HubSpot and Salesforce cleanup for a healthcare software company that catches facility-level adoption drops without touching PHI

What The Facility Signal Cleanup delivers

A 51 to 200 person company sells clinical workflow software to health systems, specialty practices and hospital departments. Salesforce is the system of record, HubSpot runs marketing and customer communications, and the two have drifted apart. Contracts sit at the health system level, but adoption happens facility by facility, so when one site's clinicians quietly stop logging in, the parent account still looks healthy and nobody notices for weeks. Usage data lives in the product database, support tickets in a help desk, and training completion in a separate platform, none of it tied to the right account. Past integrations also pushed free-text fields into HubSpot that may contain patient details. This build gives RevOps a clean, permissioned HubSpot portal, a correct parent and facility account hierarchy synced with Salesforce, a de-identified adoption feed per facility, health stages and routing that put a drop in front of the right owner fast, and reporting that reconciles across both systems. Ongoing admin keeps it working as products, sites and staff change. Once in place, a custom AI agent running in a BAA-covered environment can sit on top and write weekly at-risk facility briefs for customer success managers.

Custom build

Salesforce stays the system of record because contracts, facility hierarchy and cases already live there, so the build strengthens it rather than migrating. HubSpot remains the right place for customer communications and re-training nurtures, but only after the portal is locked down and stripped of anything resembling PHI. HubSpot Breeze features are useful on the marketing side for summarizing engagement and drafting non-clinical content, but should not process customer records unless the company has confirmed BAA coverage for that use. The adoption feed and the at-risk briefing agent are a custom AI build orchestrated with self-hosted n8n, because the company needs full control over where data flows and what gets logged, which off-the-shelf connectors rarely guarantee.

Signs it is time

• A renewal conversation surfaces that one or more facilities stopped using the product months ago and nobody on the account team knew
• HubSpot and Salesforce show different owners, stages or contract values for the same health system, and leadership no longer trusts either churn report
• An internal review finds free-text fields, form submissions or integration logs in HubSpot that may contain patient names, dates or other PHI
• Customer success managers track facility health in personal spreadsheets because the CRM shows only the parent account
• Former employees, agencies or unused integrations still have active access to the HubSpot portal

Systems and data

• HubSpot portal (settings, users, permissions, properties, workflows, lists, forms, connected apps)
• Salesforce (accounts, account hierarchy, opportunities, contracts, cases, and the HubSpot sync configuration)
• Product usage database, read only through a de-identified, aggregated facility-level view (active clinician seats, logins, module activity counts)
• Help desk ticket metadata (volume, category, severity, facility) with ticket bodies excluded
• Training and onboarding platform completion data per facility, such as LearnWorlds
• Customer feedback surveys tied to facility and role, such as Zonka Feedback

Where your team weighs in

• The privacy or compliance officer decides what counts as PHI in each field, which vendors are BAA-covered, and approves purging quarantined data, because the build should never make that legal call itself
• RevOps and sales leadership decide which system owns each disputed field (owner, stage, contract value, facility status) before sync rules are rewritten, since this changes how both teams work
• The customer success lead sets the slip and at-risk thresholds per facility type (a small specialty clinic and a large hospital department behave differently) and signs off after a two-week review of alerts against known accounts
• Medical or regulatory reviewers approve any re-engagement or training content that describes clinical outcomes or product benefits before it enters a HubSpot nurture

How we keep it right

• PHI never enters AI prompts, audit inputs, HubSpot properties, n8n execution logs or dashboards; any AI component that might touch customer data runs only in an environment covered by a BAA, and the audit reads configuration, not records
• Usage data arrives aggregated at facility level with small-count suppression, and any new field added to the feed requires compliance sign-off
• Every merge, property archive and sync rule change is backed up first and logged with who approved it, so any change can be reversed
• No automated email reaches clinicians or facility contacts with clinical claims unless the exact content has passed medical and regulatory review
• Health alerts are validated against a hand-checked sample of accounts each month to catch false alarms and missed drops

How you know it works

• Median days between a facility's usage falling below its baseline and a logged CSM action
• Share of active facilities with a matched, current adoption feed in Salesforce and HubSpot
• Duplicate account and contact rate, and count of open sync errors, trending down after cleanup
• Share of at-risk alerts actioned within the agreed window
• Retention and expansion reports in HubSpot, Salesforce and Databox reconciling to the same figures each month

From pilot to live

1. First slice: boundary, audit and a pilot cohortComplete the PHI map, quarantine risky fields, run the severity-ranked audit and fix critical findings. Clean the hierarchy and wire the adoption feed for a pilot group of health system accounts with several facilities each, and have CSMs compare alerts with what they already know.
2. Full cleanup and every facility liveFinish permissions, dedupe, property governance and sync rules across the whole portal. Extend the adoption feed, health stages and routing to all facilities, launch the reviewed re-training nurture, and rebuild retention and attribution reporting.
3. Ongoing admin and an agent on topMove to the monthly admin cadence with change log and quarterly access reviews. Add a custom AI agent, inside a BAA-covered environment, that reads de-identified facility signals and drafts a weekly brief per CSM listing slipping sites, what changed and a suggested next step, with the CSM deciding what to do.