Patient Relationship Management

BarryChaikenBy Barry P. Chaiken, MD, MPH, Chief Medical Information Officer, Infor
Twitter: @bchaiken

Opentable. TripAdvisor. Angie’s List. Healthgrades. No person or organization maintains immunity from scrutiny by consumers. Although reviews can deliver either positive words or embarrassing comments, they surely capture the attention of both the reviewer and the reviewed.

Yelp, one of the better known online consumer review companies, recently announced its partnership with not-for-profit ProPublica to bring together healthcare quality statistics taken from the Centers for Medicare and Medicaid (CMS) and consumer opinion surveys. CMS collects data from more than 4,600 hospitals, 15,000 nursing homes and 6,300 dialysis center around the U.S. As Yelp rolls out these reviews, healthcare organizations can expect increased use of this information by consumers when making choices on where to seek care.

As the Affordable Care Act expands coverage and high deductible health plans capture more money from consumer pockets, increasing numbers of patients focus on the quality of services received from providers. These services extend beyond patient care to encompass patient experience metrics that are easily judged by the average consumer including respectfulness exhibited by caregivers, pleasantness of facilities, and wait times. Patients with sub-par experiences often post negative comments on one or more social media platforms to express their dissatisfaction. These posts then form the building blocks for a provider’s online reputation.

As patients act more like consumers, provider organizations with poor reputations experience decreased utilization of services which hurts revenue. With margins small and competition increasing for patients, few organizations can afford a decline in patient visits. For providers to survive in this new era of healthcare consumerism, they must learn from the experiences of other industries such as retail and hospitality, and apply those basic approaches to managing their relationship with patient-consumers.

Why Relationship Matters

For more than 60 years, employer-based healthcare insurance dominated the payment structure for the delivery of healthcare. With employees shielded from the actual costs of care, demand for services rose faster than inflation causing the cost of care to rise in lock-step. Only after healthcare costs started to impact the competitiveness of American businesses did employers begin to increasingly shift the cost burden of care from employers to employees.

The shifting cost burden is not the only major factor driving the importance of patient relationships. The disruption of the marketplace caused by the Affordable Care Act brought millions of additional patient-consumers into the marketplace. Provider organizations work to attract as many of these existing and new patient-consumers as possible to fill facilities and generate revenue. Providers now base their survival on making their connection to these patient-consumers “stick” the same way consumers exhibit loyalty to a particular restaurant, hair salon, or grocery store.

Welcome to PRM

Patient Relationship Management (PRM) represents a healthcare version of customer relationship management (CRM). CRM facilitates the interaction with current and future customers by leveraging information technology. It helps organize, automate and coordinate sales activities, and supports marketing customer service and technical support efforts.

In addition, CRM often uses social media to build customer relationships. For example, many organizations employ Twitter, Facebook, and LinkedIn as a CRM tool to track and communicate with customers, and permit them to share their opinions and experiences with a company, products, and services.

As CRM is relatively new to healthcare providers, organizations must be careful in how they design their PRM programs. In addition, they must identify clear goals and objectives for their programs and understand the options available to them to respond to patient feedback.

Smartphones offer a powerful tool to interact with patients in a meaningful and timely manner. Using smartphone texting and Internet access capabilities allows organizations to effectively reach patients to gather patient responses. With smartphone use at over 90% in the U.S. it is truly an ubiquitous information technology device.

Linking a care delivery episode to a patient’s perception of delivered services offers a view of how successfully an organization is satisfying the needs of patients. If the goal of a provider organization is to attract and retain patients, obtaining this PRM information allows organizations to continually monitor patient perceptions of care delivery and make adjustments as needed. In addition, PRM can immediately identify patient relationship problems (e.g., extended wait times or rude staff behavior) and allow a representative from the organization reach out to the patient to explore potential remediation.

Analysis of collected PRM data provides valuable information on what initiatives might provide enhanced patient-customer relationships. Dashboards generated from the data guide managers on the status of operations and potential problem areas.

Solidifying Relationships

As provider organizations adjust to an era where attracting and retaining patients matter, solidifying those relationships requires a strong feedback loop that links care delivered with patient perceived value. Use of paper questionnaires and other traditional survey methods fails to account for the importance of linking care and response in a timely manner.

Patient-consumers, trained by other industry CRM efforts to expect a close relationship between a product or service vendor and themselves, are beginning to expect a similar experience with their various healthcare providers. In addition, as more of these patient-consumers pay for their own care, they increasingly scrutinize the care experience they purchase.

For organizations to track their own performance and adjust nimbly to patient perceptions and needs, they require technology tools to secure actionable, timely information from patient-consumers. Smartphones offer provider organizations a valuable technology tool to use in their effort to maintain strong and binding patient-consumer relationships. When putting together a CRM program in a healthcare organization, focus on the needs of the patient and patient care so that the C in CRM becomes a P for patient.

About the Author: Barry Chaiken is the chief medical information officer of Infor. With more than 20 years of experience in medical research, epidemiology, clinical information technology, and patient safety, Chaiken is board certified in general preventive medicine and public health and is a Fellow, former Board member, and Chair of HIMSS. As founder of DocsNetwork, Ltd., he worked on quality improvement studies, health IT clinical transformation projects, and clinical investigations for the National Institutes of Health, UK National Health Service, and Boston University Medical School. He is currently an adjunct professor of informatics at Boston University’s School of Management. Chaiken may be contacted at