Health Cloud Administration
jLearn About the Health Cloud Data Models
Health Cloud is a powerful CRM tool for supporting providers, payers, pharma, and MedTech companies. Built on the Salesforce platform, some Health Cloud objects, APIs, and other capabilities are built directly into Salesforce. Health Cloud also expands on Salesforce objects such as cases, leads, and campaigns to help manage patients and members. But Health Cloud is more than just an extension of core Salesforce objects.
Health Cloud offers a managed package that brings together best practices and successful setup processes from healthcare and life sciences directly into your Salesforce org so that you don’t have to manually configure them. The Health Cloud managed package also gives you access to additional objects, Lightning components, and Apex triggers. Additionally, Health Cloud offers multiple optional add-on packages for more specific purposes like claims management or patient referral. Most of these add-on packages are unmanaged, and they can help you expand Health Cloud’s capabilities. For example with Care Request Extensions, Health Cloud provides Lightning components and flows, which can be customized by users to suit their requirements.
Health Cloud also offers unique data models, user interface, and processes specific to healthcare. A data model consists of the objects and the fields that are used in Salesforce records. Health Cloud-specific data models offer standard and custom objects and fields that support specific healthcare concerns. For example, the Benefits Verification data model has objects and fields that help patients, providers, and payers confirm their benefits coverage and eligibility.
To help your company navigate the world of healthcare with ease, Health Cloud offers clinical and insurance data models, social determinants of health, and so on. If you’re part of a payer organization, you could be interested in learning about the Health Insurance data model or the Provider Network Management data model. Based on your role, find the data model that is most helpful to your work.
| Data Models | Roles |
|---|---|
| Benefits Verification |
Providers, Payers: Contact Center Agents, Front Desk Staff, Benefits Processors, Patients Life Sciences: Field Case Managers, Patient Services Agents |
| Care Management | Providers: Care Coordinators |
| Claims |
Payers: Member Services, Agent Care Managers, Utilization Management Nurses |
| Clinical |
Providers: Care Coordinators, Case Managers, Social Workers, Nurses Payers: Call Center Agents or Service Agents, Intake Specialists, Office Admins Life Sciences: Pharmacists |
| Code Sets for Diagnosis and Procedure |
Providers: Care Coordinators, Case Managers, Social Workers, Nurses Payers: Service Agents, Intake Specialists Life Sciences: Pharmacists |
| Electronic Health Records |
Providers: Care Coordinators, Case Managers, Social Workers, Nurses Payers: Service Agents, Intake Specialists Life Sciences: Pharmacists |
| Health Insurance |
Payers: Call Center Agents (Intake), Service Agents, Utilization Management Nurses, Payer Medical Directors, Payer Clinicians |
| Home Health Care |
Providers: Schedulers, Caregivers, Clinical Managers (Home Care Aides), Care Coordinators, Intake Coordinators Payers: Authorizations Units |
| Intelligent Appointment Management |
Providers: Care Coordinators, Assistant Care Coordinators, or External Care Coordinators Payers: Schedulers, Call Center Agents, Referral Coordinators |
| Intelligent Sales |
MedTech: Admins, Sales Reps, Warehouse Managers |
| Life Sciences Program Management |
Providers: Care Coordinators, Case Managers Life Sciences: Program Managers, Admins, Patient or Member Call Center Reps, Patient Services Executives |
| Provider Network Management |
Payers: Payer Marketing Specialists, Provider Relationship Managers, Physician Liaisons, Payer Network Specialists, Payer Credentialing Specialists, Payer Contracting Managers, Admins, Network Managers Providers: Provider Business Analysts, Office Managers, Physicians, Provider Managers, Admins, Hospital Admins |
| Remote Monitoring and Device Registration |
Providers: Care Coordinators, Caregivers MedTech: Field Care Managers, Patient Support Reps Developer Admins, Admins, Rising-Risk Health Consumers |
| Social Determinants |
Payers: Call Center Staff, Case Managers, Care Coordinators Providers: Physicians, Case Managers |
| Utilization Management |
Providers: Care Coordinators, Providers Payers: Call Center Agents (Intake), Service Agents, Utilization Management Nurses, Payer Medical Directors, Payer Clinicians |