Report: Patient relationship management could curb readmissions

Readmissions ripe for PRM

An example that might appeal to buying teams is the inability to limit 30-day readmissions, a benchmark that is often a burr in the side of hospitals because it involves patients seeking follow-up care after a prior discharge. An unanticipated readmission within that time frame may reflect low-quality care under value-based care approaches, thus subject to less reimbursement from either insurance carriers or Medicare.

Brian Eastwood

Currently, care managers follow up with patients about their progress in the hopes of curbing readmissions. Patient relationship management could automate this process and make it more customer-friendly through frequent, but shorter, check-ins, Eastwood said.

Another way PRM could help is with healthcare organizations seeking to expand into outpatient and specialty care while keeping patients within their network. In such cases, PRM could use automated processes to assist a patient who underwent joint replacement to seamlessly transition to a physical therapy office for the next steps of recovery, according to the Chilmark report.

PRM's roots resound at HIMSS

The theme behind patient relationship management -- it's more than simply customer relationship management (CRM) for healthcare, Eastwood said -- was felt throughout last month's HIMSS 2018 conference. At the event, there was much discussion about how to improve a patient's journey through the full healthcare system, from initial symptoms to returning home.

Health IT buying teams will start to hear more about PRM as their organizations butt heads with problems not easily solved in-house.

Many vendors entering healthcare "see a lot of opportunity around customer-centric operational models," said Scott Richert at HIMSS. He is vice president of enterprise infrastructure at Mercy Technology Services, a division of Mercy based in Missouri.

Although he was not referring to PRM specifically, Richert noted that health IT vendors can serve as a doorway into better services for patients, such as through CRM-like systems that can help patients flow through the various stages of care.

Functions weave with patient behavior

Chilmark examined seven core functions of patient relationship management technology, which are familiar to many health IT professionals:

• care coordination;
• CRM enterprise and healthcare-specific activities;
• patient education;
• patient messaging;
• personal health records (PHR);
• portals; and
• revenue cycle management and practice management.

Often, patient care and follow-up efforts straddle several of the functions noted above. For example, providing patients with condition-specific care guidelines involves care coordination, education and PHRs.

"The tough part of it is looking at principles of behavior change and bringing them into application design," Eastwood said.

Diabetes prevention, for example, involves an intense, 16-week program with a lot of steps and check-ins. If one step doesn't go right with a patient, the error can derail a patient's adherence to the program, he said. The challenge in designing diabetes programs with PRM is to decrease those potential pitfalls along the way and understand how people interact with the technology.

Retail brands have good experience with consumer behavior, but tracking patient behavior is more complicated because it may require patients to change their actions in positive ways or stop doing something bad to improve health.

From a PRM point of view, the goal is to issue patient reminders and updates "without it being this overwhelming burden," Eastwood said.