Hear from healthcare IT expert, John Halamka, MD, CIO Beth Israel Deaconess Medical Center, as he shares his thoughts on why CRM is key to success in a new healthcare payment landscape.

Meaningful Use Stage 1 and 2 created a foundation for capturing data, exchanging healthcare information, and providing analytics.

Certified electronic health records (EHRs) meet all the important functional criteria for the regulatory compliance requirements of 2009-2016. However, as we transition from fee for service medicine to payment based on quality/outcomes, EHRs alone are not sufficient for purpose. To survive in an alternative payment environment, providers need “care management” which I define as enrolling a cohort of patients with specific diseases/problems into a guideline/protocol/pathway, then tracking their progress on that care plan. Value-based purchasing creates new incentives to keep the patient healthy and use “care traffic controllers” complemented by novel IT tools, to optimize outcomes while reducing total medical expense.

Customer relationship management (CRM) software is key to success in these new payment models which reward quality of service not quantity of service. Once considered a tool for salespeople, CRM enables accountable care organizations and payers to track patient care preferences, identify gaps in care, and provide mid-course correction for deviations from care plans. For example, if a diabetic needs a foot exam, eye exam, home glucometer, hemoglobin a1C and urinalysis every year, we can use CRM to ensure all of these happen and if needed, deploy home care services to close the gaps.

Clinicians are already overburdened with data entry requirements. Will this CRM responsibility fall to clinicians? Likely not. Just as we’ve used collaborative approaches to enable doctors, nurses, social workers, pharmacists, and technicians to practice at the “top of their license” by spreading regulatory burden across multiple roles, it’s likely that CRM tools will be used by case managers, care managers, and designated mid-levels (nurse practitioners) who serve on patient centered care teams.

One of the major themes in the IT industry for 2017 is the concept of modular components that layer on top of EHRs and provide complementary functions. New standards such as FHIR (Fast Healthcare Interoperability Resources) make it easier for third parties to send and receive data from EHRs, which will increasingly require/benefit from other platforms and third party applications in much the way that mobile phones enable great power and versatility through their apps. Customer relationship management will be a critical addition to basic EHR functionality over the next 18 months.

Very often, healthcare automation lags other industries by a few years. Retail, finance, and travel industries spend 20-30% of operating expenses on IT. Healthcare spends 2-4%. As consumerism and changes in reimbursement reward high quality with good outcomes at low cost, customer relationship management in healthcare will become a must have.

About John Halamka

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician.