Salesforce + Provider Relationship Management: Info, Use Cases, Solutions, and AI Strategy

Subject Matter Expert: Tony McCune

Today we’re talking about provider relationship management, aka the critical part of a healthcare and life sciences (HLS) organization’s daily operations that includes the processes, strategies, and solutions used to manage interactions and relationships with physicians, specialists, provider networks, etc. 

Provider relationship management (PRM) touches multiple areas and teams (e.g., Physicians Liaisons, Care Coordinators, Marketing and Engagement, Leadership), and helps with building, maintaining, and strengthening provider relationships to achieve things like increased revenue and organizational growth.

If you’re sitting there thinking ‘that sounds important,’ you’re absolutely right. It significantly impacts business and organizational outcomes, to the point where poor PRM opens up the door for:

• Operational inefficiencies
• Compliance risks
• Financial loss
• Slow short- and long-term growth
• Reduced opportunities
• Lower quality of care or services

The good news is that those are all things Kicksaw actively helps our HLS clients avoid, by putting them on the right path to achieve their goals and empower their teams. This blog is here to give you a better idea of how you can do the same, with information about provider relationship management challenges, use cases, solutions, and tips.

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Provider Relationship Management Challenges

We’ve found that pain points associated with PRM can usually be linked back to common solution and process issues:

• Disorganized and/or disconnected data
• Manual or complicated processes and an overall lack of automation
• Lack of visibility and oversight for both data and processes

HLS team PRM pain point examples:

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Provider Relationship Management Use Cases + Solutions

If any of those challenges sound familiar, or you’re looking to get ahead with your provider relationship management in general, we’re at the fun part: solutions for improvement and growth.

Physician Liaison Team

Solution in Action: 

• Liaisons can prep for the day and their call with schedule and route optimization, as well as an auto-summary of key information  

• Integrated call/visit capture can be used to gather information, prompts can walk them through post-call/visit processes, and AI can pull key information to auto-fill Salesforce fields, generate follow-up communication, send summaries to key stakeholders, etc.

• They have the ability to analyze their performance (including which of their provider visits can be linked to booked appointments), bring up relevant information in real-time for the provider, and coordinate and communicate with critical resources from the field

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Care Coordination Team

Solution in Action: 

• Provider referral request, benefits verification, and prior authorization information can be centralized, with automation to pull key information into Salesforce fields

• Automated guidance is available to help with Standard Operating Procedure adherence and suggested Actions can be given when needed

• Centralized, HIPAA compliant communication is available for provider and patient support needs, with AI automation to deflect routine cases and escalate when necessary

• Automated voice capture takes the manual burden out of gathering complete call information, and they can use Agentforce to automate call summaries, fill in key Salesforce fields, etc.

• Auto-generation of personalized follow-up can be supplied via preferred channels or patient/provider portals

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Marketing and Engagement Team

Solution in Action: 

• Data and automation is readily available to help Marketing and Engagement support Liaison/Sales teams target, personalize, and appropriately time outreach

• Automation, Flows, and AI to helps with email building and personalization, generation of campaigns and follow-up/communication, as well as populating fields for form conversion

• ROI for efforts is clearly visible, which helps them optimize campaign performance with engagement to outcome reporting

• Pattern analysis from all available data sources and Flows help automate segmentation

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Leadership Team

Solution in Action: 

• Improve oversight with alerts and notifications based on escalation triggers, including compliance risks

• Team and individual performance is clearly visible, with detailed analytics and automation with recommended Actions for improvement

• Automation supplies summaries and reports so the focus can be on high-value tasks and strategy, and they have the ability to breakdown ROI at a macro- and micro-level

• Save time with automation to generate follow-up and communication

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Getting Started With Your Own Solution and AI Strategy

Something all of the solutions mentioned above have in common is that they address those central issues we mentioned in the ‘provider relationship management challenges’ section of this blog. Each one helps achieve:

• More organized and connected data
• Automated and streamlined processes 
• Improved visibility and oversight for both data and processes

Because of this, we advise anyone looking into improving their PRM focuses on getting their data cleaned up, organized, and centralized. 

Why? 

It will give you immediate value and provide a solid foundation to move forward, as it helps eliminate information silos, improves information accuracy, and creates better visibility into your processes and operations. It also gives you a solid foundation to get the best results possible when you invest in AI tools like Agentforce. 

A comprehensive report detailing physician feedback about the future of healthcare stated, “87% of clinicians…agreed healthcare information for patients already needs to be improved, and this is likely to become even more critical in the future” — your data and what you do with it can set you apart when it comes to provider relationships.

You can also start looking ahead at what solutions to prioritize for impact. To maximize ROI start simple and focus on outcomes, by investing in solutions that eliminate manual processes and simplify complex workflows.

If you need advice on provider relationship management solution roadmapping, governance, or optimization — or if this blog has inspired some questions — please reach out, we’re happy to help.