Salesforce is notching wins in its bid to provide customer relationship management software to healthcare companies but faces a formidable foe with a home-field advantage — Epic.
Salesforce has been targeting the industry since 2015 and is building a suite of artificial intelligence-enabled products including tools that can help providers verify benefits and book follow-up appointments and help patients find a provider.
Related: Is Salesforce the big tech company that figured out healthcare?
Meanwhile, Epic's CRM product rolled out two years ago, Cheers, is winning business from systems already connected to its market share-leading electronic health record product. About half of its EHR customers use the company's contact management tool that gives call center staff more information about a patient's medical history and about a quarter use a product designed to make it easier to build marketing campaigns.
Sam Seering a product manager at Epic, said the company saw health systems spending up to 12 months to integrate a CRM product from a vendor and it aimed to be faster. The company primarily competes with CRM tools built by large vendors including Oracle and Salesforce, he said. Alex Lennox-Miller, lead research analyst focused on healthcare IT at Silicon Valley Bank agreed.
"The biggest competitors to Salesforce are Oracle and Epic," Lennox-Miller said. "When Epic announced Cheers in 2022, that was basically a shot across the bow to Salesforce."
Health systems increasingly view CRM products as critical to adding customers while deepening their relationship with existing ones. Providers are able to enhance patient experiences with more intelligent call centers, build specialized marketing campaigns based on characteristics identified in a health record and use less manpower to fight denied claims.
"We said that healthcare needs CRM, so I think [EHR and other types of companies] coming to the CRM world is actually very, very good from a market perspective," said Amit Khanna, senior vice president and general manager of health at Salesforce. "But it also proves our thesis that in 2015 when we started CRM for healthcare, it [was] the right thing to do. The market has realized it."
A health system's decisions on CRM depend on the functionality desired along with the budget. Here is how three providers are approaching their programs.
Northwell Health
In March 2023, New Hyde Park, New York-based Northwell Health saw an opportunity to completely change how its EHR, CRM and data infrastructure operated. Northwell chose Epic's EHR system, Salesforce's CRM product and Google Cloud for its data infrastructure.
When the health system implements the first phase of its new EHR in April, the Salesforce and Epic products will be integrated. Epic pushed Northwell to use Cheers and it would have been cheaper but executives declined, said Joseph Moscola, the health system's executive vice president of enterprise services.
Moscola declined to provide specific financial details, but said the system was spending $1.2 billion to implement both Epic and Salesforce. The combination will create a better user experience, he said.
“Epic is a fantastic electronic health record, and they have [an] incredible amount of additional functionality that we are using,” Moscala said. "But just when it comes to this, I mean CRM is all Salesforce does."
Building deeper integrations between EHRs and third-party CRM companies can be difficult and costly. Northwell spent time trying to determine how it could get the two products to work together in a more meaningful way, Moscala said. Protecting patient information was a priority, he said.
After the first phase of the integration is completed, Northwell plans to automate MyChart messaging using Salesforce’s chatbots and streamline patient tracking and referral management. Moscala said. That should help patients be matched with the right clinicians faster.
Nebraska Medicine
Nebraska Medicine began using Salesforce to improve patient experiences in 2019, before Epic introduced Cheers. The Omaha, Nebraska-based health system sought to mimic the way retailers and airlines, for instance, interact with customers.
Alison Freemyer, manager of marketing operations at Nebraska Medicine, said the CRM is able to pull limited information from its Epic EHR and use it to target emails to particular groups of patients. For instance, an email about preventative lung screenings might be sent to people with a history of smoking. Freemyer said the health system's nonclinical employees don't have access to sensitive patient information in the EHR.
"[CRM] allows us to provide the care people expect," Freemyer said. "Today, people expect health systems to care about them really deeply, to know them really well and to provide really personal experiences equal to the types of experiences other types of organizations and companies provide. I think that's something that healthcare struggles with."
Tampa General
Tampa General Hospital issued a request for proposals for a new CRM in August 2023 and went live with Epic Cheers in September. It already uses Epic's EHR.
Tampa General was focused on finding a vendor to improve patient care coordination. The system, which has five hospitals, considered Salesforce but found Epic delivered similar functionality at a lower cost and had a faster deployment time and was more closely integrated into existing workflows, said Dr. Peter Chang, senior vice president and chief transformation officer.
He said systems should prioritize the experiences of current patients before spending the majority of their time seeking new patient growth from website traffic. “I think it's putting the cart before the horse a little bit," Chang said.
It rolled out the initiative that used Epic Cheers and other third-party vendors in September. The integration creates a more customer-friendly experience, Chang said. Customer service representatives speaking with patients are able to route information to the proper clinical team. The system does not charge for the interactions, he said.
"In the near future the automated system will know that a caller has an appointment coming up in two weeks and ask if that's what they're calling about," said Chang, adding that automation would mean representatives would handle the more complex calls.
Tampa General said it planned to turn on other features in Epic's CRM by the end of 2025.
