CRM in Healthcare: Vertical Markets Spotlight

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While CRM technology is used in many similar ways across a lot of industries, in healthcare there are special considerations due to the Health Insurance Portability and Accountability Act (HIPAA), a federal regulation that protects sensitive patient health information and limits what information doctors can share and with whom. HIPAA also requires special data storage and communications safeguards to ensure that patient data is protected from hackers. CRM systems have a special role to play in this very volatile and regulated market.

The global healthcare CRM market, which research firm IMARC Group valued at $13.9 billion in 2022, is expected to grow at a compound annual rate of 12.7 percent through 2028.

Healthcare organizations use CRM solutions to manage customer-related processes, including comprehensive patient management, dashboards and reporting, caregiver management, communication tools, appointment scheduling and automated reminders, and a lot more. CRM systems record patient information, such as medical histories, office visits, prescriptions, medical bills, etc., into a holistic profile. Some offer proactive support to patients, caregivers, and loved ones. They are widely used across all kinds of healthcare operations, from the largest hospitals, clinics, diagnostic centers, pharmaceutical manufacturers, and health insurance providers to small practices with just one or two practitioners.

Some of the major healthcare CRM players include Salesforce, Microsoft, Oracle, and Pegasystems, according to Evolve Business Intelligence Research.

Not surprisingly, healthcare CRM gained ground during the COVID-19 pandemic, and it was forced to adapt to the new prevalence of telemedicine that replaced in-office visits. But even before COVID, the remote monitoring of patients with various data integrated into CRM systems had been a growing trend. Now that people are returning to physician’s offices and other healthcare facilities, the remote monitoring of patients with chronic conditions continues to be an area of growth. Convenience, around-the-clock support, proactive care, and better health outcomes are among the top reasons for both patients and providers to like this option.

“As consumer demand for healthcare moves online, healthcare providers are often finding that they are getting more disconnected from their customers,” says Alex Levin, CEO of Regal.io, a provider of outbound phone and SMS sales solutions.

“Establishing positive customer relationships is essential in healthcare,” says Scott Chesrown, cofounder and chief operating officer of Perry Health, a New York-based provider of at-home diabetes care and monitoring. “Efficiently caring for patients and managing complex medical conditions such as diabetes requires being able to personalize individual care journeys for patients to drive outcomes.”

Perry Health had previously used a CRM system connected to an automated dialer, but these systems lacked functionality for managing complex journeys across various teams and made it difficult to intertwine the data across multiple systems, according to Chesrown.

“We have been able to invest in all kinds of new scalable customer flows with Regal.io, and we were able to achieve massive productivity gains by using their automations. We’re able to ensure the right teams are helping our patients with the right problems, be it nurses, dietitians or health coaches. Regal.io has driven a 50 percent increase in customer engagement and has made our team four times more productive.”

Closely related to patient monitoring and outreach is patient education, another healthcare priority that only intensified during the pandemic. Proactive outreach with prevention and self-care information can protect people from developing serious illnesses or symptoms.

This is important for parents, especially people who will be first-time parents, to keep mom and baby healthy.

Such was the case for Children’s Wisconsin, which uses its CRM system as the engine behind its outreach to new parents. The healthcare provider’s program sends targeted emails at very specific times throughout the newborn’s first year of life, emphasizing Children Wisconsin’s availability to help with a variety of healthcare needs for infants.

“One of the things we do is our baby first-year newsletter that marks different milestones,” says Kelly Lentini, program manager for CRM at Children’s Wisconsin, a 300-bed acute care pediatric hospital in Milwaukee. The newsletter includes what to expect at different intervals in the child’s development. There are also reminders for checkups when recommended.

The newsletter gives parents reassurance when development is going as expected and warning signs for parents to act quickly when it isn’t, but the underlying message is that Children Wisconsin “is there for them and we are very easy to reach,” Lentini says. “This helps a relationship with us and them that we hope continues until the child reaches 18.”

Interestingly, the most successful outreach program that Children’s Wisconsin has conducted is one for adults who had congenital heart disease as children. Like other pediatric healthcare facilities, Children’s Wisconsin doesn’t provide care for adults, but it has a continued interest in their long-term health. The outreach program resulted in a 400 percent increase in lapsed patients returning to healthcare providers for wellness checks, according to Lentini.

Some healthcare providers are using CRM systems to monitor the health and well-being of their own employees, an issue that has become critically important due to the stress of healthcare jobs, says Dinesh Sheth, founder and CEO of Green Circle Life, which provides an all-in-one communication and engagement application for employees to access HR, wellness, and healthcare services from any PC or mobile device.

According to a 2022 Physician Burnout & Depression Report from Medscape, 56 percent of critical care physicians and 60 percent of emergency medicine physicians report burnout, which hurts healthcare organizations’ ability to hire and retain skilled doctors. The industry is still seeing high turnover, as healthcare employment is still below pre-COVID levels. 

“We provide a platform for employers to communicate effectively with their employees, which is a different take on CRM,” Sheth says. “Most organizations are very focused on connecting with their customers or patients, but sometimes their employee services are not as efficient as they should be. We supply a health and wellness solution to help their employees engage in a healthy lifestyle.”

The healthcare industry, especially recently, tends to have very high stress levels and employee burnout, Sheth notes.

“There is a high turnover rate; many physicians are quitting. And while several industries have shortages of employees and professionals, the need is particularly critical in healthcare,” Sheth says, because it can cost nearly a million dollars to replace a physician when one takes into account all of the training that is required to reach certain levels within the profession.

Companies need to ensure that their employees know not only workplace policies and procedures but also that the employer supports them, Sheth says. The company’s employee engagement and communication platform, SmartFHR, schedules proactive outreach on a continual basis. In addition to other capabilities, SmartFHR allows healthcare providers and other employers to engage employees in their own health and wellness initiatives for better outcomes.


Much of the idea behind patient education, patient outreach, and communication with internal employees is helping people be engaged in their own healthcare, a trend that has really taken off in just the past few years. Another element of self-care that is becoming more common in the healthcare industry involves self-service web portals that enable current and prospective patients to make appointments, start the intake process, fill out forms, access their healthcare records, review educational materials, and take advantage of other services.

Patients expect friction-free experiences every time they interact on any channel, Pegasystems says in describing its customer service for healthcare solution. Pega’s system provides omnichannel, artificial intelligence-powered, end-to-end automation and other technology to enable patients and contact center agents acting on their behalf to tap into real-time guidance to handle many of their own healthcare needs.

Pega is one of many CRM vendors offering self-help healthcare platforms. To make such platforms work, though, often requires integration with electronic health record (EHR) systems—also sometimes referred to as electronic medical record (EMR) systems. For most healthcare providers, this integration is critical.

Typical EHR systems provide a full detailed record of all care received and act as the central hub for all medical data and billing, but they don’t offer the flexibility and configurability needed to effectively manage day-to-day patient encounters.

By integrating their CRM and EHR systems, healthcare providers gain a full suite of patient engagement tools that unify marketing, lead intake, patient onboarding, care management, billing, insurance claims settlement, and more. At any stage in the patient care pathway, providers can communicate with patients by text message, email, or phone. And they can even gather real-time insight into patient feedback afterward, allowing them to respond quickly and efficiently to patient concerns.

This was the impetus for Epic Systems to pair its EHR with Press Ganey, a provider of patient, member, employee, and customer experience solutions across the healthcare ecosystem. The two companies in March announced a collaboration and deep integration of patient experience data and insights into Epic’s more than 300 million patient records.

Further integrations between these two vendors, and between the plethora of other systems in the CRM and medical records spaces, are ongoing, giving patients personalized experiences and providers a holistic understanding of all patients.

The end game for all healthcare organizations is where CRM really shines. CRMs can improve patient engagement, which can improve patients’ chances of returning for future healthcare needs and referring other people to the organization. It can also help providers grow and maintain their patient rosters over time. 

Phillip Britt is a freelance writer based in the Chicago area. He can be reached at spenterprises1@comcast.net.

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