CRM: The Smart Bet vs. The Safe Bet

Gary Druckenmiller, Jr.
Tue 8 Nov 2022
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Play it safe.

Better safe than sorry.

You don’t get fired for buying IBM.

You don’t get fired for using (insert your organization’s EHR brand here) for your CRM.

Classic maxims many executives and IT leaders live by. But should they? When it comes to choosing a Customer Relationship Management solution today, the answer is simple.


A better maxim for healthcare leaders would be “look before you leap.” While you might not get fired for using your EHR’s add-in “CRM module” as your CRM, you will end up with a CRM solution that doesn’t make your consumers cheer. Or your CFO.

That’s because the EHR wasn’t designed to deliver the business-building power you expect from a CRM. The reason: Their focus. As we all know, the EHR was designed to move the industry from paper charts to electronic health records. That focus has been a resounding success. More than 94% of healthcare organizations now use EHRs.

But 29 years after Peppers and Rogers introduced the one-to-one future, 14 years after the term “healthcare consumerismentered the vernacular, and nearly three years since the pandemic exposed healthcare’s broken digital consumer underbelly (exposing the need to accelerate innovation and digital transformation), major EHR vendors are only now fleshing out their first attempts to respond to consumerism with bolt-on CRM solutions.

Is it safe to go all-in on a CRM from a vendor whose core competency is electronic health records? That’s not unlike buying into Shimmer, the dessert topping that was also a floor polish. That lack of focus, that 40-plus years of sunk costs into EHR as a core competency, is a huge risk that’s obscured by the deep investments and relationships healthcare organizations have established with their EHR vendors.

However, knowing full well the limitations of the EHR, the question must be asked: is it risky to innovate on a contemporary CRM platform that works with your EHRs? Or is it risky to bet on a CRM ßeta test built on 1980’s-era innovation? Sure, you can check the CRM box by pouring more dollars into an existing EHR relationship. But when it comes to choosing a CRM solution, what feels like a safe bet—doubling-down on your EHR investment—isn’t the smart bet.

It’s crucial to invest in the future, in true digital transformation that will delight consumers as well as the marketing and finance departments, and your clinicians, as opposed to taking the safe but certainly not smart path. Here’s why.


Ask yourself if your organization can afford not to look beyond your EHR vendor’s CRM offering. Would it be wise to consider those who specialize in CRM? Given the unprecedented financial and operational pressures providers, hospitals, and health systems are under today, it’s crucial to ensure the CRM you settle on is a bona-fide business builder, with high ROI.

Unlike the COVID pandemic, providers can’t count on federal and state agencies to shore up their finances as the economy takes a nosedive, elective procedures continue to wane, bad debts grow, operational and CapEx costs climb, staffing shortages worsen along with rising labor costs, and so on.

In fact, hospitals are facing their worst year financially since the start of the pandemic, according to the American Hospital Association. When it comes to healthcare, you can’t cost-cut your way out of a pandemic or a recession. You must find ways of running more efficiently and differentiating yourself from the pack by giving consumers a more satisfying end-to-end experience—one that results in higher patient retention and market share gains.

Meanwhile, a new generation of innovative healthcare providers and consumer-savvy retailers are leveraging the latest CRM technologies to outperform and outcompete entrenched providers who, in the main, wrongly believe they can rely on their system of record—the EHR—to drive consumer engagement that activates markets and builds the business.

Certainly the chaos and losses healthcare endured during the first year of the pandemic had never been seen before. But there was a silver lining to that dark cloud. Congress, the states, and the White House (both the Trump and Biden Administrations) swung into action and authorized policies that eased the financial burden on providers—even to the extent of forgiving most if not all of the loans.

Those unprecedented actions helped alleviate the fiscal impact of revenue loss due to delays in non-urgent care, and costs associated with COVID-19. But these emergency acts can’t be counted on as we head into the uncertainty of the 2023 economy and beyond.

Healthcare organizations today need to plan for the worst case scenario. Attempting to leverage the EHR as a CRM platform, simply because it’s your system of record and you have a great relationship with the vendor, is “hiring” the wrong system for the wrong job. If we are going to put the patient first—which is what CRM is all about—then we need to fuse the best our EHRs can be with the best CRM technology available. And that takes us right back to focus and core competencies.


Let’s drill into specific technical aspects that EHR administrators and C-suite healthcare leaders in general need to know, so they can look beyond their EHR for CRM capabilities with confidence. Here are the top eight arguments.

  1. EHRs are essential but legacy technology. The leading ones were designed and built in the 1980s as the digital patient chart of record for on-premises use. They have 40 years of legacy code running them, reflecting 40 years of legacy thinking. It’s almost impossible for EHR vendors and their development teams to be an expert in anything other than core EHR functionality, because their entire culture is built upon that. You want a CRM solution that’s built by healthcare data experts, not EHR experts, and not retail CRM experts.
  2. EHRs are not native to the cloud. Often what appears to be a modern EHR implementation in the cloud is what techies refer to as a “lift and shift,” where legacy on-premise systems are simply redeployed in the cloud—when in fact, they should be replatformed. The leading EHRs are not cloud-native and, as such, can’t provide the capabilities a cloud-native solution can (such as elastic scaling, to name but one obvious difference). It’s 2022. Your CRM should be native to the cloud and operate on a PaaS/SaaS managed services model, with all the technical, team, and financial benefits that brings.
  3. EHR’s only show part of the patient picture. When your EHR is your CRM, your organization's knowledge about the patient is limited to their interactions and visits within your enterprise. What do you know about that person after they leave? Nothing. What do you know about them before they come into your system? Nothing. The EHR record at the heart of your CRM only has data from when patients are within the constructs of your hospital framework. You can’t provide a holistic consumer experience with partial or fragmented data.
  4. EHRs are data silos. According to Morning Consult, 97% of healthcare executives want greater data interoperability, nearly half said their data is fragmented and siloed, and 58% didn’t believe their EHR could support their enterprise data strategy. Their EHR can’t support their CRM strategy, either, because doing so requires a cloud-native solution that integrates data from EHRs (plural) and other IT systems (clinical, financial, marketing systems, etc.) both inside and beyond the hospital’s four walls. You need a CRM that plays well with others and breaks data silos.

  1. EHRs are vertically integrated. This is a variation of point #4, but it needs to be called out explicitly. Most EHR vendors (and, to be fair, most HIT vendors) hold patient data hostage to monetize interoperability. They charge integration and usage fees if you need to connect your patient data with the outside world. This creates an extra financial burden for providers at a time when operating margins are shrinking, cash flow is tighter than ever, and costs overall are rising due to inflation and the ongoing staffing shortage. You want a CRM that integrates with whatever data sources you need to paint a full 360-degree picture of the patient as a consumer.

  1. EHRs have never been a revenue generator. Beyond billing, the EHR has never been a revenue generator. It’s blind to new consumer acquisition, retention of past patients, retention and expansion of families as they move from generation to generation … the EHR is notorious for its inability to track and report on any of that. In rare cases where an EHR does connect some of those dots, it won’t engage the consumer. It simply sends an email telling them “something has happened” and to logon to their portal. The entire point of embracing healthcare CRM is to enable omnichannel patient engagement and exceptional consumer experiences—a point EHRs entirely miss.
  2. EHRs, FFS, and VBC don’t mix. You work in a world where there are myriad care and payment models, and they can differ from patient to patient and contract to contract. Your EHR lives in a fee-for-service (FFS) world. Full stop. Your CRM needs to be smart enough to support your population in ways that are not simply reactive for sick care (FFS), but proactive for health care (i.e., value-based care, or VBC). It needs to understand and act on risk stratification, SDoH, TCM (transitional care management), gap closure, and so on—the consumer’s clinical context—so it can engage at-risk and underserved communities to improve the population health outcomes that drive the quality, equity, and satisfaction scores that drive revenue. It’s essential that your CRM has both FFS, APMs (alternative payment models), and VBC in its DNA. It must understand population health management and talk to consumers not just at a clinical level, but at an individual level, automatically across the entire journey. Not just part of it.
  3. EHRs won’t let you outperform retail leaders. The industry is changing fast. Hospitals and health systems must prepare to compete with retail giants who are getting into healthcare. They are decades ahead of healthcare in understanding digital transformation and omnichannel consumer engagement, and they’re getting better at understanding healthcare by the day. Your CRM needs to give you consumer engagement capabilities as sophisticated as the best retailers, and leverage the healthcare delivery, reimbursement, and interoperability savvy that will elude these retailers for some time. That’s how you pull and stay ahead. Your EHR can’t bring all that together. A cloud-native CRM that’s built for healthcare can, and will.

One additional comment on the changing retail landscape of healthcare and its relation to CRM: We won’t see Walmart or Walgreens or CVS getting into secondary or tertiary care. They're not getting into orthopedic visits and surgeries and cancer care or nephrology or other specialities. They're doing primary care, end of story. They're going after the low hanging fruit, because there's higher out-of-pocket spend from consumers, now that deductibles are through the roof. 

By embracing a true healthcare CRM, you have the opportunity not only to compete head-to-head with these new entrants, but to own it all—find, guide, and keep patients for life. You can earn the same level of trust and satisfaction that these giant retailers enjoy, but do it in healthcare.


I’ll say it again. When it comes to choosing a healthcare CRM solution, the safe bet isn’t the smart bet. The smart bet is the safe bet—choosing a contemporary, cloud-native CRM that has no trouble connecting to multiple EHRs and other IT solutions, and is built to find, guide, keep, and delight patients for life (not to mention delighting clinicians and healthcare marketers).

Your EHR is a great clinical tool. It’s your system of record. But CRM is about your patients as consumers. What about them? Can your EHR ingest and master consumer and provider data to power sophisticated, clinically contextual engagement strategies? Can it interoperate with your martech stack? Can it help you measure and optimize ROI across all engagement efforts? Can it integrate without hiring a costly system integrator? Can it do all of this in months, not years?

Your patients are only patients 1% of the time. They're consumers 99% of the time. You need the “consumer 360” profile to engage them as non-patients too. That’s the path to the patient satisfaction and consumer loyalty that drives financial strength and business stability in an uncertain economy.

I’ll leave it at this: I’ll wager you wouldn’t even consider an EHR or even an EHR add-on toolfrom a CRM or RCM vendor. You’re after core competency. So why consider a CRM add-on from an organization whose core competency is the EHR?

At a minimum, given the economic future we seem to be facing, and the need to electrify the consumer experience, conduct the due diligence and talk to the leading healthcare CRM vendors (of which we are one that I hope you’ll consider).

Play it smart. You won’t be sorry, and your patients (and CFO) will thank you!


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Tags: Healthcare
Gary Druckenmiller, Jr.
General Manager Customer Relationship Management Innovaccer

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