EMRs’ plans to deliver CRM is a resolution you shouldn’t bet on

We, the founders of Cured, are proud alumni of the game's biggest electronic medical record (EMR) company. We understand how the access to transactional patient access, revenue cycle, and clinical data that EMRs provide can drive health tech innovation. EMRs can be a tremendous force in setting the foundation for health tech companies to build upon to improve the status quo. 

In this article, we’ll cover how health systems should evaluate the CRM landscape and make informed choices that will save time and money while enabling them to more efficiently and effectively reach and engage patients.

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The hurdles EMRs create when positioned as a catchall solution.

When evaluating new technology purchases, the significant investment required for EMRs tends to influence health systems chief information officers (CIOs) to have an EMR-first mentality. The downfall of this approach can be a costly one. 

Epic famously won the market by shifting the industry buying preferences from best-of-breed toward a single integrated platform. However, the EMRs latest foray to expand its platform with the promise to deliver customer relationship management (CRM) functionality (e.g., Epic's Cheers, Oracle Cerner's HealtheCRM) misses the mark for organizations needing to build relationships with their patients effectively.

The most notable and valuable use cases for CRMs in the health system landscape center around acquisition, retention, and loyalty for patients, which are areas solved by marketing automation and areas that influence revenue and build your brand; EMRs may solve other CRM problems (e.g., contact centers and basic appointment reminders), but it is certainly not the solution for your marketing, business development, or growth teams.

Healthcare business and technology leaders can save thousands of hours (and millions of dollars) by not hanging on the hope that EMRs will solve every problem they face.

Here's why:

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Enterprise resource planning (ERP) companies tried this over a decade ago and failed.

Transactional systems do not deliver modern consumer experiences that build relationships. We've seen this play out before. Before the EMR became the technology of choice in healthcare, every other industry used ERPs to manage their transactional processes (e.g., supply chain, finance, human capital). Similar to how many health systems use EMRs – these are designed to address your day-to-day operations (e.g., encounters, orders, charting, revenue cycle). Similar to Epic and Cerner in the current EMR landscape, two prominent leaders emerged in the ERP space – SAP and Oracle. A decade later, all those organizations that relied on ERPs realized they needed an additional layer to communicate with their constituents (e.g., vendors, partners, businesses, customers) – and with that came the advent of the CRM.

ERPs we're not designed to manage or house engagement information (e.g., preferences, accounts, contacts, opportunities, cases), and those same ERP platform vendors attempted to make inroads by making a CRM "on top" of their ERP platforms. They both failed. Meanwhile, a company started by ex-Oracle leaders called Salesforce began to thrive. They created a purpose-built Salesforce automation platform to solve many early CRM use cases. Leaving Oracle and SAP scrambling to build or acquire platforms to gain market share… but it was too late.

Salesforce was already the de facto choice and created the opportunity for many other CRM-first companies to enter the market. Instead of adopting new technology, many enterprise organizations stuck with their ERP vendors for their CRM. Years later, almost all have purchased Salesforce – a costly lesson. 

For those ERP companies, CRM was an afterthought. For the CRM companies, this was their sole purpose. The experience and usability Salesforce and its followers provided never matched those early attempts from the ERP players.

The same is and will be true of any EMR company trying to build a real CRM – especially one that can provide proactive outreach, engagement, and marketing. 

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EMR's history with CRM is lackluster and full of undelivered promises 

Customer relationship management can mean many things, and EMR has been toying with the idea of CRM for many years. EMRs historically have repurposed internal messaging capabilities as CRM functionality for front-line staff to send messages to health information management (HIM) and billing teams to resolve patient calls. However, this is a tiny percentage of what is possible and needed for a great digital experience.

We mention this because while EMRs may launch a more cohesive attempt at CRM, it still centers around providing service to your existing patients. It is not about growing your market share or getting new patients to your services. Furthermore, this needs to address a health system's world of B2B relationships. Payors, providers, employers, and donors require powerful, digitally-driven relationships to develop the total addressable patient market. 

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CRM strategy focuses on driving people to EMR portals, which are under-invested in and lack patient adoption and usage

You must recognize that almost all patient-facing communication from EMRs is routed in lackluster patient portal experiences. You may receive an email, but it will be unbranded plain text and send you to the portal (e.g., web or mobile app) to log in to finally read the message. 

For particular communications, this is ideal (e.g., lab results, sensitive clinical updates). However, there are more effective means to drive action for most situations (e.g., appointment reminders, basic appointment preparation, patient instructions, wellness reminders). At most health systems, less than half of their patients have activated a portal account, and a smaller percentage interact with it regularly. It's pretty hard to be an effective CRM if all the messages you send require your patient to log in to a portal or app to take real action.

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EMRs are not built to drive prospective patients interaction, limiting opportunities to establish new patient relationships

Ok, let's discuss the elephant in the room. EMRs interact with existing patients. What about those who are not yet patients or are no longer patients? Those who are part of a patient's household have come to your website, filled out a form, and called your contact center to learn more about scheduling appointments. Since EMRs rely on the dataset from the underlying record, it does not have the tools or the data model to store and manage information about all these "prospects." Once again, this a reasonable idea if you are focused on servicing your existing patients — not so helpful when growth is a primary function of your CRM initiative. 

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We've seen this reel before (e.g., BI & Analytics, Population Health, App Stores, Portals, PHRs)

In many ways, big EMRs are like Google regarding new product offerings. They identify platforms other vendors have built and are gaining traction within their customer base, then dip their toes into those waters. Some have become core (patient portals), and others have shown limited success (app stores, personal health records). Many platforms have become the leaders in those areas, despite EMRs' entry, because they created a purpose-built tool to solve a large problem area. The lesson for Health Systems is that just because EMRs build or offer new products does not mean it is the best solution for your needs. It may be quite the opposite —specialization matters. 

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There is little to no consumer-focused DNA in-house at EMR organizations

EMRs haven't historically invested internally in Marketing and CRM. EMRs employ brilliant, talented, and skilled people who focus on healthcare providers and EMRs—an exceptional value to their customers and their products. However, to build a product that crosses boundaries and injects strategies and techniques from other industries, like a CRM, you need a lot of outside expertise. An EMR is a lot of things, but they are not marketing, growth, or consumer experience experts.