Digital-Data

Pega vs Salesforce Health Cloud

by Paul B. Stevenson, MPA, CPA

Evolving technology and changing government regulations have begun to transform healthcare patients into healthcare consumers. According to McKinsey and Company, “Companies that can learn to understand, guide, and engage healthcare consumers, while inspiring their loyalty, have a significant opportunity to change the healthcare landscape.” Salesforce and Pegasystems are two companies that are leveraging CRM technology to help payers and providers connect better with patients. Let’s examine both to see which is a better fit for your organization.

 

How will a CRM tool help your company?

A modern CRM puts all of your relevant patient data into one central location that your entire company can access from one platform, including contact information, communication history, and customer history, and allows you to engage your customers with the technology they use daily. According to Gartner, by 2022, 70% of customer interactions will involve emerging technologies such as machine learning applications, chatbots, and mobile messaging, up from 15% in 2018. It minimizes data entry and automates many tedious administrative tasks to make your team more efficient.

 

What are the advantages of Salesforce Health Cloud?

Founded in 1999, Salesforce is recognized as the world’s leading CRM. In 2018, Salesforce dominated sales, leading the way with a 19.5 percent market share. Global sales percentages alone are not a reason for a company to purchase the software, but it is a good indicator that Salesforce offers a high-quality product. Some of its most prominent clients include Time Warner Cable, Dell, Comcast, Wells Fargo, and American Red Cross. 

Salesforce built an industry-specific platform on top of its award-winning CRM called Salesforce Health Cloud in 2016. It focuses on connecting patients, providers, administrators, and specialists using social and mobile technology. It aims to improve the patient and provider relationship by helping doctors provide insightful and personalized care. According to ZDNet, Joshua Newman, chief medical officer at Salesforce, the lines between citizen, consumer, shopper, and patient have merged. “Every industry is focusing more on customers, and it’s happening for patients. Making people happy with a better experience helps care,” explained Newman. 

 

Features 

Salesforce Health Cloud is available as a subscription service and has two plan editions: Enterprise or Unlimited. These editions offer all of the technologies included with Salesforce CRM offerings, plus many healthcare-specific features to extend the world’s best CRM into the world of healthcare.

Patient Health Timeline: Patient Health Timeline displays data in a user-controlled timeline view that allows clinicians to see the chronology of information in the patient’s EHR record.

Patient prioritization page: Build rules-based filters to prioritize patient outreach based on clinical data to take the most important actions first.

Population analytics: Aggregate data from multiple EHRs to analyze patient populations for opportunities to enhance care at taking action on multiple patients with data-driven omnichannel communication automation.

EHR integration with HL7-compliant interface: Using Mulesoft, Jitterbit, or other cloud-based, endpoint-agnostic integration tools to aggregate information from multiple EHRs into one user interface. 

Entitlement and SLAs: Use state-of-the-art customer service tools integrated into the platform to measure and improve the patient experience.

 

Salesforce Health Cloud software also offers the following:

– Complete Patient View

– Patient Timelines Patient Profile

– Patient Care Team Network

– Care Team Productivity

– Intra care team collaboration

– Configurable patient setup

– Care plan customization and management

– Patient lists

– Patient segmentation filters

– Risk stratification (Wave for Health Cloud)

– Clinical Data Management

– Clinical data model

– EHR Data Objects

– Individual patient model

 

Pega Health Systems

Pegasystems, based out of Cambridge, Massachusetts for the last 40 years, is a software provider that specializes in customer engagement and case workflow automation capabilities, which are part of its Pega Customer Service solution. Pegasystems’ overall revenue grew by 12% in 2018, bringing its annual total to $950 million, half of which is from CRM applications.

 

Features 

Pega’s healthcare software is run on the Pega BPM platform that touts low-code app authoring. According to Pega, the main features of their healthcare management technology include the following: 

– Dynamic case management that provides complete visibility into and managerial control over a case—such as a customer inquiry, a claim, or a patient receiving long-term care—across all relevant systems and processes throughout the case lifecycle.

– Workflow automation, including rules-based routing, prioritization, and escalation.

– Embedded predictive analytics, enabling healthcare organizations to parlay insights from “big data” into personalized customer services and offers.

– Automated decisioning based on configurable business rules to enable straight-through processing (for a customer service inquiry or a claim, for example) whenever possible; and to provide decision support for service representatives or healthcare providers when straight-through processing isn’t possible.

– Pega Build for Change® technology, which enables business users to design and implement key health management system features without having to do any coding.

 

Pega healthcare software offers these solutions:

– Benefits and products development

– Sales and enrollment

– Customer service

– Marketing and retention

– Care management

– Claims processing

– Compliance

– Medicare and Medicaid

– Appeals and grievance

 

Which system is the better fit for your company?

Salesforce comes out on top in three significant ways: 1) While Pega’s low-code environment is similar to Salesforce’s declarative “Clicks, Not Code,” it is still not “no code” that Salesforce pioneered over 20 years ago. Salesforce’s drag-and-drop solutions allow someone with no programming background to build applications using prepackaged blocks of code, which saves you both time and money. 2) Salesforce dominates the customer service sales landscape. With less than $1 billion in annual revenue, Pega hasn’t yet shown that it’s capable of developing the same breadth of technologies that Salesforce can. Gartner points to the low value received per dollar invested as a shortcoming of Pega, presumably due to the consultant heavy implementation and maintenance of the system. 3) Financial and management resources are the most important factors in selecting a CRM for your healthcare organization. Salesforce provides more value to your organization because it allows for more flexibility to develop in-house when consulting dollars are scarce.

 

If you’re looking for a reliable, trusted CRM with straightforward pricing that allows you to keep advancing your company’s goals while reaching your customers with the latest technology, Salesforce Health Cloud is tough to beat.

 

Paul StevensonPaul is Simplus’ Subject Matter Expert in HLS CRM Strategy. An expert with deep CRM experience in healthcare, telecom, distribution, and financial segments, Paul is a consultant who drives CRM innovations to clear a path for growth in revenue and operational efficiency. He has hands-on experience in developing, marketing, and selling CRM Apps and is a proven project leader with skills to lead CRM integrations with payer, provider, telecom, and proprietary operational and financial information systems.

[email protected]

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