Going digital has become a buzzword in the healthcare industry, and while answers abound to help healthcare leaders achieve this goal, the right question is hardly ever asked.
In our view, the right question is how to maximize engagement for all users (patients, providers, employer groups, payers, etc.) and simultaneously create financial value for the health system and a good experience for those users. From that point of view, going digital is to create meaningful connections and experiences for users by humanizing a set of technologies (e.g., websites, mobile applications, text messages, chatbots).
Think for a moment about chatbots, agents that have good information available but more often than not do not understand our human needs and leave us frustrated. That’s technology that connects to us, but not meaningfully. If a chatbot agent could anticipate the real questions and concerns on our minds, we would hardly want to speak to a live agent. Technology that fails to connect patients to providers in meaningful ways will simply be ignored.
Digital is not IT
We engaged with various health systems leadership teams to gather our perspective on digital. At first, we found that there was a great deal of pent-up frustration around digital. A common comment was, "We’ve already spent a large sum of money on technology and didn't receive the benefits from it. Our physicians are more frustrated, and our patients can't get what they truly need — why should we invest in yet another technology endeavor?" We soon came to realize that digital is often confused with IT.
IT is about enabling technology systems, and digital is about making the experience of using those technologies more human and meaningful to each end user. For example, many hospital systems send text messages, but very few are able to suggest a follow-up appointment time that actually fits the preference of the patient. If health systems were to text three or more timeslots and locations that are convenient and preferred by the patient, actual visit volumes would increase. There are many such "use cases" and examples of meaningful and human experiences that can be created using technology. Thus, digital requires a different skillset and thinking by health systems. Digital helps to extract the value from investments already made in technology. From that point of view, digital creates value by using IT systems, but digital is not IT in itself.
The engagement economy
We live in an engagement economy, where the currency is engagement through highly relevant and tailored experiences, conveniences, clicks, mobile/web usage, etc. To win in this economy, you must give something meaningful to the user such as immediate information, convenience or personalized care: a clinic visit, a paid online service, sharing of preferred appointment times, communication mode. In turn, you are then positioned to deepen the relationship with the user by offering conveniences, along with the best health outcomes.
The examples below tailor to two different consumer types: clinicians and patients.
Improve referral leakage. Clinicians are hardly armed with full information and knowledge to provide clinically appropriate in-system referrals, nor to help patients with the difficult task of making educated self-referrals. Providing clinicians with clinically driven specific types of referrals that correspond to high-quality outcomes and are within a given system (or clinically integrated network) gives the clinicians usable, relevant information, which in return can have them create trackable referrals that have appropriate follow-ups with the patient. Also, offering easy-to-consume clinical reasons why a patient might want to self-refer to a set of physicians within the system can provide a health education benefit to the patient. With more visits, the system has more data and information available, including clinical information and engagement data, such as how the patient made the appointment and preferences about times and locations. This information enables the provider to tailor future treatments even more precisely to that patient. When the provider organization gives more tailored clinical help that benefits clinicians and patients, the provider receives an ROI in the form of improved in-network utilization.
Targeted patient care. Targeted care to patients, where technology is humanized to provide the best patient experience. Many patients do not adhere to a strict annual set of visits around key gaps in care, such as screenings. A digital health system can reach out to a patient about a specific care visit that should occur, providing clinical information about why the visit is important and suggesting specific times within the next three to four weeks to allow for the patient’s preference. The patient then can schedule a visit with one click.
Often, unless patients are well educated on their own health, they do not know what potential new types of clinic visits or procedures they should have done. Scheduling also often remains a process full of friction, requiring the patient’s time and attention (multiple clicks, long process of talking with an agent, etc.). When the health system provides patient education, oversees what the patient should be doing and provides options for care, the patient finds the process more convenient and enjoys peace of mind. In return, the health system gets some new visits. And in fee-for-service environments, the additional revenue can help the health system tailor specific downstream care for the patient and offer even more tailored clinical advice and monitoring. In value-based care, upstream visits that are clinically targeted can help the patient contain clinical risk for their health through prevention and early detection.
Much of the patient experience has been focused on the episode once the patient walks through the front door rather than fitting the care delivery process into the patient’s existing life and lifestyle. The same could be said for other constituent groups, including providers, employer groups and payers.
How to begin
In a COVID-19 world and beyond, it appears that the use of telehealth and ultimately digital health experiences are here to stay. Start with simple scheduling and episodic enhancements around patient access, scheduling, registration, intake, new patient acquisition, financial clearing and billing/payment. All of these experiences create a path toward true, relational engagement with all stakeholders. Once the foundation is put into place around such simple experiences, items like proper patient and provider matching, tailored communication, education and lifestyle management for patients and even follow-on services (e.g., physical therapy visits for patients with cancer, orthopedic surgeries from chiropractic referrals) are possible.
It’s likely your organization already has invested in the necessary technology to make meaningful digital connections. Now it’s time to extract the value from that investment. The digital unification process helps you do so.
4 principles health systems need for extracting value
Making meaningful digital connections with users requires integrating the human experience by stitching a purpose-built experience across multiple technologies. We call this "digital unification," and it can be achieved by following four basic principles.
- Don’t attempt a heart transplant; conduct a bypass instead. Don’t rip-and-replace or layer new technology on old problems. Many health systems, for example, are fast to implement customer relationship management software without defining a path to value. Instead, define the user experience that will create the desired engagement, and then stitch together the right connections among your infrastructure and transactional systems to deliver that experience.
- Start with a small, interdisciplinary tiger team. Health systems are consumed with day-to-day tactical firefighting and the challenge of keeping the lights on. The operations team cannot be burdened with what is inherently an innovation challenge. Most health systems struggle with innovation because there isn’t an operations person who can be spared to truly innovate on new products, solutions and, in this case, experiences for the end user.
- Run short sprints and create a well-defined, iterative path to value. Most health systems invest vast sums into creating large scale innovation designs and implementation. A bias toward action is what is needed to fail fast so you can quickly move on. Innovation isn’t about starting with the perfect idea but iterating to evolve to the right idea.
- Have each initiative auto-fuel subsequent initiatives. Each initiative to solve for a digitally enhanced experience should look to generate tangible financial value quickly. Most innovation projects take time to start, gain support and then die due to long horizon investment needs. Having initiatives payback within six to 12 months is key to auto-fueling ongoing innovations.