Talk to your patients: Create a better patient experience with integrated EHR and CRM

In our COVID-19 world, it's more important than ever for healthcare providers to deliver holistic, patient-centered experiences.

by Jake Harwood

By early March, I’d heard from practically everyone who has my email address—airlines, a hardware store from two states ago, a fast-casual salad spot I love—about their COVID-19 plans and their commitment to keeping me healthy. I was promised that seats were being wiped, stores cleaned nightly, hand sanitizer stocked. The one voice I hadn’t heard? My healthcare provider’s.

Amidst the cacophony of information, I’d expected to hear from the academic medical center where I receive care, a voice that I trust deeply.

But I can’t fault my health system. For one thing, they’re stretched to their limits and frantically working to care for vulnerable and seriously ill people. For another, this is part of a longer story that started well before COVID-19. Electronic Health Records (EHRs) need help if they’re going to create meaningful, affinity-building patient experiences that promote wellness and gently nudge patients to take better care of themselves.

Seeing the whole patient

The EHR is a health system’s technological backbone, focused on clinical documentation, decision support, and generating claims that keep the doors open. With limited development resources, the giants— Epic, Cerner, MEDITECH—have prioritized creating clinical tools that enable providers to deliver higher-quality care and spend less time documenting. Their core competency is clinical—keep the patient safe, facilitate the provider’s work, warehouse the documentation.

However, truly managing an end-to-end patient experience expands far beyond that clinical purview, from tracking preferred communication styles and managing grievances all the way through to coordinating care with local agencies and marketing to prospective patients. When I have conversations with clinical leaders about relationship management, they often share the same sentiment: “We need to learn from other industries who do this better than we do.”

Leave something in your Amazon cart for more than a day or two, and you’ll get a reminder email that shows you the top product reviews and why you’d love to own it. By comparison, I have a family history of high cholesterol and a lipid panel order 11 months overdue, and I haven't heard a peep about it. We know from every perspective—patient satisfaction, population health, value-based care—the importance of preventative care and health maintenance, and still struggle to close these gaps in care.

So how do we build a more proactive, patient-centered experience?

Remember the best customer experience you’ve had, and think about how to make your patients feel the way you did.

Beyond basic outreach

Relationship management platforms like Salesforce aren’t just for crisis communication, although they certainly help. Building on the affinity generated by your teams of providers and support staff creates stickiness that keeps patients engaged with your health system.

Stickiness matters in terms of delivering better health outcomes and maintaining patients. In a recent survey on patient engagement technology, KLAS reported that 56% of patients feel “detached” from their healthcare provider, and that those patients are “twice as likely to want future development of price-transparency tools”—they want the ability to shop around. Connection between patients and their health systems influences whether they feel involved in their own health, a rough proxy of their propensity to adhere to care plans and participate in routine health maintenance activities. More importantly still, systemic patient engagement reduces costs, improves the quality of care, decreases error rates, and improves overall health.

Creating personalized experiences that truly engage patients requires bringing together the data captured in the EHR—clinical profiles, patient registries, demographics, appointments, admissions, and all the rest—with a clear understanding of who the patient is, what’s important to them, and how they interact with your health system. That level of integration can enable such experiences as:

  • High-touch contact centers. Integrating clinical data alongside risk scores, HCC coding, household and caregiver relationships, and engagement data like outbound communications and inbound inquiries creates a personal call experience. At a recent site visit, I sat with a call center agent who started a call by addressing the patient by her name and asking, “I see you called us yesterday about a referral for your ankle. Is that what you’re calling to check on today?” In another, after scheduling a patient with his PCP, the agent asked about their transportation-insecure father, for whom they were primary caretaker and who was due for a lower extremity check. Aggregating the data in a meaningful, 360-degree patient view allowed the agent to create a layered, positive experience and address the care needs for two family members at once.
  • Intelligent population health outreach. By running traditional marketing and communications campaigns through a CRM platform, you quickly learn about your patients’ behaviors. Building segmentation for digital and traditional media channels sets the stage for intelligent population health outreach, where you can engage patients with customized messages on their platform of choice to address gaps in care and promote health. Layering in additional services like online scheduling makes patients feel cared for and creates low-friction opportunities for them to take an action that improves their health.
  • Gamified journeys. We’ve all heard that it takes 66 days to change a habit. From smoking cessation to healthy eating to exercise, CRM platforms allow you to create journeys that help keep patients engaged along the way. By creating a gamified experience—earn points for a walk, more for a run, and milestone achievements for days and weeks without smoking—you create novel opportunities to keep patients on course and scale the reach of your care coordinators, who can monitor and encourage large numbers of patients engaging with a digital platform. By better understanding and tracking patients in their health journeys (just as we do in commerce and retail), we can understand the moments where they are at highest risk of falling off and support them along the way. We can demonstrate, at greater scale, that we care.

Some assembly required

You’ve been around healthcare long enough to know the path to integration isn’t straightforward—any enterprise architecture diagram makes that abundantly clear. Following a roadmap will help you stand on the shoulders of those who’ve come before you:

  • Define your data strategy. CRM creates, and requires, huge amounts of data. Develop a data ownership, rationalization, and warehousing strategy that unifies identifiers across platforms (five-digit zip codes or nine? Unique patient IDs from EMPI, or match on other criteria?) and structures what will happen to the data you create. And do that before you start creating.
  • What goes from where to where. Your engagement platform will need information from across your ecosystem—providers, patients, medications, appointments, outstanding balances, email addresses. Map out the source systems and the destinations, whether you need to feed data real-time (API or HL7) or via batch, and whether you’ll pull from the data warehouse or directly from the source system.
  • Go easy, then go hard. Build skills iteratively through progressive implementations. Start with a single call center, your provider relationship management team, or implementing basic clinical marketing before you bite off an access center transformation or advanced patient segmentation. You’ll get a better understanding of what’s possible—and how.
  • Focus on your people. The success of your change management and training programs will dictate the success of your platform roll-out. Engage your teams early and often in iterative development and sprint demos. Paint a picture of why better engagement tools are critical to improve patient care.
  • Think aspirationally. We often get caught in digitizing whatever workflow we had before. Remember the best customer experience you’ve had, and think about how to make your patients feel the way you did. Instead of building a better medication refill workflow, why not proactively engage patients before they need a refill? Instead of showing a badge that your patient’s overdue for a flu shot, why not send them a map of the closest clinics to their home and let them schedule an appointment at the most convenient one?

Connecting the dots

Some of the same innovations that excite me about EHRs excite me about CRM. While Epic and Nuance are investing heavily in voice recognition and a fundamental change to documentation, Salesforce is investing in sentiment analysis and predictive actions that will help patients get better answers, faster, and with fewer hurdles. Some core functions won’t change—your clinicians will continue to document, write notes, and place orders in the EHR, and that’s the system of best fit. For engagement, relationship management, and attracting new patients (I haven’t  even covered that!), a robust CRM platform presents the opportunity to make patients feel more heard, cared for, and engaged. 

Ready to bring EHR and CRM together?