Salesforce has announced the preview version of Salesforce Health Cloud. The preview version is available today with general availability scheduled for February 2016.
It does not seem that long ago when patient records were in paper files and the information exchange between Doctor, Hospital and Pharmacies was a scrap of paper with the barest of information. Salesforce seem poised to take healthcare provision to a completely new level.
This may be the first version of their new product but there is a lot to be both excited and concerned about. What Salesforce have done it to allay many of the potential fears by careful consideration of the risks and the extensive partner list they have already engaged with.
Security in Salesforce Health Cloud
Everyone’s primary concern will be around the security of their personal health Data. Only this week the Dean Street clinic in London sent out an email with 800 names and email address of patients who potentially have HIV and earlier this year Healthfirst in New York admitted a data breach.
Salesforce has built the platform with built in tools to ensure adherence to HIPAA requirements. One of these tools is Salesforce Shield which includes delivering flexible encryption of data so that relevant information is only seen at appropriate points. Genomic Health were one of the first users of Salesforce Shield and Salesforce clearly recognised that it was a first step to the wider Healthcare market acceptance.
Customers or Patients ?
As Salesforce expand their reach into new markets there is a concern that the language used needs to be toned down. The label “The Customer Success platform” needs to be toned down, especially in the UK where healthcare is often seen as vocational and caring profession. Salesforce are careful to use the language like “build stronger relationships with patients”, but actually this is more about ensuring a complete view of information for the practitioners to make considered decisions.
The advantage that Salesforce has is that within its sales focused environment it has already built the hooks and tools that the medical profession can take advantage of such as integration to wearables. Salesforce has also partnered with companies such as MuleSoft and Persistent Systems who have provided leading EMRs from Epic, Cerner and GE; access to Electronic Medical Records (EMRs). Phillips has also helped Salesforce integrate with its medical devices.
With the interfaces to mobile devices and wearables Salesforce is ready to take advantage of devices such as FitBits bringing a massive data set to help medical practitioners ensure better outcome for their patients.
Can Salesforce Health Cloud make life better?
Healthcare both in the US and elsewhere is driving towards delivering a better patient experience in the same way that the service industry does for customer experience. In the US this is being driven by three federal initiatives: The HITECH Act, the Health Data Initiative (HDI) and the Affordable Care Act (ACA). These are aimed at improving both the quality of healthcare provided and patient experience, as well as making healthcare more affordable and therefore available to the population.
One of the key factors is outcome based payments are driving healthcare providers towards greater efficiency. This can only be accomplished with the help of technology that not only is compliant and secure, but also delivers increased efficiency and comprehensive data and information about patients. Salesforce believes that they can provide this and if people are willing to be monitored more proactively from devices they are carrying and wearing, proactive medical care may reduce health risks and therefore cost.
The new Salesforce Health Cloud will provide a complete view of patients that not available to doctors today as it looks at trends and the complete timeline of a patients medical history. It will be able to draw data from medical records, wearables and other sources, seeing which treatments worked in the past and for how long. The expectation is that this will deliver insights that previously were difficult to see. With the right permissions data can be extracted from a wider set, looking at demographics or even household relationships.
This is where the volume of data available to Salesforce become slightly scarier, the data set it will be building up will be huge and it will be interesting to see what future regulations will protect that data. Salesforce may also become a greater target for malcontents and it will need to ensure that is can effectively ring fence this medical data.
Salesforce has indicates that Salesforce Chatter will be available for healthcare professionals to discuss patient matters. While this is interesting there is a question of how secure these conversations will be as they are not obviously in the scope of Salesforce Shield. While instant messaging can be useful it will be interesting to understand at what point that data becomes encrypted. It will also be interesting to see whether patients have a right to view such information once it has been recorded on request.
Single holistic system
The vision that Salesforce portray is a single holistic solution where every healthcare practitioner involved in a patients care will be connected to the single system. This seems utopian and it will be interesting to see where Salesforce pitch their product when they announce the pricing next year.
Salesforce have not designed this platform alone though and it is likely that it will be adopted by a number of providers across the globe once the regulatory authorities have looked at it. The early adopters are likely to be those who helped designed the product and these include Centura Health, DJO Global, Radboud University Medical Center and UCSF.
Centura Health, Colorado’s largest healthcare system, have been using the system, but within a closed environment rather than the total healthcare arena that Salesforce are advocating. Nevertheless it is a step forward as Jim Rogers, RN, Connect Director at Centura Health expounds: “Health Cloud puts Centura Health patients at the center of their healthcare journey.
“We’re excited to use Salesforce Health Cloud to move our oncology navigators onto a single platform, standardizing their workflows, and increasing collaboration with ambulatory, acute, and post-acute care coordinators, and tracking patient outcomes in real-time.”
In terms of partners to assist with implementation a measure of how serious Salesforce are can be seen by those it has chosen to partner with to help with implementation, integration and customisation. These include Accenture, Deloitte Digital and PwC.
The features that are inherent to Salesforce can, with slight modifications, allow healthcare providers to deliver an improved efficiency. Setting reminders based on triggers such high blood pressure readings, immunisation based on age or other factors will be determined during implementation. The data and costs associated with these can be instantly reported back to the healthcare provider and what if scenarios can be run to see how cost effective a potential change can be.
Private Communities in Salesforce Health Care
There are more questions than answers within this new solution, not least around the patient private community that Salesforce have announced. Whether all care givers to a specific patient will need a Salesforce license is not known. The one advantage that Salesforce have over traditional linked systems is that there is no requirement for a local server to host data and the cloud computing environment means that anyone can access.
The other question is that this seems to be a closed environment with limited access for patients themselves to access their own data. It will be interesting to see whether there becomes a demand for this in the future. A portal at least would be useful so that patients can see their upcoming medical appointments.
There is little doubt that this is significant step for Salesforce, and they will start to compete with some well-established players in this market. What will be interesting is to see which software vendors integrate products such as practice management platforms into the Salesforce Health Cloud solution. There is potentially a huge overlap between these systems, the difference is that Salesforce Health Cloud puts the patient first and most others see them more as a piece of data within the wider application.
In a canned statement said Joshua Newman, MD, Chief Medical Officer, GM, Salesforce Healthcare and Life Sciences concludes his vision of Salesforce Health Cloud, “The era of precision healthcare is upon us.
“Just like we use precision medicine to target more personalized treatments for cancer and other diseases, precision healthcare is enabling our customers to develop more meaningful, accurate and long-term relationships with patients. Health Cloud is a huge step forward in our industry’s transformation.”
If Salesforce Health Cloud gains traction in the US, it will be interesting to see how the public healthcare regions in the UK look to implement such a system. Implementation across public health care is fraught with the perils of large software implementations but if the price is right it may well be attempted.