-Namaste is a customary greeting originating from the Indian Subcontinent when individuals meet, and a salutation upon their

parting. The same has to be redefined - well-defined for the Todays patients as they are both customers and consumers.Unless the patient is in a critical condition and is being driven to the closest hospital, the patient can choose which hospital to purchase services from. Patients are now managing Hospitals business. So each patient, or a prospective patient, is an asset. PATIENTS HAVE MULTIPLE CHOICES.

When Leonard Kleinrocks initial idea of Internet or packetization way back in 1960s was floated, little did people realise the effect of Internet on an already labyrinthine doctor-patient relationship. Two fundamental changes are evident because of the Internet- patient empowerment and transformation of point of care.
Patient Relationship management as consequence Healthcare provider such as Physicians, Dentists, therapeutist, Labs,Pharmacies ,Diagnostic Centers and hospitals, and the patients have to rethink their attitudes and approaches. The challenge is to manage the new developed autonomy of the empowered patient. Patient Relationship Management is a way to understand, diagnose and evaluate threats and to recognize means of systematic improvement.

Definition-PRM;A definition of the Swiss ICT on the occasion of the user forum e-Health thus phrased: Under the designation Patient Relationship Management, all efforts of maintaining the relationship between health professionals and patients including information and communication technologies can be subsumed1

Around the Dawn of the Mellinium Healthcare showed its interest in Relationship Management. There were approaches from medical practitioners of describing the doctor-patient relationship before,

An attempt of describing the new role of the patient made by Smith. He focussed on the communication between patient and doctor and interrogated the patients about their attitudes

The year 2001 was a golden year of PRM research. Now, for the first time the concept of Relationship Management was applied on Life science and Health Management. The main focus of a Patient Relationship Management would revolve around:Patient Retention:- (number of new "quality" patients) Patient Acquisition:- (number of new "quality" patients) Patient Satisfaction:- (question results from survey and/or focus groups) Patient Servicing:- (average response time for patient complaint/inquiry resolution, first call resolution) Patient Referrals:- Referral Management . Patient Win-Back.

Patient Satisfaction
Over the past several years, the issue of patient satisfaction has gained increasing attention across the healthcare industry. As a result, industry leaders have been focusing on improving patient satisfaction through various initiatives.
Patient satisfaction is not a unitary concept but rather a final end product of perceptions and values. Perceptions are patients' views about events which reflect what happened. Values are the criterias patients apply to those events. They demonstrate the degree to which patients consider specific events to be good, bad or ugly. Patient Feedback is one the proven methodologies of measuring patient satisfaction, Information Technology has been playing a key role in redefining the patient feedback process.

Patient Feedback Softwares traditionally enable the following Transform patient feedback into actionable information. Promote immediate service recovery through real-time alerts. Demonstrate the effectiveness of patient satisfaction investments through trending reports. Consolidate feedback from multiple sources, including surveys, kiosks and staff.

A noticeable trend catching up is on Patient Call back Programs. The AHRQ study states that not understanding discharge instructions is one of the top eight dissatisfiers to patients (Forster et al., 2005). In contrast, a Press Ganey study cited in the Studer Groups Hardwire Results found that patients who received post-discharge calls that helped them understand their care regimen were more likely to recommend the calling hospital and to say they were satisfied with their nursing care (Setia & Romn, 2008). A recognized value of post-discharge call programs is the opportunity to resolve common, avoidable complications of medication errors. Medication errors or medication emergencies after discharge can occur for a variety of reasons, such as the patient not understanding the Prescription, right dosage or inappropriately taking the hospital prescribed medications with over-the-counter medications.

Post-discharge calls present an opportunity to uncover such adverse events before they escalate. This is also why well-executed; post discharge call programs include standardized scripts matched by good listening and interview skills to identify initial signs of medical complications in time to initiate early intervention. Next Generation Patient Relationship Management Systems does caters to the requirement of having a standardized script based post-discharge calling systems which would proactively guide the Patient Relationship Manager on the purpose and the business context of the Feedback and help the Managers to Qualitatively analyze feedback to provide meaningful information on patient experience.

CRIPTING TH POST-DISCHARGE C
The typical script being used by hospitals that are committed to post-discharge calling consists of these common questions: Have you experienced any new symptoms or have previous symptoms worsened? Do you have a lingering or new fever? Did you receive a discharge summary and have you read it? Do you have questions about your medications? Do you have an appointment with your primary care physician for follow up? Do you know how to contact your primary care physician or the hospitalist who treated you during your stay? Has this call helped you feel better about your treatment?
Patient Relationship Management for Patient Care Convergence. Patients perception about Quality care in a Hospital also revolves around Assistance/Guidance/Care provided to him not only during the Hospital Stay but across Patients Journey. Patient Relationship Management can play a Pivotal role in managing the Patient Expectations and perceptions. The Diagram illustrates some of possible ways of assisting the patient.

The following would be other usages of the PRM in a Provider Environment.

Social PRM..!!

So what exactly is social media? A good definition offered by Christina Thielst in her book Social Media in Healthcare Connect, Communicate, Collaborate is: Social media are electronic tools that enhance communication, support collaboration, and enable users across the globe to generate and share content. Social media has, and will continue to be omnipresent in daily life, and more specifically, healthcare. With approximately 15 percent of hospitals4 using at least one form of social media and anywhere from 60-80 percent of patients using some form of Internet content engine to research health information, the train is almost up to full steam Social media ranges from well-known portals, such as Facebook, LinkedIn and Twitter, to lesser- known sites more specific to healthcare, such as Doximity, Askdrwiki and PatientsLikeMe.These sites work for patient-to-patient, patient-to-doctor and doctor-to-doctor communication and collaboration.
Some of the broad usage of Social Media by Hospitals. Brand Monitoring

In this new age of Social Media, conversations are becoming markets so there is a market for monitoring these conversations. Social Media Monitoring tools fit into this requirement and are widely used and can be integrated with a PRM.
Service Recovery in Healthcare

The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied patients, to alter their negative perceptions, convert them into satisfied patients, and to ultimately maintain a relationship with them.
Education

Hospitals are using social media to increase their capability to reach their patients with high-quality Patient education content. At the Henry Ford Healthcare System in Detroit, physicians used Twitter to interact with more than 1,900 people and to answer tweeted questions during actual brain surgery on a 47-year-old man.
Public Relations

News and information feeds are a consistent staple of social media. Social media allows for curated news feeds that elegantly group news items by client-filtered categories. For example, All Childrens Hospital in St. Petersburg, Florida, interacts with patients to keep up with hospital news including media references,New services, new recruits and key hospital events.
Crisis Communications

Take control of the message, and keep community updated in real-time

Stratergic Hiring

LinkedIn, Facebook and other tools are being currently used to recruit Clinical and Administrative staff in Hospital. In fact there is a growing perception among healthcare providers and marketing professionals that passionate fans or critics who rise to prominence through social media are strategic hires for the Organizations.

So Patient Relationship Management Solutions are not only about Return Of Investments it also caters to the need of Hospitals-ROC: Return On Connections. Refrences
1-Swiss ICT. Information and communication association. Programm for the Forum 2006. URL: http://www.ehealthcenter.ch/files/Forum2006eHealthSwissICT.pdf. 31.10.2007. 2-Compare James Monroe Smith: Producing Patient Centered Health Care: Patient Perspective about health and illness and the Physican/ Patient Relationship. Auburn house 1999.

3- Compare: - Badenhoop, Rolf: Patient Relationship Management: CRM in der Life Sciences Industrie. Gabler 2001

- Leppi, Udo: Auf dem Weg zum individuellen Gesundheitsmanagement. Trends aus einer Studie. In: Pharma-Marketing Journal(PMJ). 25 Jg, Nr2, S.62. 2001. 4-(Ed Bennett, http://ebennett.org/hsnl/)