Patient Relationship Management Turkey V1

Patient Relationship Management
David Hancock – Director, Oracle Healthcare and Life Sciences Industry Business
Unit

Oracle Proprietary & Confidential

Agenda

• Healthcare Trends and Challenges for
Healthcare Providers
• PRM Proposition For Healthcare Providers
• Case Study
• Conclusion


Growing Healthcare Expenditure

• Healthcare expenditure is growing due to:
• Rapid advances in medical technology
• Rising Public Expectations – especially around Quality of Life
• Deliberate policy in some countries as previous cost containment
had strained healthcare systems
• Population Ageing
• With Healthcare Expenditure growing up to 1.5 – 2.5
times faster than GDP this cannot continue.


Strategies for Controlling Costs that
Affect Healthcare Providers
1. Payment per Case – DRG’s (Diagnosis Related
Groups)
• More financial risk moved down to the Provider
• Provider has more to gain, especially if they can attract more
Patients to maximise utilisation of their capacity and
resources
2. Patient Choice
• Patients can choose which Healthcare Provider they have to
provide their treatment.
• What factors would determine which Provider you would
chose?


Strategies for Controlling Costs that
Affect Healthcare Providers
3. Improving Quality of Treatment
• Governments and Healthcare Insurance Companies are
disallowing payments when Patients are re-admitted
following discharge
4. Healthcare Organisations being measured on
Patient Satisfaction
• As part of a regulatory process, healthcare organisations are
measured on satisfaction of patients who use their services
5. Improved Patient Empowerment to manage their
own and their dependants conditions
• Especially as healthcare moves from episodic to chronic
care


Relationship between Cost and QoL
100% Home Care
Healthy Community
Independent Living Clinic
Chronic
Doctor’s
Disease Mgt
Office

Quality Residential Care
Acute Care
of Life
Assisted Specialty
Living Clinic
Skilled Nursing Community
Facility Hospital

ICU

0%
$1 $10 $100 $1,000 $10,000
Cost of Care/Day

Oracle Proprietary & Confidential Source: Intel Corp 2006

Managing and Supporting the Patient Flow
Improving the Patient Experience and Quality of Life
Pushing Consumer Monitoring
to Waiting Room Attracting Patients
BIG ISSUE BIG ISSUE BIG ISSUE
“I should talk “Which Provider “I know when my condition is
to my Dr.” should I Choose?” getting better/worse”

Patient Patient
Unaware Aware Get Patient is Patient is
Visits HC Dis-
patient patient Treatment Compliant Stable
Profsnal charged

“I may be at “I am prepared for “I am happy
risk…” my appointment” “It is important I with my Quality
take my of Life”
medication and
Consumer Wasted follow treatment Meeting ALL of
Awareness Appointments the Patients’
plan”
Needs
BIG ISSUE BIG ISSUE Adherence
BIG ISSUE
BIG ISSUE


PRM Focus on Patient Flow
Velocity Down the Flow Keep Patient Here

Patient Patient
Unaware Aware Get Patient is Patient is
Visits HC Dis-
patient patient Treatment Compliant Stable
Profsnal charged

• Identifying, Stratifying and Targeting Patients • Improving the Dischcarge
• Attracting Patients Process
• Improvement in Administrative Processes • Adherence
• to improve utilisation of resources • Patient Monitoring
• to help Patients get treatment • Supporting Patient Behaviour
• to improve patient experience Modification
• Making interventions
Focus is on Access, Resource Focus is on Outcome,
Utilisation and Attracting Patients Experience and Quality of Life


How does this Relate to Clinical
Systems in a Provider?

PRM Discharge and Post-Discharge
PRM Pre-Admission and Admission
CPOE

Nursing/Ward
ADT

System

ADT
Pharmacy

Surgery


Technology Roadmap Cholesterol
Monitor
Blood Pressure
•Dashboards Monitor
Agent (Telecarer) •Analytic Apps
Interaction Channels Assisted

Web/Portal
Business WWW Pedometer

Phone Intelligence

Email
• Patient Info • Results Captured
Training • Case Info Glucose
from Self Care Sensor

• Determinations
Web
Conference
Digital Plaster

Web 2,0 Clinical WWW
Systems
Smart
Phone Home Hub
Appliance
Access and Utilisation and Attracting Patients Medication
Tracker
Outcome
Quality of Life


Siebel Healthcare in EMEA
SALES/ACCOUNT
MANAGEMENT

BROKER/AGENT
MANAGEMENT

CALL CENTER

PROVIDER/CARE
DELIVERY CALL
CENTERS

PORTALS

BUSINESS
INTELLIGENCE


Andalusian
Health
System Public
Andalusian Public Administration
Health Sytem
7.975.672 inhabitants

38 370 80,629
8
Hospitals Primary Care Professionals
Ambulancy &
Health Centres Transp Centres


Main Services

SMS Campaign
24 * 7
Booking services for 370
1. Expected Pollen Levels
Primary Healthcare Centers
2. Flu Vaccination Campaign
3. Heat Wave advice
Hospital waiting list management
4. Antibiotics information

Hospital Discharge Follow-up 24
saludandalucía
hrs
Medical advice

1. Pediatric advice
2. Teenagers and sexuality
Living Will Registry Mgt 3. Vaccination
4. Child nutrition


Northumbria Healthcare
The Customer NHS Foundation Trust

• Northumbria Healthcare is based in Northern
England on the borders of Scotland

• It is part of the National Health Service, within
which hospitals compete for business and
patients and referring agents (general
practitioners, dentists, opticians) can exercise
their choice

• Northumbria Healthcare is entirely dependant
upon the reimbursement that it receives from
the commissioners (national insurer) as a result
of the patients that it treats

• Northumbria Healthcare NHS Foundation Trust
is one of the largest healthcare employers in the
North East, with over 6,000 staff.


ACUTE SERVICES

Maternity / Children
Services
PATIENTS
Outpatient Clinics

EMERGENCY
Therapy Services
A&E

diagnostics
Primary Care
GP’s
Dentists
Inpatient Services
Opticians
NHS Direct REFERRALS
Walk in Surgical Services

How do Patients Access their services?

ACUTE SERVICES

Services
PATIENTS

Outpatient Clinics
A&E

Therapy Services

diagnostics
Primary Care
GP’s
Dentists
Inpatient Services
Opticians
NHS Direct
Walk in Surgical Services

What does their communication network look like?

ACUTE SERVICES

Services
PATIENTS
Outpatient Clinics
•Frustrated & Stressed patients
A&E
•Missed messages and communications
•High incidence of repeated communications Therapy Services
•Contribution to high level of DNA’s
•Difficulty in managing National waiting targets diagnostics
•Danger of errors- sent to wrong clinics etc
•With the “Choice” agenda, danger that patients
go elsewhere for treatment Inpatient Services
•Dangers of “miss-counting” episodes and
therefore losing income
Surgical Services

What is the outcome?

ACUTE SERVICES

Services
PATIENTS
Outpatient Clinics
A&E
A Single Point of
Contact! Therapy Services

diagnostics
Primary Care
GP’s
Dentists Inpatient Services
Opticians
NHS Direct
Walk in
Surgical Services
Centres Contact Centre

What did they require ?

What do they see as the role of the contact centre ?
Role of the Contact Centre
Proposal For Improving
the Patient Experience

Patient Operational
Contact Services

END TO END PROCESS


Where were they starting Northumbria Healthcare
NHS Foundation Trust
from? IN HOUSE DATABASE
CURRENT SITUATION
• Creaking
In-House
Access • Doesn’t Maintain history of previous
Database contact
• Doesn’t provide common scripts
• Doesn’t provide access to
Knowledge Base
• Doesn’t Support advanced
Messaging
• Has limited process automation ie
“Workflow”
Patient
Admin • Isn’t interfaced into or out of PAS
System
• Doesn’t Build relationships between
patients
PAS
• Is not a contact tool


What Did They Need?
PATIENT

Standard Scripts Ability to fulfil service
Common Message requests
ORACLE
CUSTOMER RELATIONSHIP
Single Point of Contact
MANAGER
Record of Contacts Remove paper chase
(CRM)
“Single Experience” Through electronic
notifications
CONTACT CENTRE
Knowledge of Patient
Automate Process
Relationships
through workflow

Access to Knowledge Follow up services
Base for enquiries requests through
workflow,email, SMS


What are their Data Sources?
PATIENT
Our main patient data source and
record of clinical activity is the
Patient Administration System
(PAS)

Oracle It is essential that our CRM
system acts as a front end to
CRM DATA
this key clinical system
CONTACT CENTRE H
I
S
CLINICAL SERVICES


What was their Project Strategy

We recognise the enormous opportunities to improve the experience of our
patients and improve the efficiency of the services we provide.
However, we are approaching the opportunities with caution and have
divided the programme into stand alone phases, each independent and
supported by a stand alone business case -

Stage 1 Stage 2 Stage 3 Stage 4 Stage 5
Controlling the Extend Better Multi Chronic
interaction interfaces resource Channel Disease
between the with allocation Delivery- Management
Trust and its clinical through
Internet
Patients systems demand
TV
Each high level stage will be completed before moving onto the next
stage. This will allow us to build confidence and support amongst the
clinical stakeholders by demonstrating increasing added value as each
stage is completed.


PHASE 1 Objectives
PATIENT
Outpatient Clinics

Therapy Services
SMS / Email
Reminders Book and
amend
service diagnostics
CONTACT CENTRE
appointments

Inpatient Services

Surgical Services
Use Script
data base for “Controlling the interaction
patient between the Trust and its
Maintain interaction queries Patients”
history for all contacts


PHASE 2 Objectives

CONTACT CENTRE

RADIOLOGY

PATHOLOGY

Other Clinical Systems

Oracle
CRM
TWO WAY NEW HIS
INTERFACE

Extend interfaces with clinical systems


PHASE 3 Objectives
PATIENT Improved
Resource
management

Improved
Outpatient clinic
SMS/ Email throughput
Reminders Through Better
elective demand Improved
CONTACT CENTRE management Profitability

Through less Improved Surgical
DNA’s List management

Improved Patient
Satisfaction
Better Patient
Outcomes
Better resource allocation through demand management


PHASE 4 Objectives
PATIENT

•Exploring the introduction
•Expanding the
of wireless symptom
communication channels
monitoring technology
for patients.
•Expanding the telecoms
•Investigating email, SMS
capability to include
and interactive or
complex tele-health
community TV
facilities
CONTACT CENTRE

Multi Channel Delivery-
Internet – tv


PHASE 5 Objectives

THE REAL PRIZE – Chronic Disease Management
In the UK, it is estimated that seventeen and a half million people live with a
chronic condition and around 80% of GP consultations relate to chronic disease.
By 2015, almost five million people in the UK will die from a chronic disease, with
a cost to the UK economy of £18.8 ($28) billion.
.”Chronic disease places a huge burden on NHS resources. Those with
chronic conditions are significantly more likely to see their GP, to be admitted
as inpatients, and to use more inpatient days than those without such
conditions. The burden of chronic illness falls principally on the elderly, so as
our population ages the incidence and prevalence of chronic diseases will
increase”

Royal College of Physicians


PHASE 5 Objectives – Chronic Disease Management
CHRONIC DISEASE
MANAGEMENT INFORMATION
CARE PLAN
COMPLIANCE
CONTACT POINT
SELF CARE SUPPORT APPOINTMENT
ARRANGEMENTS
PATIENT WITH CHRONIC
• Condition monitoring DISEASE
• Improving patients quality
TECHNOLOGY
of life
Cholesterol
• Early interventions Monitor

• Avoiding adverse clinical
CONTACT CENTRE
events
• Earlier Patient Discharge

ESTABLISHED
INFRASTRUCTURE
AND NETWORK Blood
Pressure
Monitor
Glucose
Sensor


Conclusion
• 5 key drivers for Providers and Health Systems to improve
the way they deal with and interact with Patients
• Patient Choice, Payment Per Case, Disallowing payment if patient
re-admitted, Measurement of Patient Satisfaction, Patient
Empowerment
• Needs to be a New Class of Solution that works either
side of clinical applications

PRM Discharge and Post-Discharge
PRM Pre-Admission and Admission
CPOE

Nursing/Ward

ADT
System

ADT
ADT
• Oracle is leading vendor in this area
Pharmacy

Surgery

• Oracle has many references and a great vision of how this
can be developed.


Q U E S T I O N S
A N S W E R S

Patient Relationship Management Turkey V1

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