All industries, be it manufacturing or services, have realized the scope of Customer Relationship Management (CRM) application in their marketing activities. Many have implemented the CRM concept as an effective marketing tool,especially in the hospitality sector, which can help them in making consumer’s loyal to their organizations. Most healthcare facilities globally are as yet to get clued on this concept especially in a developing country like India, be it India Shining or Whinning. A few corporate hospitals and some private hospitals have implemented solutions, crafted either inhouse or by their local friendly vendor. This leaves

Indian hospitals however have been not very keen on implementing CRM program in their organizations as the demand supply ratio for diagnostic and therapeutic modalities is on a lower side and also decentralization of high tech treatment facility is not applicable due to absence of regulatory authorities.

Absence of regionalisation is forcing these hospitals to implement CRM initiatives because in narrow geographical boundaries same types of modalities are present and the competition is so acute that in the available clientele, due to sharing of the patients hospitals sometime find difficult to recover the operating cost also.

The main reason, which prevents hospitals to implement CRM programme, is that they see CRM as a capital intensive software programme. The understanding of the hospitals is correct to some extent because CRM is also known as e-relationship management and the nomenclature suggest that CRM cannot be implemented if you don’t have computer infrastructure. Traditional mass marketing is directed at those who don’t know-and probably don’t care-about an organization.

In CRM, the focus is on targeted, more personal marketing directed at those who already know us and those who have a higher probability of continuing to use our services.

CRM in hospitals is statistically accurate, health care targeted marketing process that assesses the health needs of the residents in the community, monitors health care usage and health events, and then uses a prediction model to determine which residents are most likely to be in need of specific health services.

The power of the targeted marketing program is not in its ability to serve as a directed public relations/promotional tool, but rather in its ability to identify markets so that you can effectively get the hospital’s message to individuals in those markets, giving the hospital a step-up on the competition.

Steps to implement CRM

Maintain database:

Hospitals should maintain a database, which can be continuously updated, refined and used to produce on-demand lists of patients who are the best prospects for a particular service, such as maternity, orthopedic work, or cardiovascular services. The list can be generated from the health check department or the diagnostic wing where results of preliminary screening are reported.

The biggest problem is the confidentiality of the data as reports and other documents related to health of patient can be seen by the treating physician or any other physician to whom the case has been referred. Use of these documents for the purpose of any activity apart from treatment or retrospective clinical study needs consent of the patient. If the hospital does not takes written consent for access to this data, patient may create legal complications. The idea is that this is a database to be used only by the hospital and its medical staff in marketing to targeted patients.

This process shows its physicians, especially specialists, that the hospital can bring them business. The process gives the hospital ongoing market assessment reports. This is an extension of the market assessment that we do initially and can answer questions raised in that assessment.

Build a CRM culture:

The promise of marketing (e.g., that we deliver quality service, Quality Health care at affordable price) has to be delivered once the patient is into the hospital. Hospitals need to work on educating employees through soft skill training programmes such as customer service, telephone etiquette, interpersonal behaviour. Investment in marketing initiatives can go waste because of a “bad moment” such as a fumbled admitting experience or a rude operator at your telephone bank.

To take support of the physicians in general and specialist in particular, hospitals should have solid evidence that we are continuously improving our services and products. The bottom line for successful implementation of CRM — It is not only about implementing software it requires training at every level and a general cultural shift toward excellent customer service.

Employ and train patient service officer:

Hospitals should appoint Patient service officers and train them to deal with patients, their relatives and their complaints. The patient service officer can report to patient service committee where they can highlight the problems faced by the patients. These officers should be trained to co-ordinate between various support service departments to solve the problems of the patients.

It is generally seen that dissatisfaction amongst patients is due to very small problem, which remain unattended to. For example, electricity switch is not working properly and the patients complaints to the nurse, the nurse registers the complaint to the engineering department and then she fails to follow up that whether the switch has been repaired or not.

In this particular case is the nurse to be blamed? The answer is no because given the fact that nurse to patient ratio is very critical in most of the hospitals it is very difficult for her to meet the requirements of medical care then where is the time to attend to complaints of the patients.

Ideally one Patient Service Officer can be employed for every 10 patients and their job responsibility should be to attend to all the complaints given by these patients from admission to discharge. These officers may not solve all the problems because the resources required in some cases may be beyond the scope of their authority and such problems they can put forward to Patient service committee. Also a grievance is well handled if it is listened to properly. If a patient has some problems and any employee of the hospital listens to his problem with patience and assures him with confidence that his problem will be solved the patient will feel some satisfaction.

Action on patient feedback form:

Now a days many hospitals have started taking response of the patients for the services delivered to them through patient feedback forms. For CRM programme to be successful it is important that hospitals consistently monitor this feedback form and take appropriate action wherever required. If a patient is suffering from an ailment such as cancer he needs to come to the hospital on a regular basis. If patient finds that none of the things have improved he feels that there is no concern for patient and then he feels that all this exercise like patient feedback form is meant for show off only. For successful CRM programme it is important that what is promised, it is delivered.

Prerequisite for CRM programme

CRM programme can be implemented successfully in hospitals and increase customer retention as well as revenues. It is not necessary that hospitals should invest huge amount in the initial stage. They can test the CRM concept by applying in any one department such as OPD and if successful extend the same to other departments.

Even if the computerised system is not available, or the data base is not maintained properly then also wishing luck at the time of admission in the hospital, offering rose buds for wishes with future at the time of discharge can build long lasting relationship with the patients and increase patient base for the hospital.

Hospitals all over world provide health care services on 5 dimensions – curative, preventive, promotive, rehabilative and restorative and 3 levels – primary, secondary and tertiary care. More or less service line of hospitals is same including ambulatory care, in-patient services, diagnostic services and support services. Marketing a hospital is therefore an important part of its revenue generation. A hospital can apply two strategies to retain its clientele as well as increase number of patients:
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‘High investment, high risk strategy.
Low investment, low risk strategy.
High investment, high risk strategies’

1. Adding new services:
Infrastructure has to be developed.
New technology has to be acquired.
Staff has to be trained or recruited. Acceptance by community can be doubtful even after a positive need and feasibility study.
2. Widening line of services offered to market:
ECG, EEG, EMG, USG, 2D ECHO and a range of diagnostics facilities can be added to increase the patient base and turnover at diagnostic wing.
3. Market segmentation of niche:
Market segmentation is done for a particular service after identifying the need of community. ECG is done as an OPD procedure for ambulatory patients, Screening test for health-conscious patients, IPD procedures for inpatient and now it is conducted at doorstep of patient as a part of home care.
Low investment, low risk strategies
To maintain revenue generations and patient turnover, hospitals, which cannot afford high investment and high-risk strategy the option can lie in:
New methods of service delivery.
Adding new features to existing service.
Increasing peripheral consultant referrals

New methods of service delivery have already been accepted and many organizations modified services delivery in the form of home care option. Some organizations that were not primarily into delivery of services they are now providing modified versions of existing service. Mobile cardiac ambulances and diagnostic vans are a few examples of this strategy.
Other strategies


Screening Services:
Screening service is specifically aimed at preventive aspect of healthcare. Past few decades have seen a rise in frequently undetected cases of diabetes, hypertension, blood cholesterol, visual and hearing problems. These minor problems slowly and slowly show transition to more acute problems like cardiac arrest and patient not only undergoes trauma but he also ends up paying huge bills for treatment.
Behaviour Modification programme:
Behaviour modification programmes generally stress on health life style components like anti-smoking, anti-alcoholism, diet and nutrition programme. This behaviour modification programme can be conducted through small centres where investment will be low, hospital will enjoy credibility, advantages over unfamiliar single purpose agencies and brand trait.
Occupational Health Programmes:
Many production-oriented industries are at a high risk of occupational diseases. Such production units can be identified in the clientele zone, their diseases should be identified and a programme can be developed for prevention and treatment and then offered to industrial workers. Hospital can get huge clientele base due to uniqueness of programme through tie up with industrial units.
Adding new features to existing services is a “low risk low investment” strategy. Hospital can identify new methods of utilizing existing services and deliver new features with current market offerings. For example many of the tertiary care hospitals have a Physiotherapy department. Physiotherapy department can be coupled with sports medicine. With increasing interest in exercise and perhaps the likelihood that people will do more walking, running and cycling, there are bound to increase in number of sore muscles, joints, feet, knees etc. A physiotherapy department can also act as Medical Gymnasium (Physiotherapy and Sports Medicine) with installation of a few machines.
In a medical Gymnasium the team of professionals can be: Instructor – to provide guidance on type and quantum of exercise one can do. Doctor with major in sport medicine Physiotherapist to treat minor ailments occurring’s as a result of exercise. Dietician to provide guidance on type of diet to be eaten.

The major benefit of low risk low investment strategies is low competition as market is approached with a new offering.
The only factor to be guarded against in case of service innovation is that encouraged by success of our offering to market, other hospitals will also come up with “Me-too service” which can be a copy or a better modified form of original offering. In such condition it is important for a hospital to maintain its leadership by continuous innovation and executive of aggressive marketing tools. In case a new service offering exhibits low acceptance or no acceptance by targeted segment than also hospital is at low risk because regular services are provided by the department along with the innovated service. Whereas in case of addition of a new department a hospital may lose a huge fund if it is not accepted by the community.
Innovation of services offered to market. Service innovation strategies can be planned and executed when hospitals are pro-active in identifying the health need that can arise in community. After generating an idea of service innovation, it is very important to translate that idea into a viable service offering to new clientele zone.