Ep 95 – Unlocking the Digital Front Door: Patient Relationship Management in Driving Value-Based Outcomes, with Dr. Anil Jain and Alex Lennox-Miller

Patient Engagement is of paramount importance in value-based care.  Healthcare organizations are increasingly turning to solutions that promise more targeted patient outreach, more coordinated care management, and more potential for patient self-support in between care episodes. These solutions fall under a broad umbrella that can be described as patient relationship management, or PRM – and despite its name, it’s much more than a rebranding of customer relationship management for healthcare.

True PRM is not just a “CRM for healthcare.” It focuses on patients’ needs outside of the healthcare facility setting –in between care episodes — as they live their everyday lives. It is more than improving engagement at the hospital bedside, more than making phone calls after hospital discharge, and more than launching a “portal of portals” to provide a unified engagement experience. A comprehensive PRM strategy can support value-based payment models by bridging the gap between the care setting and the patient’s home. In this episode, we interview Dr. Anil Jain (Chief Innovation Officer for Innovaccer) and Alex Lennox-Miller (Senior Analyst with Chilmark Research) to discuss how C-Suite executives should plan their future journey in PRM and digital transformation.  Patient Relationship Management is key to unlocking the digital front door in the Race to Value!

Episode Bookmarks:

01:45 Does patient engagement have more of an impact in value-based care than SDOH?  What is Patient Relationship Management (PRM)?

04:45 The current state of dysfunctional patient engagement

05:30 How can a unified data platform create a more effective omnichannel approach to engaging patients?

06:30 Siloes of data and lack of consumer-orientation creating a less than ideal care journey for patients and families

07:15 PRM is not just for value-based care.  Billable events in FFS are also an opportunity for providers.

08:00 More engaged patients have better clinical and cost outcomes, with providers seeing improved quality measure performance.

08:40 The positive impact of a PRM platform on providers, nurses, and staff (i.e. lower burnout, higher satisfaction)

09:45 “The use of actionable clinical information within a robust PRM solution can help interdisciplinary care team members practice to the top of their license.”

11:00 Understanding the “full context of a patient”  (looking beyond the single patient record)

12:15 The use of clinical data in PRM (and how that differs from traditional CRM systems used in business)

12:45 Developing a patient engagement strategy for Congestive Heart Failure (based on clinical data and risk stratification)

13:45 “Clinical data can help create stratifications around risk.  However, that data needs to also be coupled with non-clinical data to determine how best to motivate and engage patients.”

16:00 Only 15% of hospital patients and 30% of medical practice patients access their health records electronically!

17:00 Will the 21st Century Cures Act create a more vibrant ecosystem of information exchange brought about by native APIs?

18:30 The limitations of legacy patient portals due to lack of robust data consumption and integration

19:45 How COVID-19 has reshaped patient engagement through experiments in virtual care

20:45 “A platform with rich APIs is critical to building a comprehensive Patient Relationship Management strategy.”

22:00 Patient recognition during COVID-19 that care delivery is grossly deficient in managing effective consumer relationships

25:30 Effective Patient Engagement versus Ineffective Patient Inundation (the need to integrate communications within provider organizations)

28:30 The potential for PRMs to revitalize patient engagement and provide more consumer-centric care based on optimal data integration.

31:00 Using non-clinical factors to develop open APIs, systems, and algorithms to match patients to resources in the community

34:00 PRM can provide value-based cost savings in the millions of dollars (i.e. 50% decrease in 30-day readmissions, two-thirds decrease in ED utilization, 10% increase in care compliance)

35:30 “True patient engagement has a profound impact on the measures that organizations are tracking.”

37:00 Communication-focused improvements for the consumer have better ROI than clinical improvements that optimize provider workflow.

38:40 Impacts of PRM on patient education, care plan adherence, and health literacy

43:00 Potential benefits of PRM in preventing disease progression with low- or medium-risk patients

44:30 The modularity of mature PRM platforms that can integrate condition-specific, behavioral science tools

47:00 The importance of a holistic PRM approach on longitudinal chronic care and the challenges of specialty care fragmentation

51:45 Overcoming system fragmentation through a governance process for PRM that includes both primary care and specialists

53:45 Technology must enable the right solutions and be a part of an overall, comprehensive strategy (technology is not the solution in and of itself!)

56:30 Parting thoughts on how C-Suite executives should plan their future journey in PRM and digital transformation