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Even innovative hospitals are being challenged by the next step in the evolution of online customer relationship management (CRM): putting patient records online and seizing opportunities for meaningful medical and marketing interaction. Sometimes, even folks on the leading edge blink. Growing numbers of hospitals are implementing less-complex online CRM applications and integrating them with their overall CRM and marketing strategies. But even the most innovative are challenged by the next step, which is to grasp the opportunities associated with online availability of patients’ personal medical records.