Surviving the healthcare landscape will require the right technology

The healthcare technology landscape can be best described as the Wild West. It’s been in a constant state of change for more than 25 years, and it’s still evolving.

In 1996, the Health Insurance Portability and Accountability Act ushered in a new era of healthcare data security. Then, the Health Information Technology for Economic and Clinical Health Act of 2009 mandated the implementation of electronic medical records. Shortly thereafter, the Affordable Care Act introduced healthcare exchanges and forced providers to embrace value-based reimbursement while delivering a consistent quantity and quality of care.

Now, nearly 30 states have mandated some form of transparency in healthcare, meaning providers have to make accurate care estimates available to patients before service is conducted. Aside from meeting regulations, this transparency is also necessary to meet the specific expectations of modern healthcare consumers.

Smarter healthcare technology consumers

Today’s Baby Boomers, Generation X members and Millennials have all grown savvier as consumers. Over the past few decades, they’ve become accustomed to a certain level of healthcare technology service from every company they interact with. They check in for flights and check their bank balances on their phones. They also conduct research, price-match products and learn exactly what they’re getting into before every transaction.

The ACA’s implementation has created a higher frequency of high-deductible insurance plans, resulting in increased out-of-pocket costs for consumers. Being responsible for a larger portion of their medical bills, patients are increasingly demanding upfront price estimates and payment options, services that are achievable through healthcare technologies.

When consumers check in for their flights online, for instance, they know exactly what to expect before they put their phones back into their pockets. Airlines don’t wait until their planes land before telling passengers how much their tickets cost. They estimate and collect those costs upfront. Using smartphones, iPads and laptops, consumers can make well-informed choices on their own time — and without being put on hold by customer service representatives.

Still, the healthcare industry isn’t an airline or an online retail store. So how can today’s healthcare providers adapt to the demands of modern consumers and grow their revenue in this climate? Providers also must ask how they will change their workflow processes and update their IT infrastructures to suit consumer expectations and government regulations that change on a day-to-day basis.

Adapting to the new healthcare technology landscape

Organizations that fail to find the answers to these questions won’t be able to provide the top-notch customer service that makes it easy for patients to get in the door. I also predict that they won’t be in business in the next five to 10 years. While they’re still operational, they’ll be stuck chasing down debt on the back end due to a lack of transparency and accuracy.

Wise patients won’t take long to leave such organizations and find providers that grant the level of accessibility and transparency they need to make relevant, pivotal healthcare decisions. Those organizations’ reimbursements will evaporate as patient volumes, Hospital Consumer Assessment of Healthcare Providers and Systems scores and macro scores continue to drop.

Fortunately, adapting to this new landscape doesn’t have to overtax any healthcare organization. Providers can consistently deliver high-quality care at scale by using cutting-edge healthcare technology and keeping these four important tips in mind:

1. Use predictive analytics strategically.

Electronic medical records already have real-time clinical decision support built in. Once a decision is made and an order is placed, providers are automatically informed about whether it was a sound decision. For example, if a doctor orders penicillin for a patient, the system will inform the doctor if the patient is allergic to the antibiotic.

Healthcare providers must continue to embrace the proactive use of predictive analytics technology, such as clinical decision support, to help themselves and their patients make thorough decisions. The right revenue cycle solutions will help prioritize tasks and patients that will provide larger revenue streams and avoid processes that could affect those streams negatively. For instance, it can preemptively alert a provider that a patient hasn’t received authorization for a procedure rather than wait until after the procedure is performed.

Without this proactive alert, organizations will face increasing risks of arduous collections processes and lost revenue. At the end of the day, a predictive analytics solution needs to be as touchless as possible. Human intervention should be required only to address exceptions, not to uncover them.

2. Put consumers in the driver’s seat.

Patients can already log in to a portal to see their lab results, but they should also have the option to log in and see the financial and administrative sides of their healthcare. With the help of healthcare technology, providers can empower and inform patients about everything they need to know before they arrive for their appointment, including financial and administrative information.

A self-service patient portal can give patients the power to schedule appointments online and learn what their cost share will be for whatever procedure they’re scheduling. They can see accurate estimates and up-to-date statements in an easy-to-understand format. If they have two insurance plans, they can figure out who the primary payer is. Once they know how much their cost share will be, they can pay it easily with a credit or flexible spending card.

A self-service portal where patients can conduct all the financial and administrative tasks regarding their care would be a huge step forward in making organizations more consumer-friendly. This centralized technology in healthcare allows providers to interact with patients clearly, conveniently and in the ways patients prefer.

3. Revamp patient identity management.

It’s more important than ever for providers to make sure they know with absolute certainty the identity of every single patient who walks through the door. The magnitude of fraud in healthcare is growing more disruptive to organizations and their patients. When patients have their identities stolen, they and their doctors now have to worry about inaccuracies in their medical records that could impact the quality of their care.

A national patient identifier system would work wonders to solve this problem, and such a system could become a reality sooner rather than later. In the meantime, however, providers can take proactive steps to get a firmer grasp on who their patients are, where they’ve been and what care they’ve already received.

It begins with data profiling software that cleanses and analyzes patient data to uncover code and terminology discrepancies between different organizations. Once the data is standardized, the organization can give each patient a unique identifier. Using this identifier, providers can easily see every treatment and medication the patient has received and then use a predictive analytics solution to improve the quality of that patient’s care.

4. Increase coordination between inpatient and outpatient providers.

For some reason, healthcare providers have traditionally disassociated inpatient and outpatient care, failing to realize that many discharged patients continue their road to recovery with outpatient organizations. The lack of coordination often results in higher readmissions for preventable occurrences.

Today, if a patient is readmitted within 30 days, it’s a financial hit to the original provider. This incentivizes hospitals to revamp their post-acute care coordination efforts to help patients follow through with and complete their care after they’ve been discharged.

With the right care coordination platform, healthcare organizations could gain access to a messaging system that allows providers to instantly and safely talk to each other about a patient’s adherence to discharge plans. They could follow through and track the patient accordingly without the risk of discussing sensitive patient information on the phone or through an insecure messaging platform.

With constant shifts in regulatory practices, security concerns and the expectations of technologically empowered consumers, today’s healthcare providers are feeling the pressure to change for the better. Fighting for the future of their organizations means balancing regulatory and consumer demands while also improving transparency and quality of care. It isn’t a losing battle, though, and every day, we’re seeing healthcare technology evolve to provide solutions that help modern hospitals meet these high demands.

Cindy Dullea is board certified in nursing informatics, is a certified healthcare access manager and held the rank of rear admiral in the U.S. Navy, where she served as Deputy Commander of the Navy Medicine National Capital Area and Deputy Director of the Navy Nurse Corps. Today, she serves as Experian Health’s chief marketing officer, a position she’s held since 2015. She remains at the forefront of bringing consumerism to healthcare by empowering clients to connect with consumers by tailoring the patient journey with data to predict health conditions and message effectively.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

© Copyright ASC COMMUNICATIONS 2018. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months