice sticks to direct communications only. "We send appointment reminders and let people know a throat culture was normal or send immunization records," she said. "We don't want to bombard the parents."

The lower expectations aren't surprising, Pegasystem's Taylor said. Yes, tech needs to catch up, but behaviors do, too, she said. "If you make a [dinner] reservation on Yelp you have to confirm it," she pointed out. "Imagine if doctors were allowed to do that."