Healthcare organizations are struggling to keep up with the changes in care in the last several years like value-based care and virtual care. While no single solution exists to address these complexities, a holistic approach to automation and innovation can help.
During a session sponsored by Olive at the Becker's Hospital Review 9th Annual CEO & CFO Roundtable in November, Lori Jones, president of provider market, and Matt Kalina, national strategy lead, both at Olive, along with more than a dozen healthcare CEOs and CFOs, shared perspectives on how automation technologies can help organizations with value-based and virtual care.
Four learnings:
- Value-based care has data and tools that weren't available a decade ago but is still lacking in technology. Despite advances, Lori Jones explained that healthcare is still operating disparate systems that depend on human "routers" to interact. The lack of connectivity between patients' EHRs and their health insurance details is one example of that. In addition, much of the infrastructure currently in use is "archaic," one roundtable participant said, and attempting to operationalize intricate risk-based arrangements on outdated infrastructure is inefficient. "We're looking at modernizing some of the infrastructure in order for organizations to be more flexible and responsive in maximizing patient outcomes," Matt Kalina said.
- Automation can help reduce waste across payers, providers and health systems. Automation technologies, such as Olive's AI-as-a-Service platform, can eliminate the need for many manual processes, freeing up staff to work on higher-value tasks while lowering labor costs. These technologies can also enable organizations to track which physicians are assigned to which patient panels, adding value from both a patient engagement and a compliance perspective. "Having an automated way to audit and de-risk the factors that you're supposed to be doing [as part of value-based care] presents a huge opportunity," Matt Kalina said.
- Virtual care is here to stay but will require next-generation data and interoperability solutions. Brick-and-mortar healthcare institutions are facing a learning curve and cultural resistance with respect to adopting virtual care. Several participants said they had experienced pushback from providers and nurses when trying to implement virtual care but were unsure whether that pushback was a cultural or an education problem. Automation technologies that facilitate remote patient chart reviews and save physicians time can win over the skeptics.
- The healthcare industry is poised to become an innovation leader. In the context of current labor shortages, attendees converged on the need for innovation that increases capacity. "How can we do more with fewer people?" one participant asked. Autonomous Revenue Cycle Management, point-of-service authorization and other technologies that integrate the healthcare system and the payer in the same AI space are some solutions that are moving in that direction.
"In the 30-some years that I've been in the industry, this is the first time that I think we will see healthcare start to lead innovation, and 10 years from now other industries will say 'I want to do what healthcare is doing,'" Lori Jones said.
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