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Health Plans

Lessons Learned from the Retail Industry

September 11, 2018
Healthcare needs to leverage the best of retail and CRM techniques to better understand patients. Our health, patient satisfaction and patient engagement depend on it.

Let me say at the outset that referring to patients as customers and drawing parallels between the healthcare and retail industries may make some uncomfortable, but bear with me; physicians, hospitals, health plans and especially patients all stand to benefit.

I recently had the privilege to collaborate with and learn from a panel of healthcare and retail industry IT leaders. One of the key takeaways for me: despite differences in terminology, there are similarities between the healthcare and retail industries as to how the two industry verticals personalize their approach to filling customer needs.  

As anyone who shops knows, retail clearly has mastered methods of personalization. They incorporate your in-store and online shopping behavior, even the time of day you’re likely to open emails or respond to text messages, to send you updates about products of interest. They email targeted sales promotions based on your ‘likes’ and the offers you’ve previously accepted.  

Healthcare has traditionally centered around the doctor-patient relationship. Clearly the nature of the doctor-patient relationship differs significantly from the standard relationship retail brands have with their customers; however, there are many similarities. After all, a patient - the customer of one or more physicians - benefits when they are comfortable with their doctor, otherwise known as the vendor, and have a trusting relationship. Similar to retail, a lasting relationship and loyalty also are beneficial for physicians.  

Increasing Consumer Expectations of Healthcare

As retail capabilities have improved, we as consumers have increased our expectations of healthcare; we expect convenience for scheduling appointments, communicating with our physician and care team and avoiding long waits in a doctor’s waiting room. Unfortunately, many of us continue to have experiences similar to one of my recent interactions with the healthcare system. Long story short, my physician practice and health plan never coordinated to authorize an MRI. Eventually, I was able to sort it out. But it was a frustrating experience, one that challenges the brand affinity most of us are seeking with our healthcare providers.    

Likewise, brand affinity is important to providers too. 

Virtually every healthcare organization struggles with patient engagement. Consider Lucy, a 42-year-old mother of two teenagers and a part-time caregiver for her elderly father. She’s prediabetic, and the single best way to prevent her from progressing to diabetes is to engage her in a healthier lifestyle comprised of physical activity and weight loss. Much easier said than done, however. Lucy’s success is heavily rooted in how well and how personalized her physician and care team engage her in her health, which is made much easier with a patient relationship management (PRM) approach.

Care coordination helps prediabetic patient Lucy

CRM Approach Critical in Value-Based Care

In today’s move towards value-based arrangements, we see how critical it is for healthcare networks to create affinity and customer loyalty. Competitive markets understand patient or member experience is now front and center to solidifying a relationship for future services.

Patient experience and satisfaction also are critical to improving quality performance. Post-care surveys capture the experience of both inpatient facility and outpatient physician encounters, and those survey results help to form the scores used for quality comparison across providers. Great experiences lead to happy consumers and begin the affinity process.  

Health networks are working hard to build that alliance with their consumers. As noted in a recent Chilmark Research report, Patient Relationship Management: Solutions and Their Effective Application, healthcare organizations are increasingly seeking PRM solutions for “more targeted patient outreach, more coordinated care management, and more potential for patient self-support in between care episodes.”

PRM and CRM tools can leverage key patient information beyond clinical care, including data ranging from consumer experience ‘likes’ (and hopefully dislikes too) to social determinants of health. Some might say the EHR has these capabilities. But I would argue the EHR is not focused on CRM but rather on critical clinical data necessary for patient history and billing. As but one example, imagine having information to target those patients who have had an unsatisfactory experience at a physician office along with personalized insights to correct the situation. 

Geneia + Salesforce: Population Health Management Expertise and #1 CRM

To help health plans, hospitals, physicians and employers improve their patient focus and engagement, Geneia chose to partner with Salesforce. I believe one of Salesforce’s leaders said it best,

"With Geneia’s expertise in population health management and Salesforce’s track record in customer and patient relationship management, we are able to provide a solution that uniquely serves the needs of healthcare organizations moving into more patient-centric models of care."

By building the traditional data sets around the patient and having the CRM capabilities to expand messaging and encounter experiences, we see the value for health networks, and broadly speaking, all of the partners charged with patient care, to have this level of consumer information for all of its patients. Whether it be a payer, provider or employer, all have the opportunity to improve their effectiveness, especially customer satisfaction, by using PRM capabilities to, for example, communicate patient care interventions.  

As Geneia’s head of product, I have a bit of the ‘dare-to-dream’ mentality. I’m also fortunate to spend much of my day bringing my dreams to fruition. I imagine a future in which a CRM approach is taken with every patient, whereby the essential historical views are available to the right caregiver, and a patient’s level of risk (healthy, rising, chronic or catastrophic) and social needs (socioeconomic, transportation, healthy food, mental health) are used to direct the patient to the ideal location for services whether that’s a physician office, a retail pharmacy, urgent care center or even the home in the case telemedicine and remote patient monitoring. And even further, we are in a position to leverage the best of CRM, analytics and multi-modal communication – phone, email, chat, text – to be more patient-centric, meeting the patient where they are, when they want and to measure the degree and quality of their engagement for continuous improvement.

Remote patient monitoring helps patients like Ms. Emma Smith

If healthcare industry leaders – and physicians, health plans and hospital networks –really seek to have a solid patient relationship, which is always important but even more so in the face of illness, then healthcare needs to leverage the best of retail and CRM techniques. Our health, patient satisfaction and patient engagement depend on it.