Patient centered care requires healthcare relationship management technology

The healthcare industry is experiencing unprecedented disruption on multiple fronts, including the rise of consumerism, quality-based payments, and accountable care.

As a result, healthcare executives feel as though they are standing with their feet in two canoes: in one canoe, they are balancing the current demands of the fee-for-service healthcare paradigm, and in the other they are grappling with the emerging value-based, consumer-driven model that is quickly becoming the new normal. To successfully navigate the turbulent waters of change with feet in these two canoes and avoid plunging into the icy abyss, healthcare leaders must harness the power of data to drive action and accountability, resulting in an outstanding customer experience. To succeed, healthcare leaders must execute a focused healthcare relationship management strategy.

The disruption is being led by reforms that challenge the status quo of the care delivery system by forcing hospitals, health systems, physicians, laboratories and other providers to embrace value-based reimbursement models, improve outcomes for consumers, and lower costs within the system.

At the same time, employers are shifting more of the healthcare burden to employees with high-deductible health plans, forcing consumers to scrutinize how they are spending their healthcare dollars in the traditional and retail setting. As a result, consumers are demanding high quality and cost transparency and will shop around to find the best deal.

In order to compete in this new consumer-driven environment, providers across the care continuum must put the patient at the center of their operations and deliver a level of service that will keep patients coming back.

Welcome to the consumerization of healthcare.

To consistently achieve the level of service that consumers have come to expect from other industries, healthcare leaders must embrace technologies beyond electronic medical records (EMRs) and information systems that are designed to support clinical documentation requirements and back office processes, such as billing.

EMR systems are necessary, but you need more
EMRs are built to serve as systems of record as opposed to systems of engagement. They are designed to maintain patient medical records, capture clinical documents and notes, manage medication lists, capture codes used to support billing, etc. EMR systems are crucial for documenting episodes of care and maintaining clinical information. But when it comes to engaging with patients or providers beyond internal clinical process, EMR systems are limited. Healthcare relationship management (HRM) technology, with robust profiling and targeted communication capabilities, makes it possible to truly engage with patients, providers and other stakeholders to deliver on the promise of an outstanding customer experience.

Healthcare Relationship Management
While the last five years of healthcare IT has been dedicated to implementing EMR systems that demonstrate Meaningful Use standards, the next five years will be even more important as healthcare leaders seek solutions that help them acquire and retain patients within the complex healthcare ecosystem.

And the stakes are high. Acquiring new patients is expensive, yet losing business is even more costly. According to Healthcare IT News, it costs 90 percent less to get current patients to return for future care than it does to attract new patients. This is especially important considering that many practices lose about half of their patient base every five years.

A healthcare relationship management platform that includes healthcare-specific CRM capabilities can tap into a wealth of patient data, direct healthcare professionals to take action on this data, track interactions for accountable follow-up, and measure acquisition effectiveness and patient retention. A healthcare CRM that was designed from the ground up to support healthcare's complex data is required to address the highly specialized needs of healthcare entities. While industry-agnostic CRM solutions are marketing to the healthcare industry opportunistically, they are fundamentally too generic to be useful without significant ongoing customization and may even expose the healthcare organization to serious risk due to HIPAA requirements.

For example, in a large health system, it is not uncommon for 20 or so physicians to retire or transition each year. If each of these physicians serves 1,800 patients, this equates to more than 34,000 patients who will lose their physician every year. These patients can represent a value of almost $50 million annually to a health system. Unless the care experience is truly exceptional and the patient has an active, value-based relationship with the network, they are at risk of moving elsewhere for their care.

With a healthcare relationship management platform, the health system can proactively capture physician transition events. When a physician announces his retirement, the healthcare relationship management platform can segment the impacted patient population automatically and put in place a patient retention campaign that nurtures patients with personalized engagement via emails, valuable collateral, and automated text messages based on that patient's preference. The team can then track, trend and gauge the campaign for effectiveness, answering questions such as why a patient left the network, or at which point an at-risk patient became a repeat, loyal customer.

Bottom Line benefits
Aside from clinical procedures, the provider's patient engagement strategy will define the consumer's experience and influence his relationship with that provider. A healthcare relationship management solution facilitates an effective way to engage and retain patients while creating a more profitable healthcare organization. For example, one of the Midwest's largest safety net hospitals experienced a problem with patient no-shows for orthopedic surgeries, with roughly 33 percent of patients not showing up or arriving unprepared. Adding up the cost of labor, materials and time, each of these surgeries cost the hospital around $25,000, or almost $5 million annually. Many of these no-shows were attributed to long wait times associated with procedure registration, while others were canceled due to patients arriving unprepared with little knowledge of pre-procedure instructions.

Utilizing a healthcare relationship management platform, the hospital was able to create an engagement strategy that helped prepare patients for these expensive surgeries and also provided the hospital leadership team with metrics and critical intelligence on the patient experience.

Now the hospital encourages pre-registrations and efficiently reaches out to patients according to their preferred methods of communication with insurance benefit information and estimated co-payments. Helpful reminders are sent out 72, 48 and 24 hours in advance with directions, parking information and pre-procedure instructions.

Within three months, "no shows" were down 9 percent, representing a potential $10 million in annual revenue that would have otherwise been lost, while reduced wait times have increased patient satisfaction rates.

Enabling at-risk population health initiatives
As the Affordable Care Act ushers in a renewed interest in population health, healthcare leaders have struggled with the best way to reach groups of individuals with at-risk chronic diseases. Healthcare relationship management solutions can help healthcare organizations put the consumer at the center of these efforts.

Until now, providers haven't had an easy way to reach at-risk patients, which may explain why 55 percent of providers say they don't communicate with patients between visits, and half of healthcare professionals believe their job begins and ends during regular office visits. In the age of ACOs and value-driven healthcare, it is more important than ever for physicians and health networks to act as around-the-clock wellness consultants.

Using a healthcare relationship management platform, health systems and providers have real-time access to aggregated profiles and insight segmented by chronic conditions, such as diabetes, obesity and heart disease. These patients can then receive personalized information and reminder communications to better manage their care and conditions, bringing a personalized, one-on-one relationship to all at-risk patients in the population while reporting on the effective management of that population to payers such as Medicare, who reward top tier at-risk population engagement and management.

Closing
In order to successfully compete in the new consumer-driven healthcare environment, providers across the care continuum must make the patient relationship their highest priority. By placing the customer at the center of their strategies, healthcare entities can deliver a level of service that will attract more of the right patients and keep them coming back in both fee-for-service and quality-based care paradigms.

Brad Bostic founded hc1.com to address the critical need for healthcare systems, diagnostic laboratories, ambulatory service providers, and post acute care organizations to deliver an outstanding client experience. As the leader in healthcare relationship management, hc1.com powers healthcare relationship management across 700 client locations spanning five countries, including Cleveland Clinic, Sonic Healthcare, Alere, and Labors.at. hc1.com has been recognized with numerous awards including the Red Herring Global 100, Mira Health Technology Innovation and Excellence, and Companies to Watch Spotlight Award.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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