C
Crossroads
Command Center
SmartBug × Crossroads Treatment Centers

From Marketing Spend to Patient Census: A Connected Crossroads Patient Journey

A practical HubSpot + Talkdesk + MedGen operating model to connect campaign attribution, PAC intake, patient follow-up, and treatment outcomes — without forcing MedGen to become something it is not.

View Future-State Flow →Compare Integration Paths

Full-Funnel Visibility

Track lead source, campaign, call outcome, appointment status, treatment drop-off, and re-engagement.

PAC Operating Discipline

Move from manual call-center handling to structured intake, callback, SLA, and re-engagement queues in HubSpot.

MedGen as Clinical Truth

Keep clinical data and scheduling in MedGen while syncing the right operational signals back into HubSpot.

Why this matters

The Current Gap

Crossroads generates demand through SEO, SEM, paid social, referral partners, and community engagement — but today the organization cannot reliably tie that demand to patient conversion and census impact. Most lead volume comes through phone calls. Without unique phone numbers, structured CRM intake, and MedGen outcome feedback, Crossroads can only estimate marketing performance instead of proving it.

Today

Where the funnel leaks

  • Same phone numbers reused across campaigns and geographies
  • PAC team not consistently working leads in a CRM
  • Missed and abandoned calls not reliably converted into callback queues
  • MedGen holds the source-of-truth clinical and census data
  • Point tools create fragmented patient communication and SMS opt-outs
  • Marketing cannot prove which campaigns generate scheduled patients or census
Tomorrow

What changes

  • Unique DIDs map every campaign and geography to attribution
  • PAC works a single intake + callback queue in HubSpot
  • Talkdesk events flow into HubSpot tickets with SLA timers
  • MedGen scheduling, encounters, and census sync back to HubSpot
  • Compliant SMS re-engagement triggered by clinical signals
  • Executives see campaign → scheduled → arrived → census in one view
Future-state architecture

Recommended Future-State Patient Journey

Seven steps connect a marketing dollar to a treatment outcome. HubSpot becomes the operational layer. MedGen stays the clinical source of truth. Talkdesk powers the conversation.

01
Campaign / Referral

SEO, SEM, paid social, community partner, referral pamphlet, website, chat.

02
Unique DID

Each campaign, geography, or referral source uses a trackable Talkdesk number.

03
Talkdesk Call Event

Inbound, missed, abandoned, answered. Recording and disposition captured.

04
HubSpot PAC Workspace

Contact matching, intake ticket, callback queue, SLA, owner, campaign attribution.

05
MedGen Handoff

Scheduling, patient creation, clinical workflow, treatment records.

06
MedGen → HubSpot Sync

Patient ID, appointment status, encounter, census, drop-off, re-engagement trigger.

07
Executive Reporting

Campaign ROI, location demand, PAC performance, conversion, census impact.

Design principle: HubSpot should not replace MedGen. HubSpot should make MedGen-driven outcomes visible to marketing, PAC, and leadership.
The four pillars

The Operating Model Elizabeth Is Trying to Prove

01 — ATTRIBUTION

Marketing Attribution

Unique Talkdesk numbers map every campaign, geography, and referral source back to HubSpot Campaigns and reporting.
02 — INTAKE

PAC Intake & Callback Management

PAC works in HubSpot for intake visibility, missed-call queues, abandoned-call callbacks, and SLA management.
03 — CLINICAL

MedGen Clinical Handoff

Once scheduling or patient creation is needed, MedGen remains the system of record for clinical and appointment workflows.
04 — RETENTION

Re-Engagement Loop

When a patient no-shows, drops from treatment, or needs follow-up, MedGen sends the signal back to HubSpot to trigger compliant SMS-based re-engagement.
Integration decision

MedGen Integration: Two Viable Paths

Both paths deliver a connected operating model. The deciding factor is MedGen's write capabilities — and how much manual work Crossroads is willing to absorb at PAC.

Recommended if available
Option A

Writable MedGen API Available

Best for: highest automation and cleanest PAC experience.

How it works
  • HubSpot captures lead and intake data
  • SmartBug middleware pushes approved patient/scheduling data into MedGen
  • MedGen returns patient ID, appointment, encounter, census, treatment status
  • HubSpot uses those signals for reporting and re-engagement
Benefits
  • Most complete closed-loop attribution
  • Less duplicate entry for PAC
  • Better operational consistency
  • Stronger executive reporting
Dependency: MedGen must provide a write/update-capable API or interface for the required objects.
Estimated implementation
~308 hrs
Based on current draft scope
Option B

Read-Only MedGen FHIR + Manual PAC Handoff

Best for: lower integration dependency and faster path if MedGen write access is unavailable.

How it works
  • HubSpot captures lead, intake, callback, and attribution workflow
  • PAC manually creates or schedules the patient in MedGen
  • MedGen FHIR API sends read-only patient, encounter, appointment, outcome signals back
  • HubSpot closes the loop for reporting and re-engagement
Benefits
  • Feasible if MedGen write access is limited
  • Still enables outcome visibility
  • Reduces risk of waiting on MedGen interface work
  • Provides a practical phase-one path
Trade-off: more PAC manual work, less automation between HubSpot and MedGen, requires reconciliation controls.
Estimated implementation
~256 hrs
Based on current draft scope
Recommendation

Don't make the decision binary too early. Run a focused Discovery & Design sprint to validate MedGen write capabilities, Talkdesk connector requirements, PHI field strategy, and PAC workflow readiness.

Operational mockup

What the PAC Team Would See in HubSpot

One workspace replaces a stack of disconnected views. Every call, callback, and scheduling handoff is visible — with SLAs, owners, and attribution baked in.

New inbound
47
Missed / abandoned
12
Callbacks due today
23
Scheduled in MedGen
31
No-shows / re-engage
8
SMS opt-out risk
3
Location census gaps
5
Top campaign source
Knoxville SEM
Ticket: Inbound Patient Inquiry — Paid Search / Knoxville MAT
ContactMatched or New Contact
Source DIDKnoxville SEM Campaign
StatusNeeds Intake
PAC SLAAnswer / callback within 90 seconds target
MedGen Patient IDPending
Next StepComplete intake → Schedule in MedGen
Compliance StatusSensitive Data Fields Enabled
OwnerPAC Queue · Auto-routed
Leadership view

From Campaign to Census

This is the visibility Crossroads cannot get from disconnected tools. The goal is not just CRM adoption. The goal is knowing which activities generate patients, which locations need demand, and which parts of the journey are leaking conversion.

Lead volume by campaign
2,847
+18% vs last 30 days
Calls answered vs. abandoned
84%
Target: 90%
Callback completion rate
71%
Within SLA window
Intake → Scheduled
46%
Conversion to MedGen
Scheduled → Arrived
68%
First appointment
No-show / drop-off
112
Re-engagement eligible
Re-engagement conversion
23%
Returned to treatment
Census impact by location
+47
Active patients MTD
Spend efficiency
$214
Cost per scheduled
HIPAA / 42 CFR Part 2

Compliance-First Data Model

Crossroads operates under HIPAA and 42 CFR Part 2. The data model must protect patients first — and only carry the operational signals required to run attribution, intake, and re-engagement.

Guardrails

  • Activate HubSpot Sensitive Data before PHI-related properties are created
  • Keep MedGen as the clinical source of truth
  • Only sync operational fields needed for workflow, attribution, re-engagement
  • Use field-level permissions for PHI-related fields
  • Avoid clinical notes, diagnosis, medication, treatment narratives in HubSpot
  • Use SMS with strict opt-out governance and compliant messaging
  • Avoid PHI in sandbox, testing, screenshots, dev environments
  • Document every sync field with a business justification

Data Classification

Safe Operational
  • Campaign source
  • DID / phone source
  • PAC owner
  • Callback status
  • Location
  • Appointment status (if approved)
  • MedGen patient ID
  • Re-engagement eligibility flag
Sensitive / Governed
  • Patient identity
  • Treatment status
  • No-show / drop-off status
  • Appointment details
  • PHI-touching intake notes
Avoid Unless Approved
  • Diagnosis
  • Medication
  • Clinical notes
  • Substance use details
  • Full treatment documentation
Next step

Recommended: Discovery & Design Sprint

Before final implementation, SmartBug recommends a focused Discovery & Design sprint to validate the data model, MedGen API capabilities, Talkdesk integration requirements, PAC workflows, PHI field strategy, and executive reporting requirements.

01
Future-state patient journey map
02
HubSpot object and property model
03
Talkdesk DID attribution design
04
PAC ticket pipeline and SLA model
05
MedGen integration architecture
06
Option A vs. Option B recommendation
07
Implementation estimate and timeline
08
HIPAA / Sensitive Data configuration checklist
09
Reporting dashboard blueprint
For Thursday

Key Decisions to Confirm

The fastest way to a recommendation is to get clear answers on the questions below. Each unlocks a specific piece of the architecture.

The Strategic Statement

The goal is not to replace MedGen or rebuild Salesforce. The goal is to create a connected operating model where Crossroads can see every step from campaign source to patient outcome — and act on the gaps quickly.

SmartBug Recommendation

Validate the flow, confirm the MedGen integration path, then build the smallest reliable system that proves attribution, PAC accountability, and census impact.