How Healthcare Can Embrace the Digital Transformation

398
mobile phone with healthcare provider on screen with a stethoscope connected to the phone

For years, healthcare’s digital experience has lagged behind other industries, especially in the health insurance space. Then a global health crisis hit. 

The COVID-19 pandemic forever changed how consumers interact with technology, propelling many health insurance organizations to speed up their digital agendas. Pre-pandemic, consumers had mixed expectations of digital interactions with their healthcare. Now, consumers expect those operating in the healthcare space, including healthcare providers and health insurance carriers, to deliver digital innovation that makes care decisions straightforward and personalized. 

Digital transformation will help the broader healthcare ecosystem operate more transparently, making it easier to provide for patients while growing their business. 

What have we learned in the past year, and where can we improve?

Build a strong cybersecurity foundation

Because patient privacy is of the utmost importance—and rightfully so—healthcare organizations weren’t able to transition to remote solutions as quickly as other industries during the onset of the pandemic. Still, they had to figure out ways to deliver information and care while maintaining public health recommendations. 

Results were mixed. More patients tried telehealth than ever, meaning more consumers were exposed to a cost-effective and convenient way of seeking care. On the other hand, the healthcare sector experienced the largest share of security breaches in 2020, most commonly via ransomware. 

Information technology—and especially cybersecurity—must be core to all healthcare operations moving forward. Patients will continue to expect to be able to manage most aspects of their care virtually and if the healthcare sector wants to keep up, they’ll need to start with a robust cybersecurity foundation. 

Use technology to increase transparency

Failing to adopt virtual solutions inherently makes the healthcare process feel less transparent. If a patient needs to call every time they have a question, whether it’s about their benefits or their treatment, then that’s already a barrier to accessing vital information. Patients deserve to be able to access information about their healthcare at any time. 

The U.S. government agrees. As of January 1, 2021, hospitals began implementing a 2019 Centers for Medicare & Medicaid Services (CMS) transparency rule. This rule requires hospitals to provide clear and accessible pricing information about their items and services in two formats: 

  1. A comprehensive machine-readable file with all items and services
  2. An online display of shoppable services in a consumer-friendly format

While this isn’t sensitive patient information, this requirement means that hospitals will need to invest in a level of IT functionality to upload and maintain this information. 

Additionally, CMS issued a final rule requiring greater healthcare price transparency from health insurers. Soon insurance providers will be required to provide an online shopping tool allowing consumers to view a personalized estimate of their out-of-pocket costs for shoppable items and services. The tool will have to show consumers the negotiated price between their provider and their plan, increasing transparency about their benefits. 

Watch for updates on this and other federal agency initiatives; regulations are changing quickly as the government continues to iterate its desired outcome. 

Healthcare organizations will face increasing requirements in the coming years to offer greater transparency and more advanced technology. If they aren’t currently positioned to do so, last year proved why they need to catch up.  

Deliver a better consumer experience

The demand for accessing care and related services (e.g. scheduling, billing, claims) is part of a larger consumer revolution. While demands for a better consumer experience in the healthcare space have been simmering for years, they reached a peak in 2020. 

The current healthcare system seems almost deliberately confusing—at least the patients who simply want quality care. Patients receive several different bills related to one course of treatment or for multiple family members in their household. Getting a hold of someone to explain the charges and help them pay their costs can sometimes feel like a second job. 

For an industry committed to helping people, many organizations struggle to make it easy for patients to accept care. Streamlining these processes on the backend will lead to a better consumer experience and ultimately greater healthcare utilization. 

Technology can help fix a broken healthcare system

While there are many reasons why our current healthcare system is so confusing and frustrating, technology will play an important role in ultimately ensuring consumers have the information they need to make informed decisions for their families.

Subscribe

* indicates required