Powering Seamless Patient

Management with Salesforce Health

Cloud for Health Insurers
Across all segments in the insurance industry today, digital Not only does care coordination address a patient’s individual
agility is crucial. Whether they’re in P&C, health or life needs out of a healthcare setting, it also allows lowers costs
segments, insurers have to create digital ecosystems and for insurers by avoiding preventable, expensive claims. Care
leverage new technologies to build new business models and coordination is most effective when patient data seamlessly
offer personalized products and services that are catered to flows across all channels to deliver instant, actionable
the individual needs of a customer. insights for all parties.
For health insurers, the digital ecosystem takes on new With Salesforce Health Cloud, Capgemini can help our clients
meaning, as it allows them to connect to the various effectively control patient management.
ecosystem members in their customer/patient’s lives – the
healthcare provider, pharmacy, external agencies offering
services like x-rays or bloodwork, rehabilitation providers and
more. For patients with chronic conditions like Type 2 diabetes
or multiple health problems, care coordination is crucial.
Salesforce Health Cloud – • Lowered Costs – effective care coordination involving
education, support and medical treatment can prevent
Smarter Healthcare Management repeated trips to an emergency room.
• Improved Efficiency – insurers don’t have to waste time
Salesforce Health Cloud is a health IT Customer Relationship
trying to locate patient records or other pertinent data.
Management (CRM) system that enables care coordination
All records and data would be instantly available on the
and patient management via a seamless data exchange.
Health Cloud platform.

For insurers, Salesforce Health Cloud offers Health Cloud Benefits for Practitioners include
• A 3600 view of the patient, including profile, clinical
• Improved engagement with their patients
data, past health history, health timelines, and care
• Ease of treatment “beyond the walls of traditional care”
team networks
• Live, real time consults and engagement through use of
• Care Team Productivity – allowing Intelligent Task
Skype option.
Management, Care Team Collaboration, Concurrent
Care Plans, Care Plan Customization and Management
and more. Health Cloud Benefits for Patients include
• Clinical Data Management – including Electronic Health • Improved ease of patient engagement
Records (EHR) and Health Level 7 (HL7) Integration via partners. • Raised awareness of health condition through ease of
engagement driving better outcomes through better and
Health Cloud also harnesses Salesforce Service Cloud to offer raised adherence.
an omni-channel, personalized end-to-end experience. • Ease of access. Accessibility to physician or practitioner
not dependent on “journey” or “trip” to the physician or
Health Cloud benefits for insurers include practitioner location. Improved adherence through ease
• An improved customer experience – patients receive of access.
personalized care addressing health and lifestyle needs
that can improve quality of life. Patients can also utilize
their insurer’s health cloud platform to access the “golden
record,” a one-stop look at all the data on the patient.

Salesforce Health Cloud

BH
Admins Physicians Nurses Practioners Patients Care Givers

Solutions
Before After
During
Personalized Patient Real-time Care Team Patient Engagement
Acquisition Collaboration Anywhere
Connected
Health Cloud IT Systems
Cloud
Radiology
Complete CRM
Mobile
Sales Service Marketing Community Analytics Apps EHR

Labs
Social Open Ecosystem Territory Claims Patient Clinical Contract
(2,800+ Partner Apps) Management Data Rounds Trials KOL Management
Wearables
Data Scalable Metadata Platform
Science Devices
Data & Mobile UI Collaboration Analytics Workflow Identity APIs
Objects
Apps
HIPAA Compliant Trusted Multitenant Cloud

2 Healthcare Complaints Management

Capgemini can enable insurers to fully leverage Health Cloud Salesforce products such as Patient Community Cloud,
by building a middleware layer on the Health Cloud platform. Marketing Cloud, Service Cloud and Health Cloud.
Our solution will deliver a set of pre-defined integrations that Health Cloud could be set up with appointment schedules
will allow the insurer to seamlessly integrate their Salesforce and provide notifications to the patient and care team.
Platform to healthcare information systems. This will enable Health Cloud and Community Cloud could also send data
real-time sharing of diagnosis and discharge data directly back to the hospital through HL7 messages, post an
from the hospitals and care clinics. Additionally, these amendment to the EHR or send alerts to care providers.
integrations would simultaneously set up data in related

Potential Scenario/Use Case

Debbie Green is a single mother of two who works part- Department exhibiting signs of excess alcohol intake. In
time and has trouble making ends meet. Debbie, who has two previous visits to the ER, Debbie has required medical
depression and fatigue, has recently been to the Emergency intervention to restore her to a functional coherent state.

Transition from Institutional Care to Home Care using Health Cloud

EHR Integration.
Discharge Planning Case file electronically loaded from
Health Cloud

Patient Interaction
Patient is discharged
with Practitioner

Patient Orientation for

Use of Health Cloud
Health Cloud becomes the
Notifications sent to
Outcomes Practitioner/Patient of first
Continuum of Care Transaction
Platforms Platform
scheduled appointment
Event Prevention
First Appointment
and Care Case Management
Post discharge case care plan
initiated.
Better Care
Decisions
Patient Engagement Appointment Completion
Patient engages live with Practitioner Next Appointment Scheduled based on care plan.
Right Care,
Right Place Patient receives notifications EHR/EMR charts updated automatically.
For next appointment Billing processes automated based on care
Medications can be ordered.
Patient can enter required data as requested Consults can be ordered.
by practitioner prior to next appointment.

With the help of Health Cloud, Debbie’s insurer can • Alcohol addiction – Education on the effects of alcohol,
holistically address her medical and behavioral health needs, support groups, etc. Health Cloud can also leverage
including her alcohol addiction and depression. Community Cloud to help Debbie find online support, if
she is unwilling to attend in-person meetings.
After Debbie is treated at the hospital, her EHR will be • Depression – Medication, appointments with a mental
updated on Health Cloud and accessible to her health insurer, health professional, etc.
who will then be able to glean important insights from her • Coping Mechanisms
data and focus on preventive care. The insurer can create a
plan for Debbie that addresses her: Health Cloud becomes the Continuum of Care
Transaction Platform for Debbie Green.

3
Capgemini As Your Salesforce Partner Award

Salesforce Health Cloud “Innovation in Analytics”

Dreamforce 2016
Implementation Partner
“Innovation in Financial Services”
• Associated with Salesforce since 2007 Dreamforce 2015
• Global Strategic Partner Status and Privileges
• Strong collaboration across Leadership, Sales, Project “Innovation in Marketing”
Delivery and Product Management Dreamforce 2012
• Fullforce Master certified in Financial Services, Service
Cloud & Platform
• Launched 3 Fullforce Solutions around Retail, Insurance • Forrester Wave: Capgemini positioned as a Leader. Know
and Manufacturing to bring a strong focus on next-generation areas necessary
for Salesforce: experience design, digital, and mobile
• Granter: Capgemini categorized as ‘global full-service CRM
1300+ Salesforce practitioners world-wide, including: provider’ and a leading Cloud Provider
1700+ Certified Consultants across Sales Cloud, Service • IDC: Capgemini has been profiled as a Major Player
Cloud & Developer areas. Many practitioners are certified worldwide that offers the entire gamut of service
in more than 1 application. offerings
• Everest: Capgemini seen as Leader in the Cloud application
Services scope
300+ Business Analysts, Integration Developers, Testers,
Data Specialists & Reporting Analysts 50+ OCM &
Training Specialists 30+ Large Engagement Managers

Approved Plans to add another 800+ ractitioners in Interested to Learn More?

2017 through recruitment and internal training/
certification initiatives Email : [email protected]
or visit us at www.capgemini.com/insurance

About
Capgemini
Capgemini, one of the world’s foremost providers of consulting, technology and outsourcing services, enables its clients
to transform and perform through technologies. Capgemini provides its clients with insights and capabilities that boost
their freedom to achieve superior results through a unique way of working, the Collaborative Business Experience™.

A global leader in consulting, technology services and digital transformation, Capgemini is at the forefront of innovation
to address the entire breadth of clients’ opportunities in the evolving world of cloud, digital and platforms. Building
on its strong 50-year heritage and deep industry-specific expertise, Capgemini enable organizations to realize their
business ambitions through an array of services from strategy to operations. Capgemini is driven by the conviction
that the business value of technology comes from and through people. It is a multicultural company of 200,000 team
members in over 40 countries. The Group reported 2017 global revenues of EUR 12. 8 billion.

The information contained in this document is proprietary. ©2018 Capgemini.

All rights reserved. Rightshore® is a trademark belonging to Capgemini.