مدیریت روابط مشتری از طریق برنامه های پشتیبانی تصمیم گیری کسب و کار الکترونیکی: یک مورد از همکاری پزشک و بیمارستان

Customer Relationship Management (CRM) is a valuable concept for hospitals to establish long-term physician relationships. Given predetermined reimbursement amounts, clinical interventions by physicians can significantly impact hospital profitability and quality. Therefore, disseminating quality and cost information to physicians can build lasting relationships, while insuring financial stability. This paper presents a CRM approach adopted by a hospital through a web-based Physician Profiling System (PPS). We discuss physician involvement in PPS development and present a high-level cost-benefit analysis. Post-deployment results indicate that PPS strengthened relationship with physicians, improved efficiency of clinical operations, while simultaneously improving patient satisfaction.

As competition and the cost of acquiring new customers continue to increase, the need to build and maintain customer relationships has become a fundamental priority for businesses. Customer Relationship Management (CRM) is critical not just in traditional buyer–seller relationships, but also in nontraditional customer–supplier relationships. For instance, the relationship of hospitals with physicians, insurance companies, and patients' employers is unique and does not fit the traditional customer–supplier model. Although patients are the end-customers of hospitals, the physicians who admit their patients to the hospitals are also valuable co-customers [38]. Therefore, it is important for hospitals to build strong and long-term relationships with physicians just as they do with patients and insurance companies. The purpose of this paper is to present a CRM approach in which a healthcare organization designed and developed an Intranet-based system, called Physician Profiling System (PPS), to build relationships with one vital customer constituency—the physicians who practice medicine at the hospital. The paper presents empirical evidence of stronger relationships between the organization and physicians, in addition to financial and quality improvements, resulting from the CRM initiative. The outline of this paper is as follows. In Section 2, we briefly review the CRM literature followed by the CRM perspective in healthcare. Section 3 reviews physicians' decision-making process and the requirements it places on hospital CRM. Section 4 presents the case study of the development and deployment of a web-based information system to support CRM in a hospital and the ensuing outcomes. We also present empirical data to demonstrate the impact of the CRM application on physician retention, hospital quality and performance. Finally, we present conclusions, limitations and areas for further research in Section 5.

The research and case study presented in this paper has several implications. We demonstrate that by following the CRM tenets, hospitals can augment their relationships with their key customers–physicians. Treating physicians as customers can lead to better working relationships and reduced turnover. Further, our findings demonstrate that electronic means of delivering physician profiles provide an opportunity to facilitate and manage physician–hospital relationship. Sharing information with physicians can lead to improvements in quality as well as financial performance of healthcare organizations. This case demonstrates the vital role of business strategy and process redesign supported by information systems deployment to affect organizational change. Although researchers have frequently made this point, it has not always been followed in practice. Our case study demonstrates that success of creating profiles was achieved through a well-defined strategy to improve performance and to involve physician customers both in planning and implementation. Further, we find that trust between the customer and the supplier appears to be critical in the implementation of a CRM. Trust between physicians and the hospital was a prerequisite that lead to changes in clinical practices on the hospital floors. Even well-designed information systems fail to demonstrate the ‘conversion effectiveness’ because of the lack of system use or the inability of the users to make changes where they matter. In our case study, the hospital's organizational strategy to sustain customer relationships with physicians appears to be driven by the pressures of a changing marketplace in which profitability is decreasing and scrutiny on quality is increasing. In such a scenario, where hospitals and physicians both felt the ‘pain’, it increased the likelihood of success of a well-designed CRM strategy. Although further research is required, we believe that such marketplace challenges are not unique to healthcare. Proactive organizations, such as SJHS, can draw their customers' attention to such market challenges in building lasting relationships, prior to the onset of adverse business conditions. Notwithstanding the above implications and contributions, there are limitations of our study. First, the PPS benefits were captured following the implementation of Intranet-based CRM initiative. Given that the physician performance data were available in the DSDW prior to the CRM initiative, it was not possible for us to isolate the impact of the PPS. Second, due to the introductory nature of PPS, we did not examine the savings from PPS physicians on a case-by-case basis. Further, measurement constructs and variables for PPS effectiveness are still evolving. Such analysis will be possible after physicians directly use PPS and usage data linked with performance are available. We provide practitioners and researchers with an example of managing nontraditional customers, thus demonstrating wider applicability of CRM. We invite researchers to examine other business arrangements that can benefit from CRM principles. Such areas may be business-to-business situations, such as business organizations and legal counsels, third-party suppliers and end-customers. Similarly, electronic commerce is redefining the customer–supplier roles. In addition, CRM principles can also be applied in managing relationships with electronic intermediaries and members of the product or service value chain. Future research can examine changes in resource consumption before and after the CRM implementation and its link with the intensity of usage. In addition, organizational impacts, such as power imbalances and shift due to published ‘report cards’ in PPS, can also be examined. Glossary of Terms DRG Diagnosis Related Group. One of 500+ categories used to classify patient diagnosis. Originally designed for billing purposes, now also used for clinical quality and financial outcomes1 LOS Length-of-Stay. Duration of stay of patients in the hospital—generally measured in days. MDC Major Diagnostic Category. DRG rolled up into major categories. Generally corresponding to a major human body organ, e.g. heart, kidneys, brain. Morbidity The incidence of disease, the rate of sickness as in a specified community or group1 Mortality The proportion of deaths to population.1 Expected mortality is a mathematically calculated risk of death for a given DRG. PPS Physician Profiling System. A web-enabled system reported in this paper developed to provide an overview of physician performance vis-à-vis physician peers and external benchmarks. APS-DRG All Payor Severity DRG is an adjustment for severity of all patients. The adjustment is based upon a model using historical data from all payors. Risk-adjustment Accounted for the possibility of loss, injury, disease, or death.1 A normalization process accounting for potential risk based upon severity and morbidity. Generally performed in reviewing resource consumption in treatments. Severity The advanced nature of a patient's disease condition. Specialty Category or discipline of specialization, such as cardiology, family practice, and neurology