Ready for a customer relationship

In the new NHS, it’s even more vital for trusts to consider what’s important to the people who matter – the staff who work for them, the patients they serve, and the commissioners who buy their services.

That’s the view of Tom Bell, GP stakeholder engagement manager at Cumbria Partnership Foundation Trust. “We’ve got the perfect storm coming in terms of increased competition; we’ve got to get more outward looking,” he says. “As [management guru] Peter Drucker says, you have to know who your customers are and what’s important to them.”

‘We wanted to build bridges out to the stakeholder world, such as GP practices and leagues of friends’

He believes that CRM (customer relationship management) is the way to do this and has been working with Optevia to achieve this.
As a model for managing an organisation’s interactions with clients and stakeholders, CRM has become part of the fabric of business life. Only relatively recently, however, has it started to make inroads into health services and the NHS.

Yet according to Steve Lyon, business development manager for health and housing at CRM specialists Optevia, CRM is a great way to create staff and resource efficiencies, and to improve the patient experience.

Dedicated systems

Optevia – a Microsoft “inner circle” partner and expert in Microsoft Dynamics CRM – supports users of the software to exploit the technology to meet their needs, and those of their customers.

Rather than an off-the-shelf solution, trusts can work with Optevia to create their own systems to meet their exact needs, whether these requirements are around clinical or business functions.

“CRM is a technology framework for creating solutions,” explains Mr Lyon. “Often that means managing customer interactions, but it’s much more than that; it’s something that gives organisations the capability to produce ways of delivering solutions.”

In a commercial setting, he adds, CRM is a way of managing existing customers, prospective customers, and customer complaints, with the idea of building and maintaining a healthy customer base. In the public sector, however, it has the added value of being able to feed back into the service the information which can help it perform better and improve effectiveness.

“The public sector is still catching up, but we’re increasingly expecting all our interactions, in whatever settings, to be digitised, and health is no different,” he says.

He sees enormous potential for CRM across the health sector, in clinical and non-clinical settings. It’s a great way of interacting with stakeholders (see Lancashire case study, below), be they the local CCGs or patients.

Business development

This can build the intelligence that is vital to business development in terms of bidding for contracts. “In clinical terms, health service organisations are looking for effectiveness, which might be based around CQUINs,” adds Mr Lyon. “But more importantly, the overall ambition is to reduce the costs of the old-fashioned ways of working. Trusts have a whole range of requirements and have to ask what they want to do and what they want to know. CRM can help.” (See case studies)

For this to happen, he says, the system has to be usable and, ideally, designed in conjunction with the end users. “The obstacle is that people have busy lives elsewhere, but this is a short term obstacle and the results are definitely worth it.”

CRM is designed for modern ways of working, including mobile working, making it ideal for community teams. Community nurses can add to the patient notes on tablets while out in the field, for example, and this is automatically transferred to the record back at base. “Online or offline, the CRM doesn’t care,” he says, explaining that it will transfer whenever it gets a signal.

CRM has its fans in the health service, sometimes among managers who have experienced it elsewhere. With a background in business, having previously worked for the government’s Business Link, Mr Bell already knew the value in having a reliable system for connecting with customers and recording interactions.

“When I joined the trust, there was already an old CRM in place but it was gathering dust. It was only used for membership, so the best value wasn’t being extracted from it. The trust has learned that you need to continually invest in IT projects to get the best out of it, and so we wanted to customise the CRM so that it worked well for us.”

As a foundation trust, capturing the views of members is vital for Cumbria, as is making the most of engagement opportunities. “We had some clear objectives; we wanted to build bridges out to the stakeholder world, such as GP practices and leagues of friends.
“If you capture issues from stakeholders then you get clarity over what you’re doing and where you’re going.”

The bigger picture

Engagement is increasingly important for the trust in the new world of clinical commissioning groups and health and wellbeing boards. But it can be hard to prove the value of engagement activity. “It’s about impact, but there are lots of roles and it can seem quite woolly if there’s no sense of what you want to achieve,” says Mr Bell.

‘CRM is a great tool for reporting to senior managers about what’s actually going on. It brings the information to life in terms of the bigger picture’

By bringing together a proper record of all engagement, and the resulting comments, you can create a full picture of what’s important to your customers, and how you are doing in relation to that.

CRM adds hygiene to the audit trail, he adds, and also ensures that the intelligence is gathered, stored, and available to colleagues. “It’s the old thing of what happens if you get run over by a bus – with CRM there’s continuity, there’s information which is of use to your colleagues.”

CRM is a great tool for reporting to senior managers about what’s actually going on, he says. “It brings the information to life in terms of the bigger picture,” he adds.

Optevia worked with the trust to configure the dashboard reporting tool within CRM, effectively embedding the “big picture” element. The dashboard means that all data can be recorded on the system from any device, which avoids replication and saves on travelling time as the engagement team doesn’t have to return to a desktop computer to record outcomes of meetings. The dashboard can also transform the data into simple graphics for presentation purposes.

Cumbria takes engagement seriously, and has recently built a team of engagement workers. “At the end of the day we’re selling something – we’re managing and building our reputation with stakeholders. The CRM is key to helping us do that.”

Case studies: what they really think of you

Lancashire: Using CRM in engagement

As a foundation trust, Lancashire Care is understandably keen to engage with its 14,000 members and stakeholders, and to do so in an organised and structured way. So it has turned to public sector CRM specialist Optevia to make that happen, and is very happy with the results.

“At the trust, there were a number of separate databases viewing different aspects of management information,” says stakeholder engagement manager David Keddie. “We had a membership database, which was externally managed, and there were others recording different outputs, such as a log for GP enquiries. We wanted to try to rationalise this to have a single resource, which would be a repository for all that information.”

The trust worked with Optevia to develop a solution that would lead to all its engagement information being stored in Microsoft Dynamics CRM, a project that took around six months to complete.

‘Sometimes there’s a lag between stakeholder perception and what the trust is doing about an issue, so one of the aims of CRM is to sharpen up communications with stakeholders’

An important aim for the new system was capturing all the engagement activity being carried out at the trust, and that by no means stops at the membership.

Stakeholders such as GP practices, local politicians, local authorities and third sector organisations are each important to the trust, and often have valuable insights to share. The Microsoft Dynamics CRM solution allows all engagement activity to be recorded in the single resource, so that senior management can see at a glance exactly who has been talking to whom, when and, crucially, what has been said.

The result is an unparalleled picture of what members and stakeholders are thinking, what they like, what they don’t like, what they feel is going well, and what isn’t working.

“Sometimes there’s a lag between stakeholder perception and what the trust is doing about an issue, so one of the aims of CRM is to sharpen up communications with stakeholders,” says Mr Keddie.

“You can do stakeholder bulletins, but you can also make them more specific. For example, you might have a general bulletin for GPs as a whole, or something more bespoke.”

When issues are raised with the trust, there is an opportunity for specific comments to be recorded and captured. This could be to do with eligibility criteria for referrals, for example, or waiting times. The comments facility gives a fuller picture to managers about what is actually causing concern on the ground.

“In broad terms, the trust is seeking to protect and grow its business. To do that, it has to provide services of a particular quality. CRM lets us record engagement activity with dialogue, so it gives us a more sophisticated understanding of what comments are.”

This ensures that the trust remains competitive as intelligence from stakeholders becomes part of the corporate memory.

As the range of engagement increases, other features of the solution are becoming invaluable. For example, using an engagement calendar that records all instances of engagement helps ensure there isn’t duplication.

“With 7,000 staff over 400 sites we don’t want to be uncoordinated,” says Mr Keddie. “We don’t want several people targeting the same GP practice at the same time – that’s not helpful for the GP, and not great for us; the information we have means we can plan our engagement.”

Lancashire Care is also using the CRM to segment stakeholder communications and target audiences more specifically. As an example, the CRM has been used to target public members within a particular trust constituency to inform them of forthcoming public governor elections and to encourage members within that constituency to stand for election as governors.

Mr Keddie has a number of tips for other organisations thinking of taking the CRM route. “It’s an incremental approach. Start the conversation as widely as possible; the initial scoping needs to be as broad as you can make it. Technical input is also key.

“With any database you have to establish a critical mass of colleagues who can see value in the resource. Manage the process so that colleagues have access to CRM, that they have ‘how to’ guides, and protocols. Information governance is important too.

“It’s working well, but it’s not completely finished. We appointed relationship managers several months ago and as the range of engagements increases, the quality of the intelligence is improving. CRM is a key piece of infrastructure that underpins what the engagement team is doing.”

Using CRM to improve patient care

Trusts free to choose their own solutions are now starting to work with Microsoft and Optevia to develop joined up solutions to manage multiple data sources and to meet specific needs. For managers and clinicians alike, Microsoft Dynamics CRM is ticking the right boxes.

Most trusts share the problem of managing multiple data sources in which there are data silos. Data is not shared; it may be duplicated in multiple sources; and can lead to errors and mismatches, for example where one data source is updated with a new address but a second is not.

There are also usually some applications that have been set up in-house by clinicians. For example, a doctor might have developed an application to meet a need that has grown into an enterprise solution for just one group of medics.

‘The end objective is for a truly joined up system that allows clinicians to call up and add to the patient record in whatever setting they happen to be’

The health service is not unique in encountering such challenges. Other enterprise-sized public sector organisations share them too and have started to solve them with CRM in which they can offer applications that meet the needs of particular teams but have the ability to pull in data from different sources so that it can be updated, shared and viewed consistently. In other words, offering bespoke applications without data silos.

As trusts start to develop strategic objectives for offering streamlined care, increasingly clinicians are working in a more joined up way: for example, a patient coming to hospital for heart surgery might have rehabilitation at home, or in the community. That means that clinicians in the community will need information about what happened to the patient in hospital.

The end objective is for a truly joined up system that allows clinicians to call up and add to the patient record in whatever setting they happen to be. Getting there is often a journey involving lots of small focused projects and iterations involving the business users – Microsoft Dynamics CRM providing the glue that will hold it all together in the background – for example, to get data feeds from different sources and to maintain a data model that holds all the information for each patient.

Although most users access their solutions through desktops, Microsoft Dynamics CRM can offer exactly the same experience on mobile devices regardless of whether they are connected to a network. The latest version of CRM includes native deployment to W8 and iPad devices.

Data protection issues with hand-held devices are avoided by offering a high level of security and writing to the application rather than the device – for example, a photograph of a wound is held against the visit record for a patient and not in the device’s image folder.

Clinical engagement

The success of Microsoft Dynamics CRM projects depends on meaningful engagement with clinicians. The days of IT departments imposing a system on clinicians is over.

Project teams work closely with Optevia in ensuring that their business users are involved in the analysis process and have a hands on design role. There are no surprises for the users when the solution is released for their use and they have had a say all the way along.

‘Being able to work in a coordinated way with patients and with colleagues soon starts to bring its own rewards’

Trusts choose Optevia and Microsoft Dynamics CRM for several reasons. They often already have access to Microsoft technology and want to continue to invest in a platform that will be supported for a long time. In addition to sustainability, Microsoft Dynamics CRM is also very scalable: projects can include a few users up to a few thousand.

Although most trusts expect to see new systems bring some financial benefits in terms of reducing duplication, and being able to close down some existing computing systems, often that’s not the main measure of success. Being able to work in a coordinated way with patients and with colleagues soon starts to bring its own rewards.

Introducing new IT systems and ways of working like Microsoft Dynamics CRM is getting easier as generations migrate through their careers. Junior doctors and nursing staff coming through have grown up in a computerised world, and they expect to use IT; it’s never been a problem with them.

At home, all generations are exposed to technology in the proliferation of devices and apps for fun and shopping and gain access to information easily.