Delivering personalized healthcare to a patient population of over 3 million is no easy feat. But Geisinger Health System was up for the challenge and approached it like any other large-scale organization looking to create tailored interactions with each person their system serves would: through customer relationship management (CRM) technology.
“What I mean is taking individual preferences, individual styles and individual motivations and being able to tailor that to the patient. It's not a one-size fits all kind of thing," Chanin Wendling, Geisinger’s AVP of Informatics said during the Digital and Personal Connected Health Forum at HIMSS17. “Just the fact that we are talking about the patient experience, we are talking about them as a consumer, as a customer, that idea reaching the top level of priorities is phenomenal for healthcare.”
Wendling shared how the physician-led health system, which serves 45 counties throughout rural Pennsylvania and New Jersey and also has a health plan, decided to develop a system-wide plan to bring in CRM as the core technology to facilitate personalized service at each and every patient interaction.
“What we want to do is be able to look at you and know you and be able to tailor and deliver that care based on what we know,” said Wendling, giving a few examples of hypothetical patients ranging in things like age, income level and comfort with technology. “Some people like to use technology, some don't. Some prefer a lot of data and analytics from the doctor to take them through their options to their care, some just want doctors to tell them what to do. Some prefer handholding. Some respond better to the drill sergeant approach.”
To figure out which patient prefers which approach, Geisinger began building a CRM system with an outside partner. The began pulling together information from their provider network, employees, existing system technology like their scheduling platform and EHRs to identify where CRM could improve the service – such as giving notifications about appointment time preferences – and where it could be used in novel ways to connect the patient journey.
“A lot of benefits from the CRM is getting patients to the right care setting,” Wendling said. “Having them motivated, interested and informed enough to come to the regular visits instead of the emergency department. Or, for example, you can actually use very fancy technology to do some tracking and find out when a patient is near an ED but could be better served at an urgent care center and you can message them and direct them there instead.”
To get there with CRM, the first steps are setting up capabilities in the patient portal where patients can indicate their preferences, such as getting reminders through the portal or text messages versus the mail or calls. Geisinger is also working on building out a feature where patients can input their own health data, and took extra steps to serve those with specific conditions like cancer.
“In our cancer center, we deployed the MD Anderson Symptom Index. It was previously done by a nurse who would actually ask the patient questions and then report them in the EMR. We converted that to a patient-only mechanism. Guess what? The pain scores reported were higher by the patient than by the nurse,” Wendling said. “Did the pain scores actually change? No, the nurse was putting in a filter, and maybe a more logical filter than the patient would because it is an individual thing, but knowing that the patient thought they were in higher levels of pain is important for their treatment in addressing that pain.”
Geisinger took ideas from other consumer industries and applied them to their system, like offering refunds if patients didn’t like the service and surveying them about the methods by which they are willing to divulge information – such as by taking personality tests or allowing clinicians to use information on past healthcare decisions to inform a later one. On the backend, the CRM technology provides insights to different departments like billing. The health system has also launched two pilots – one for breast cancer and one for diabetes and obesity for food insecure patients.
“Ultimately, the idea is we tool all this information and we make a journey map and figure out how, along the way, we deliver care to different traits,” said Wendling. “Fundamentally, if I get a better experience, get patients more engaged, I've got to believe their outcomes are better."