What CRMs Can – and Can’t – Do for Health Systems


Q&A with Craig Kartchner
AVP of Marketing and Customer Experience

For years, customer relationship management (CRM) systems have been foundational to reaching existing and potential customers. But for leading healthcare systems, a successful marketing strategy has to go beyond traditional CRM. Balancing limited appointment inventory with patient expectations requires highly precise, real-time data paired with sophisticated automation.

This Q&A with Craig Kartchner, AVP of Marketing and Customer Experience at HonorHealth, delves into the finer points of CRM for health systems – where the product gaps are and how it fits into a more comprehensive marketing ecosystem. By rethinking traditional marketing strategies and focusing on each patient’s next best action, healthcare leaders can make more informed decisions about how to best leverage CRM.

How are healthcare organizations defining and integrating CRM?

I don't claim to know it all, but I think that healthcare has often mis-defined CRM. They have borrowed too much from the origins of CRM, which was for sales and developing a relationship with sales prospects.

But really the interaction and relationship that you're managing with a CRM in the sales environment is around a product or service. It's much more confined and defined, and there are a lot fewer and less complex interactions than in healthcare. Healthcare organizations are not going to get what they want out of a traditional CRM tool.

What are some gaps in CRMs for healthcare organizations?

CRM is an ambiguous term, and there's overlap with a lot of other platforms. You really have to think of the health system’s entire ecosystem of which CRM is just one component. Marketing automation is often conflated with CRM. Sometimes it is the same platform, but the two shouldn't be confused, given that they serve separate functions.

Even more important is your data modeling and the way you analyze your data. Predictive analytics and propensity modeling does not happen in a traditional CRM. In addition, some patient engagement tools, appointment reminders, etc. are not CRMs. They provide ways to serve your customers' needs and engage with them. Those tools relate to the CRM, but they are not the same thing.

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Do healthcare marketers consider CRMs as tools or strategies? Why?

That's a good distinction. I used to be very guilty of that exact mentality. I used to believe – and even used to describe it in presentations – that a CRM is like the person in court who would whisper in the king's ear and say, "Hey, this next guy coming in the room is the Lord of So-and-So," so the king can remember, "Oh Lord So-and-So, pleased to meet you." I thought we needed to catalog every single interaction in the CRM, in addition to response rates, so you could prompt the next interaction.

It turns out that patient needs may not be easily catalogued in the CRM. And if you don’t understand what the patient needs, then it doesn't matter what you do. Those needs come from integrating with your EMR and other platforms.

How do you make the case to leadership for a CRM strategy?

It is difficult to gain approval because it’s expensive to build an ecosystem beyond just a CRM. Convincing your leaders includes sharing the benefits of having access to patient data to better understand and market to your customer, benefiting both the provider and the patient. With retailers, for example, they want their vendors to have access to their data. They give vendors real-time access to register-by-register data. They know exactly what's on the shelf, what's in inventory, and what's being purchased at one point-of-sale versus another.

In healthcare, marketing departments are the ones who help sell appointment inventory, but we don't have the access to the same level of data that Coca-Cola has from Walmart’s inventory, for example.

What can marketers do to improve the healthcare patient journey?

One problem is that we don't have enough primary care providers. Every health system in America has a primary care provider shortage. So, we are all petrified of losing additional providers. We can't do anything that would make their jobs more difficult, increase physician burnout, or add steps to their workflows that would increase the likelihood of them becoming dissatisfied. What can we do? I recommend two things.

  1. Be an expert. We do a lot of market research. If you don't do a lot of market research, start. Look at what you already have – HCAHPS, CG-CAHPS, etc. It’s likely that you'll have to commission more research to really understand your patients' pain points, wants, and needs. Once you're the expert and you have the data, you can then provide more value. You can be the voice for the customer because you are serving up data and not just opinions.
  2. Present the value. Once you're the expert and aggressively serving up data, pitch it. You must present it in a way that helps both the physicians and the patients. When you pitch providers, you can show respect for how difficult things are right now. For example, you can say: “You are overwhelmed. You're not staffed well enough. I want to help you better manage your appointment inventory. The more you share with me, the more I can help you. I won't run campaigns that are going to exacerbate your already overwhelmed schedule.”

Is there resistance to leveraging data to help your marketing strategies?

Historically, clinic staff have found that marketing, and sometimes call centers, can mess things up. We can send the wrong patient to the wrong appointment type or fail to do the necessary pre-work like the insurance verification.

They’re worried about that, and rightfully so. We used to do marketing campaigns where it was based on a clinic opening or a service line, promoting oncology because it's next up, or since it's Heart Month we're going to run a heart campaign. People know that's antiquated and it’s not going to work.

It's important to balance supply and demand. We have to market down to the individual appointment slot. There is availability out there, even though it's limited. But we need real-time access to appointment inventory to see where the specific slot is, not simply which clinic needs additional volume.

Do healthcare marketers need a different type of technology that ties into the CRM?

My team has literally gone clinic to clinic in our system to talk to the staff who help the physicians with their scheduling. We want to get a better understanding of the appointments: which ones are restricted and why; which ones are appropriate for which type of patient; when a patient needs a time slot that's 15 minutes versus 20 minutes. But it’s not tenable to do that manually on an ongoing basis.

To answer your question, yes. You need the CRM to be part of your always-on automated marketing system. Campaigns might exist for brand marketing or mass media, but in terms of building volume and associated revenue, it's not a campaign. It's an “always-on” strategy.

What have you implemented at HonorHealth to provide this type of experience for your patients?

We have enabled some features like waitlisting that make our strategy more “always-on”. But the biggest struggle is the lack of inventory and matching the supply with demand. We have a much better understanding of the appointment slots that are available and which ones are restricted. Now we're turning on tools to automate putting patients on a waitlist. If something opens up, we can automatically offer that slot via text. Then we’re sending that feedback to our EMR in real time.There used to be a 24-hour delay, and it would be a wasted appointment if it's same-day or next-day. We are also working on the low-hanging fruit of the patient waitlists, serving up available appointments immediately via SMS.

How do you prioritize patient retention and lifetime value?


We've focused almost exclusively on acquisition and not nearly enough on retention, but that is shifting. We have a formula to calculate lifetime value, and we take it into consideration when we're budgeting different brand campaigns. A lot of the tools that we're automating right now are definitely focused on retention.

To me, it's inexcusable that we have a shortage of appointment availability right now. There is a lot that we can predict – we know that people with certain conditions need to come in on a certain cadence. We need to do a better job of predicting that, because those are existing patients, and we need to retain them. That means doing a better job of predicting what they need and getting ahead of it, so they don't encounter a three month wait time to see their provider.

That's the part that a CRM can help with. It can provide the prompts, triggers, alerts, and even assignments to different team members to handle certain tasks.

Why aren’t all healthcare marketers adopting that type of technology?

One, it’s the expense. To build that ecosystem, you not only need operational dollars, but you also need the resources to integrate it intelligently.

Another barrier is data access. One of the most critical things that I can do as a leader is forge relationships with the people who can help us serve patients better. Then I think about how I can pitch this in a way that's going to make sense to them so that we can work together collaboratively on the patient's behalf.

Which key stakeholders do you need support from to access the data?

Clinical leaders are absolutely paramount as are the operations leaders. Then you need whoever are your data science, data analytics, or data warehouse leaders – they can open doors. Finally, you need support from frontline workers, mainly at the clinics and hospitals. These are the people who work at the front desks who are doing scheduling and rooming.

We have done a lot of rounding to specific clinics. Our call center leaders go out at least once a week specifically to talk to frontline staff. They ask, “What is frustrating you right now? What are you hearing from patients? What types of calls are you getting? What appointments seem to be mislabeled?” They dig into those details. Those relationships are so important to maintain.

What are the core metrics and KPIs that are crucial to justify a CRM investment?

follow up

We've used metrics such as the return on marketing investment and acquisition rates. One that I'm super intrigued with right now is percent wasted appointments, or how many of our total appointments go unused. More than any other metric, it can point to whether we are being as efficient as possible with the limited supply that we have.

It's taken us months of work to figure out how many appointments are available because there are so many different types of appointments, restrictions, and blocks. Just figuring out what your inventory looks like is hard enough. Then you try to figure out in real time – or as close to real time as you can – how many of those appointments you're filling. It’s a daunting task.

But that's exactly where we need to go from a marketing perspective, because it's about getting patients in, as well as from the patient experience angle, because people are desperate for appointments and we need to serve them better.

What's the challenge with getting access to appointment data?

The data is so complex, and if you don't have a robust, clear, and complete picture of it, you probably will misuse it or at least it'll go wasted. That's why it's been effective to develop these relationships with the data team, frontline workers, clinicians, and operations staff. We are better understanding the way it's set up to then suggest efficient changes, without making it more difficult for them.

What's next as you look into the future of CRM?

It’s propensity modeling – better predicting what your patients want and need in real time and serving it up to them. It's that “always-on” mentality. You can't do it manually, it has to be automated. You need machine learning or AI to help you intelligently serve up the appointment slot to the right person at the right time. I think that's the future: getting your platform together with the proper intelligence and datasets to be able to do what we described.

Listen to the full Hello Healthcare podcast interview with Craig Kartchner on your preferred streaming platform or watch the full video interview below.

About Craig Kartchner

Craig Kartchner is a senior healthcare executive with experience in marketing, communications, and customer experience. Craig oversees propensity modeling marketing and enterprise-wide CRM. His role includes mapping customers’ healthcare journeys to identify and reduce friction points and provide a better consumer experience. This involves working with all areas of the company to remove barriers to accessing care, and to make it easy and valuable for patients to engage in their own care. Craig has been with Phoenix-based HonorHealth for over five years.