The enterprise engagement platform and patient-centricity: Setting the stage with CRM

The problems surrounding our fragmented healthcare system are well documented – avoidable medication errors, duplicate testing, and poor care transitions leading to unnecessary readmissions.

Editor's Note: This is the first post in a three-part series on the enterprise engagement platform and patient-centricity, co-authored by Jessica Friedeman and Gary Druckenmiller. Stay tuned for parts two and three, where they'll discuss leveraging physician relationship management (PRM) to create unified enterprise campaigns and crossing the chasm between care settings.

Upon leaving his post as head of the Centers of Medicare and Medicaid Services (CMS), Dr. Donald Berwick summed up the situation best in an interview when he stated, "Healthcare is broken. We have set up a delivery system that is fragmented, unsafe, not patient-centered, full of waste and unreliable. Despite the best efforts of the workforce, we built it wrong. It isn't built for modern times."

We have made strides to address this issue since Dr. Berwick made that comment in 2011. One of the key strategies undertaken in the US to address fragmentation in healthcare, as well as to improve quality and safety, is the implementation of Electronic Health Records (EHR). Bolstered by the HITECH Act of 2009 and the Meaningful Use Program (now in Stage 2), over 90% of US hospitals are using certified EHRs. This centralized data source is the information backbone of many of the delivery and payment models such as PCMH (Patient Centered Medical Home), ACO (Accountable Care Organization), and P4P (Pay for Performance), that are designed to help replace a fragmented healthcare system with one that is based on value and coordinated care; a system designed to achieve the triple aim of higher quality and increased safety at lower costs.

Gap in the Healthcare System

However, there is a fundamental flaw in the current approach. The good news is that it's not a fatal flaw. It is better characterized as a gap. But it is this gap that is standing in the way of patient-centricity. The gap is that the central data source, the EHR, is not truly patient centric. At its core, the EHR is a collection of billing and diagnostic codes which can deliver a great profile of an individual's medical status but does not provide any insight into the person. Since we are all more than the collection of our ailments, it stands to reason that the provision of patient centric care must be aided by the delivery of information, and data, that could provide insights into the individual. If available, this information may help frame communications and consultations; could be leveraged in a shared decision making/participatory medicine framework; would serve to complement the clinical treatment with an effective engagement model.

There is more good news. This data exists in robust Enterprise Engagement Platforms featuring Customer Relationship Management (CRM) and Physician Relationship Management (PRM) functionality. This series of blog posts will explore how marketing and strategy teams operating from a single platform can leverage the consumer intelligence powering marketing programs, in tandem with the solid relationships built with the community of providers to deliver integrated, coordinated care over a lifetime. In this first post, we'll start at the beginning of the relationship as it is forged leveraging healthcare CRM functionality.

Driving Patient-Centricity Through a Robust Healthcare CRM Platform

While billboards, radio spots, and newspaper ads still are used to promote brand awareness, investment in sophisticated, targeted database marketing, spurned by competition, has become a necessity in healthcare. In fact, a 2014 study by the Society for Healthcare Strategy & Market Development (SHSMD) reported that over 66% of US hospitals had invested in a CRM system. The more robust systems incorporate comprehensive consumer data at the individual and household level to create propensity and segmentation models that help marketers deliver targeted and relevant communications to the members of their community.

Within the healthcare ecosystem, the marketing suite is definitely ahead of the curve as it relates to understanding and leveraging increasing healthcare consumerism. This makes senses as marketing departments are staffed with professionals trained to identify consumer desires, values, needs and subsequently frame products and services in such a way to drive adoption (acquisition) and ongoing utilization and loyalty (retention). As marketing in the macro-economy has evolved from mass marketing/broadcast to bulk mailings with partial personalization to now micro-targeted, beacon-triggered cell phone alerts when passing by an affinity retailer, the same tactics are beginning to be utilized by healthcare organizations. This is where the process of driving patient centricity throughout the healthcare experience begins– with effective consumer marketing leveraging a robust healthcare CRM platform.

Whether outreach efforts are focused on engaging patients attributed to a Medicare Shared Savings Program ACO or driving patients to a new bariatric surgery service line, if communications are not focused on connecting with the consumer's values and preferences, marketing efforts will fail. Relying on simple demographic targeting – filtering on age, income, and children, – may not be enough to create messages that will connect with diverse populations. One way of tackling this issue is to create different patient and prospect personas. The attributes of the persona would dictate not only the messaging but the best media mix for reaching that segment of the targeted audience.

Creating the Foundation for a Patient-Centric Experience

The Deloitte Center for Health Solutions created a model that breaks down the US population into six distinct segments – Casual & Cautious; Content & Compliant; Online & Onboard; Sick & Savvy; Out & About; Shop & Save – based on surveyed patterns of behavior and attitudes related to their own health and how to navigate the healthcare system. These segments provide valuable 'clues' as to how a healthcare organization can personalize products and services for consumers. Dividing a campaign's target audience into these segments may be a good place to start in terms of crafting targeted messages for services that may have wide appeal or utility. The challenge is how to split a database into these persona segments.

Once again the world of consumer marketing can help out. The consumer data companies that provide credit scoring have been gathering petabytes of data on consumer behavior. Over the years these companies have developed extremely sophisticated modeling and classification systems that look beyond sociodemographic data but also at behavioral, lifestyle, and cultural inputs at the household level. For example, MosaicR USA from Experian crunches 300-plus individual data elements into 19 Groups that encapsulate all US households. These 19 groups are further broken down into 71 unique segments identifying consumer preferences and choices. These segments provide valuable marketing insights, including communication preferences (e.g. responsiveness to mail, listens to radio), purchasing patterns (e.g., shops online, purchase for child), and leisure time pursuits (e.g., keeps an active lifestyle, read sports magazines).

Thus, the foundation for patient-centric care experience will have these 4 attributes:

1. A marketing campaign centered around the consumer/patient benefit as opposed to the healthcare service being offered.
2. Message segmentation based on distinct personas.
3. Omni-channel deployment leveraging known communication preferences most likely to engage the target audiences.
4. Methods that allow the audience to engage and respond

To close the loop, the CRM system must have the ability to integrate directly, from a data and response standpoint, to a variety of offline and online tactical execution modalities, in order to learn and improve campaign performance, including:

- Print
- TV
- Direct Mail
- Email
- SEO/Organic Search
- SEM/Paid Search
- Display Advertising
- Web Response Form
- Call Center

Example: Cancer Center Serving a Tri-State Area

The marketing campaign is now segmented on 3 dimensions – audience, message, and delivery mode. The payoff occurs when the response is analyzed systematically, insights are gleaned from the trends in the data, and new strategies are created that are informed by the data insights. An example to illustrate how this could work follows:

A cancer center serving a tri-state area launches an awareness campaign consisting of print ads, digital display ads, and paid search. A working hypothesis due to the demographics – age and geography – was that lung cancer information and treatment would generate inquiries. There was also belief that print ads with a call-to-action (CTA) to call for an information guide would pull well. A look at the data uncovered the following insights:

- GI Cancer/Liver cancer had the best response
- Prostate Cancer driven by Proton Beam Therapy had good response
- Head & Neck cancer had a high response rate but high bounce rates
- Treatment Ads had better response that Disease Information Ads
- 67% Response came from Desktop Computers, followed by mobile devices
- Print Response was poor

From these insights, the following strategies were implemented:

- Increase promotion spend to keywords related to GI and Head/Neck Cancers
- Content of Digital Display Ads focused on Therapy
- Head/Neck Inquiries included nurturing campaigns (triggered emails)
- Invest in Web, cut back on print, watch mobile

Continuous learning resulted in higher marketing ROI over an extended period of time. However, there is no reason that the same insights that drove the marketing should not inform communications between patients and providers at first encounter and throughout the care continuum.

Jessica Friedeman serves Evariant as Director, Presales Engineer, providing technical and industry support in the sales process. Leveraging over a decade of experience in the healthcare industry, Jessica works closely with the sales team to mold customer requirements to Evariant's offering and acts as a key connection between Evariant's product development and organization's customers.

Gary Druckenmiller, Jr. VP of Client Solutions, functions as lead strategist, digital marketing thought leader and C-level executive sponsor for all of Evariant's enterprise clients, primarily focused on advising health system leadership of opportunistic methods to improve their digital presence and interactive growth potential. Prior to Evariant, Gary served as Vice-President for Harte-Hanks, responsible for healthcare digital strategy and deliverables including multi-channel campaigns, paid digital media, social media, CRM and analytics. Gary has been with Evariant for 5 years and can be heard often on the hospital marketing speaking circuit. Gary has a bachelor's degree in marketing from Bentley University.

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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