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CRM for Senior Care: Data with Donuts!

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We all have a visual of a marketing or sales person from a SNF facility or Home Health agency walking into a hospital to meet with a discharge planner carrying a box of donuts. What if solid actionable data accompanied them?

The needs of healthcare service providers have morphed significantly over the past few years. Service providers need to have access to actionable data that allows them to understand their local territory and use this data to achieve their goals to provide quality, cost-efficient, and risk-diversified care across the entire spectrum.

A Customer Relationship Management (CRM) system for healthcare services in Long-Term, Post-Acute Care (LTPAC) needs to be a data-driven tool that enables administrators and clinicians to achieve these goals by optimizing the census under their care.

The healthcare landscape:

  1. Shift from Fee-For-Service to Fee-For-Value

Healthcare costs represent a staggering 17.8% (CMS Source) of the US GDP and are growing. Payment reform will continue to put pressure on financial outcomes (FFS Universe) and push service providers to carefully optimize their census to deliver quality and cost-optimized care. Essentially, bringing in more residents that are a better fit for a care provider’s core competency is the key to achieving these outcomes.

  1. Healthcare is Ultra-Local

Healthcare service providers need to have an in-depth understanding of their local terrain in addition to national macro-trends. This is especially true for senior care where it is critical that they build close relationships across the spectrum of care from hospitals to the caregivers next in line. Close coordination between multiple settings of care will be vital.

  1. Multiple settings for single Episode of Care

Bundled payments and ACOs expand the span of control and impact for caregivers and administrators in the LTPAC industry to encompass the entire spectrum. A caregiver needs to have a holistic vision of a resident’s care that includes ALL care settings with a view to minimize expensive rehospitalizations. As an example, a medication-reconciliation process needs to be included as a part of the entire intake management system.

  1. Mobility is “table stakes”

The ubiquity of BYOD? and mobile devices has resulted in the requirement for timely information access and updates directly from the point of interaction. No longer is access to data on-the-go a nice-to-have, it’s a must-have.

Therefore, a Healthcare CRM for the LTPAC industry needs to have the following critical attributes:

  1. Data Driven In-take Process with Sales Decision Support

It is imperative that a CRM solution provide timely access to relevant data at the point of use. The purpose of the data is to maximize successful quality and cost-efficient patient outcomes. At a minimum, the intake process needs to include patient data from an upstream setting of care. As an example, a Skilled Nursing facility needs to know the referring hospital, referring physician, clinical information (medications, allergies, labs) and financial data associated with the patient. Planners at a care setting will rely on this data coming from field sales teams to assist in the pre-admissions decision process. Sales Decision Support (SDS) that assists planners in census management based on the data is going to be key. It is possible in the future that an AI deep-learning engine (Matrixcare-Microsoft Partnership) may provide the SDS using data from a variety of sources.

  1. True Referral Source Identification

In many cases, it might be difficult to identify the real referral source behind a resident. Understanding the true referral source allows sales to target the right individual or group to pitch their value proposition. As an example, it might be the orthopedist that referred the patient and not the attending physician at the hospital as identified in the submitted claims form. A CRM needs to provide the capability to identify the true referral source.

  1. Post-Discharge Follow up

Caregivers need to follow up with a resident post-discharge and ensure adherence to the medication regimen and therapy. Caregivers need to focus on ALL settings of care and control quality outcomes cost-effectively across the spectrum. Or, they should find themselves partners that will collaboratively achieve common goals for patient care. A CRM tool needs to embed the capability to schedule regular, post-discharge follow-ups with progress notes.

  1. Mobile Workforce Management

Data and content need to follow the individual, not the other way around. A CRM needs to provide sales teams the ability to dynamically adapt to changing goals, tasks and schedules on the move.

In summary, the requirements of a healthcare CRM optimized for the LTPAC industry need to go well beyond the ability to manage a workforce and enter contact information. It needs to include timely, mobile access to relevant clinical and financial data during the intake process. It also needs to provide tools to support post-discharge patient follow up. A CRM for LTPAC can no longer be just a sales management tool, it needs to be a critical part of providing high quality, cost-efficient, risk-diversified care across the care spectrum.

Krishna Bala, Ph. D.

Krishna Bala, Ph.D is AVP of Engineering at Matrixcare, where he leads development for several key products in the platform. Previously, he served as Sr. VP of Engineering at Sigmacare which was acquired by Matrixcare. He is a seasoned, high-tech entrepreneurial executive with more than 20 years of strong technology execution skills in startups and larger companies. Dr. Bala received a Ph.D from Columbia University for his work on Routing Algorithms. He is widely published in technical journals, is the co-author of a graduate level textbook and has 9 awarded patents. He is a fellow of the OSA.