Health Cloud Background
Healthcare data is messy. And to solve this problem Salesforce is focused on creating a CRM to manage patient and provider data in one place.
We’re telling the stories of two different customers and how building on Health Cloud is helping them crush their goals.
Customer 1: International Bay Area Healthcare Nonprofit
- Improved care quality and increased the number of patients they could serve by 7x.
- Eliminated complexity and established processes that could be managed in-house and improved over time.
Customer 2: Fortune 10 Healthcare Provider
- Rebuilt their 3-year product investment in 6 months (at half the price).
- Made coordinating patient care more affordable and easier.
How We Helped an International Bay Area Healthcare Nonprofit keep up with Explosive Growth
Change is the catalyst for opportunity and with changes in California’s insurance laws, this international Bay Area Healthcare Nonprofit saw an increase in clients from 500 to 3,700 over the course of four years. Recording nearly 80,000 client visits per month and collecting notes from more than 3,600 practitioners -- this nonprofit’s systems and processes were stretched to a breaking point.
Pushing a System to its Limit
A blend of paper notes, excel sheets, and multiple client tracking systems were time-consuming and inefficient. On top of that, there were fundamental questions about their data integrity, the potential loss of information, and the quality of case management they were able to provide as their client base continued to expand.
To support this growth, they realized they needed a single-platform solution that supported their workflow in three key categories -- solving three key problems:
Provider & Practitioner Management: How could they manage and support their partners better?
Case Management: How could they manage workload more efficiently?
- Referral & Authorization Management: How could they still work effectively when processes get complicated?
While Salesforce’s Health Cloud was the obvious baseline solution, this nonprofit believed the solution they were building could create value for other providers experiencing some of the same problems.
Working with CodeScience
CodeScience was selected as a partner due to our experience on Health Cloud as well as our ability to design solutions that scale. Through our Discovery phase, we found and solved four problems to meet their budget and timeline.
- The current solution wasn't built for scale: Taking the time to analyze and understand the capabilities of their solution allowed us to discover that it wasn’t designed with scale in mind. To build an application that could scale and create the value they were looking for required us to build from scratch using Health Cloud as the base. Some key features they needed were not native to Health Cloud and would require custom development. When situations like this occur, CodeScience works with our customers to understand the tradeoffs. As the Director of Product Management put it, “CodeScience was able to help us make smart decisions around customization efforts to maximize specificity while avoiding too much technical debt.”
- The current processes weren't built for scale: Building for scale is paramount for a successful application. To build for scale not only requires developers to plan for handling large amounts of data, it also requires some fundamental changes to processes. CodeScience implemented standardized processes to provide structure and templates -- these templates ensured greater accuracy in data and allow clients, practitioners, and new employees all to onboard faster and with less room for error. Their Salesforce Program Manager explained, “[CodeScience] eliminated redundancies, replaced manual workflows in Excel, email, and paper-based, and created data validation that didn’t exist before. It was really an engineering manager’s dream come true to have an incredibly knowledgeable team come in and set us up with the latest and greatest toolset, processes and architecture.”
- Keeping current clients happy: One of the most nerve-wracking moments for our clients is when systems are migrated over. There has to be close alignment on all fronts to ensure that this transition happens smoothly, and if all these pieces aren’t orchestrated correctly, systems crash and cause frustration with their current customers. Having launched over 200 applications, we have the experience and the knowledge to know what to look out for when migrating to a new system.
- Aligning with Salesforce: With Health Cloud just coming out of beta at the start of this project, some features were still not quite ready to use and documentation wasn’t always fully developed. Using our intimate knowledge of Health Cloud and our connections with Salesforce, we were able to quickly solve problems and adjust course as needed. It was important to not build a solution that would be outdated the moment it was released. To help assuage fears, we developed the entire solution only using Lightning.
What Happened Next
After a successful build and implementation, this nonprofit has grown and now has a dedicated team of in-house Salesforce engineers -- that CodeScience brought up to speed and trained on best practices. We were able to eliminate unnecessary complexity in their processes and stood up their team for continual improvement.They are now able to meet the 7x growth they were faced with and deploy a solution that meets the needs for other providers.
A project like this is never truly complete, but the Director of Product Management is certain they will continue to rise to the challenge. “I’ve been through so many of these implementations where at the end of it all, you feel lost and scared to say goodbye to the team behind it. But having the CodeScience team’s patience and willingness to make sure we have the knowledge we need to build on top of their product with the same best practices was incredibly reassuring. We’ve been set up for success.”
Building it Better: Helping a Fortune 10 Healthcare Provider Scale on Health Cloud
With the mission to take the messy data out of electronic medical records (EMRs), this Fortune 10 Healthcare provider had the vision to build a product that had three goals in mind: reduce costs, increase patient satisfaction, and improve overall health. And they did just that by building it themselves. This product sold well, but they quickly ran into a serious issue: it didn’t scale.
Moving to Salesforce
To help solve this scalability issue of their homegrown product, they worked with a Systems Integrator to re-platform to the Service Cloud on Salesforce. Within a few years, several large healthcare systems started leveraging the product, but the provider found themselves running into the same problem -- it wasn’t scaling.
The SI built a code base that provided about an 80% foundation, but each implementation incurred a substantial cost, increasing the total cost of ownership for clients and making it near impossible to roll out updates and bug fixes with each client running different instances.
Working with CodeScience
To uncover what was going on, CodeScience conducted an audit to look at their development practices, tech stack, and code.
Our Lead Architect on the project, Krishna Tatta, discussed the findings, “In addition to uncovering technical issues, we found that the product strategy had drifted and little of the application, from integrations to UI, had kept up. With the prospect of a large potential customer on the horizon, they wanted to seize the opportunity to take the product to the next level.”
In the meantime, Salesforce had launched Health Cloud, which presented a better capability set and features. We surfaced three main questions:
How could the Provider bring disparate systems together for consumers while also piecing together their own discrepancies in the platform?
Would CodeScience refactor the Provider’s existing app -- an app they’d heavily invested in, and already iterated on once before? Or would there be a fresh start?
What was the v1 for the Health Cloud refactor as well as the one-year roadmap?
Third Time's the Charm
Proposing another re-platforming generated anxiety for the client. Their Chief Product Officer explained, “This was a risk -- it was our third attempt, and there was the chance we were throwing good money after bad...A big part of the confidence we had to keep going -- and on an aggressive timeline with a fundamentally different platform and formal product offering -- was the partnership with CodeScience. We know healthcare. They know Health Cloud and Salesforce.”
To be truly successful and scalable, we knew that we had to transform their code, which required customization for each and every client, to a managed package (the complete, end-to-end code base whose same instance could be installed for each and every client). But to get to this endpoint, there were three areas that had to be addressed.
- Re-prioritizing Requirements: Along the way, the product had gotten bloated, convoluted, and this impacted its ability to scale. Krishna explained the team’s findings, “The old application had become a mass of superfluous features, complicating both the user experience and the technical scalability. We did a deep discovery to get the requirements for the new build, and had to let go of the past.”
- Building on the Platform that was Available: With Health Cloud just being released, there were features that our client wanted now, but were likely going to be available within six months. “We had to make decisions around what to build from our end, and what to wait for from Salesforce,” said Krishna. Reconciling these roadmaps required extensive collaboration between us, our client, and Salesforce. Fortunately, our long-standing relationships with Salesforce and deep knowledge of Health Cloud facilitated a partnership between the three companies that broke down hurdles and expedited the process.
- Creating a Product that Every Customer Wants: We knew that just because we built a great product, not every customer would make the switch. JT Lovell, CodeScience Product Owner clarified, “[The Client’s] prospects already have a working system, whether it’s ideal or not. We had to give them a compelling reason to jump ship -- not just roll out a minimal MVP, but launch with a top-of-the-line package.” This meant understanding the product inside and out and making the components not only smarter but better in every facet. In short, design and build a product that delivers more value.
What Happened Next
In six months, we were able to rethink, replatform and rebuild the entire product they’d been working on for three years, at half the price.
The Provider’s Chief Product Officer put it this way, “When I talk to my partners in the broader company, they don’t believe me. We rebuilt the entire product and then some in six months, hitting our timelines and budget.”
The product not only exceeded expectations in timeline and budget but delivers a superior experience. From a vastly improved UI to a scalability perspective, our client has confidence in their capabilities.
Their Director for Strategy and Design for Care Coordination shared this, “By the end of this year, we’ll have a legacy group of clients on the product as well as net new clients. There’s been no resistance in getting people to make the switch, and the feedback has been amazing.”
This is a product that is built to disrupt an industry for the better.
The vision is really just taking shape. Built for closed-loop learning, the care pathways built into the product will continue getting smarter in order to enable providers themselves to continue taking care of the most important function: serving their patients.