Scott MacStravic, Ph.D.
While “labeling” or naming ideas, products and services is more often a marketing challenge, it applies equally to management efforts. What we call new initiatives, significant changes, strategies, etc. can greatly influence both how we go about them, and how they are perceived as well as responded to by those who are affected by them. And there are widely divergent approaches to the labeling of management initiatives.
Customer Relationship Management
CRM, for example, focuses on managing the organization’s relationships with customers; that is clear from the label. But the ways that these relationships are managed, the “hands-on” elements that are changed, directed, monitored, etc. may be any mix of ingredients--information about customers, communications with customers, interactions with customers, etc. And within just these three ingredients are a wide range of specific applications that may or may not be included under the general CRM label.
Perhaps most important to how CRM efforts are carried out, and to how well they are accepted and implemented by staff, as well as appreciated by customers, is what the purpose, or end result of CRM is supposed to be. In the vast majority of current CRM initiatives, the success measures used to judge its worth and calculate its ROI are financial results – increased revenue and profits for the firm.
But this often means that CRM, in practice, often harms, even ends customer relationships, when customers react and respond negatively to initiatives that increase profits for the firm. Automated phone systems are a classic example, where firms dramatically reduce their costs of interacting and communicating with customers, while customers are angered over the dramatic increase such systems create in the time it takes to interact with the firm, and may reduce purchase or switch to another source.
Patient Care Management
PCM includes an equally wide range of dimensions. It may focus on the care that patients get between admission and discharge, often called “utilization” or “care” management. Or it may extend to pre-admission and post-discharge follow-up, and be called “case” management. It may focus on the service, rather than clinical elements of patient experience, and be called “patient experience management”. Or it may include lengthy episodes of care and even months or years of “disease” management”.
The ingredients for any of these PCM may include the medications orders that physicians write, focusing on CPOE systems, for example, or on physician and nurse adherence to HEDIS, EBM, or pay-for-performance bonus standards and guidelines. They may relate to the time that patients wait in ERs, or between visits by staff while waiting or during inpatient stays.
Similarly, the purpose for PCM may be to improve overall patient care quality or safety, reduce costs, increase patient satisfaction/loyalty, improve revenue or profitability. Unless the intended results are included explicitly somewhere in the labels for or descriptions of management efforts, they may be misunderstood and misapplied by staff or patients, and fall well short of achieving their intended results.
Proactive Health Management
This is even more clear in proactive health efforts, because of the even wider than normal range of dimensions, ingredients and purposes that may be involved. PHM may focus on wellness and fitness promotion, on disease/injury risk behaviors or conditions, or on already existing diseases, disorders, dysfunctions or syndromes. It may focus on any or a number of specific examples in one or more of these categories. It may involve traditional medical, complementary/alternative, or integrated approaches to these, relying on physicians, nurses, coaches, trainers, counselors, or a wide range of other practitioners in the process.
But perhaps most important, PHM may be aimed at a wide range of outcomes, for both provider and patient. Providers may invest in PHM for “community-benefit” PR, tax-exemption or mission fulfillment reasons. They may pursue PHM as a revenue and profit generating business. They may plan, manage and implement PHM efforts based primarily on the benefits they deliver to patients’ health and life quality.
Whatever the “official” label for PHM, as well as other management efforts, they should be described for all concerned so as to include all the ingredients and intentions included. As healthcare providers seek greater “transparency” in their operations, being open, clear and complete about their intentions and approaches with respect to CRM, PCM and PHM is surely one of the more important applications for honesty and integrity. And it can make the difference between staff grudgingly and passive-aggressively pretending to implement such initiatives, and enthusiastic commitment to them.
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