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Health Insurance Provider Achieved Operational Excellence & Competitive Advantage with Salesforce
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Table of Contents
Among the most crucial industries in the world, Healthcare is the one that requires the best IT solutions. According to reports, the Healthcare industry got a fancy share in CAGR and is predicted to grow by 7.9% compared to 2020 by 2027, which is approximately 282 billion dollars in 2019.
There were times when healthcare organizations used to store their internal management and patient data in the EHRs (Electronic Health Records). Since the entrance of Healthcare Management Software and CRMs, these organizations have given thought to modifying how they manage their data and the patient’s and staff’s schedules.
With the surpassing of a global pandemic, moving and handling all tasks digitally becomes a constraint. Considering the patient’s expectations and regulatory changes, the healthcare industry has witnessed a life-changing transformation. Rendering the best medical and patient-centric services has become essential to success.
Technology is a big cheese when it comes to fulfilling customer expectations and providing quality care. However, there were numerous challenges that healthcare providers were crossing paths with. Some of them are lack of real-time data, internal technical expertise, and management of legacy systems.
Salesforce already had a tool for serving healthcare management, the “Patient Relationship Management Tool.” But a few years back, they re-launched it with Salesforce Health Cloud, capable of allowing end-users to work on well-structured applications.
Take a deep insight into Salesforce Health Cloud in this blog. And now, just by leveraging health cloud technology, particularly it has reconceptualized how healthcare services are delivered to patients.
Salesforce Health Cloud is a patient relationship cloud-based platform that helps healthcare organizations unify patient clinical data and nonclinical operational data. It enables healthcare teams to make informed decisions based on actionable intelligence.
The Health Cloud is built over the Salesforce Service Cloud and offers features like EHR-to-Salesforce API connections, smart case management, and record management. It is Salesforce’s only patient and member relationship management platform charged with the power and security of a cloud.
Check out the live demo of Salesforce Health Cloud, showcasing its powerful features and capabilities tailored for the healthcare industry.
The Health Cloud data model is designed with power-packed features, streamlining healthcare operations and patient outcomes. Here are the key features:
The advanced therapy management feature simplifies the scheduling of multi-step treatments for patients with rare illnesses. It helps to produce personalized medication by utilizing genetics and biomarker data.
is designed to simplify the scheduling process of multiple steps within therapy for patients with rare illnesses. Here, advanced therapy means medical practices that use genetics and biomarker details to produce personalized medication and the therapy involves multi-steps performed in distinct locations.
Integrating benefits verification enables businesses to streamline patient access workflow that helps patients and caregivers find the right coverage. This feature enables patients to know the available benefits and have the necessary coverage for treatment. This automatically verifies patient eligibility with insurers so they can get care.
Health Cloud Patient 360 brings healthcare providers and support teams together, providing healthcare and life science organizations with clinical and non-clinical data in a 360-degree view. This facilitates cost-saving automation, actionable intelligence, and real-time data to deliver personalized care and patient success. It includes key features:
By leveraging enrollment and management tools, healthcare providers can enhance the impact of care programs to drive adherence and patient outcomes. This feature simplifies care program creation (such as nutrition, diet, and wellness plans) and captures patient consent in e-sign.
Health Cloud revolutionizes patient-to-patient support by enabling medical experts to provide tailored care. This individualized approach spans the entire patient journey, ensuring comprehensive assistance. This platform facilitates seamless engagement throughout the acquisition, treatment, and discharge phases, thus fulfilling patient needs and enhancing service efficiency.
It ensures constant patient engagement. Through integration with private Salesforce communities, real-time healthcare advice becomes accessible to patients and medical professionals alike. This fosters a strong sense of confidence and trust among patients, fortifying the patient-provider relationship.
It seamlessly integrates with existing Electronic Health Records (EHR) systems, yielding a centralized view of tasks and goals associated with various treatment plans. This integration enhances the efficient management of health records, promoting better patient care. Also, it streamlines operations while enhancing collaboration among caregivers.
It facilitates personalized patient interactions across diverse communication channels, including online platforms and phone interactions. Medical staff can promptly respond to individual patient demands, offering an elevated level of care throughout the patient’s journey.
These are the key features of the Health cloud simplifying operations and providing personalized patient care.
Let’s talk security first. With Security Integration, you’re bringing together different apps’ authentication mechanisms. This not only boosts the user experience but also reduces user admin hassles. Picture this: Client apps must log in with legitimate credentials, just like they would for your organization’s system. Plus, they’re shielded by the same security measures as the regular Salesforce interface. It’s like wrapping your apps in a secure, unified blanket.
Now, imagine blending multiple apps’ user interfaces (UI) into one. That’s User Interface Integration. And what’s the good thing here? You don’t have to work on the UI of every other application. Salesforce makes it easy-peasy. Your users get a one-stop-shop entry to all things Health Cloud. Say goodbye to hopping between different apps.
Business logic meets integration. Often, your business logic is spread across various apps. That’s where Business Logic Integration comes in handy. It lets you extend related business processes from one app to another, making sure your workflows are seamless from end to end. Salesforce plays well with inbound logic from outside the platform and outbound logic from within.
Bringing it all together at the data layer is a breeze. Data Integration is like getting all your apps to jam in harmony. Imagine multiple apps, each speaking its programming language, working together through a standard open API. And they all manage data in a shared database. Health Cloud supports various APIs – SOAP, REST, Streaming, Bulk Data Transfer, you name it. So, data integration?
However, additional integration considerations and types are essential in Healthcare and beyond. Here are some other integration types and considerations:
Interoperability Standards: In Healthcare, sticking to standards like HL7 and FHIR is necessary. They make sure info flows smoothly between different systems and groups.
Authentication and Authorization: When integrating, strong security is a must. Only the right people should get their hands on patient info, so robust authentication and authorization are key.
Single Sign-On (SSO): With Single Sign-On (SSO), healthcare pros can enter multiple systems using just one set of login info. It’s a win-win: easy access and top-notch security.
API Integrations: Utilizing Application Programming Interfaces (APIs) to connect different systems is a common practice. It provides REST and SOAP APIs for integration purposes.
Event-Driven Integrations: Implementing event-driven architectures can improve real-time data synchronization between systems, ensuring healthcare professionals can access the most current information.
Patient Consent Management: In compliance with privacy regulations like HIPAA, managing patient consent for data sharing is critical. Integration should support consent management and tracking.
Clinical Decision Support Integration: Healthcare organizations can promote better decision-making on patient care by integrating clinical decision support systems.
Geolocation Integration: Location-based services and geolocation data can enhance patient care coordination, especially in emergencies or when dealing with mobile healthcare services.
Population Health Management: Integration with population health management tools allows healthcare businesses to track patient populations and make timely improvements constantly.
Telecommunications Integration: Integration with telecommunications systems can facilitate secure communication between healthcare providers and patients, especially in telehealth scenarios.
Legacy Systems Integration: Many healthcare providers are still dependent on legacy systems. Integrating these systems with modern solutions like Salesforce Health Cloud can be complex but is often necessary.
Research and Analytics Data Integration: Healthcare providers may integrate with research databases and analytics platforms to support medical research and clinical trials.
Salesforce Life Sciences Cloud: Leveraging with Health Cloud capabilities enables Pharma, Biotech, and MedTech companies to scale patient-centric experiences across their organization. This integration reduces drug costs and improves sales transparency.
Data Cloud: Integrating Data Cloud capabilities empowers healthcare teams to engage with patients at every touchpoint and provides relevant health insights and contextual data.
Mulesoft: Salesforce Health Cloud integration with Mulesoft enables consolidating data from any system and automating complex tasks to deliver a connected customer experience.
Remember, the connections needed will depend on what the healthcare team wants to achieve. A thorough assessment of these requirements, including compliance with healthcare regulations, is essential when planning and implementing integrations in Salesforce Health Cloud or any healthcare system.
Most businesses face challenges in the Health Cloud successfully due to a lack of technical knowledge and experience. To make the journey seamless, we prepare simple steps to leverage its out-of-the-box capabilities.
Relate a single contact to multiple accounts so you can easily track the relationships between people and organizations. For example, a care provider who is represented as a contact can be related to an organization’s primary account as well as to a patient’s person account record.
Chatter helps cloud users collaborate in real-time with Salesforce. It’s a fast, simple tool that enables users to talk to each other, work together, and share information. Suppose Cure Well’s care coordinator, Sam, wants to post updates about his flu diagnosis for his therapist. Chatter helps her do so with a few clicks.
To help maintain the privacy of your users’ data, enable data protection details for lead, contact, and person account records.
Install the Health Cloud managed package in your org so that you can begin implementing this cloud for your users. After that’s done, you can install the optional unmanaged packages that extend Health Cloud with extra features.
Grant users access to Health Cloud CRM licenses.
Permission sets enable users to use specific tools and settings according to their user license. With permission-set licenses, you can give users access to features beyond those included in their basic user licenses. To use Health Cloud users need the Health Cloud permission set license and the Health Cloud Platform permission set license.
Health Cloud Platform
This permission set license provides access to Health Cloud-related standard Salesforce objects for features that are built directly on the platform and aren’t part of the managed package.
Health Cloud for Experience Cloud Site
This permission set license provides access to Health Cloud objects and features for site users.
Person accounts store information about individual people by combining certain account and contact fields into one record.
From Setup, enter Person Accounts in the Quick Find box, and then select Person Accounts.
Acknowledge the org implications of enabling person accounts.
Make sure the account object has at least one record type.
Make sure user profiles that have read permission on accounts have read permission on contacts.
The organization-wide default sharing is set so that either Contact is Controlled by Parent or both Account and Contact are Private.
After you enable person accounts in your org, update the Use Person Accounts setting so that you can use person accounts to represent patients and members in Health Cloud.
After person accounts are enabled, assign them to profiles.
With person accounts enabled, configure a default mapping record to create patients or members in Health Cloud.
From Setup, in the Quick Find box, enter Custom Metadata, and then select Custom Metadata Types.
Salesforce has taken care of every problem in the Healthcare and Life Science industry through its Health Cloud.
Patient data is often scattered in different places in traditional systems, making it hard for healthcare workers to see and use all the data. This can cause problems in the care and understanding of patient conditions. Salesforce Health Cloud puts all the patient data in one place by unifying data from different sources like EHRs, lab results, and patient history. This gives healthcare workers a complete view of each patient, making it easier to provide the right treatment on time and schedule appointments.
Care teams need to work together to provide efficient healthcare. However, they often need help with communication and collaboration, miscommunication between providers can lead to delays in patient care and low-efficiency outcomes. This cloud makes care coordination easier by giving a platform for teamwork. Care teams can coordinate, share information, and plan treatments, all in one place. They can stay updated and get alerts in real-time. This helps them give care on time and work together better.
Providers often face trouble giving personal and engaging patient experiences. With good patient engagement, they find it easier to make patients follow treatment plans and care for their health. Health Cloud helps providers engage patients on their favorite channels and give personal interactions. Using data, providers can find out what each patient needs and likes.
Providers have to do many tasks, like scheduling, checking insurance, and writing notes. These tasks take too much effort. Providers often need more time to feel energized and focused on patient care.
With features like easy scheduling and self-help tools in Health Cloud, providers can work faster and better. Automatic insurance checks and completion of care activity also speed up care, ensuring patients get service quickly.
Health Cloud has immense capabilities that streamline patient care and can be beneficial for:
First, let’s clear the air: It’s not EHR vs CRM; it’s about EHR and CRM working hand in hand. Health Cloud Salesforce isn’t here to take the place of your EHR. Instead, it acts as the bridge that connects legacy systems and integrates apps into a flexible, compliant platform. It turns valuable insights into tangible actions while maintaining a patient-centered care approach. Also, it helps hospitals and health systems by streamlining patient care and special clinics to specialize in specific areas of care.
And that’s not all. Health Cloud goes beyond just enhancing your EHR. Specifically tailored for healthcare providers, it offers:
A comprehensive 360-degree view of patient data, including real-time condition updates, appointment history, medications, and specialists. All are neatly accessible in one place, eliminating the need to switch screens or devices.
A holistic patient experience, empowering you to craft personalized care plans and foster connections within caregiver networks.
Seamless real-time patient coordination and engagement through private Salesforce Communities. This feature allows patients and caregivers to exchange secure messages whenever needed.
Health Insurance Provider Achieved Operational Excellence & Competitive Advantage with Salesforce
Improvement in the Registration Process
E-course tracking made easy
Growth in revenue
Health Cloud brings tailored features to the health insurance sector, empowering payers to engage members and providers in proactive, efficient ways, including:
With smart utilization management, real-time integration, and effective risk identification with legacy systems and EHRs, agents can access a comprehensive view of any member’s health.
Agents with in-depth member knowledge can deliver tailored interactions and proactive assistance through intelligent suggestions. A dynamic knowledge base equips agents with real-time member information for swift and thorough support.
Opt for omnichannel communication, automated workflows, and pre-made templates to strategically engage members from their first step – acquisition and onboarding – to staying put. Health Cloud is the cornerstone of patient support for big and small biotech and pharma companies.
From Fragmented Systems To Seamless Care: Transforming Healthcare Operations with MuleSoft Integration
Increased Overall Management
Improved data storing and management
Improved appointment management
Health Cloud is the bedrock for patient support initiatives across biotech and pharma firms, both large and small.
Enhance medicine delivery efficiency by navigating prior authorizations, patient registrations, and fulfillment tracking. This sets the stage for expanding therapy-specific support programs, simultaneously reducing operational costs and bolstering positive health outcomes.
Health Cloud facilitates tailored engagement by meeting patients and HCPs where they are, across their chosen devices and in real-time. Individual case management, accessible through various touch points like phone, web, and mobile, grants companies immediate insights into patient journeys and enables personalized care.
If you are intrigued by the seamless Salesforce Health Cloud features like intertwining clinical data, social determinants, and individual preferences, Salesforce has four different licenses per business requirements and usage.
Check out the detailed Salesforce Health Cloud pricing here to ensure an enhanced care process and improved outcomes while fostering good patient relationships.
Cost: 325 USD/ User/ Month (Billed Annually)
Features Included: Agentforce capabilities (build and customize autonomous AI agents to support employees and patients 24/7), Clinical and Insurance data models, deliver personalized care with integrated care management, utilization management by automating decisions based on medical policies, and advanced therapy management capabilities.
Cost: 500 USD/ User/ Month (Billed Annually)
Features Included: All Enterprise edition features along with more storage, Salesforce Health Cloud data models, and automation capabilities, predictive and generative AI, and premier success plan and full sandbox.
Cost: 700 USD/ User/ Month (Billed Annually)
Features Included: Out-of-the-box capabilities of Salesforce CRM for healthcare, All Unlimited edition features with Service Einstein AI, Data Cloud capabilities, Slack, customer communities, and more.
Cost: 700 USD/ User/ Month (Billed Annually)
Features Included: All Unlimited edition features with Sales Einstein AI, Data Cloud capabilities, Slack, customer communities, and more.
Deciding the right Healthcare product from these four editions based on requirements, leads to a better decision.
Here are the latest innovations in Health Cloud announced by Salesforce CRM for the healthcare industry.
Salesforce AI, a game changer in the healthcare industry, streamlines numerous tasks from analyzing patient medical histories, summarizing provider notes, and creating personalized patient outreach emails. This innovation enables organizations to deliver more personalized and timely care, enhancing patient experience and satisfaction.
Patient and Member services enhance patient interaction by providing a robust contact center for immediate support. By leveraging pharmacy benefits re-verification and financial management assistance, it provides more accuracy in medication coverage.
This innovation caters to public health challenges such as disease surveillance and monitoring outbreaks. It offers behavioral health to support a patient’s mental well-being and a crisis support app for instant assistance during emergencies. By harnessing the intelligence of Salesforce Health Cloud assessments, it can deliver valuable insights and better health outcomes.
These are the latest innovations of Salesforce for the healthcare industry.
In conclusion, the implementation of Salesforce Health Cloud holds paramount importance for healthcare service providers. This cutting-edge solution empowers you to seamlessly manage patient data, enhance care coordination, and drive operational efficiency.
As you embark on this transformative journey, remember that leveraging suitable resources and ongoing support, such as partnering with a trusted Salesforce Implementation company like Cyntexa, is instrumental in navigating challenges and optimizing outcomes.
By harnessing the capabilities of Health Cloud, you can elevate patient experiences, improve decision-making, and ultimately lead your industry with confidence and innovation.
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Salesforce Health Cloud streamlines patient information management, offering a unified platform for healthcare providers. It enhances care coordination, improves patient engagement, and provides a 360-degree view of patients' health data.
Salesforce is used in healthcare to improve patient care, streamline operations, and enhance engagement. It offers tools for managing patient data, care plans, and communications, ultimately leading to better healthcare outcomes.
Salesforce Health Cloud is a specialized CRM platform for the healthcare industry. It provides features for patient data management, care coordination, and collaboration, aiming to deliver patient-centric care and operational efficiency.
Benefits of Salesforce Health Cloud are better care to patients, properly aligned operations. Enhanced patient engagement, improved care coordination, and a comprehensive 360 degree view of entire patient’s history and details, encouraging healthcare providers to deliver better experience and informed decision making.
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