Hospital information systems help manage and record the massive amount of medical data associated with patient care, and their financial functionality is set up at the provider’s expense and for the provider’s benefit. But in today’s increasingly consumer-centric environment, this fundamental orientation presents a challenge to hospitals and health systems.
The Evolution of the Patient-Consumer
Over the past few decades, consumers have become used to having real-time, multichannel, reliable access to their account information in industries such as banking or travel,and being able to manage those accounts remotely. Consumers are beginning to have expectations of similarly accessing and managing their healthcare account information. Moreover, the rise of ratings platforms and increasing price transparency in health care means that patients are in a position to act on those expectations, shopping around before deciding on a physician or facility, rather than merely venting in a survey after the fact. This evolution has increased pressure on provider organizations to keep pace with the needs of patient-consumers.
Technology is both where providers are falling short and where solutions such as consumer-focused add-ons and better design can meet those expectations set by other industries. To address these issues, providers should focus on optimizing these solutions to deliver three essential benefits to consumers:
- Greater functionality and access via the patient portal
- Accurate account information
- A seamless experience even when third-party technology is being used
Optimizing the Patient Portal
Patients want more control and more information, and the way to deliver both is through the patient portal. Hospitals need to configure the back end of the patient portal to get patients exactly what they want to see, where they want to see it. Thus, a robust mobile site is essential. On a desktop computer or mobile device, patients should be able to:
- View medical history and medication records
- Schedule appointments
- Self-register for appointments before they arrive at the clinic
- Request medical records
- Request prescription refill orders
The portal also should have the most accurate, most recent information about account balances—as well as a simple, intuitive way to pay down those balances and to see the account adjusted in real time.
Accurate Account Information
Before delivering services t patients, hospitals must aggregate many data points to produce accurate pictures of what the patients can expect to owe for their episodes of care. Hospitals should verify benefits, determine the patients’ portions, and communicate te information to the patients, offering payment plans if necessary.
After the services have been delivered, patients expect to receive single, clear statements that include everything they’re being charged, rather than separate statements for each specialist or medical unit (e.g., lab, radiology, etc.). This information also should be available through the patient portal.
Being able to deliver the same simple, clear information to patients with chronic illnesses and multiple episodes of care will of course require greater technical capacity and attention. Doing so effectively requires capturing and charging the costs of various services promptly and making clear where the patient’s payments have been applied. The ability to fold in new charges to an existing payment plan also is essential for this patient population.
Functionality and a Seamless Experience
With rising out-of-pocket costs, health care’s legacy of confusing charges and inexplicable price variations has led more and more patients to simply ignore their medical bills. To stem this tide, hospitals must eliminate barriers and reduce any points of friction in the self-pay follow-up process.
Formerly, hospitals would send most of their outstanding balances to a vendor, which would call and send statements and try to collect as much as it could, typically taking a percentage of the accounts received. With the massive rise in deductibles, hospitals have a much greater need to develop more creative self-pay options, including an increased range of payment plans and channels for making payments on them. With so much on the line, it’s crucial to convert to a strategic, automated process for some or all of these accounts.
Consumer expectations may seem like a second-order issue for healthcare organizations focused on providing excellent care. But meeting these expectations, via in-house systems or carefully selected add-ons, also can help sustain the trust patients have for the organizations that has been built by physicians, nurses, and other front-line healthcare staff.
Kent Ritter is a director, Navigant, Chicago.