Accessibility is the linchpin to a consumer-oriented healthcare system. Hospitals that can give patients whole access through a digital journey are positioning themselves to leapfrog their competition.
Other industries prove the case — the player that can offer products or services faster or closer to the point of need wins the consumer. Take Venmo for example. The fund transfer app has so permeated the digital wallet space that its brand is now a verb for digital payment. Venmo leapfrogged banks and other online payment services by offering a free, secure and instant way to transfer funds. In the past 24 months, Venmo payments have grown from $12 billion to $100 billion, dominating the digital wallet market.
By contrast, healthcare is just beginning its foray into consumerization, so opportunity to be the next Venmo is abundant. Many hospitals are already getting started.
At the Becker's Hospital Review 5th Annual Health IT + Revenue Cycle Conference in Chicago, 32 hospital revenue cycle and IT leaders discussed this potential in an executive roundtable sponsored by Change Healthcare. What follows is their take on what a digital patient journey should look like, why investing in the digital experience matters and how it can benefit hospital strategy. They also discussed new technologies for improving revenue performance.
Relationships are built on trust
Creating a digital journey for consumers starts with "whole access," an end-to-end relationship with a brand. Executives agreed this relationship encompasses shopping for care, booking appointments, paying bills, connecting with providers and engaging in their health. Creating long-term engagement, they said, is contingent on building continuity and transparency into that experience.
The added challenge of healthcare consumer relationships is the complexity of patient needs. "Healthcare is a multifaceted journey, not just a series of events or single events," said a CIO from a mid-size health system on the East Coast. Patients may have multiple diagnoses or manage healthcare appointments for other family members. Each one of those touchpoints along the way involves shopping, booking, paying, connecting and engaging.
A well-designed consumer experience, however, makes this complex web of touchpoints feel like straight line. Take the billing experience, for instance. Disjointed bills detract from continuity. "An important concept is the single, consolidated journey," agreed a CIO of a health system that spans multiple Western states. "You go to the hospital, and how many bills do you get after that? You may get one from the hospital, the ED, the anesthesiologist. You don't have that in other industries."
The director of clinical informatics at a teaching hospital in Florida took it one step further: "You have to treat the patient like you've had an experience with them before, even if you as an individual haven't." That includes capturing and retaining payment preferences, for example.
This cohesive journey, when combined with transparency, can help build trust and loyalty. The executives in the room were aware of the need for greater transparency around prices, but most were still grappling with how to make meaningful price information available.
Hospitals largely see the CMS mandate to publish charges as a hurdle to true transparency, according to a director from a nonprofit system in the Midwest. "We look at [CMS requirements] as more of a drag on our meaningful price transparency, which we see as out-of-pocket costs," he said. "We have a website where patients can go and get their own estimate, depending on what they are seeking at the hospital." Other revenue cycle and IT leaders nodded in agreement. Two leaders in the room said their organizations are just months away from being able to put guarantees around the price estimates they give patients — and to take the hit if they miss the mark.
Aspirations for a digital patient journey were aligned — leaders agreed it should encompass the full consumer relationship, and to create trust, it should be cohesive and transparent. The challenge, executives also agreed, is getting there.
Achieving whole access and revenue optimization requires disruption
The discussion offered a peek behind the curtain at some of the efforts and technologies leaders are looking at to power these transformations.
A streamlined digital journey with accurate, timely price estimates and consolidated bills requires more efficiency on both the front and the back-end of the revenue cycle. Hospitals are looking to partners like Change Healthcare to help create this efficiency with solutions that can provide accurate out of pocket cost estimation and tools to help patients “shop, book and pay” for care. In addition, robotic process automation and artificial intelligence solutions can be used to improve coding accuracy for charge capture or predict claims at risk for denial, for example. Instead of waiting for retrospective audit or denial, AI can make recommendations based on patterns pulled from hundreds of thousands of claims, reducing the propensity for denials. One clinical documentation director said her West Coast health system uses a CDI tool that has reduced the number of charts her nursing staff needs to review. The tool flags charts that require another look and may need clarifications from physicians before claims can be filed.
"We've been able to do more with less staff," she said. The end result is a more productive staff and more efficient revenue cycle.
A handful of executives (about 25 percent) in the room also said their health systems are investing in robotic process automation. Of those investing, just over 60 percent said they have already implemented the tools. A smaller cohort said they are investing in artificial intelligence.
Their responses indicated most efforts are still new — a few executives raised their hands when asked if they've seen the return on investment for these tools — but those who had started implementing the tools were already beginning to see benefits. As the CMIO of an integrated health system in the Midwest put it: "This is an area where I can positively state there is a return on investment. There is money on the table here."
A digital patient journey is table stakes
The roundtable discussion indicated new technologies are poised to disrupt hospital financial operations, and early investors are already seeing more efficiency and productivity. These elements are key to creating the streamlined digital journey consumers want, with simpler bills and transparent price estimates.
It's an investment leaders in the room agreed is nonnegotiable to stay competitive. "I see this more as table stakes than strategic growth at this point," said one CIO. "If I went to Amazon and had nearly one quarter of the trouble I have when I go online to schedule an appointment and try to pay a bill, forget it. I'd never use it," said a charge capture director from a Texas health system.
The digital patient experience is seen as essential to capturing millennial patients and older patients alike, according to a vice president of revenue cycle from a medical center in the South. "It's a differentiator. If you're not doing it and your competition is, you're behind the eight ball. It isn't just the millennials; it's everybody," he said.
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