Healthcare is struggling to become consumer friendly…. I think few would argue that. Only five years ago, I was rebuked strongly at a meeting for calling our customers consumers instead of patients. That has changed somewhat but, with that as the starting point, you can imagine how far healthcare still has to go. And I think Salesforce can play a large role in transforming the healthcare experience.
This is the third article in my series on how various consumer entities can improve healthcare for all. So far, I’ve suggested that Apple digitize the intake process for the consumer and that Amazon offer an insurance exchange and establish Amazon Health to innovate the healthcare consumer experience.
However, this article is a bit different. Amazon and Apple are direct-to-consumer companies; Salesforce is not. Salesforce is the company you go to when you want to be a great consumer-facing company.
So, how can Salesforce contribute the most to healthcare?
I believe that Salesforce should establish an X-Prize like competition for the company that develops the EHR and Practice Management System on top of its platform. Salesforce is the indirect answer to three of the biggest problems facing healthcare: consumer experience, interoperability, and agility.
Salesforce and Healthcare: The Elephant in the Room
I think we would all agree that Salesforce could develop a phenomenal EHR. That is not in question. However, if you’ve read my other two posts on this subject, I have been adamant that these companies stay true to their core business.
Salesforce is a platform purchased by companies to help them deliver on the consumer experience. They didn’t develop an ERP in the 90’s and they probably shouldn’t develop an EHR today. But that doesn’t mean they don’t still have a role to play.
Let’s explore how Salesforce can become one of the most important healthcare companies in the world.
Today in healthcare, a consumer is unknown to the healthcare system until they become a patient. Most EHR systems were not designed to handle potential patients. To be put into the system, you have to be given an MRN (medical record number), and you have to be registered as a patient.
Today in healthcare, touch points are not coordinated. If you call to inquire about a billing issue, you will go to a call center. That call center is not using the EHR to log your call — in fact, many healthcare call center staff have 8-12 applications open at any one time to handle incoming calls. The information logged on that call will, more than likely, not make its way to anyone else in the health system. The next person you speak with will be blind to your last encounter with the health system.
The consumer of today is generating health data on their own. While this data is not always clinically relevant, it is an important point of experience.
Much of healthcare is about the hundreds of decisions we make during each day. A platform that can collect this information, analyze it, and interact with the consumers (even before they become patients) is a way to promote population health. The encouragement from a trusted partner, like a health system, is a strong catalyst to healthy living.
Salesforce is a platform that handles consumer records, listens socially for their thoughts, provides a way to respond to the patients through many channels… and that is just the start. They have mobile, social, and web capabilities to integrate the experience from the couch to the exam room to the call center: a complete view of the customer journey, with tools to reduce the friction often associated with the healthcare experience.
Let’s not forget about the internal consumer: the physicians are upset with the EHR experience.
Clinicians want to care for patients. They want technology to be ubiquitous, but in the background. An MD Anderson study found 72% of participants prefer doctors who do not use a computer during patient exams. Unfortunately, physicians will have to wait for the EHR providers to develop something to address this problem. The power resides in the wrong hands.
Most healthcare projects start with addressing the mess that is healthcare IT. For example, our health system had 1,800 application instances, and most of these instances had a set of fields relating to the patient. In order to present the right data through a new mobile application, we spent months and millions of dollars just to get the data right.
Salesforce provides developers with secure access to the data so they can solve sticky problems on their own through Force, the API-enabled development platform. Mulesoft can also be utilized to gather the data from the disparate systems. A one-time project can set up the data to be accessible through the API.
Much of this is the work of the Health Cloud team today. From there, you can invite your favorite partners to begin to create solutions.
This seems to me like a much better solution than putting it on the EHR vendors’ roadmap. It’s sorta like putting it on your kid’s chore list: it will get done… sometime.
The movement of data within healthcare is stymied today by architecture and complexity.
Ever wonder why you get asked the same questions over and over again during your hospital visit? Secure data-sharing is at the core of the Salesforce platform. This data-sharing platform, with the enhanced workflow capabilities, makes Salesforce a powerful tool to creating a coordinated care experience.
The Other Side of My Mouth
The biggest problem with Salesforce today is the price. It is considered an add-on by most healthcare companies and the way it is deployed simply doesn’t justify the expense.
The second problem is that most healthcare companies have an easy mechanism for selecting their competitor: Microsoft Dynamics. The way Microsoft has leveraged its entire suite of products in healthcare makes a Dynamics decision far more likely than a Salesforce decision.
A conclusion here might be building an EHR, or buy an EHR company with enough market share. These are multi-year, multi-million dollar contracts. Salesforce would be positioned as tightly-integrated into the EHR, becoming part of the accepted cost model for iteration of capabilities.
They would take a stronger position than Microsoft, as the EHR is central to the operation of a physician practice or hospital. This would certainly be a bold move, but one that I believe would be welcomed by the industry. I still believe it to be a risky proposition.
If you know anyone at Salesforce, please forward this along. My hope in writing this is to receive care at a health system that never hands me a piece of paper never asks me the same question twice and can interact with me every day as I make health decisions.