Healthcare CRM Overview: Use Cases, Benefits, Challenges


Healthcare CRM is typically positioned as a universal marketing tool for providers, but is often used for other purposes. Is there a possibility that healthcare has reshaped the system and is now much more than a relationship management solution?

Search Grand View states that the global healthcare CRM market was worth $ 6.6 billion in 2015 and expects it to grow at a CAGR of 9.5% over the forecast period (2013-2025). The reasons for the increasing demand for CRM are that it is linked to the general evolution of the healthcare IT industry and that it is linked to emerging regulations and standards of care delivery that require providers to better understand their patients and communicate with them throughout the care continuum.

While healthcare always needs more time to become familiar with workflow management technology, hospitals are enthusiastically adopting CRMs. According to the Society for Health Strategy and Market Development (SHSMD) of the American Hospital Association (AHA), 60% of U.S. hospitals use CRM. With that in mind, we also noticed that all of our clients needed individualized advice Healthcare CRM implementation and wanted to use it in another way. In addition, we have created healthcare CRM demonstration.

So we became interested in how caregivers actually use their CRM systems. Is there a particular pattern, or does each vendor address the solution in a unique way? Here is what we found.

Hospitals + CRM =?

We collected a number of cases of use of large, small and medium-sized hospitals, as well as outpatient centers. In general, large caregivers apply CRM capabilities primarily to the reach of patients and the health of the population by:

  • Manage preventive care email marketing campaigns;
  • Inform patients about cancer trials;
  • Create a single repository to collect and synchronize PHI across multiple facilities;
  • Provide patients with post-discharge follow-up.

Medium and small hospitals use CRMs to optimize their internal processes rather than external communication efforts, in order to:

  • Optimize case management;
  • Introduce the collaboration of the care team;
  • Improve scheduling and alerts;
  • Monitor medical equipment.

Outpatient centers focus on interacting with patients and improving internal processes, in order to:

  • Consolidate PHI into a centralized database;
  • Track patient interaction activities, appointments, and follow-ups;
  • Evaluate staff performance.

Accordingly, we can summarize the usual CRM functions of use or demand:

Communication module

  • Programming;
  • Initiate and track patient interaction (calls, emails, text messages, etc.);
  • Setting reminders and alerts (for appointments, important patient events, etc.);

Patient module

  • Add or update patient records with additional information (names, contacts, locations, card numbers, insurance, etc.);
  • Segment patients to target similar groups and communicate effectively with them (pregnant women, patients with COPD and obesity, patients with remission bladder cancer, etc.).

Task module

  • Add tasks for administrative staff, care team and nurses;
  • View and update tasks;
  • Monitoring of the assignment of priority, deadlines and completion status.

Reporting module

  • Creating custom reports to compare the ROI of launched campaigns, track the rate of non-patient submissions, and more.

An overview of how hospitals use CRM

The use cases gave us an interesting insight. While it is natural for CRM application areas to overlap between different providers, large caregivers and outpatient centers devote most of their efforts to patient outreach.

The reason why large hospitals focus on communicating with patients through CRM may be rooted in some factors. First, a hospital’s IT infrastructure can be very complex and other systems can be used to take advantage of the provider’s other needs (case management and collaboration of care teams, for example), so they use this. inherent marketing tool, well, for marketing.

Another idea is that health systems are the ones that set trends and develop them. They are the upper cortex and should be role models in patient involvement, preventive care, and population health. Last but not least, great caregivers are the first to be affected by values-based care and ACO requirements. Therefore, for the sake of quality care, savings and shared reimbursements, it is necessary to reduce patient acuity and put yourself on the preventive side as soon as possible.

Outpatient centers put interaction first for their business model. Patient visits are key to the operation of the centers, so providers need to be proactive. It’s not that these centers intentionally scare patients into luring them into a bunch of unnecessary checks, tests, and procedures. No, they should show care outside the doctor’s office for patient loyalty and trust.

Medium and small size hospitals adopt a different perspective from their CRMs, using them for personal improvement. This approach is also worth mentioning, as here caregivers aim to improve the delivery of care within the clinical setting. They make up multi-departmental care teams and guarantee effective collaboration with technology.

2 Subtle Advantages of CRM for Vendors

We’ve already talked about some obvious benefits that caregivers can get from CRM patient care, care team collaboration, team management, and more. But there are two important bonuses, which medical CRMs provide in the first place.

Data security and compliance

Data protection is a long-term concern for providers. According to the 2016 health data non-compliance report, health care suffered 450 PHI violations, with more than 27 million records of patients stolen. 2016 was the year with the most defaults since 2009. Moreover, the settlements to resolve alleged HIPAA violations they were a record $ 22,855,300.

HIPAA and other compliance requirements are not easy to meet, but they are costly to ignore. While CRM alone is not enough to ensure rock-solid PHI protection, it still improves overall security by encrypting sensitive data and allowing backups to recover it after a malicious or force majeure attack.

Providers may also introduce access control so that only previously approved health specialists could retrieve particular patient information. In addition, providers adhere to federal and state law and avoid financial penalties for illegal data storage and mishandling of patient information.

3 challenges of CRM adoption

Every candy has its acid, so we can’t just talk about benefits. Like any solution, CRM adoption can be difficult at times.

CRM adoption challenges

Goal setting

Before deciding to invest in a healthcare CRM, providers must clearly define the goals to be achieved through the system, including specific milestones and measurable metrics. In another case, caregivers may come across an absolutely useless and very expensive system.

The reason is that by not being able to select and name specific goals, vendors will tend to invest in features, and CRM relies on unlimited features available. Vendors, in turn, are able to sell features to meet universal needs. Therefore, caregivers can spend a good penny on tools they will not use.


CRM will work for a healthcare organization if it integrates seamlessly with all other infrastructure systems. Which, by the way, is not a piece of cake. Healthcare CRM is not the primary source of data and needs a connection to multiple applications to add value.

Many healthcare providers have strict policies on access to data and do not allow integration, in whole or in part, especially when it comes to systems like EHR. Therefore, caregivers should provide their provider with a computer infrastructure map to ensure integration from the outset. In the event that caregivers have purchased multiple systems from different providers, they may need to establish communication with all of them to verify collaboration and effective integration between the systems and healthcare CRM.

There is also the challenge of PHI recovery, rooted in a contradiction between allowing CRM to automatically centralize data and create a complete copy of the data collection, or processing patient information from an independent system under demand. Vendors should discuss both options with their vendor’s CRM consulting team and find a compromise between response time and security.

Staff training

Most health professionals are too busy to get excited about another system to understand and include in their daily routine. Therefore, clinical agents will have to face the challenge and streamline staff adaptation to the new solution. This means that clinical workflows need to be adjusted to include CRM as one of the default tools, not an optional “see if you’re interested” app.

CRM futurism

Artificial intelligence is everywhere right now and CRMs will also get AI updates. Becker’s Hospital Review recently published a announcement of IBM and Salesforce have partnered to align their AI platforms and increase customer engagement in healthcare, weather and financial services.

Artificial intelligence will analyze a mountain of automated data collected by a healthcare CRM, including patient-generated health data, emails, schedules, and more. It will run machine learning and predictive analytics algorithms with NLP to provide multiple knowledge, recommendations, and predictions about marketing campaigns. , interaction with patients and team collaboration.

But we keep our hopes up for at least a year, we don’t expect any AI-based healthcare CRM to be available until 2018 at the earliest. The reason is that at first glance it will take a significant amount of time to create an artificial intelligence product and test it, especially in the case of combining two AI platforms.

In healthcare, CRM is bigger now

Somehow, providers were able to transform the relationship management application into a new system capable of becoming anything the caregiver wants, from collaboration and billing to performance appraisal. and equipment monitoring.

Our consultants say this is how healthcare CRM works. It is a bottomless box with an infinite number of alternative tools, which can be configured the way the user wants and needs it. Caregivers only need to ask for one wish, and they clearly want internal and external optimization through multiple processes. Hopefully, more wishes will come true when СRM enters the era of AI.

Healthcare CRM software by ScienceSoft

Are you ready to enter the patient-centered era with a dedicated CRM by your side? Take a closer look at its capabilities and practical benefits for you.

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