Complete the form below to receive the white paper.
From insurance companies to solutions providers or marketing agencies working on behalf of pharmaceutical companies, every entity that interacts with patient health information (PHI) must comply with the Health Insurance Portability and Accountability Act (HIPAA) framework. Ultimately, patients rely on healthcare organizations and the tools that power them to protect their sensitive PHI and to preserve their right to privacy while ensuring they get the care they need.
In healthcare and life sciences, meticulous HIPAA compliance concerns more than avoiding legal consequences—it’s the cornerstone of patient-centric care. It’s also the foundation of enabling more personalized care journeys and greater health outcomes through more connected data, systems, and teams.
Behind general hospitals and private physicians, pharmacies are the third most common type of covered entity to commit alleged HIPAA violations. Combating these violations and prioritizing compliance starts with using technology tools designed with HIPAA in mind, especially when it comes to platforms that directly interact with consumer data, such as Customer Relationship Management (CRM) systems.
Managing patient and provider information and communications requires a sophisticated approach to compliance that doesn’t exist in many general-purpose CRM tools. Choosing a HIPAA-compliant CRM software system, created specifically for life sciences, enables biopharma companies to operate more efficiently and access the data and information they need without defaulting to manual workarounds and stop-gap systems that ultimately put PHI at risk.
The right CRM won’t just protect patient data and help maintain compliance, it will actually enable more seamless collaboration and coordination across teams, prescribers, pharmacies, payers, and other stakeholders. To build a secure, flexible, and scalable data foundation at your biopharma company, you need a CRM that’s HIPAA-compliant—and even better, purpose-built and patient-focused like Courier Health.
HIPAA was created to ensure the confidentiality of private health information, allowing healthcare organizations and providers to effectively communicate about patients as needed while safeguarding sensitive information from other parties. The law includes details about patient rights and providers' obligations to safeguard those rights.
HIPAA establishes three main provisions related to protecting PHI:
Compliance with HIPAA doesn’t mean you can’t ever share patient information or discuss care plans or treatment status. Communicating with other healthcare professionals, talking to approved contacts, and advocating for patients are critical elements of a patient’s treatment journey. Instead, HIPAA provides the framework for managing PHI effectively so that organizations can offer care while still respecting the patient’s privacy and personal preferences.
Patients trust their healthcare providers to protect their health and dignity by maintaining the security of their PHI. Not taking HIPAA compliance seriously can expose patients to unnecessary stigma and harm, and it can expose an organization to legal penalties. Revealing PHI to the wrong party could lead to embarrassment, interpersonal challenges, and even discrimination that otherwise wouldn’t have occurred. Given the stakes involved with human lives and health outcomes at risk, these are unacceptable outcomes.
Data is the core of any CRM platform, making PHI the pulse of CRM in healthcare and life sciences.
However, not all CRM solutions are created equal.
Most generic CRM systems were designed for sales and marketing teams across a broad range of industries, including everything from media to retail to education to automotive. To fit the complexities of healthcare and life sciences, a sector with stringent regulatory requirements and patient lives and safety at risk, these general-purpose CRM systems require complex, expensive upfront customization and ongoing maintenance. In life sciences, employees are too often forced to improvise with their standard CRM tools, trying to make them work for specialized biopharma processes in a workaround that unintentionally doesn’t comply with HIPAA regulations.
While several healthcare CRM tools today have privacy measures to uphold HIPAA, truly redefining the way life sciences companies engage and support patients and providers requires more. Next-generation CRM tools for healthcare and life sciences emphasize keeping PHI secure while still making information accessible to those users who need it, securely leveraging data to create a powerful internal command center to manage the end-to-end patient journey. This starts with an understanding of the diverse data sets, systems, and teams involved in the healthcare ecosystem and a powerful data model that is built for PHI (not generic objects).
Having the CRM infrastructure strengthens your operations and enhances the patient experience, ultimately driving better patient outcomes.
Cultivating a trusting environment with patients ensures they feel comfortable being honest about their health history and overall journey to start treatment. This, in turn:
While establishing rapport and being attentive to patients and caregivers can go a long way, organizations must reinforce their patient-centric approaches with a robust commitment to security and HIPAA compliance, especially in their CRM systems.
A specialized CRM enables a secure, compliant patient experience that minimizes the risk of both large data breaches and one-off exposures. These tools help fulfill HIPAA requirements for privacy and security systems while strengthening your reputation as a trustworthy organization.
What’s more, when you trust that patient data and other sensitive information are being managed and leveraged properly, you can begin to unlock new opportunities to engage and communicate with patients without compromising security or compliance. Instead of a general-purpose CRM that takes a rules-based approach to managing consent preferences, as one example, a sophisticated, purpose-built CRM will enforce patient preferences for email over SMS (text) messages and can execute programs accordingly.
HIPAA-compliant CRM systems follow national standards for several aspects of transmitting healthcare information, including:
Using a compliant CRM builds these codified standards into your day-to-day operations, making it easier to organize patient data for streamlined communications.
This standardization in data management and formatting process creates ripple effects that reduce manual complexity and improve your operations across your organization. For instance, instead of using spreadsheets to track prior authorization (PA) status or downloading patient documents to a local computer, unnecessarily exposing patient data in the process, teams can efficiently, effectively, and securely manage patient information and documents from one centralized system.
Utilizing a HIPAA-compliant CRM is your first line of defense against HIPAA violations and associated legal consequences for exposing PHI.
Basic civil penalties for HIPAA violations start at $137 per violation and can exceed $2 million per violation, depending on the circumstances of the incident:
(It’s also important to keep in mind that an issue with your data security can result in violations for entire sets of patient data at once, multiplying the fees you may have to pay.) Both individual medical professionals and organizations that commit HIPAA violations can be criminally prosecuted for revealing PHI, with a minimum fine of $50,000. If convicted, liable parties may need to pay restitution to impacted patients and may be required to serve jail time.
The right HIPAA-compliant CRM system will help protect against intentional, malicious sharing of patient data by locking out unauthorized parties and tracking how patient accounts are accessed. Additionally, the most sophisticated CRM tools will further prioritize security by minimizing unintentional mistakes. This requires a purpose-built approach that is designed specifically for the needs and realities of biopharma commercial teams. As regulations evolve and patient data becomes more complex, these systems automatically obfuscate PHI, reducing the risk of accidental exposure.
Most reputable healthcare and life sciences CRM will comply with HIPAA regulations. Taking a truly patient-centric approach, however, means going beyond “checkbox” solutions and demanding more from your systems.
As you assess your options for a patient CRM system, keep specialization, technical functionality, and system integration at the top of your mind.
Investing in a CRM that offers cutting-edge, practical measures for managing PHI is critical. Several security measures work in tandem to protect patient information on CRM software platforms, including:
Increasingly, these security measures should be table stakes for biopharma companies investing in a CRM system.
In addition, a CRM is a software tool that should adhere to general cybersecurity best practices, such as those established by Service Organization Control Type 2 (SOC 2) standards.
There are many complex steps involved in the journey to ensure patients start and stay on treatment. It’s a process that involves collecting, storing, and managing disparate data sets at high volumes, a task that most generic CRMs aren’t designed for.
The right CRM should be able to seamlessly connect with diverse data and systems, including:
One of the main functions of a CRM is to facilitate communications with customers (in healthcare, this is patients and providers), whether by giving you an accurate snapshot of the contact or by enabling interaction/communication with stakeholders directly.
When evaluating CRM solutions for your life sciences company, ensure they’re natively equipped to handle phone calls, email messaging, text (SMS), and more – no bolt-on tools required. With over half of patients preferring to communicate with healthcare providers through digital platforms, it’s essential to have a robust solution that can power personalized, omnichannel communications at scale.
Along with having the functionality to communicate on multiple channels, your CRM must also factor in the complexity of patient or caregiver consent preferences. Advanced patient CRM solutions will respect communications preferences based on which options patients or caregivers select, providing you with a flexible way to engage with patients, in the method and manner they prefer.
Discovering the right solutions starts with assessing your organizational goals and unique patient/program complexities and finding a solutions partner that meets – and exceeds – those needs.
Begin by asking what your organization hopes to achieve with your CRM system. Start with these key themes:
Gather a cross-functional group of leaders to provide a practical vision for your CRM implementation. Use their feedback to develop criteria to ensure you select a system that will work, and be utilized, in the long term. The right solutions provider should partner with you on this process, supporting internal education and change management, quarterbacking implementation, and helping to drive adoption company-wide.
After reviewing your basic requirements, prioritize different tools based on their importance to your organization.
Here are just a few examples of features to look for in a healthcare CRM that go beyond HIPAA compliance:
Determine which features are non-negotiable, and focus on finding providers that share your priorities. When building your list, consider how each feature could support your current operations or elevate your workflows for future growth.
Before you can start using your new CRM system, you’ll first need to handle the initial implementation and integration with your data.
Getting support from your solutions partner can be the difference that drives a successful deployment. Ask potential partners about the training resources they offer to support your team, both during implementation and after launch. Inquire about timelines, account support models, and how they facilitate the launch process.
The initial integration period is just the first step, as your CRM is central to patient and provider engagement strategies. While executives rely on it for high-level insights and reports, your daily users depend on it as their core platform for managing patient and provider interactions.
If your team encounters challenges, you need a partner who is dedicated to resolving issues and shares your commitment to overall patient outcomes and program success.
Being intentional about how you engage and support patients and providers allows you to build strong relationships and eliminate barriers to starting and staying on therapy that improves overall patient outcomes.
To achieve that intentionality, you need software systems that understand the biopharma patient journey, treat patient privacy as non-negotiable, and offer tailored dashboards and user views that support your unique programs. HIPAA-compliant CRMs specifically designed for Field Access and Patient Services make it possible to provide data-driven support and engagement, while still proactively protecting and respecting PHI and HIPAA.
As the only patient-focused CRM purpose-built for life sciences, the Courier Health Platform enables centralized patient and provider management, omnichannel workflow automation, and advanced analytics—without the high cost of customization.
Is your current CRM flexible enough to keep up with the life sciences industry's demands while being secure and robust enough to support compliance standards? It may be time to switch to a platform that transcends standardized CRM capabilities and enables next-generation patient-centricity.
Reach out to our team to learn more about making the switch to Courier Health.
True patient-centricity. Everyone says it, but few deliver. Upgrade your patient experience with Courier Health.
Contact Us
