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The Broken Promises of Customer Engagement in Healthcare

Blog: Appian Insight

Customer engagement is a hot topic, and not just in Retail. At HIMSS in LasVegas, customer engagement in healthcare is a buzzing topic.

Now, it may not be called “customer engagement,” but make no mistake. With all the evolving, (and let’s not forget cool!) tech in Healthcare, how the patient…the provider…the member…interact and engage with each other (and even with different systems) has become a core focus of healthcare institutions.

What’s more, it doesn’t matter if your organization is a provider or a payer institution. Customer engagement is important. Period.

Why? We are ALL consumers. And, it doesn’t matter where you work, what your role, what you do.

You are a consumer. You have gotten used to immediate gratification…your needs met as you decide you have them. Mobile technology and devices have spoiled us all. They have expanded our expectations.

And so it plays in healthcare.

Of course, these sound like the same promises vendors have been making for years!

Ever heard, “Get the right data to the right people at the right time?” Of course you have.

While innovation in healthcare is incredible, the promises have largely gone unmet. But now, all those broken promises are holding you back.

There is one technology that binds all that data and workflows and process together and begins to deliver on the promises made a decade ago or more. Can you guess what it is? Perhaps not…

Here’s a glimpse at a recently published paper that reviews how to better achieve customer engagement in healthcare: How to establish the systems behind the smiles:


Our Challenge
You may have heard the phrase, “The Systems Behind The Smiles.” Popular in the hospitality industry, Systems Behind the Smiles are the web of systems and processes front-line workers need to put organizational ideals into practice, and as a result, extend fantastic service that results in customer smiles.

The phrase comes from a book—Customers For Life: How to Turn that One-Time Buyer into a Lifetime Customer. While certainly not intended for the healthcare industry, we can learn a great deal from it.  For example, consider this nugget, taken from the chapter, titled Systems, Not Smiles:
“What’s needed in restaurants, car dealerships, department stores, and every place else is systems—not just smiles—that guarantee good service. Every business is composed of systems. Those systems must work together to create a process that is efficient and responsive to a customer’s wants.”

Not too long ago, we spoke of front-office versus back-office. The former dealt directly with customers. The latter played crucial but supporting roles.
Increasingly—and especially in healthcare—these layers are merging. Back-office systems are becoming front-office systems, as customers—especially younger ones—prefer mobile apps over human interaction.

Even when front-office staff interact directly with customers, they interact with back-office systems. These trends dictate complete transparency of any systems directly or indirectly affecting your customer’s journey. To meet evolving customer expectations, it is becoming more and more important to mold your back-office processes to these journeys.

Healthcare is full of complicated systems, and customers—members, patients, providers, and partners—increasingly call the shots. Our challenge is to design, manage, and improve the systems so we can maximize their smiles.


Health plan customers are demanding more collaboration with everyone involved in their care. The more payment shifts from volume to value, the more it rewards collaboration across healthcare providers and payers.

Meanwhile, cost pressures require elimination of redundancy, rework, and mistakes, all of which require even  more collaboration and coordination. Sharing data is a challenge: failure to take advantage of new sources of data about patients and events surrounding their care is a massive missed opportunity.

Of course, along with these pressures and opportunities comes risk.  Risk includes real and perceived threats of breaches of patient data, increased amounts of bad data, and changing consumer preferences (what do health plan customers “really” want?).


The sum total of these systems and processes must be aligned to support improved member and provider experience. This represents “The Systems Behind The Smiles.”

There is no magic bullet (i.e. technology) we can place in front of healthcare customers to magically transform their experiences with the healthcare system. In fact, 40-60 percent of customer dissatisfaction is due to systems, not smiles. No matter how personable or well-trained front-line customer service representatives are, the systems they rely on can (and often do) determine the outcome of customer experiences.

For a health payer, customers range from insurance plan members, who sometimes become patients, to health providers and provider organizations dealing with those members and patients. Meeting these customer experience challenges requires mastery of complex, dynamic, and mission-critical patient data management processes. Requirements include access to multiple systems of record (care management, claims, recruiting, member services, and compliance), while ensuring standardized cross-functional workflows, as well as data governance and quality assurance. What’s more, the systems put into place to share data, encourage collaboration, and manage risks so that all involved can simply count on them working right the first time…and every time thereafter.


If you enjoyed this excerpt, please download the full paper! After you’ve read it, share your thoughts.

And if by chance you’ve read it and are still at HIMSS16, pop by booth #10430! I’d love to have a live (and lively) discussion.

Fritz Haimberger

Healthcare Practice Leader

The post The Broken Promises of Customer Engagement in Healthcare appeared first on Appian Insight Blog.

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