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I've been looking over the Salesforce Health Cloud data model and was wondering if anyone could speak to their use of cases: https://developer.salesforce.com/docs/atlas.en-us.health_cloud.meta/health_cloud/admin_data_model.htm

I would've assumed that if the patient is the account and contact that the case would be an opportunity as it involves the whole care plan. I would've thought that each visit would be an opportunity and anyone in the opportunity team can do their part (intake, visit, payment, etc).

No need for answers to be specific to Health cloud maybe I'm just missing the other use cases of the Case object.

Anyone have any pros and cons of why a case is better to see the patient through this process versus an opportunity?

Thanks!

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tl;dr version:

In my eyes, Cases are a more natural fit for a patient-care model. Opportunities could have been used, but it feels like that would require a lot of shoe-horning to make it work.

long version:

Besides the fact that Salesforce seems to provide additional objects (and supporting logic) for tracking visits as Cases, there are probably additional considerations given to permissions so that other people can see a patient's contact info (Account or Contact) without being able to see their (sensitive and confidential) medical history.

If Salesforce is marketing this towards healthcare organizations, I'd assume that their out-of-the-box solution would need to be certified as compliant with the appropriate regulations in the countries they're pushing this in (HIPAA in the United States). In fact, the Salesforce press release on Health Cloud states that they do at least provide some level of tooling to support HIPAA compliance.

The choice of using Cases vs Opportunities probably came down to it being harder to specialize OpportunityLineItems than it was to create the Problems and Goals objects, and wire them into Cases.

Opportunity was made for sales. Opps have financial information, and their OpportunityLineItems need to be linked to a Pricebook2Entry, which in turn needs a Product and a Pricebook. It might be easy at first to model a patient visit as an Opportunity, but how would you fit interventions and outcomes into the Opp - Line Item model?

Like Opportunity, the standard Case object has a standard lookup to Account. You can just as easily create a Case from an Account as you can an Opportunity.

There's nothing stopping anyone from wiring the Problems and Goals objects into an Opportunity, but if you're not tracking costs (which are probably better left to an industry-specific billing solution because of the need to comply with various regulations), and not using OpportunityLineItems, then why use Opportunity in the first place?

One last thought. If all things were equal, I'd think that as a healthcare provider, seeing a patient as a 'Case' (to be solved) would probably be a more natural thought than seeing them as an 'Opportunity' (to make money). Insurance companies probably see it the other way around.

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In addition to the answers above, the Cases object has standard features that Opportunity does not. For example: Case Assignment Rules, ability to assign to Queues, escalation rules, email to case, and other features. I've learned the hard way that opportunities are hard to triage and assign without tons of custom work.

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