The Value Of Customer Relationship Management System

Published Date: 02 Nov 2017

The Business people understood the value of customer relationship management system which helps them to create a good and long term relationship with their customers. The CRM systems helps increase the productivity but also improve the quality of the customer service. The same concepts can be used to set up PRMS in health care organizations. Clinicians can set up an ongoing rapport with their patients with such a system in place, enhancing them to develop focus on prevention and giving them a new component to assist developing patient satisfaction and wellbeing. Handling relationships across organizations and over time is good for clinicians and patients and assists to develop efficiency (Chiang, 2005).

According to Schoeder and Madeja (2004) the chains of pharmacy competing for development in face of essential competitive challenges face a terrible requirement to develop revenue (in light of decreasing reimbursements from government and insurance) and productivity (to cope with severe reduction of skilled staffs of pharmacy). To indicate these challenges the requirement is for streamlined functions aligned with their objectives of the business. As proven by major chains of pharmacy, choosing the correct workflow system of Rx can offer a definitive competitive edge in the marketplace. To enhance efficiency of operations across the chain, managements required to deploy right fit pharmacy management system. With appropriate implementation approach and sufficient due diligence these systems can support with:

Work process segmentation for effective labor division.

Addressing pharmacies shortage by automating and streamlining the steps of a workflow process. The system must target for effective prescriptions filing while freeing up pharmacists for consultation with customers and permitting time of technicians for value added services.

Checks of systemic data to scan influence of medicine allergies or medicine combinations to assure wellness of the patient and offer counseling to develop patient relationships.

Developing levels of customer satisfaction and repeat business through consistent and timely service of customers.

Rationalizing operations through sharing of data across locations of store permitting patients to refill or order their Rx from any shop. In this area important developments are possible with distributed/remote operations and workload balancing (Gartner, 2003).

Pharmacy management systems must operate seamlessly, unfailingly and flawlessly in complicate multi-store, cross geography surroundings enhance chains of medical store to run profitably and efficiently. Some of the functionality driven difficult features involves integration capabilities, workload balancing, smooth processes of workflow, and combine across channels, centralized data view and counselling activity records. From the perspective of architecture, the pharmacy management systems can be centralized with client terminals and corporate as a hub at the stores. An alternative could be standalone systems of store driven where frequent connectivity with headquarters is not important or even an integration of two. The model to be regarded can be chosen based on the specific needs of pharmacy chains (Body et. al, 2004).

Health care delivery companies are acquiring CRM (customer relationship management) techniques to meet developing expectations of patients, develop a service of customers and assure the loyalty of customers. Stronger rivalry and developing markets have aroused models of customer centric business that needs highly effective communication and management processes of relationship to succeed.

About RxCare

RxCare is a solution for Patient Relationship Management from Infosys Technologies. It represents the method of handling with patients beyond face to face delivery of clinical services. Their solution assists organizations in health care delivery to gain numerous targets. They are: 1) to handle patients with chronic diseases efficiently; 2) develops satisfaction of patients; 3) coordinates health care delivery through effective multiple communication channels; 4) combines information silos through Central Master Patient Index; 5) develops the results and efficacy of outreach initiatives; and 6) expands and retains base of patient through effective processes of referral management (Damle et. al, 2007). According to Ford and Fotler (2000) the technology characteristics important in Rx Care system involve: 1) rapid response; 2) scalability; 3) flexibility; 4) ability to handle peak loads; 5) restricted access; 6) ease of maintenance; 7) robust downtime architecture; 8) real time synchronization; 9) ability to assure rapid roll outs of upgrades/maintenance; 10) reliable disaster recovery; and 11) ease of integration. The chains of pharmacy can select between custom built products, buying out the source code or ready to deploy products and customizing it for their needs. The appropriate selection will rely on factors like geographical spread, complexities and size of every organization. Their present state with respect to process standardization and system sophistication are also essential considerations. Thus selecting right pharmacy system has been one of the difficult queries faced by pharmacies. However in this area successes reveal that it is a difficult determination that requires to be planned and estimated with five to ten year roadmap carefully in view. Given the multitude of individual operational nuances and considerations the option is always specific to every chain of pharmacy. Retailers will require to estimate their particular surroundings for constraints, big term vision and opportunities before determining whether a process is aligned with their particular targets.

1.2 Problem Identified:

Information technology has its impact in almost all the areas. Health care industry is not an exception to it. With increasing competition in the healthcare sector, hospitals are focusing more and more towards retaining existing patients and bringing in new patients to their organizations by offering them high quality patient relationship management systems. While the PRMS are a central part of almost all hospital in developed countries like UK and US, India has its application only few of the top rated corporate hospitals. Health care organizations on gaining better understanding of the needs of their patients would be able to offer improved health care services to them (Oinas et. al, 2008). Such personalization would turn a success factor in the health care sector and would serve as a motivation for hospitals to employ information systems for enhancing their operations of providing health care services to patients. This research will stand as an eye opener in revealing the benefits of patient relationship management systems to healthcare industry thereby making each and every hospital in India; adapt the same for offering high quality healthcare services to the needy. Further, this study will also guide software vendors in effectively deploying patient relationship management systems in Indian hospitals.

1.3 Aims and Objectives:

Primary objective

To investigate in detail the benefits, challenges and myths of RxCare system in relation to the effective implementation Patient Relationship Management System in certain selected hospitals in India.

Secondary objectives

To identify the need for RxCare System in relation to the patient relationship management system in hospitals in India

To analyze the impact of the RxCare System in relation to the effective implementation of patient relationship management system in improving the quality of healthcare services offered to patients and retaining them in certain selected hospitals in India

To investigate the challenges associated with the deployment of the RxCare System in relation to the effective implementation of patient relationship management system in certain selected hospitals in India

To propose strategies for effective use of the RxCare System in relation to the effective implementation of patient relationship management system with certain selected hospitals in India.

1.4 Research Questions:

Why the patient relationship management system is needed in Indian hospitals?

To analyze the impact of the patient relationship management system in improving the quality of healthcare services offered to patients and retaining them

To investigate the challenges encountered by software vendors in the implementation of the patient relationship management system in hospitals in India

To propose strategies for effective deployment of the patient relationship management system in hospitals in India

1.5 Significance of the study:

A detailed report on how patient relationship management system functions, along with the benefits rendered by the patient relationship management system to hospitals, challenges encountered by software vendors in deploying patient relationship management systems in Indian hospitals and finally strategies to be adapted by both software vendors and hospitals for making the best use of the patient relationship management system in India is to be delivered at the end of the study.

1.6 Limitations of the research:

This sample size of this research is merely 100 for quantitative analysis owing to timt constraints.

For this research data gathered is with respect to benefits, challenges and myths of patient relationship management systems of corporate hospitals in India and is not applicable suitable for organizations other than that.

1.7 Chapterization Plan:

This thesis consists of the following five chapters

Chapter 1: Introduction: It comprises of the introduction to the study, containing, research background, aims, objectives, significance and limitations of the study. Besides, this chapter has the research questions and a problem statement.

Chapter 2: Literature review: It is the chapter containing the concepts of e-learning provided by researchers in the past.

Chapter 3: Research Methodology: This chapter explains in detail the research methodology such as research design, sample design, data collection techniques, data analysis and interpretation techniques.

Chapter 4: Data analysis and interpretation: This chapter analyzes and interprets the data collected through a methodology proposed in chapter 3.

Chapter 5: Results, Conclusion and Recommendations: This chapter has the presentation of results as observed from chapter 4 and consists of the conclusion obtained by connecting the proposed research objectives with facts inferred from the results. This chapter also has strategies and recommendations for future research.

Besides, the research is supported by bibliography, that lists out the sources referred for undertaking this research and appendices that contains tools used in collecting secondary data.

Chapter-2: Literature Review

2.1 Introduction

The health care service plays a primary role in the welfare of the public. A system of patient relationship management (PRM) much generally called as the CRM (Customer Relationship Management) can therefore be reasonably agreed to by a public hospital, and might be significant to leverage the satisfaction of the patient. The customer relationship management is the principle and key strategies in administering the interactions among the commercial firms and their consumers. It is not less significant in the context of health care (Koh et. al, 2005). It is since the patients are the principal customers of hospitals and some other healthcare settings (Kohli, 2001), the phrase patient relationship management is utilized for the systems in those firms. With the patient relationship management, the healthcare firms focus is set on recognizing and meeting the requirements of patients (Siau, 2003).

The patient relationship management engages in tracking the information of patients from the data of diet and exercise to the prior diagnosis information, to the allergy information and the history of the family all of those could be further added or edited by the patient themselves, authorizing her / him in the information provision and looking for. By accumulating all of this material, the providers of health care would be capable to send e – information to patients regarding the newly published studies of health care that might be applicable to the patient or provide offer expertise suggestions that fit the profile of patients (Siau, 2003). Also the patient relationship management in the health care could assist promoting the education of diseases, and the services of prevention and wellness (Hallick, 2001). These details also could be utilized to automate the operations of those call centres, in which regular advice for definite feature of care could be made accessible in the call centre without having to divert physicians or nurses from their primary care duties (Siau, 2003).

Preferably, one of the services accessible in a patient relationship management is for the patients to mail the providers with the questions that are related to health, and obtain responses with detailed treatment answers or options to the questions, make easy the follow – up nurses or doctors (Siau, 2003). The dispute and the challenges is that the capability to support this in the setting of a public hospital. The health care firms must have an important advantage and some prospective to construct such association with the patients (Hsu et. al, 2004). It is in the case of hospitals with areas of catchments, the utilization of the similar hospital entails the health history of patients and the epidemiology of the locale, have to be comparatively well known by the firm (Oinas et. al, 2008). Enhanced understanding of the needs of patients would assist the health care firms to offer better care. This is necessary for providers demanding to supervise and avert diseases, since the customized information could be dispersed more effortlessly without possessing to mass market all details on a specific disease to all the people right to use of a Web site or getting newsletters. This extent of personalization will turn out to be a serious success characteristic in the industry of health care, and gave out as one more alternative for the providers of health care to utilize the systems of information to get better the care they offer (Siau, 2003).

The information of a HIS (Hospital Information System) has to be then used by a patient relationship management in order to make stronger and sustain the association among the customer and hospitals. It has been since the greater part of the data necessary for patient relationship management comes from the hospital information system, the patient relationship management has to be seamlessly incorporated with hospital information system in order to discharge the prospective of patient relationship management utilised to the maximum extent. If all the information gathered could be examined suitably through multi-dimensional analysis technologies and data warehousing the medical institutions could offer closer associations, two – way communication and personalized medical services (Hung, Hung, Tsai & Jiang, 2010; Ramakrishnan,, Hanauer, & Keller, 2010).

2.2 Meaning and definition of Patient Relationship Management

According to Shanmugasundram (2008) in hospitals also customer relationship management is a vital role in the business strategy of managing the customers and also offering them the long-term services. The building relationships with the customers may be easy but maintaining their relationship is more important than all. The effectiveness of the customer relationship management depends upon the level of the customized services and the customer satisfaction for which a customer is ready to pay a price. The customer relationship management should be the combination of the Process Relationship Management (PRM) efforts plus the Supplier Relationship Management (SRM) efforts. The customer relationship management in hospitals has to focus on maximizing patient by imparting training to the staff members, augmenting patient care and how to maintain good customer relations and have to bring changes in the organization and schedules to reduce patient discomfort and the waiting time. Thus the patient relationship management is to maintain the good relationship among the patients.

Malhotra (2009) points out that the migration of the customer relationship management to the patient relationship management is the natural evolution of building the realization that when the need arises, the promoted hospital is there to help. In the health care world a patient is called a paying customer. The value of the true relationship management begins with the customer or patient now. The customer i.e. patient requires more and high considerate level of communication because the patient has passed from the world of not-needy customer relationship management into the world of needed patient relationship management. Thus the patient relationship management is needed for the patients as well as for the hospital management.

According to Dai (2011), in the business processes, by integrating the hospital business philosophy, customer relationship and the medical technology into enterprise customer relationship management (CRM), by which the hospital establishes a patient centred management system, is named as the Hospital customer relationship management (HCRM). Patient relationship management is the software which improves the efficiency and the quality of services. This system is proposed to retain and maintain existing customers and to expand the ranks of the loyal customers, to get the customers lifelong ultimately and to absorb the potential customers. In order to win the competition, of the domestic hospitals they must improve the core competitiveness in satisfying the patients. The competition among the hospitals, strength is considerable is the competition for customers so the hospitals will pay more and more attention to the patient. The patient relationship management increases the patient satisfaction. Thus patient relationship management software is mainly focused to maintain and retain the existing customers for a lifetime relationship.

Kunders (2004) define that the patient relationship management will characterize the Health Care Providers (HCP) as a successful leader to build the relationship that strongly expertise in the technology, knowledge and the quality of the services. For the patient’s quality of service is the main competitor and a differential advantage to create the enduring value. The patient relationship management is defined as an internet based set of services in order to help both the health care providers and the patients to maintain and to develop the life long relationship. Thus the patient relationship management is a tool to allow the health care providers to manage and develop relationships with patients using the information technology. The patient relationship management helps in binding the strong relationship between the patients and the organization.

2.3 The users of patient relationship management system

The primary and most important users of the system of patient relationship management are the professionals of health care chiefly the doctors and nurses and also the patients. It is for the professional of health care, the systems for patient relationship management have to be tightly incorporated in accessible electronic health record (EHR), and hospital information system (HIS). So that, the execution of these systems, aggravates negligible impact on the accessible workflow. The patients have to clearly register themselves in order to utilize a system like this because of the privacy problems that might get a rise. It is indispensable to produce a web portal particularly for patients, or incorporate to an accessible portal for that rationale. The architectures that are projected does not need patients to have access to the internet at home as some kiosks could be raised at the hospital, offering that the patients a mode to sign up and direct their favourites (Kurtz, 2002).

2.4 The services of patient relationship management system

The following are some of the services offered by the patient relationship management system.

2.4.1 Alert service

As an obligation, a system of patient relationship management has to offer the ability to send personalized alerts to patients regarding the appointments, treatments and exams of consultation. The alerts have to be explained by the channels of patient – specified like that of an SMS, Email, call using voice synthesis, etc. and the agenda they favour. In addition to this functionality, the patients also have to be alerted regarding the exceptional debts to the health or hospital maintenance information reminders (Hallick, 2001).

2.4.2 Waiting times display

Another significant service is offering the estimated waiting times of the consultation service, emergency room, types of exams and the laboratory service (Siau, 2003).

2.4.3 Clinical data and cancel appointments entry of data before the appointments

An additional service is the capability of patients to cancel some appointments and the capability for the patients interprets the appropriate information preceding to the scheduled time, which then could be accessed by the doctor or physician.

2.4.4 Clinical data entry

It is that the patients must also be capable to enter some clinical information, on a defined schedule by the health professional.

2.4.5 Launch information to the population

It has to be probable for the profession of health throw information to teach the population, based on a group of policies. Permitting targeted health advertising and marketing (Hallick, 2001).

2.4.6 Application Development Framework

The ease of use of a stable and structured development framework offers an easier means, to the developers – from the firm or third party in order to develop applications that appear native to the major portal and generate a flawless knowledge at the same time as all data required is being distributed and modularity in development improves best alternatives for each field. The chief anxiety of this structure is a privacy and security of patients. An API (application programming interface) has to be developed as a segment of the incorporation with all the arrangement (Siau, 2003). Generating such a characteristic accessible offers the firms, its segments and some affiliated firms, tools to effortlessly develop the claim that smooth the progress of the correspondence and follow – up of the surrounding population and patients. The deployment, hosting and approval of the appliance developed by this structure have to be of the accountability of the organization.

2.5 Integrations of the system

To be effective, the system of patient relationship management has to be integrated with the divergent information systems that are accessible at the hospital. Some of the information systems are the electronic health record (HER), hospital information system (HIS), the laboratory information system (LIS) etc (Koh et. al, 2005).

2.5.1 Electronic Health Record

The electronic health record is that in which all the clinical data of the patients will be stored and maintained. It is this system in which the professionals of health work on a day by day basis. It is much more significant to incorporate into the system of electronic health record the clinical information introduced by the patient on to the system of patient relationship management. This is done by offering the professional of health care a unique gateway to all the clinical data.

2.5.2 Hospital Information System

The hospital information system possesses all the information of hospital activity, and holds the admittance, discharge and shift the ADT events. This information comprises of the demographic data, emergencies, exams, consultation appointments, treatments and hospitalizations of patients (Hallick, 2001). The hospital information system is the major resource of information on the system of patient relationship management for all the services it offers, making incorporation with is the hospital information system a requirement.

2.5.3 Laboratory Information System

The laboratory information system includes all the details that are derived from that of the workflow of the laboratory. It possesses all the selected laboratory tests, their outcomes if accessible, and the choice to lay down the laboratory analysis. This arrangement is not necessary to be integrated with that of a patient relationship management system, but it offers significant information, not only the selected examination to drive reminders to patients. But it also possesses analytical information that could be utilized in policies to send the details of the population (Hung et. al, 2010).

2.6 Architecture of patient relationship management system

The architecture of Public relationship management has been illustrated in the following figure 1.

Figure 1: System architecture of public relationship management system

Source: Vardasca and Martins (2011)

2.6.1 Patient relationship management database

All the system of public relationship management has been supported by a database that confines the applicable information and arrangement standard execution of the system.

2.6.2 Public relationship management broker

The function of the broker is to switch all the communication with information systems that there is a requirement of incorporation. This broker shall encompass the capability to correspond HL7, as it is the de facto customary of communication among the systems of health care. A rising number of systems are utilizing this standard (Kurtz, 2002).

2.6.3 Public relationship management internal portal

There might be a transversal portal that is only easy to get to within the hospital to administrators to organize the system and also to the professionals of health care in order to send the educational information to the population, and to administer the applications that are organized on the portal. It uses to work as the back office of the system. The confirmation on the interior portal is attained by means of the internal Active Directory so the consumer do not require to keep in mind another password, and the system management be supposed to not be accessible outside of the firm (Siau, 2003).

2.6.4 Public relationship management public portal

The first entry point and the chief front – end is the public relationship management public portal. It is here in which the patients and population record into the scheme. It is in this portal there had to be offered all the configurations and services of patient, configurations and the firm deployed claims. The portal must have to utilize the HTTPS protocol, offering a protected right to use to all the services (Hung et. al, 2010). The confirmations have to be based on the National Health Service number, offering an unmistakable identification. This relates applications, created utilizing the recommended structure, in spite of where they are hosted and permits integrated exhibit to the end user.

2.6.5 Public relationship management notification gateway

Another chief constituent of the architecture of the public relationship management system is the PRM Notifications Gateway. It is in which all the alerts are analysed and passed to the particular channels. It is suggested utilizing an SMS channel, as the easiest route to aware the patients, a channel of Email, another way of easily alerting the patients with the access of internet and the voice channel which if for those patients who are not comfortable with the emails and SMSs. The communication boundaries of this doorway to all the channels of communication (email, SMS etc.,) have to be designed and framed in the way of abstract and generic. This is because that in the mere future new services of alert could be integrated easily (Hung et. al, 2010).

2.6.6 Public relationship management web service

There has to be accessible a web service that could be consumed by desktop, Smart phone, tablet applications or some other services. This would offer the systems of public relationship management with some flexibility on the ease of access to the end users, and improvements in the development of user interface (Koh, et.al, 2005).

2.7 Benefits of Patient Relationship Management Systems 

According to Parvatiyar and Shainesh (2001), the patient relationship management systems increase the customer satisfaction and the patient’s health effectively. The patient relationship management systems improve the pricing and the product models. It also improves the understanding of the patients. The patient relationship management systems are automated tools or software and so it has separate or unique place among the patients. Thus the patient management system is useful for the patients and the health care providers.

Goyal (2005) argues that the patient relationship management systems increases the customer retention. With the better care of the patient’s i.e. by the better service management it attracts the new patients to the hospitals. The important purpose of the patient relationship management systems is the continuous patient care and follow-up the treatment protocols. With the software tool all the details of the patients are automated. Through the automated systems based on the loyalty and the relationship among the patients will be there for life long. Thus the patient relationship management services with their best service management which attracts the new patients to the hospital organizations.

Xu, Tjoa and Chaudhry (2008) state that the patient relationship management is a centralized process is provided for the patients who support to reach the goal of the organizations. The feedback is collected from the patients and from their families in order to satisfy their needs. The qualitative and the quantitative data are collected on the patient dissatisfaction which will be used to identify the quality improvement projects. The continuous support is given by the patients to the organizations. Thus the quality is improved with the patient relationship management systems.

According to Rodrigues (2010), with the patient relationship management systems the healthcare providers benefit from the optimized revenue through the effective outreach campaigns, improved communication, increased user productivity and the greater patient satisfaction. The disorganized information across the hospitals constitutes a major drawback in the efficient delivery of the healthcare. The patient relationship management solution provides the best solution for the most of the problems which arise in the patient related non-clinical service delivery. The patient relationship management is designed to meet the needs of the patients as well as the healthcare providers. The efficient referral management system is processing for expanding and retaining the patient base. The database is specially designed for the healthcare. Patient relationship management helps the healthcare delivery organizations to achieve the following objectives they coordinate the delivery with care through the efficient multiple communication channels, improves the efficiency and also outcomes with the outreach initiatives and also manage the patients effectively. Thus the project relationship management systems maintain and retain the efficient patient base.

2.8 Service quality dimensions in hospital

Measuring the characteristics and quality of the products of intangible services has become an immense challenge for the administrators and managers in the industry of health service. The organizations of health care require measuring the satisfaction of patients in order to point out the problems that are related to the patients and take measures to rectify them (Ford, Bach & Fottler, 1997). In the same way it is mentioned by Bowers (1994) that the purchasers and consumers of the health care are making resolutions based on their insights on the quality of the service offered and their pleasure with the providers. The following table 1 some of the service quality dimensions of hospital.

Table 1: Service quality dimensions of hospital

Source: Chiang (n. d)

It is indicated by Sower et al Eds. (2001), that a numerous of studies have tried to address the issue of defining the service quality in the context of hospital and adapting or developing a tool to measure particularly the hospital service quality. It is argued by Carman (1990) that the dimensions that are service – specific other than those in the SERVQUAL might require to be added to entirely confine the consumer’s explanation of service quality. The question arises is that what the dimensions of the service quality are significant for the consumers of health care (Bowers et al Eds., 1994). An assessment of the study points out that there is a huge difference in how the quality of service is operational zed and conceptualized for the industry of health care. It is found that there are various explanations regarding the service quality among these associated literatures. As such it is suggested by Sower, Doffy, Kilbourne and Koher (2001) that it is more or less not possible to propose a consistent and comprehensive definition for the service quality of hospitals. The study made by Chiang (n. d), referred to the associated outcomes of the study and take into account of the human proportions of service, the infrastructure of the health care firms and the technical competence. Accordingly, the study proposed some seven dimensions of hospital service quality. They are medical outcome, medical procedure, serviceability, medical ability, medical facilities, physical environment and medical information.

2.9 Patient Relationship Management – Improvement of Patient Health and Satisfaction

For a number of years, the commercial business has understood the advantages of the systems of customer relationship management (CRM) that assist them develop long – term consumer relationships. Consecutively, customers have grown familiarized to deal with businesses that proactively recognize and serve up their necessities. It is through mechanized systems based on the perceptions of reliability and relationship – based marketing, customers have developed to rely on accommodating follow – up correspondences. This is based on their recommendations or favorites for music, books and other goods that the people who are with related favorites have benefited from. Same type of concepts could be utilized in order to institute systems of patient relationship management in the healthcare firms. With such type of system in place, the clinicians could establish ongoing associations with their patients that enable them to amplify focus on avoidance, and providing them a new instrument to assist enhance satisfaction and well – being of the patient.

2.10 Challenges faced in the implementation of Patient Relationship Management

The following are some of the challenges that are faced during the implementation of the patient relationship management. They are:

Defining of clear objectives

The hospital must possess an apparent set of goals that it would like to attain through the patient relationship management. Those objectives required to be defined and listed as the quantifiable metrics. Without doing so, the hospital could not be able to assess the advantages or the ROI of the patient relationship management system.

Employing a core team of patient relationship management

The initiative of patient relationship management is not a project on information technology. A core team of PRM has to be created added to the contribution from Senior Executives, Information Technology, Top Management, end – users and Customer Service. It is only after the necessities are obvious should they would be handed over to the information technology for the implementation.

Defining of the processes

It is significant for the procedures to be obviously explained and imposed in order to set up the project on patient relationship management for success. One superior perform is to generate a central repository, that are accessible to all that stores all the definitions of the process. This permits the document to be accessible for referencing by any person using the scheme. Key procedures that required being explained from the beginning is the process of change management, process of Feature Re – evaluation etc. Also the clear security deals together with the access management require being in a position to ensure that significant data is not easy to get to by persons who shouldn’t be accessing it.

Organizing the application

Once the patient relationship management had been rolled – out, it is significant to re – align the job culture of the panels around it. The operations of the business have to suitably map with the application of patient relationship management. Also this means that the end users have to execute day – to – day activities through the application of patient relationship management by evasion and not optionally.

Deciding on the current partner

The rate of success of patient relationship management significantly goes up with the correct solution associate. Preferably choosing an associate who could perform both, implementation and strategy is important. It is significant that the partner has to share the risks of the implementation. Performing with a salesperson that makes out restricted work culture, technology restrictions and take note to the workers is ideal (Sah, n. d).

2.11 Research gap

The patient relationship management helps the hospitals to increase the satisfaction of patients, incorporate the silos of information by the way of central master patient indicator, synchronize the liberation of care by the way of effectual multiple communication channels, patients with the chronic diseases could be managed efficiently, the outcomes and the efficacy of the outreach initiatives could be improved and the patient base could be retained and expanded through the effectual referral management processes. There are some studies that analyzed regarding the patient relationship management its usefulness and its importance in improving the health and satisfaction of patients. The research gap found in this study is that there is no study that deals with the patient relationship management from the perspective of Indian hospitals, its importance in offering quality health care services. Hence this study analyzes the patient relationship management practices in the Indian hospitals, the challenges associated with the deployment of the patient relationship management system in hospitals in India and the strategies for the effectual use of the patient relationship management system with hospitals in India.

2.12 Summary

It can be understood that patient relationship management systems are a new way of attracting customers of healthcare sectors, i.e., patients towards a hospital or healthcare organization adapted by today’s hospitals in order to establish and maintain a healthy rapport with them. Patient relationship management systems offer numerous benefits to hospitals. Especially when it comes to offering quality healthcare services in a customer friendly manner, patient relationship management systems stand as best tools. Like any other technology or system, there exist some challenges in the deployment and implementation of Patient relationship management systems too. However, by adapting appropriate strategies and implementing the same, patient relationship management systems can yield their best to hospitals in maintaining healthy relationships with patient for a lifetime.

Chapter-3: Research Methodology

3.1Introduction

The following chapter discusses in detail the research design, research paradigm, sampling design, types of data, data collection, analysis and interpretation techniques adapted in this research in addition to explaining the ethical considerations and limitations involved in this research.

3.2 Research paradigm

A research paradigm is a dynamical scientific works system including their perceived values by peer scientists, and ruled by associated citation decay and endurance and intrinsic intellectual values. Recognizing a developing research paradigm and evaluating alterations in an occurring paradigm have been a challenging activity due to the complexity and scale involved. Research paradigms fall into two categories by name (1) Positivism and (2) Interpretivism (Morris, 2006).

Positivism in the social sciences which has been based heavily on the natural sciences scientific principles. Positivism is the view that the sociology must use the natural science method. Positivism is also referred to as quantitative research (Babbie, 2001). Conversely, Interpretivism is the interpretation of science. Interpretivism focuses on referring meaning for shared linguistic for a symbol or representation. Interpretivism is also referred as qualitative research (Chalmers, 2004).

3.2.1 Research paradigm adapted in this study

This research adapts positivism. According to Hjorland (2005) positivism is an epistemological position that supports the application of natural science methods to social reality study and beyond. Positivism is an outlook which believes that one must view at a thing as a knowledge source only when there is some sort of empirical proof in it. Positivism assures that knowledge is gained only on perception basis of the senses rather than intuition. Positivist approaches depend greatly on manipulative and experimental methods. This research adapts positivism since it verifies the research hypothesis by analyzing gathered numerical data from primary respondents.

3.3 Research approach

Research approach as the name suggests can differ essentially relying on what is to be researched, and testing if it is a scientific method, and viewing whether it is proper to research other scientists or common methods who have attempted the experiment (Gliner and Morgan, 2000). The two famous research approaches in practice are qualitative and qualitative research approaches (Jackson, 2011).

Denzin and Lincoln (1994, p 6) defines qualitative research to be multi paradigmatic in focus. Its practitioners are sensitive to the multi-method approach value. A qualitative researcher constructs a holistic, complex picture, analyzes reports, words, and brief informant’s views and conducts the natural setting study. On the other hand, Quantitative research is associated closely with reasoning and deduction from general principles to particular situations. Quantitative research is used in research by predicting the responses to queries which can be measured. This type of research responses queries similar to how many, who, how much, when and how always and surveys. Quantitative analysis gathers data that is factual and can be assumed and measured statistically (Cooper and Schindler, 2006, p 3).

This research makes use of quantitative approach. Happ et al (2006) have described that quantitative research is an inquiry mode used always for deductive research, when the target is to check hypothesis or theories, collect descriptive information, or inspect variable relationships. These variables are yield and estimates numeric data that can be examined statistically. Quantitative data have the importance to support to setup cause and effect, provide measurable evidence, to create generalization and replication possibility to a population, to yield effective procedures of data collection, to offer insight into experiences breadth and to facilitate groups comparison. This research surveys 100 healthcare professionals working in 5 different hospitals in Chennai, India that make use of RxCare in managing their patients for quantitative analysis.

3.4 Research Design

Richey (2007) says that a research design deals with the matters such as selecting participants for the research and preparing for data collection activities that comprise the research process. Research designs basically are of two types as shown in the following figure:

Figure 1: Types of research designs

Source: Fowler, 2002

As the above figure shows research designs are of two types by name conclusive research design and exploratory research design.

3.4.1 Exploratory research design

According to Burns and Bush (2006, p 26) Exploratory research design is referred as gathering information in an informal and unstructured manner. The exploratory research design is proper when the researchers knows small about the opportunity or issue. Exploratory research design is not limited to one specific paradigm but may use either a qualitative or quantitative approaches.

3.4.2 Conclusive research design

Conclusive research is defined as a research designed to assist the decision maker in deciding, evaluating and choosing the better action course in a given situation. Conclusive research may be either descriptive or causal research design respectively (Malhotra, 1999, p 75).

Casual research is referred as the research design where the major emphasis is on deciding a cause and effect relationship. In fact the causal relationship could be due to other factors specifically when dealing with perceptions and attitudes of people. On the other hand Brannen (1992) described that descriptive research as the name suggests describes descriptive data about the population being studied and does not try to set up casual relationship between events. It is used to explain a happening, an event or to offer accurate and factual description of the population being studied. In a descriptive study the things are measured as they are.

3.4.3.1 Research design used in this study

This study makes use of descriptive research design. Descriptive research design needs a clear specification of what, who, where, when, how and why the research is to be done formal design is needed to insure that the description encloses all phases (Mohan, 2007).

3.4.3.2 Justification for choosing a descriptive research design

The main difference between descriptive and exploratory research is that unlike, exploratory research, descriptive research formulates a hypothesis in advance. Kirsch G (1992) says that Descriptive research answers the questions of who, what, where, when and how. It does not answer the questions of why. Descriptive research deals with everything that can be measured or counted. The present research study is descriptive in nature because it analyzes in detail the challenges, benefits and myths associated with implementing patient relationship management in Indian hospitals.

3.5 Sampling Design

Sampling plan or sampling design is a definite schedule for gaining a sample from a given population (William, 2009). There are two sampling techniques by names

Non-probability sampling or non-random sampling

Probability sampling or random sampling

Probability sampling or random sampling is chosen according to mathematical guidelines whereby the chance for choosing of every unit is known. (Tayie, 2005, p 32). There are four types of probability sampling techniques by name (i) Clustered sampling (ii) Simple random sampling (iii) Stratified sampling and (iv) Systematic sampling.

On the other hand, non-probability or non-random sampling technique is more useful than others are they all share 2 similar characteristics. First investigating sampling errors is impossible if non probability sampling is used. Second all non probability sampling techniques reflects attempts to lower down the sampling cost similar to probability sampling techniques (Takona, 2002, p 248). The four types of non-probability techniques are (i) Quota sampling (ii) Convenience sampling (iii) Judgmental sampling and (iv) Snowball sampling.

3.5.1 Sampling design adapted in this research

This research makes use of both probability sampling techniques since this research does both quantitative analysis.

Of the four types of probability sampling strategies for this quantitative analysis, this study makes use of simple random sampling.

3.5.2 Justification of sampling techniques used

This study uses simple random sampling for quantitative analysis. Simple random sampling is a procedure in which each possible sample of a specific size within a population has common and known probability of being selected as the study sample. It is the most basic kind of probability sampling (Parasuraman, Grewal and Krishnan, 2009, p 339).

3.5.3 Sampling unit

The sampling units for quantitative study are the following five hospitals from Chennai India

Apollo Hospital

Malar Hospital

Harvey Heart Hospital Ltd

Ramachandra Medical college and hospital

Miot Hospital

3.5.4 Target population

The target population in this research for quantitative study is 100 healthcare professionals from target hospitals that use RxCare for managing its patients. The healthcare professionals who participated in the study are doctors, administration staff, lab technicians and IT department staff.

3.5.4 Sample size

The sample size for the quantitative study is 100.

3.5.5 Sampling plan

It has been planned to collect quantitative data through online surveys.

3.6 Data Collection Method

Research data are nothing but facts or observations on which test or argument is made (McDaniel and Gates, 1998). Data may be of two forms by name primary and secondary data. This research makes use of both of them.

3.6.1 Method adapted to collect primary data in this research

Myers (2008) says that primary data are the new data that are collected for the research project. Primary data do not exist until and unless it is generated through the research process as part of the project. Primary data is closely related to and has implications for the method and techniques of data collection. Primary data include data from interviews, fieldwork and unpublished documents such as minutes of meetings and so forth. In this study Primary data are collected both in quantitative as well as qualitative forms. Primary data have been planned to collect data from 100 healthcare professionals from 5 hospitals and 10 software professionals from Infosys are using closed and open ended questionnaires respectively.

3.6.2 Reasons for using closed and open ended questionnaires and in the research

Closed ended questionnaire are used in this research since the research intends to conduct quantitative analysis. Closed ended questionnaires are objective in nature. Closed ended questions ask respondents to choose from predefined answers that are closest to their viewpoints. Questions may be true or false, yes or no, sliding scale or multiple choice questions. Closed ended questionnaires were simple to respond and tabulate than open ended but they do not permit respondents to elaborate (Moody, Daniel, 2002).

3.6.3 Method adapted to collect secondary data

According to Khurana (2009) Secondary data is the data that were collected by someone else for a different purpose. When gathering secondary data every source of information used must be identified in the paper. Secondary data are cheaper and quicker to gather. In this research, secondary data has been collected with the help of books, journals and online magazines that talk about patient relationship management system and also the websites of the target hospitals.

3.7 Data analysis and Interpretation of data

Data analysis techniques vary in their ability to detect differences in the data. Statisticians refer to this as the "power of the statistical analysis."The power of the analysis technique increases as precision in measurement increases. In this research the quantitative data is analyzed using statistical tools and qualitative data is analyzed using simple text analysis.

3.7.1 Analysis of Quantitative data

This study tests the following hypothesis:

Null Hypothesis: Indian hospitals do not find it really challenging in implementing Patient relationship management systems

Alternate Hypothesis: Indian hospitals find it really challenging in implementing Patient relationship management systems.

Null Hypothesis: Patient relationship management system does not help in improving the quality of healthcare services offered by Indian hospitals to patients.

Alternate Hypothesis: Patient relationship management system helps in improving the quality of healthcare services offered by Indian hospitals to patients.

The following are the statistical tools to analyze the primary quantitative data collected.

Graphical method

Karl Pearson Correlation coefficient

Sample percentage method

Graphical method

Graphical method is the process of presenting the collected primary data in visual form or form of figures. There are many forms of graphical representations such as histograms, bar charts, pie charts, scatter diagrams. The biggest advantage of using a graphical method is to present the data in a readable form. This study uses bar charts for representing the data.

Karl Pearson Correlation coefficient

This research makes use of the statistical technique Karl Pearson Correlation test to test the proposed hypothesis. Karl Pearson Correlation test gives as a result a variable by name coefficient of correlation which helps in identifying the relationship between quantitative dependent and independent variable (Weiten, 2010, p 44). The correlation coefficient is denoted by the symbol "r". The correlation coefficient "r" is evaluated by applying the below formula:

where n = number of elements

x = Variable

y = Variable 2

Simple percentage analysis:

Simple percentage analysis is used in making comparison between two or more series of data. In this method, percentages are used to describe relationship percentages can also be used to compare the relative terms.

Percentage = No of responses X 100

_________________________

Total number of responses

The statistical tools are implemented with the help of the following software tools

Microsoft Excel

In this study, Microsoft Excel is used to create graphs for the percentages calculated from the collected primary data.

SPSS

SPSS is a windows based program that can be used to analyze quantitative data through application of several statistical techniques. Statistical Product and Service Solutions is capable of managing huge number of data and can offer accurate results within no time. SPSS is used commonly in the business world and Social Sciences due to its numerous features and benefits

3.8 Strategies for validating findings:

In any research, the results obtained are validated for correctness with the help of two parameters by names validity and reliability.

3.8.1Reliability:

Reliability is the degree to which the measures yield stable results and are free from error i.e. the measurement procedure stableness. Reliability involves the reproducibility or consistency of scores test i.e., the degree to which one can expect similarly stable individual’s deviation scores across testing situations on parallel or verifying components (Zikmund, 2003). In this research the researcher has ensured reliability by confirming that all the respondents had answered all the questions and no question has been answered more than once.

3.8.2Validity

Validity has been referred by the extent to which the measures of test what it claims to measure. The measure is valid if it measures what does so cleanly and is supposed to measure, without including these factors accidentally (Gregory, 1992). In this research the researcher has ensured validity by designing the data collection tool, i.e., the questionnaire relevant to that of the research objectives and literature review.

3.9 Ethical considerations

There has to be some basic ethics to be adapted in any research. Ethics in this study is maintained by the researcher by keeping the responses obtained strictly confidential. Besides, a prior permission was taken by the researcher from the five target hospitals before conducting the research.

3.10 Limitations of the research

This research is limited to India alone.

This sample size of this research is 100 for quantitative study, owing to lack of sufficient time.

Only five hospitals from Chennai, India have been considered for the study.

The data collected for this research is exclusively with respect to a single product RxCare, a patient relationship management system, powered by Infosys and not applicable for products other than that.

3.11 Summary

This chapter makes it clear that the research is quantitative in nature. A total of 100 healthcare professionals from 5 different hospitals in Chennai was surveyed for the study using a questionnaire containing closed-ended questions. The research design adapted in this study is descriptive research and the sampling technique involved is simple random sampling. This section in addition to explaining the data analysis and interpretation techniques used for the research has described about ethical considerations and limitations associated with the research.

Chapter-4: Statistical Analysis

Frequency Table

From the following table we can observe that about 31% of the respondents belonged to 45 – 54 years. Following bar chart also shows taller bar corresponding to the same.

Age

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Under 25

6

6.0

6.0

6.0

25-35 years

19

19.0

19.0

25.0

35-44 years

22

22.0

22.0

47.0

45-54 years

31

31.0

31.0

78.0

55-64 years

13

13.0

13.0

91.0

65+

9

9.0

9.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 74% of the respondents were males. Following bar chart also shows taller bar corresponding to the same.

Gender

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Male

74

74.0

74.0

74.0

Female

26

26.0

26.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 27% of the respondents had masters and other degrees. Following bar chart also shows taller bar corresponding to the same.

Education

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Senior Secondary

11

11.0

11.0

11.0

Graduate

14

14.0

14.0

25.0

Post-Graduate

21

21.0

21.0

46.0

Masters

27

27.0

27.0

73.0

Others (Pls specify)

27

27.0

27.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 57% of the respondents had an experience of between 2 – 5 years. Following bar chart also shows taller bar corresponding to the same.

Work experience in Years

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Less than 2 years

5

5.0

5.0

5.0

2 - 5 Years

57

57.0

57.0

62.0

More than 5 years

38

38.0

38.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 32% of the respondents were occupied. Following bar chart also shows taller bar corresponding to the same.

Designation

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Service

5

5.0

5.0

5.0

Self employed professional

31

31.0

31.0

36.0

Business

32

32.0

32.0

68.0

Housewife

23

23.0

23.0

91.0

Unemployed

9

9.0

9.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 38% of the respondents expressed that their hospital invest 5 – 15% of the annual turnover in patient relationship management. Following bar chart also shows taller bar corresponding to the same.

What percent of the annual turnover does your hospital invest in patient relationship management?

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

< 5%

9

9.0

9.0

9.0

5 - 15%

38

38.0

38.0

47.0

15 - 30%

31

31.0

31.0

78.0

> 30%

22

22.0

22.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 56% of the respondents expressed that they their hospital been using Rxcare for patient relationship management. Following bar chart also shows taller bar corresponding to the same.

How long have your hospital been using RxCare for patient relationship management?

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Less than a year

4

4.0

4.0

4.0

Between one and three years

56

56.0

56.0

60.0

More than three years

40

40.0

40.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 71% of the respondents expressed that they personally used Rx care for patient relationship management activities. Following bar chart also shows taller bar corresponding to the same.

Have you personally used RxCare for patient relationship management activities?

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Yes

71

71.0

71.0

71.0

No

29

29.0

29.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 31% of the respondents expressed that the software appearance is somewhat wonderful. Following bar chart also shows taller bar corresponding to the same.

Appearance

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

3

1

1.0

1.0

1.0

4

6

6.0

6.0

7.0

5

5

5.0

5.0

12.0

6

31

31.0

31.0

43.0

7

16

16.0

16.0

59.0

8

14

14.0

14.0

73.0

Wonderful

27

27.0

27.0

100.0

Total

100

100.0

100.0

From the following table we can observe that about 23% of the respondents expressed that the software application is somewhat easy. Following bar chart also shows taller bar corresponding to the same.

Application

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Difficult

5

5.0

5.0

5.0

2

4

4.0

4.0

9.0

3

6

6.0

6.0

15.0

4

9

9.0

9.0

24.0

5

1

1.0

1.0

25.0

6

23

23.0

23.0

48.0

7

16

16.0

16.0

64.0<