Patient Relationship Management

Is Salesforce Ripe for Partnership with Health Cloud as a Patient Relationship Operating System?

Its human nature to draw analogies from past disruptors and apply to parallels in other industries. After all, we take experiences and lessons from the past to derive inspiration for future innovation. It’s in this regard that pundits have pointed to ATMs as a model to solve for healthcare’s interoperability woes, or present MINT.com and Kayak as a model for the healthcare’s move to retail and consumerization. It’s also in this regard that Salesforce is used as an example for patient engagement for healthcare. However, unlike the other industry-specific disruptors, Salesforce’s model fits healthcare as well. But just because it fits on-paper, that doesn’t mean that Salesforce is ripe to disrupt healthcare. There is certainly a lot of inertia to overcome in healthcare information technology, as Chilmark Research was quick to point out after Salesforce Health Cloud was announced

After several years of circling the healthcare market, Salesforce finally announced its intent to formally enter the market this week with the announcement of Salesforce Health Cloud. Unlike other enterprise vendors who have jumped into this market, with Blue Ribbon advisory panels (Google Health), or series of acquisitions (IBM Watson Health, Intuit) or a mixture of both (Microsoft), this announcement by Salesforce had little in the way of any of these attributes to bolster its announcement.

Salesforce is taking a much more tentative and low risk approach to entering the healthcare market and will look to its expansive ecosystem of partners who will leverage Salesforce’s existing tools to create healthcare specific solutions and services.

-Salesforce Enters the Fray: Will They Succeed Where Others Have Failed? CHILMARK BIGHT, September 2015, Brian Murphy and John Moore

Salesforce touts Health Cloud as a vehicle to acquire and manage patient data from multiple sources, from electronic health records, to patient generated data through wearable fitness trackers. Salesforce has also positioned the application as a communications platform for patient engagement and care coordination, as well as a dashboard for outcomes management and population health. Sound like every other vendor touting themselves as a PHM solution? Chilmark takes a deeper look into strengths and weaknesses:

Salesforce won’t compete with established transactional systems, but rather be a front end, as it’s not interested in being an electronic medical record provider like EPIC. As Salesforce CMO Dr. Joshua Newman told MedCity News, he sees competition from three places: electronic medical records vendors, startups and analytics firms.

EMR vendors may be entrenched, Newman said, but “they’re never going to be Internet-focused and multi-tenant.” A multi-tenant approach typical of a cloud service like Salesforce helps manage patients seen by physicians with privileges at multiple hospitals, according to Newman.

HISTalk also offered an optimistic assessment of Salesforce, declaring Health Cloud “the most interesting product I saw at HIMSS.” Mr. H from HIStalk noted the following advantages Salesforce Health Cloud offers:

  • Existing EHRs and other healthcare software products are way behind the times in meeting new requirements for health systems to treat patients and doctors as customers and to build relationships with them, including patient engagement.
  • It lets health systems that are willing to change their relationships with patients and doctors to do so effectively, with strong analytics and communications.
  • It’s cloud-based and is purchased on a relatively inexpensive per-user, per-month price with no capital outlay.
  • It’s built on the standard Salesforce CRM that has been battle-tested for years, with just those customizations needed to make it work for healthcare.
  • It integrates with the EHR and other patient and provider data sources.
  • The Salesforce open ecosystem allows using third-party apps when needed.
  • It Includes tools that allow users to build their own rules and apps.
  • Salesforce is a juggernaut that can force EHR vendors to open up their systems to obtain the data it needs.
  • Salesforce isn’t Oracle or Microsoft – they didn’t create a healthcare-specific product from scratch or acquire a questionable one, so they have no incentive to rebalance their product portfolio and walk away from healthcare and leave users hanging as big healthcare toe-dippers tend to do.

Given the optimistic outlook, what does this mean for healthcare startups and entrepreneurs Salesforce represents a good horse to attach your cart to. We’ve witnessed a plethora of companies go at patient engagement with their own custom solution. This approach lacks scale, established technology, and is crowded with competition. Not to mention, the path to monetization and profit is muddy at best. Further, Salesforce has built a rich ecosystem of extensibility via its app marketplace. Some could argue that this is exactly what healthcare needs.

The content presented in the Health Cloud Integration eBook suggests that Salesforce is still in the somewhat nascent stages, with limited adoption outside of pilots. Despite this, HCOs who have implemented the platform, such as Cancer Treatment Centers of American (CTCA) have demonstrated tangible benefits. CTCA now uses Salesforce to improve service in three different areas: physician referral intake; a 24/7 contact center; and, patient communities. The result is a 60% productivity boost for their technical team. One of the benefits to patients is their community platform, built on Salesforce Community Cloud, that empowers patients and families to support one another, join groups, participate in local events, find educational resources, and chat in real time. In turn, CTCA benefits from an enhanced referral process that improves customer loyalty and provides another way to communicate with patients.

There are clear gaps to fill. As the saying goes, “if the doctor doesn’t use it, it doesn’t matter.” Insights must reach the point of care and not be disruptive to existing workflows, but rather enhance it. It’s in this vein that partners are needed build the detailed workflows to support patient and care team communications. Salesforce represents a great candidate to partner instead of going at the crowded patient relationship management and patient engagement space alone.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration, is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell and LinkedIn.

Relationship Management Technology is Paramount in Healthcare’s Retail Transformation

Recently, HealthIT & mHealth explored whether patients should be considered customers in the strict sense of the word. Independent of this classification, there is a movement afoot in healthcare in which a transition is occurring from the status quo of a traditional market, to that of a retail market, with the patient at the center.

The retail revolution is transforming the healthcare business through the rise of consumerism, quality-based payments and accountable care. Employers are shifting more of the healthcare cost burden to employees through high-deductible health plans. With the shift toward health savings accounts (HSA) and high-deductible health plans, out-of-pocket expenses have grown. As a result, patients are evolving from uniformed price-takers into shrewd consumers of healthcare services. As they absorb more of the costs of their healthcare, patients are increasingly scrutinizing how they are spending their healthcare dollars.

Unfortunately, lack of healthcare cost and quality transparency inhibits patients from making the most-informed decision. The more the patient knows about pricing, the better they can budget for out of pocket expenses and routine costs related to chronic conditions. Recently, credit-reporting agency Transunion released the results of a survey that found that 80% of respondents listed price transparency as a factor in choosing a healthcare provider—on par with bedside manner. 79% said they’d be more likely to pay their bills in a timely manner if they had price estimates before getting care.

As such, whereas the focus of healthcare IT has been on implementing and integrating Electronic Health Record systems that demonstrate Meaningful Use standards over the last several years, the next several years will be devoted to healthcare organizations seeking solutions that help them acquire and retain patients within the complex healthcare environment. Hospital and health system economics are starting to experience this emergence of a new retail insurance market and growth of retail shopping for care. As a result of this tectonic shift, providers across the care continuum must put patient relationship management at the center of their operations and delivering quality in service to ensure patients return.

The technology backbone to patient relationship management is starting to take form and slowly permeate provider networks with new service delivery paradigms resulting. While recently at MGMA15 in Nashville, HealthIT & mHealth had a chance to catch-up with two health information technology vendors who offer solutions for the healthcare retail transformation.

The first, NaviNet, is an established health IT vendor, connecting over 40 health plans and 450,000 clinical and administrative healthcare professionals. The second is an entrepreneurial start-up, SpendWell Health, a wholly owned subsidiary of Cambia Health Solutions, which provides healthcare consumer e-commerce and retail enablement solutions for innovative employers looking to accelerate cost savings and offer a better consumer engagement / activation experience. In fact, both of these organizations recently announced a strategic partnership through which SpendWell will leverage NaviNet’s vast provider network to offer health plans, third-party administrators (TPAs) and self-funded employers an e-commerce platform that enables members to purchase bundled healthcare services directly from providers.

Enhanced transactions_0shopping-upfront-health-care-costs-a2f62f6c9d9c75b3e56c860cec4bf194

By integrating SpendWell with NaviNet’s multi-payer portal platform, the joint solution helps payers and providers reduce administrative costs associated with eligibility verification, claims submissions, collection risks and customer service calls. It also improves member satisfaction and retention in an increasingly competitive marketplace. The market for shoppable procedures as defined by the Advisory Board is more than $700 billion according to its recent report, “Blueprint for Growth 2020: Product, Pricing, and Sales Strategies for a Retail Market for Health Care.”

“Being at the nexus of payer and provider, and having access to the size and scale of network that we do, there is a distinct opportunity for innovation to enhance the provider and patient experience,” said Grant Ho, Vice President of Marketing, NaviNet. “At our Customer Forum in Boston, it became clear that enabling access and delivering value-added service to a broad and deep network was critical to our strategy and allows partners such as SpendWell to complement the NaviNet experience.”

“When you are small and a startup, a partner with the credibility and scale of NaviNet helps open doors and provides a conduit to bring our novel retail enablement solution to a broader audience,” said Kerri Mansberg, Vice President, SpendWell. “It’s striking that in some cases it’s cheaper for patients to pursue domestic medical travel – leaving one’s home state or region to travel to a designated ‘center of excellence’ for high-quality, more-affordable surgical procedures or episodes of treatment. In this transforming retail, consumer-driven healthcare market, our solution provides the type of transparency for provider groups to retain those patients and for patients to better understand what they are getting for their dollar.”

While meeting Ho and Mansberg at MGMA15 and with the transformation to healthcare retail consumerism top of mind, there happened to be a panel on pricing transparency, in which Cheri Kane, managing director at PriceWaterhouseCoopers (PwC) was a panelist.

“It’s a huge opportunity for providers to start building pricing transparency because no one really trusts their insurance company,” said Kane. “People trust their providers; the providers have the relationship. It’s an opportunity for them to share the price, help them through that price, and develop that loyalty. If not, patients are going to start turning to the payers.”

Providers who are not taking advantage of this movement will end up losing patients, said Kane, especially the younger population. “Patients will pay more for a better consumer experience,” she noted. “We have to do a better job of supporting them through that process.”

It’s clear that the empowerment of the healthcare patient-consumer is upon us. NaviNet and SpendWell are two vendors whom are committed to innovating to enable increased access and transparency to the patients on behalf of the providers.

About NaviNet

NaviNet is America’s leading healthcare collaboration network. We connect over 40 health plans and 450,000 clinical and administrative healthcare professionals, representing 60% of the nation’s physicians. Through NaviNet Open, our payer-provider collaboration platform, and our ecosystem of partners, we help payers and providers lower costs and boost care quality, while enhancing the provider and patient experience. For more information, please visit www.NaviNet.net and follow us @NaviNet on Twitter.

About SpendWell Health

SpendWell® is the leading digital health care e-commerce solution that empowers insured consumers to shop, compare and buy routine health services at actual prices. SpendWell’s online marketplace integrates benefit plans, removes consumer anxiety about surprise bills with upfront payments, eliminates patient collections risk for providers and reduces administrative inefficiencies and costs for payers. SpendWell transforms the traditional health care model for consumers, providers, employers, health plans and administrators into an online retail experience. SpendWell’s nationwide community of providers includes medical, dental, vision, behavioral health, chiropractic, alternative care, imaging and more. SpendWell is a wholly owned subsidiary of Cambia Health Solutions, Inc. Learn more at CambiaHealth.com. For more information about SpendWell, visit SpendWellHealth.com.

Image Source: http://www.gensler.com/design-thinking/in-focus/retail-health-retail-medicine-the-new-healthcare-experience