In this Xforce Data Summit session, Matt Gretczko, SVP and GM of Healthcare at Silverline, discusses the role that Salesforce plays in the healthcare system — and more specifically, how this platform has helped organizations better respond during COVID. While Salesforce is a CRM application at its core, the company has made significant investments in specific verticals, resulting in vertical clouds, such as Health Cloud. 

Learn more about the evolution of Salesforce for healthcare, as well as the ways in which they responded to the recent pandemic. This talk focuses on the role that data plays, as well as the importance of digital agility in times of change, which applies to a wide range of industries. COVID has forced healthcare organizations to really focus on their goals moving forward, and these goals are discussed in greater detail, including the importance of digital transformation, analytics, engagement, flexible governance, and more. 

This session is valuable to anyone interested in the capabilities of Salesforce within the healthcare industry and those dealing with EHRs. However, it also provides insight to any organization or management team that has needed to adapt during these unprecedented times, particularly those who were using Salesforce prior to COVID and those who have needed to rebalance and reprioritize following COVID. 

What You Will Learn

  • What is Salesforce for Healthcare? (00:01:58)
    • Introduction to Health Cloud (00:02:34)
    • Introduction of their partner ecosystem (00:06:05)
  • Salesforce’s COVID Response (00:07:01)
    • Salesforce Care Response (00:7:20)
    • Supporting those who already have Salesforce, helping them adapt (00:09:37)
  • The Role of Data (00:15:35)
  • Goals of Healthcare Organizations (00:22:08)
    • Digital transformations (00:22:19)
    • Engagement (00:24:28)
    • Flexible Governance (00:25:00)
    • Application Agility (00:26:21)
    • Robust Integration Tools (00:27:26)
    • Business Model (00:27:50)
  • Q&A (00:30:45)

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Full Transcription

[00:00:00] Welcome to another Xforce Data Summit presentation. Today we have Matt Gretczko, who works at Silverline CRM, and he's going to talk about Salesforce for healthcare and the COVID-19 response, which is something that's very topical this moment. So without further ado, here's Matt. 

[00:00:30] Great. Thanks so much, Leonard. Hi everyone, as Leonard said, my name is Matt Gretczko, and I'm the SVP and GM of Healthcare and Life Sciences at Silverline. Today I'll be talking to you about the Salesforce platform and how it's being leveraged by healthcare organizations — but specifically, how it is allowing organizations to react to COVID-19 and how that decision has really proven sure to where technology — digital agility is critical.

[00:00:55] Okay. Before we jump into, you know, the core content, I just want to give you a little bit of an overview of who Silverline is for those that don't know. Silverline is actually the largest pure play Salesforce consultancy in the U.S. that focuses on the U.S. market. You know, we do have a national presence, but we are heavily within two verticals.

[00:01:13] I oversee what we do on the healthcare and life sciences side, and I have a counterpart that oversees what we do, in financial services. And we sort of span the gamut of services. And so we do core implementations of the platform and the application. We provide managed services as well as a number of different strategic capabilities around program governance, change management, dev ops, etc., to help ensure that organizations are maximizing their investments.

[00:01:36] And you'll see some of the awards that we earned over the years, which we're proud of, being one of the best places to work, as well as winning some innovation awards with Salesforce. But yeah, the core of my presentation today is really going to focus on the technology, the solutions, and where and how we think it's compelling, to address this pandemic, but also preparing for future needs for these health care organizations.

[00:01:58] So for those that don't know, you know, Salesforce obviously has historically been known as a CRM application, right? That's what it was created for. But over the past few years, really about the past three to four years, Salesforce has made very informed investments into specific verticals. And they've started to take that core CRM application, which is now a very robust platform, right?

[00:02:20] They've made a ton of acquisitions, they've created a new product, and so it's really an end-to-end cloud platform that has a lot of power. As they’ve focused on specific verticals, they've actually now created vertical clouds within the platform. And so for healthcare, they've created what they call Health Cloud, right?

[00:02:37] And their desire with Health Cloud, is really to create the market leader that allows for what you see up here. Really, the ability to create an engagement application for patients, for members, consumers, employees, partners — for all different types of healthcare organizations. And by types, I mean segments, right?

[00:02:58] If you think about providers, you think about payers, you think about Pharma, Med Device, all of those organizations have been thought about, with this vertically focused Health Cloud. And so what is Health Cloud? What does it provide? And so one of the things, without going too deep and explaining the entire Salesforce platform.

[00:03:16] I felt this graphic, which comes from Salesforce themselves, helps explain it pretty clearly. And so at the bottom, do you have the core platform, right? You have sort of that infrastructure, right? The tooling, the piping, the ability to do, you know — create apps, processes, security, analytics, etc.

[00:03:34] On top of that, you have a lot of additional sort of product capabilities, core CRM capabilities that everyone should be very familiar with. And then on top of that, you have Health Cloud. That's where it gets really, really compelling for the health care organizations that we work with because they've tried to start to build out functionality, components, workflow, things that these health care organizations need to do.

[00:03:58] So, for example, I'll call out a few items. Think about a care plan, right? Well, many organizations have an EHR and that is the clinical system of record that doesn't change. But in order to do things that are more proactive, if you think about care management, or you think about wellness activities, or things come into play around, you know, social determinants of health as the ability to keep people healthy becomes more complex as well as a bigger focus on value based care.

[00:04:23] These organizations need to engage with patients in a very different way. And so Salesforce has created a capability with Health Cloud, where you can have more robust care plans that bring in data that's not just about EHR data. It's about other data that you might have as an enterprise that you need to use in order to manage that person’s health or communicate with them and interact with them. And so all these different purple boxes represent different components or different functional areas that they’ve built, that instead of having to customize a platform every single time you want to work with the healthcare organization, it allows us to really configure a solution, which is sort of new for healthcare organizations, right?

[00:05:02] It's focusing on that configuration side of the house, being able to rapidly deploy applications and I think that understanding is part of the reason we're going to talk today about COVID is, what we’ve seen is a lot of the organizations that have invested in Salesforce demonstrated a much greater level of agility when COVID hit, right?

[00:05:22] It wasn't about, how do we go acquire an application? Alright, how do we fundamentally change our business? It's about, how do I tweak my current application to meet this new need. Right? I have a massive increase of inbound calling, but it's for a very specific reason, which is COVID. Well, rather than having to build a new patient access center, can I just create a new workflow — and how quickly can I create a new workflow where it requires a slightly different triage process? Right? 

[00:05:49] The final comments I'll make about this is, you know, there are three releases every year. You know, it is a HIPAA compliant platform. And then what they've also done is create what they call the app exchange, which is really, think about, you know, the Google Play store, right? Or iTunes, right?

[00:06:05] They've created a bunch of partners that have created applications that now bolt onto this platform as well. And so if you think about Salesforce providing technology or the framework, you have a lot of organizations that now will create the content, for example, right? So while they have the framework for a care plan, they also have organizations that create the content that says this is a best in breed template for a care plan for a specific disease state.

[00:06:29] Or you might have organizations that have created additional tools that plug in around population health capabilities and risk segmentation — and so what's really powerful is that our job, at Silverline is not just to implement the core application, but we actually curate a best in breed solution for these organizations that checks a lot of different boxes.

[00:06:48] And then often replaces, you know, many disparate point solutions and brings it into this one consistent engagement layer. And so, that's Salesforce for healthcare, a lot more information out there on that. But I'll move on to sort of what we're seeing around leveraging this application for COVID specifically.

[00:07:05] So, there's really two approaches that we've taken with responding to COVID for organizations, right? Specific to sort of the world that we play in. One is what we're seeing here, is Salesforce actually came out, and decided to release a, what they call a Care Response Solution — which was actually access to their application for free for six months.

[00:07:29] And what that application was intended to do is to really focus on two aspects of the capability, in certain functionalities. So one, they give you access to Health Cloud, which allows you to really manage a contact center and access center. And they also gave you access to Community Cloud, which is their capability to really provide, you know, self-service capabilities —  really a portal technology. Right?

[00:07:50] How can you create a curated and authenticated experience for a specific type of audience, that pulls all the data and all the functionality from the core application? And so they provided this care response for free, we are one of the initial partners that were identified to help support organizations. That wanted to leverage this capability in order to meet the initial use case is just this massive increase in inbound phone calls, right?

[00:08:17] How do we handle this triage? How do we understand? And so what we've done is, the first organization that we've actually gone live as a few days ago was Truman Medical Center in Kansas City, right? What we helped them do was stand up this care response org and we tweaked it. So for example, they have an assessment now. So if a patient calls in and they think they might have COVID. We can run through a bunch of different questions to help triage that individual, put them into the right place and move them along that process.

[00:08:46] We also have worked with them on other areas to track those patients so they can know where they are within sort of that care timeline. And so this was a really powerful offering to the market. One, because it's free, it's allowed these organizations to not think about so much the cost — both the pro licenses were free.

[00:09:02] As well as we provided our services to stand it up pro bono. Obviously, if they want to expand beyond the COVID use cases and start to do some other things that we see healthcare organizations do, that's going to be an ancillary conversation. So, one of the solutions is to leverage the core application to quickly stand up really this patient access triage capability as well as the community serving as a self-service portal to put curated information that's validated so that people can go there and say, okay, rather than Googling this and finding a bunch of different sites, we're going to tell you as a health system the information that we believe you should need.

[00:09:37] The second thing that we've done related to, you know, COVID, is we are actually supporting existing organizations that have Salesforce to leverage the platform in order to address their needs, right? And so I wanted to speak through a few examples of this cause I think it's really, really powerful. Now I'm, I'm from New York. I live in New York City. so obviously — and we're also headquartered in New York City, so we have a lot of customers in that place.

[00:10:02] It's obviously the hotspot for the country as well. And so this is a few examples of scenarios where, when I talk about agility, right? These are organizations that had Salesforces in place, varying levels of maturity. What we've seen is they immediately called us. We called them and said, how can we help?

[00:10:20] How can we leverage this technology to quickly adapt? And so I wanted to talk through these use cases and I think they're really powerful. So the first one is one of the largest urgent care organizations in New York City. What we did with them is, we leverage Salesforce Marketing Cloud capability, right?

[00:10:35] Which is a part of the platform that allows you to engage across multiple channels, right? And so texts, email, chat, etc. And not only can you communicate and execute communications through it, you can also create a curated journey, right? You can say based upon the type of individual or the type of content I want to send them, what does that journey look like?

[00:10:56] I want to start with a text message on this day. I want to follow up with a phone call on this day, and email on that day, and I want to track the response in the interaction and tweak the journey based on that. And so one of the things we did was quickly stand up a number of different journeys for individuals that were either going into urgent care facilities or they wanted to reach out to former patients and say, if you are not feeling well, this is what we can do for you, right?

[00:11:19] And so we created curated journeys. Another organization, which is actually the largest. provider in New York State — you know, they were in the news quite often around needing to quickly stand up a patient access center for a hotspot that was outside New York City. What we were able to do is help advise and support them too quickly in 24 hours, right —

[00:11:40] And again, agility, stand up a patient access application that could quickly handle inbound triage for COVID patients or people that thought they might have COVID. In addition, we are able to also roll out recently, Salesforce’s chat capabilities, not only to facilitate some internal communications that the organization's priorities have shifted, but also to do some call deflection for patients around, Hey, what's your question? Right?

[00:12:05] If it's around COVID, this is where you need to go. If it's around something else, this is where you need to go. And so again, as these organizations have suffered through massive increases in phone calls. We want to help ensure that a multichannel strategy is being employed, and again, being able to stand up an application in 24 hours, it's just incredible.

[00:12:25] The final tool I'll talk to you — um, and you're gonna see a similar use case again, but again, leveraging Marketing Cloud, we did create for one of the largest multi-specialties groups. They have around four to eight different locations. Again, using Marketing Cloud. We help them adjust current messaging to patients, right?

[00:12:40] So, for example, a lot of elective appointments and surgeries or not happening. So they said, Hey, all these appointments, we need to send notifications that they've been canceled. Well, they also increased their tele-health capabilities, and so we want to communicate to patients, letting them know about these tele-health capabilities.

[00:12:55] What they also wanted to do is be proactive. So they actually segmented their population and said, okay, we've got X number of at-risk patients. How do we communicate to them? How do we let them know what our guidance is for them? And in the unfortunate scenario where maybe some individuals are actually going into an ER. We're going to get that ADT feed and we're going to feed that information back and also send a communication now.

[00:13:18] And so for all of these, what you're also seeing is the data component of this, right? One piece of it is the execution of the workflow and the interaction with, you know, your audience, whether that's a consumer patient — but the other piece is the data that's informing this. 

[00:13:32] And when I get to the last slide today, around what we're seeing organizations need to do, for all of these, right, is that the data that's informing the Marketing Cloud journeys — it's coming from an EHR, right? We are consuming that data, the information that they're using to identify at risk patients, they're segmenting that information from a population health solution, but then feed the HR that and feed Salesforce so we can execute.

[00:13:55] I mean, so it's not about Salesforce necessarily being the system of record for the information, it's being that engagement layer that consumes this information and then executes different activities in order to change behavior or improve health. And then the final one is, you know, they provide solutions to large employers.

[00:14:14] That's one of the areas that they focus — so they have a bunch of employers that said, hey, we don't have the knowledge or the capability to address all the questions that our employees have around COVID. And so we helped leverage the same communities capability of Salesforce, to spin up a community for that employer that allows them to put curated information for all their employees, as well as submit cases to say, hey, I think I might have it, or I have this question, or what about benefits?

[00:14:40] And so again, working with these organizations, is it possible for people to do these things with other applications? Absolutely. It's not to say that Salesforce is the only application. What we're finding is those that invested in the right modern technology, definitely are seeing greater agility.

[00:14:55] And I think what they're also identifying as we think about — and Silverline has released a number of different blogs around this, this concept of digital transformation that has always been out there, it's starting to get pulled forward. I think it's going to get pulled forward even quicker now because of COVID, right?

[00:15:10] Is organizations are going to start to rebalance and reprioritize and say, hey, we were not as prepared as we needed to be. COVID is not going to go away — you're gonna have a lot of sick people that need to be engaged. We're going to have all other scenarios like this. 

[00:15:22] Even just to run a good, competitive and effective health system — now it's necessary to do our business, “not a nice to have.” Right, so a few more pieces of content that we'll go through, and I sort of started alluding to this, but you know, often, I like to outline, what is the role of data — but what are some of the questions that need to be considered here?

[00:15:43] And again, Silverline. The application we work with Salesforce, you know, operates across provider, payer, life sciences, you know, Med Device, right? And so the questions are going to be tweaked slightly based upon the type of organization we're working with. But some of the things that come up a lot is, you know, how do you expose new data sets quickly?

[00:16:01] Right? And so a lot of conversations — HL7 isn't broken. It works, right? But the question is that you think about a new modern approach — so exposing information, transacting that information, we're seeing a lot of organizations start, you know, capitalizing APIs, in new, more architecturally savvy ways — in efficient ways to transfer data between applications, right?

[00:16:35] Especially when you talk about it being bi-directional, real-time, or activity or event-based interactions, right? If something happened in this application, we want this to occur — that's where it's really powerful. Another area that we see, how do you analyze the data you have to better segment, you know, those consumers, those patients for that level of engagement, right? 

[00:16:48] And so whether you call it patients and provider, you know, called members in a payer scenario, right, is what you want to start doing, is analyzing that data, segmenting those individuals, and then curating the experience based upon that, right? 

[00:17:03] And this starts bleeding into some things that are getting more popular in the healthcare space around things like next best actions, right? And so you have this data, you consume this data in this engagement layer. And the question is, when you go to interact with that patient, what is the right thing for you to communicate to that patient, right?

[00:17:19] What should you be talking to him about? Should you be letting them know that they didn't get their flu shot? Or you should be letting them know that they're at risk for diabetes because you have all this information on their history and you think they should attend a class the next week, right?

[00:17:33] That is what we're able to do with the data, if you start to segment it, you start to curate it. Another example is, you know, COVID brought this up — is what is the barrier minimum data that we need to triage a patient, right? We need to be realistic about that. Do we really want to consume, you know, 75 different fields, do a huge bi-directional integration, or is there some baseline data that we think is necessary?

[00:17:58] And if we have that, at least we know that moving forward, we can actually take care of that patient. And so I gave an example on the bottom left here of a sample dataset for COVID-19 triage, right? We've thought about it and said, hey, this is some baseline data that may be valuable in order to inform this type of solution, right?

[00:18:18] It's not rocket science, it is not groundbreaking, but these are the challenges that many of our customers have, is where to start, right? What is the initial guidance, right? What do you believe is going to get us to where we need to be as efficiently and effectively as possible? A few other items is, you know, real time metrics, right?

[00:18:30] I think often, there's a lot of organizations, and I talk about this on the next slide as well — is I think there's often this completion of data and analytics and assuming those are exactly the same, right? And what we try to do is help organizations move to the analytics level. How do you investigate that data?

[00:18:48] How do you mind that data? How do you use that data to better inform your operations, better form your processes? How do you deliver better care clinically or not clinically? Okay, two. These are organizations, how do you better identify potential patients, potential consumers, right? That all falls into having real-time metrics, real-time analytics versus having so much data, but you don't know what to do with it, right?

[00:19:10] And so having an appropriate integration strategy, a middleware tool, that allows you to facilitate those introductions across the organization is going to be really good, important. And then I think another one that's very, you know, COVID, you know, related is. How do you engage a new vendor application or tool?

[00:19:27] How quickly can you do that, right? How many organizations, okay, didn't have a telehealth solution and to quickly find one, right? Well, can you bring that into your environment quickly — or is it just like, yeah, we have it, but now it's completely standalone, any patient that's using that application, we don't know if we've ever seen them before.

[00:19:45] And so that's another area that as you think about enterprise architecture data, is how quickly can we stand up these other applications and use these applications to inform what we need to most — or for those organizations that have a tool, how do you extend and enhance that tool very, very quickly?

[00:20:00] And so again, data plays a huge role in everything that we're seeing. There's not one customer that we don't have a conversation around data. I think where we often struggle with is, where do they start, right? What is the right level of data integration? What is the right approach? How do we not lose anything that they've built — capitalize on anything that we think might be working, but prepare them for a future model that might require more digital engagement, more productivity, and we are curation right.

[00:20:29] I think that's really, really important. And then finally on the bottom right, I mean, just giving sort of an example is, well, why are organizations sort of using data this way? And in the provider side, this is an example, right? So, you know, patient registration, right, is a huge piece on that. We're seeing scheduling, right?

[00:20:47] How do we better facilitate scheduling, right? If you think of patient access, one of the challenges that patients have today, is they call in, they have seven different questions, right? And the original statistic that many of these organizations use is how quickly can I get someone off the phone, right?

[00:21:01] That was Demetrick, right? And the shorter the call, the more successful that call is. Well, we get a lot of pushback with our point of view. Our point of view is, no, how valuable is that phone call? That phone call is more valuable, but it takes 30 more seconds. That's what you want. That is the guidance.

[00:21:16] And so if you can have a patient call and you can schedule an appointment, but they can also pay a bill and they can also get directions and, oh, by the way, they signed up for a flu shot that might've been 30 seconds longer — but that's what the patient needs, right? And so having the appropriate data for that conversation and the appropriate workflow, it allows you execute things efficiently is really, really important.

[00:21:37] You know, referral management as well, right? How do you streamline that process and understand that? And so again, there's so many different use cases of where and how we see new data specifically. but I wanted to run through some of the questions that often come up, especially those around COVID, that we've heard organizations say, hey, I can't bring in a new application quickly or I can't expose data the way you're asking me to.

[00:21:59] These are things that we shouldn't be experiencing in healthcare at this point. The tools exist, the application exists, to not have these challenges anymore. The final slide that I'll really touch on here. It's just what are the goals that we believe healthcare organizations need to have, and hopefully everyone appreciates — this is broader than, you know, just providers, right?

[00:22:19] This is across all those segments that I've mentioned a few times — is first, digital transformation. Everyone's got their own definition of what digital transformation means, right? We created what I think is a great article around this. 

[00:22:30] But you know, thinking about the strategy side of the house, thinking about getting the customer and employees involved, insights, having a plan, and changing management, right? And if you do those four core things, there's a lot of detail behind each of those that allows you to start to execute on this digital transformation concept that has been talked about for many, many years.

[00:22:51] But has not really achieved success as much in healthcare. And one of the things that, you know, I've, I've talked about a lot in, in my career and learned from some of my mentors is, how does healthcare learn from other industries? And so there's all these great scenarios of where healthcare has learned from all these, you know, other industries.

[00:23:08] One of the ones that I love, and it's not distinctly related to digital transformation, is how ER learned from the airline industry, right? And so they're having this problem, how to better navigate beds and how do we be as efficient in beds? And an airline executive was actually brought in, and he said, hey, think about the beds, like you would think about gates right? 

[00:23:30] And how do we efficiently navigate patients between those gates, right? And you wouldn't naturally think that airlines operated similarly to an ER, but they did. And so I think as we think about digital transformation, what are the best industries in digital transformation?

[00:23:43] You think about retail, right? Retail is great at engaging — how do we start to leverage all of that in healthcare has made tremendous leaps, but I think COVID again puts front and center this agility concept as well as where some of these organizations might be falling behind. 

[00:24:00] And so where they made an investment in EHR, and maybe, I don't think it's the best EHR they could ever have. My gut says, rather than go and replace that EHR tomorrow, they might say, you know what? We should probably spend time on the digital transformation side of house because that's going to have a much bigger impact on our patients now.

[00:24:16] And then down in the future, we can maybe perfect what that looks like. Analytics I talked about, so I won't go there again, making sure it's not just about the data, but actually insights. Okay, engagement, right? How do you better engage, right? And this is a multichannel multimodal, right? We're talking about, yes, phone calls certainly are still number one in healthcare, but we are seeing a lot of organizations move into leveraging texting.

[00:24:42] We're leveraging email, we're leveraging chat. I think that's really, really important. And something that, you know, you should definitely focus on, within your organization and again, factor in all the different audiences, right? It's not only about your customers or consumers, it's about your own employees.

[00:24:57] It's about your partners — think about their experience. Flexible governance. This one might be a little contentious, right? You know, governance itself is intended to be pretty cut and dry. But I think what we're also finding is that organizations need to prepare four. How do they adapt when things change?

[00:25:13] When you're in an emergency situation, what is your governance plan then? I remember, you know, prior to Silverline, I've done a lot of work with the provider onboarding process, so credentialing, privileging, enrollment, and when Hurricane Sandy hit New York City, one of the things that I felt was exposed pretty broadly, was the credentialing process for doctors, right? 

[00:25:33] Well, the way it works today, current regulation is you're credentialed and you're credentialed by the organization, but privileged at that hospital. Well, when you had a bunch of hospitals, that were out of power, you had all these doctors that are willing to help, but there was no process in place to say how to — how does NYU or how does Mount Sinai or how does New York Presbyterian, how do they credential someone else's doctors?

[00:25:55] The process didn't exist. And what no one thought through and still haven't solved, is why do I have to credential them if they're credentialed by that hospital? Doesn't that mean they're good enough to be a doctor here? And so I think as we think about flexible governance is when things are normal, everything makes sense.

[00:26:11] But when we have an emergency, when you have a pandemic, how do we not relax it? But how do we adjust that governance model and make sure your organization thinks about that? Application agility. This was core to the presentation today, right? Again, it's not just about an application meeting your business needs or meeting your operational or functional needs.

[00:26:30] It's about how agile does it make you, how does it allow you to adapt and evolve for things that you can predict? But also the things that you can't, right? And that's really, really important. And I think, you know, what we're seeing is also a lot of organizations moving away from sort of these point solution approaches.

[00:26:46] It's like, okay, I need this problem. I'm going to solve it with this application. Well, we're helping organizations think about it. Think about an overall platform. You need a platform — and can you do as much as possible with that platform, whatever platform you select. Obviously we do a lot with Salesforce, but it's understanding that, hey, if you want to bring on that additional service line or you’re wanting to bring on that additional business unit, or that additional team —

[00:27:11] It shouldn't be about, oh, I have to go buy another application. It should be that I'm just building a new workflow, or I'm just giving you permission for that individual to do their job. And the final two here. And I’ll certainly open it up to Leonard, see if there's any questions. 

[00:27:26] You know, integration tools, right? Part of why we're having this conversation today — is you can't do a lot of what we're talking about, unless you've got the right tools in place, right? And one of those tools is your middleware, application, right? Whatever tool you end up using, obviously there's very specific ones that are leveraged heavily in the healthcare side of the house.

[00:27:44] But understanding what tools you have in place and how to maximize the efficiency — and then business model, right? We don't like to necessarily talk about healthcare in that way. I appreciate that. Part of the reason I'm in healthcare is because I love actually being closer to the impact.

[00:28:00] This COVID has brought that front and center for us, right? We are deploying technology solutions that are immediately impacting people that may or may not have code. That is, that is powerful and it's motivating. But the business model is also going to shift. I can't tell you how many of our customers are like, hey, we're not the same organization we were a month ago and we'll never go back to it.

[00:28:21] Organizations, for example, telehealth, organizations where telehealth was like an ancillary channel, that 5% penetration — now they're seeing 75% penetration like, hey, we're expecting after this thing, we might be at 50%, we might've scaled up 45% in telehealth because people are used to it now.

[00:28:38] They liked that convenience, right? I know personally, I'm repainting my house during this, right? You know what the new model was? I called into the paint store, they had it ready, I drove up, I called them and they dropped it in my trunk. Begs the question. Do I need to go into the paint store? Should that be the business model, right?

[00:28:56] Or can they always drop it off? And so I think you're going to see within healthcare and outside of healthcare that organizations are going to fundamentally operate in different ways. And I think healthcare is going to be one of the leaders in that place where I think you're going to see a lot of people leveraging the digital tools.

[00:29:11] One of the things that was part of all the packages that were pushed out by the government was the relaxing of HIPAA rules, right? And so what we've seen and I'm interested to see is, you know, there's always a big difference between a video chat and telehealth, right? Well because of COVID, we've now seen those things have been basically the same.

[00:29:31] If you have the ability to talk to someone right via video, that's okay for telehealth right now. The question is going back to governance, going back to the business model in the future — is that going to be the model? Is it going to be acceptable to talk to a patient over any application? Or are they going to relook at the requirements around HIPAA compliance, etc.?

[00:29:51] And so again, there's a lot that falls into ‘business model.’ It impacts governance, it impacts agility, but I think many of the customers that we have, are going to start thinking, where do they evolve? But also where do they maximize their interaction with patients? I mentioned COVID. That's not going away.

[00:30:07] There are going to be patients that have legacy impacts due to COVID. Their health is never going to be the same. And so what does that look like? How did these organizations help those patients in the future? So with that, I'll wrap it up — I appreciate the time today. Hopefully that's helpful. Again, my name is Matt Gretczko, I’m SVP and GM of Healthcare at Silverline.

[00:30:28] You can see my LinkedIn information there. You can go to our website. We do have a blog that's focused on a lot of different healthcare topics, and we've released a lot of information around what we're doing specifically around COVID. Feel free to reach out to me directly, but with that, I'll turn it over to Leonard and see if there's any specific questions.

[00:30:44] Yeah, thanks, Matt. I have about a thousand questions, but I'm trying to, in my head, I'm trying to cut it down. But one thing I really think that you touched on that's correct is the impact of telehealth. I mean, here in Rochester, we have a health system that I use, my wife uses, my daughter uses.

[00:31:05] We're already heavily involved in an app and in an online experience. And, you don't have to, you don't have to talk to your doctor as much and your impact on the physician or the healthcare providers is so much lower in my perception. Actually, I have a young doctor and she just is, you know, a quick question is answered within hours with a quick answer and you're done.

[00:31:25] You know, you don't call a receptionist and do all that stuff. So enough about an old man's medical issues. One thing as a software guy or software developer integration person, the whole conundrum of the EHR versus Salesforce where those two blend together — do you think it'll ever be an EHR system of record, or is always going to be an ancillary system?

[00:31:50] I don't think so — I mean, I would put my money that they're not going to be the clinical application, right? And so I think even the way you framed it up, we often have to auto-correct some of our customers, right? The immediate thing that I correct them on is, well, it's an EHR verse. No, it's an EHR plus.

[00:32:05] That is the first correction that we make — is that Salesforce is not a clinical system of record. I don't believe it ever will be a clinical system of record, right? EHRs do what they do very, very well, but there are areas that either the EHRs have been slow to move into, or they're just not well-suited for those capabilities.

[00:32:25] Even if you take something as simple as telephony integration, integrating your phone system to EHRs — not something they do today. That's core to the value prop of Salesforce is that if someone calls in, you know exactly who they are and you've got a very specific workflow. So the short answer is no.

[00:32:43] I don't believe Salesforce will become a clinical system of record, like an EHR. It's a symbiotic relationship where data from the HR informs Salesforce and Salesforce becomes that engagement application to curate interactions, curate activities with that information. And it's not just the EHRs, right?

[00:33:01] EHR is one of the biggest buckets that we see, but certainly population health platforms, certainly referral platforms, and then other data repositories, warehouses, lakes, etc., as well. 

[00:33:13] Okay, and so you were, for those of us who aren't deep into the medical record world, you talked about a standard called HR7. Is that how you get data in and out of an EHR other than using some kind of a more direct API interface? 

[00:33:27] Yeah, I mean, it certainly depends — but yeah, I mean, most organizations, that's the legacy model that they put in place and so we do have to transform HL7 in order to consume it into Salesforce.

[00:33:36] So we will consume it into a JSON format or something like that, but obviously we don't want to disrupt what works, right? And so many times what we'll see is that the EHR will have a lot of different connections to ancillary applications via HL7, and so those feeds will remain, they'll continue to consume and push information via HL7 to the EHR, EHR will then interact with a middleware tool, and what we'll do is interact with that middleware tool.

[00:34:02] And so we'll ask for that HL7 to be transformed and then we'll consume it most likely via Salesforce’s API mechanisms into Salesforce. So again, do I envision a world where HL7, you know, obviously the new fire standard, right?

[00:34:16] I don't think it's going anywhere per se, but obviously the fire API is moving towards an API approach is certainly what we're seeing, but it's going to take time, right? So a lot of these integrations and applications have been running for many, many years on those standards. 

[00:34:33] Do you see like with communities _ do you see that as the public face of all interactions with the healthcare provider, for instance, getting case notes and pushing them into Salesforce? So, the customer or patient can look at that, or do you see it more as, you know, maybe just journeys, marketing, things like that?

[00:34:52] So there's a few different interaction channels, right? So, you know, for people that are, say, you know, there's the core platform, they may log in directly to Health Cloud and see the care plans in all its entirety, right?

[00:35:03] Certainly we see the community's plays being a curated and authenticated view into that. Right? And what's really nice about the communities is it's all mobile ready, right? And so the way you build it is the first day you build it, it's also accessible on your mobile device, but it also can be built into an actual mobile application as well.

[00:35:23] They actually have a wrapper that allows you to do it easily, and so the short answer is yes. You could think about it as a model where your doctor establishes a care plan for you. The way you interact with that is via the community of the mobile device where you can get — okay, here's a task that I was assigned by my doctor. I'm interacting with the same application, the same information, just in a different way.

[00:35:43] That's absolutely the same thing when we talk about Marketing Cloud. Those interactions, sure, they might be pushed via an email, but what we can also do is push notifications to that community, and they would operate as if it was a native application on your device.

[00:35:58] You'd get a notification — hey, you have a, you know, clinical summary, right? Or, hey, you have an appointment coming up. And so I think that's what's compelling here and powerful, and it's not only that Salesforce can handle it, but about this new strategy, this digital approach. It's sort of refining that experience, as you said, and making sure that people have the best possible experience.

[00:36:18] You know, telehealth is going to be one of those examples. Most of the telehealth providers have their own application. Right? Well what we're seeing is that many of these providers now are trying to cure it and say, okay, I'm going to create an app that brings all those applications into one place.

[00:36:33] So you don't have to download seven different applications to interact with that health system, right? 

[00:36:39] So if what I'm hearing from you is that the EHR shrinks back to being a specialist tool — that it's a back office tool and the front office is more, you know, front office, the interactions more handled by Salesforce is where the —

[00:36:53] Yeah, I mean, I think so, and again, I don't want to say anything, you know, that's contentious to the market. But I think what we are seeing is certainly applications like Salesforce are more well-suited to be that interaction, that engagement layer. Are there EHR that are creating mobile applications?

[00:37:08] Absolutely. But again, we think that EHR is — and I don't think they'd argue they are very good at the clinical, the highly clinical. The question is what about all those interactions with the patient that are not clinical, that do not exist in the EHR today? Think about it, there's so many, if you think about a journey, right?

[00:37:24] EHR are also very episodic, right? Well, once you leave the four walls, there's not a lot of interaction with them, with the patient — but there needs to be, and so I think that there is a gap that applications like Salesforce are hoping to fill, is that overall patient journey or experience before, during, and after care.

[00:37:44] What does that look like to stuff that's very clinical, that it's occurring in the four walls? It's episodic, EHR does really well, but let's expand beyond that. 

[00:37:51] That's great, that's great. I wanted to plug a few — if people are listening to this and they heard some of the things that Matt said about marketing journeys and so forth.

[00:37:30] I just wanted to plug that we have two presentations, one on Marketing Cloud that's being given by Sarah Lewis and one on Pardot by Karin Tracy and the one one Pardot, Karin works for a nonprofit and is really smart about it, you know, the marketing journeys. And the other thing is we're doing a — there's a presentation on next, next best actions by somebody named Sikha Baid.

[00:38:28] And she's going to give a full demo of how she set that up. So if you're interested in some of the things Matt said, those, those are also sessions that you might be interested in. 

[00:38:36] Great, and like I said, I mean, feel free to reach out. I mean, we also, you know, we have a lot of different resources that we're happy to share.

[00:38:43] And one of the other areas I would just mention, I didn't get into on this talk, is the revenue recognition recovery — that these organizations are gonna have to go through is going to be what I think you're going to start seeing a lot of conversations around — okay, we've suffered through a tremendous hit on our revenue, how do we now take our, take our current model and quickly bring those patients back?

[00:39:04] We've had thousands of cancellations for patients, right? Well, great, how do we now communicate to those patients, and hopefully bring them back? 

[00:39:12] Yeah, exactly, right. Matt, thank you very much. This is a really informative presentation and I know you're very busy and I appreciate your time.

[00:39:22] Yeah, thank you so much. Thank you everyone. And again, I appreciate the time and stay healthy. 

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