Revenue Cycle Technology

Leveraging extensible technology to create consumer-centric healthcare ecosystems

May 30, 2023 5:25 pm

There’s no doubt that healthcare is becoming increasingly driven by consumer needs and preferences. As noted in Kaufman Hall’s 2022 State of the Healthcare Consumer Report, patients are looking for more connected and holistic clinical care experiences, ranging from the integration of personal health management technologies into electronic health record (EHR) systems to more convenient scheduling, registration and billing options.

Matthew Hamilton, director, financial alignment, at Oracle Health, in Kansas City, Missouri, said that’s why technologies with the capacity to append additional elements and features into standard EHR and revenue cycle host systems offer healthcare organizations the ability to create a more cohesive and consumer-driven patient experience.

“It’s clear that EHR vendors need to focus on extensibility to keep pace with the rapid evolution of AI and advanced technologies, which consequently evolve consumer expectations,” he said. “The ability to automate standard processes with new advancements helps our customers improve everything from the patient experience to the bottom line.”

At a recent Healthcare Financial Management Association (HFMA) Roundtable, “Leveraging Extensible Technology to Create a Consumer-Centric Ecosystem,” Hamilton and other healthcare executives from around the country shared how their organizations are taking advantage of technologies like artificial intelligence (AI), machine learning and automation to improve the patient experience — and the best way to prepare to implement such solutions.

Technology and evolving patient expectations

Today, the average consumer can shop, bank, communicate and request services with just a few clicks. Patients expect a similar level of ease and convenience when it comes to healthcare experiences. That’s why healthcare organizations are working to leverage new technologies that support positive patient experiences at every touchpoint.

“Patients now have the ability to shop for healthcare as they never have before,” said Hamilton. “As with any consumer industry, a poor customer experience can impact their willingness to return, which can directly impact a facility’s bottom line as well as the patient’s care. We have a responsibility to help improve the patient experience, keep costs down and keep people healthy.”

Many healthcare organizations have found success in supporting scheduling and pre-registration activities before the patient even arrives for an appointment. Motti Edelstein, vice president of revenue cycle with Allina Health in Minneapolis, said that his organization has a 70% adoption rate on their patient portal — and they are using those engagements and analytics to learn more about how their patients want to communicate with their healthcare providers.

“The average patient is now scheduling their own visit, self-registering when they come in for their appointments and are also paying their co-pay via the patient portal without human intervention,” he said.

More flexible patient experiences now allow patients to schedule multiple recurring appointments at once, and health systems can input recurring flexible days so scheduling systems present more convenient appointment options.

Some organizations are even leveraging these preferences to improve revenue cycle management activities. Increased adoption of patient portal systems now allows patients to easily pre-register, get prior authorization and pay co-pays before they walk in the door. But extensible technologies can also help on the back end. 

“Everybody wants to text today,” said Tina Zarro, CRCR, director of patient financial services at St. Joseph’s Health, with locations in both Paterson and Wayne, New Jersey, where a text-to-collect program was recently implemented. “And our text-to-collect has been great,” she added. “We can just send out a mass text to anyone who agrees to text with us and all they have to do is click on a button to go into the system and pay. It makes it much easier for patients to pay.”

Gauging success with AI

While there is a preponderance of new technologies, including AI tools and chatbots, available to help improve the patient experience, there is no one-size-fits-all way to measure success.

“There are so many different AI applications, so depending on the application, any number of metrics and key performance indicators (KPIs) must be used to track success,” said Hamilton. “As with anything in the revenue cycle, we best manage what we measure.”

According to roundtable participants, organizations are looking at different KPIs — including qualitative measures — to determine whether their investments in AI technologies are making the improvements sought, including ways to reduce burnout with their revenue cycle management personnel.

“It’s hard to fill positions, especially in rural areas — so having AI as a technology to help with the processes does help overall,” said Jennifer Trimble, patient balance management director at Banner Health in Greely, Colorado.

“Also, there is staff burnout, so having AI to do the tedious, redundant processes so our human employees can focus on the difficult tasks — is of benefit.”

Edelstein added that it is a challenge to define appropriate KPIs as organizations add more AI technologies to the revenue cycle. Yet, his organization’s ultimate goal is to increase net collection ratio while maintaining or decreasing the cost to collect.

“We are tracking those numbers as KPIs to try to keep ourselves within some sort of framework,” he said. “But it’s hard, especially as technology investments have costs that are very heavy during the first year. You need to give your systems some run time to see where you may have saved money or created a better patient experience.”

Leveraging extensible technology for future success

To best leverage extensible technology to improve the patient experience — and revenue cycle management — Hamilton said it’s important to take an honest assessment of where your organization is today, highlighting current pain points in detail, and then develop a three-to-five-year road map to address each of those concerns.

“While extensible technology offers many benefits, it can also introduce an internal strain on an organization due to the time and resource commitment required for implementation,” he said. “Prioritize the rollout of new technologies based on outcomes and return on investment (ROI) — and focus first on the high-impact areas.”

Edelstein said that there is no “slam-dunk” approach. He advised that organizations take a slow, methodical approach to find the right strategy — and to always keep the patient at the center of the process.

“This is a long process of finding the right programs, going through requests for proposals and trying to understand what the real values are to implementing these systems,” he said. “Often, it’s a mixture of revenue, cost savings, patient experience, and employee engagement, and you have to find a way to grade all of that.”

Trimble said it is important to get
buy in for these extensible technologies, not just from organization leadership but the personnel who will work with them regularly. And that starts with extensive education and communication efforts.

“People are scared of change,” Trimble said. “Communicating all the way down so everyone is on the same page and understands what’s coming, and why it’s coming, is important.”

Transformation isn’t easy, said Hamilton — but implementing new technologies that can eliminate tedious work opens the door for more impactful work across the enterprise.

“Start preparing now for how this can impact your organization in the coming months and years,” Hamilton said. “Take an objective assessment of where your opportunity to automate lies and begin socializing the benefits that this change can bring to pave the road for end-user acceptance.” 

About Oracle Health

At Oracle Health, everything we do is dedicated to helping people live healthier lives and improving healthcare. By connecting clinical, operational, and financial data across the ecosystem, we can help providers improve patient outcomes, access data-driven, actionable insights, reduce costs, and unleash innovation. Integrated technologies, data, and analytics empower patients in their health journey, inform clinician decision-making, and accelerate research to advance health and well-being for people worldwide.

This published piece is provided solely for informational purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions by participants are those of the participants and not those of HFMA. References to commercial manufacturers, vendors, products, or services that may appear do not constitute endorsements by HFMA.


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