Denver Health, Colorado's primary safety net institution, has been one of the early adopters of Epic’s new customer relationship management (CRM) module called Cheers. Rachel Everhart, director of research at Denver Health, recently spoke with Healthcare Innovation about the deployment.
Everhart said Denver Health had a legacy CRM solution in place before the transition to a pilot of Epic’s solution a little over a year ago. “We had a homegrown version of a Microsoft CRM product that we called the patient relationship management system,” she recalled. “There was some good early work, I think, but it was a lot of effort to get the interface built and maintained. The main problem was that we just didn't have visibility into the success of the different campaigns.”
Denver Health had a campaign reaching out to parents about pediatric annual wellness visits. “That was the flagship campaign that we initially transitioned into Epic's tool and really saw the benefits of that,” Everhart said. “We just took off from there. We have stood up a number of COVID vaccination-related campaigns and that's where we initially cut our teeth on Epic’s product and appreciated and benefited from the availability that Epic made of that toolset because of the pandemic.”
Sam Seering, product manager for Cheers at Epic, gave some background on the product’s origins. “We originally released the Cheers campaign system in 2020. The first organization that we saw access it, Access Community Health Network, actually ran a flu shot campaign back in October of 2020 as their first campaign. We knew that COVID vaccines were right around the corner coming in December 2020 and the early part of 2021,” he recalled. “We thought this could be a beneficial tool for our community members to be able to take advantage of, so we actually made Cheers campaigns available at no charge for our community members as part of that effort. We had about four dozen organizations take us up on that offer, sending out millions of communications to get folks in for their COVID vaccination series. Then we saw groups like Denver Health starting to move into non-COVID use cases. We now have opened it up so that any Epic community member that wants to take advantage of the capability is able to do so. We are having conversations with dozens of organizations every single week, and we're starting up new implementations of the technology on a fairly consistent basis as well.” The solution is still free to the Epic community for COVID vaccination campaigns, but for broader general use cases, it is another licensable product, he added.
Seering explained that the decision by Epic to create its own CRM tool came down to both what the EHR company was hearing from customers as well as the shifting expectation of healthcare consumers. “From the healthcare consumer perspective, studies have been showing that they are really looking for a more personalized level of engagement based on their particular health needs,” he said. Customers were telling Epic that tracking outreach campaigns required touching multiple disparate systems. “We saw an opportunity to create Cheers, which is fully integrated into that electronic medical record,” he added, “so that we can use that rich data set of information to drive that engagement and drive that personalization, and most importantly, track to make sure that these individuals are actually taking the action that we're reaching out for them to do.”
I asked Everhart if there were other metrics Denver Health was looking at. “The percentage of your patients who are active on MyChart is a very good metric to be tracking,” she said. “We don't send all of our messages through the patient portal, but that is one of the mechanisms and it can produce a really robust experience for patients when they're triggered to do something, and sometimes they can complete it right then and there on MyChart,” she said. “We've also been paying attention to the program-specific conversion rates I have already talked about and really knowing per campaign that we're running, what's the success rate of that event happening within a reasonable timeframe. We've also been trying to keep an eye out on any kind of opt-out or patient responses relative to not wanting to be engaged in messages.”
Seering followed up on Everhart’s mention of activating patients on the MyChart portal. He said the Yale New Haven Health System was also an early user of Cheers. It has been able to track more than 19,000 MyChart activations over a nine-month time period directly back to the use of Cheers. “They're actually one of the leading organizations when it comes to MyChart activation, so they were really targeting a very small group of individuals that hadn't yet activated their account,” he added. “Seeing those sorts of numbers is very promising.”
In addition to the ability to launch and track outreach campaigns, Seering noted that Cheers offers an integrated experience in the contact center when patients call in. “It provides that holistic 360-degree understanding of that individual. The agents are able to take action on that information, and then are able to recommend personalized next-best actions so that the health system is able to create deeper relationships with those individuals.”
He said the most important thing about Cheers is that it is fully integrated into the rest of the Epic product suite, so organizations are not needing to go through a 12- to 18-month data integration project that only results in a couple of dozen data elements being exchanged. “We see organizations receiving value within a month of simply starting to roll out the tool,” Seering said. “The other thing about having that embedded system is that it's integrated into all of the other workflows. Being able to schedule an appointment, being able to pay a bill, being able to understand what are my follow-up steps after I got a test completed. Because of that longitudinal record, we can see whether they are actually taking the actions that we're wanting them to take. Did they come in for that annual wellness visit? Did they show up at that new ambulatory surgical center? Did they provide us their social determinants of health information? What we are working on next is helping organizations understand the downstream impact of those outreach efforts — so for a mammography campaign, how many instances of breast cancer did we discover because of that outreach?”
Looking ahead, Everhart said Denver Health will be looking at Cheers as way to help maximize the value of in-office time with patients. “It could help trigger people to follow up or finish a task, but we're also going to, in the near future, roll it out for the social determinants of health screening. We've only been able to reach a small percentage of our patient population during a clinic visit. It's a very busy time when the patients have a lot going on. Our staff members are overextended, so we're really looking forward to using the tool to do a campaign for that kind of proactive outreach and we think the social determinants of health is going to be a meaningful space to invite our patients to engage in that area. We're excited to kick that off in the near future.”
Seering said the idea for Cheers started with helping customers build deeper relationships with their existing patient population. “Where we're going next is helping our community members actually grow their community of patients — finding out who are new individuals that have recently moved to the area, or who are folks that are searching for an orthopedist because they're having some knee pain and then using Cheers’ capabilities to draw them into the organization and establish that relationship.”