Patient Relationship Management

Background:

In today’s  21st century modern healthcare system it is important to stay ahead of competition and patient needs to attain overall patient satisfaction further keeping them engaged and loyal. Today’s patients are more informed regarding their options to obtain quality care and are ready to take a second opinion by switching providers, they expect convenience, instant response, and give priority to the end-to-end experience. Hence healthcare systems/ organizations must analyze barriers to consumer satisfaction and focus on patient-centric technologies to improve convenience, transparency, and speed of care delivered

There is a strong association between the patient experience, patient engagement, and clinical outcomes. Hence developing innovative systems in healthcare organizations has now become a priority. PRM stands for Patient Relationship Management System is one such specialized software system used to optimize and assist the Hospital staff to manage the Patient journey throughout the course of interaction with the healthcare system and its staff. Every time a transaction or a conversation happens between the patient and the hospital PRM assists by providing a systematic tool to record and store important Patient Conversation pointers which will help the hospital team to connect with patients on a human level. Just like deploying customer relationship management (CRM) has helped in building long term relationships by proactively understanding and serving the needs of the customers, healthcare providers can do the same by incorporating PRM.

There were good old times in India when you did go to a family physician, who probably knew your great grandfather had a seasonal allergy and has examined all your family members, probably seen 4th or 5th generation people in your family lineage.

The moment you walked into the clinic he/she kind of knew, most often, what was wrong with you. Just a gentle talk, a reassuring pat on the back, some syrup, a tablet, and a hot soup prescription, you are already feeling better by the time you walk out of the clinic.

The modern hospital is a complex environment. Corporate culture in management and operations management is more or less modeled by the hospitality industry. The look and feel you get in a five-star hotel are more or less the same as what you would expect in any modern-day hospital in Mumbai or Delhi or Bangalore.

The only problem is people go to hotels for leisure and entertainment, expecting good service. People do not want to go to hospitals but are forced to go under a lot of stress, staff in hospitals are constantly working under stress and are not trained in customer service, they are trained to save lives.

In the absence of a family physician, who used to generally bridge the gap between the hospital and the family of the patient, high attrition rates at hospitals where the front office receptionist and the nurse change every time a patient visits, adds to the tension and stress to not just the patient, attendants but also the hospital staff and doctors.

Now, most hospitals have a complex EMR or HIS or Billing system which records all transactions but does not necessarily have any information related to building trust, building relationships, building a rapport. That’s where a PRM plays an important role

Next obvious question is why do we need a PRM in Hospitals ?

As mentioned earlier, modern-day hospitals operations are evolving to be more robust and complex. In a race to meet the Occupancy rates, many hospitals miss the key factor, building trust and confidence among patients. At the end of the day, we need to realize we are dealing with human beings and not just a machine. In times of stress, People need a human touch. Building trust, building a rapport, building a lasting relationship, that’s what matters the most. That’s what is the differentiating factor in many cases between the extremely precise, highly objective treatment plan, equipped with state of the art high tech systems with the best of the best of the best Doctors losing to an average hospital with an average infrastructure, but a wonderful team of Doctors and Nurses who along with the objective metrics of treatment deliver care.  The PRM and proper training among staff throughout the organization shall bridge the gap and help in building a strong rapport between the patient and the hospital as an organization. 

Would it not be nice if the new front office receptionist can have a quick chat with the patient about the recent holiday they had while they are on hold to book the next available appointment with the doctor? Would it not be nice for the new doctor to have a quick informal conversation with the patient about the new car that was purchased? Would it not be nice for the nurse to have a reassuring chat about the long wait times to get to the lab?

 Building relationships and building rapports with the patients, record points for informal chats throughout the patient journey within the organization will empower the hospital to add a human touch to healthcare, showing that it’s care that is being delivered

ADVANTAGES OF PRM:

 

In one informal case study, it was observed that when PRM is used efficiently and effectively supported by proper staff training, sensitization of support staff within the hospital, pre and post-implementation surveys about 1 year apart indicated higher patient satisfaction metrics after the staff started using PRM effectively. The hospital staff would greet the patients well, behave more courteously and use subtle informal pointers to connect with the patients better compared to just treating patients like just another body  .

To conclude, hospitals spend their efforts on process improvement which can be measured objectively whereas patients give priority to the overall patient experience. Hence patient relationship management solutions can satisfy customer expectations within the demand of time.

 

Dr.Ashvath & Dr.Namrata Bhatta

10 Things Your Boss Wishes You Knew About Receivables Management

Account Receivables (AR) are amounts yet to be received for goods or services ordered. AR is legally enforceable claims for payments generally in the form of invoices raised by a business for the goods or services rendered to the customer. 

 

In a hospital setting, AR could be in the form of Government Schemes and Insurance Claims owed to the hospital by the administering authority, generally the claims processing department of the Government scheme or the Health insurance company. 

 

Here is where things get a little complex. If you are working in the hospital insurance claims department here are some important things you need to know.

 

  1. Each policy or agency has its cycle of payments against the claim raised. For example Insurance Company A may have a processing cycle of 15 days while Insurance Company B may have a cycle of 45 days 
  2. Accounts Receivables management is critical for a hospital to ensure proper reconciliation. Lack of an AR tracking system could lead to bad debts and bad patient experience. 
  3. Limited mode of payments. If your hospital has a limited mechanism of payment receipts, for example, if the hospital accepts only CASH payments, it somewhere reflects on the profit. The solution is to have multiple payment processing options like Credit/Debit Card, Online direct bank deposits, Digital Payments, among others. This gives more flexibility to patients to pay for services. 
  4. Interdepartmental coordination. How often do we experience that the attending doctor has given a discharge note but the Nursing Station, Pharmacy, Diagnostics, Billing Department and Claims department are running from door to door to get the right discharge summary and supporting documents? The solution is to integrate Medical Records, Pharmacy, and Billing systems that streamline the discharge process. 
  5. Hospital Staff training. Many of the medical staff and nursing staff have limited knowledge of the insurance claims process. Regular internal training could help better communication between departments and better coordination 
  6. Using multiple software systems or paper-based systems could increase the time required to gather all necessary documentation. Having one robust system across the organization could ease-out bottlenecks. 
  7. Requests for more information by the claims department of the agency or the insurance company are very common. This simply means not enough documentation was submitted during the initial claim process to justify the claim. Having a centralized information system could reduce the errors and the claims department could have access to all reports, bills, and treatment data before the claim is submitted therefore reducing the overall AR cycle. 
  8. Patients and Their Attending family members the majority of the time are not aware of the insurance coverage. It would be helpful if one dedicated insurance processing expert reviews the policy at the hospital and educates the coverage and limitations of the policy to help the patient understand the policy better and take better decisions. 
  9. Timely and Accurate information when provided to the insurance claims department reduces the overall lifecycle of the AR in question. 
  10. Develop a Plan, SOP, and KPI for your Hospital Claims department, Define roles and responsibilities. It is essential to have a plan in place. High staff attrition is a problem many hospitals face. The Claims Process plan and Process map will assist in hiring the right resource and providing training. KPI measures the performance of the department. 

 

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Solving Hospital AR problems

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