Editor's note: This is the third piece in Dr. Smythe’s four-part series on fostering healthcare innovation to face some of the biggest challenges fronting healthcare today: Chronic and Behavioral Care, Operations 2.0, Patient as Consumer and Post-Acute Care. This post discusses treating Patients as Consumers, while the previous two addressed Operations 2.0 and Chronic and Behavioral Care.
Smarter. Faster. More connected. On demand. These are the global trends that are redefining and revolutionizing every industry – and healthcare is just getting started. Today, consumers can choose to comparison shop, read reviews, crowd source recommendations for just about everything, instantly. And as consumers increasingly bear the burden of their healthcare costs, patients are starting to approach their healthcare decisions in the same way. Hence, it is critical for healthcare systems to proactively manage both the patient experience and their expectations, to increase patient loyalty, sustain the provider’s brand reputation and prevent new entrants into healthcare from siphoning patients away.
Technology can play a key role in meeting the needs of both patients/consumers and healthcare system organizations. Here are a few vital areas.
Consumer expectations are on the rise and patients are paying more attention to their healthcare costs. As of January 2015, 19.7 million Americans had high-deductible health plans making them responsible for the first $2,000 to $5,000 of their healthcare spending. Even for those not participating in high-deductible plans, out-of-pocket costs rose substantially. From 2009 to 2015, on average, deductibles rose from $680 to $1,200. It is important to note that the business of healthcare is not exactly like other markets. While financial responsibility may encourage individuals to be more discerning about services that are optional or variably priced, it may also provide an impediment to care when needed. Regardless, it is a reality, and one of the current strategies to provide some level of health insurance coverage to everyone.
Moreover, transparent marketplaces in other industries— from Airbnb to Uber—are changing consumer expectations, at a time when health systems are under increasing competition for patient loyalty. CMS, along with consumer and employer demands are elevating the need for pricing that is clear, complete and accessible. Some health systems are responding by playing offense; many are investing to meet expectations.
One common patient pain point is the bill paying experience. According to a Consumer Reports National Research Center survey, in the last two years, nearly one third of Americans with private health insurance were surprised when their insurer paid less than expected, leaving a larger-than-expected bill for the patient. As described by one family, “We just wish that a doctor's office would give us a reliable statement at the time of service; we would rather be told to bring $1,000 or know up front that we can't afford this procedure. End of story.”
In fact, as reported by PricewaterhouseCoopers (PwC), 66% of consumers have never had a conversation with their physician about the cost of a visit, 57% have never discussed the cost of a prescription, and 66% have never discussed the cost of a procedure. Technology can improve this experience by making it easier for patients to understand their cost for healthcare and pay their bills.
2. Real-time insights
In nearly every industry, there is a common challenge: “big data” is not enough to sort through the swirl of uncertainty and complexity in today’s modern society. To quote the Harvard sociologist, E. O. Wilson: “We are drowning in information, while starving for wisdom. The world henceforth will be run by synthesizers, people able to put together the right information at the right time, think critically about it, and make important choices wisely.” In healthcare, the deployment of technology and willingness of patients to engage in their care has led to a proliferation of data. The challenge; however, is in the synthesis – how do you glean actionable insights? In addition, are there ways to harness data previously unavailable from “non-clinical” sources?
In response, many health systems are revamping their online presence, as consumer-facing physician search and rating websites proliferate. Technology can also drive powerful results to improve patient experience and satisfaction. With real-time insights, providers can know how patients feel about their experience before they leave the hospital or doctor’s office. Patients can also offer perspective into health systems’ strengths and opportunity areas that can help provider organizations build patient loyalty and acquisition strategies.
One example where technology is offering new insights to improve patient experience is Binary Fountain. Binary Fountain offers a “social listening” tool that continuously monitors reviews, feedback, and mentions from the web and social media and integrates these insights with CAHPS data, point of care surveys, and other sources of patient feedback. The solution offers a single platform where health systems can distill actionable insights to inform their operational decisions and patient experience strategies. The solution both enables health systems to address patients' needs and to take control of managing their brand.
3. Virtual access
Healthcare consumers increasingly seek out convenient and immediate access to care for common conditions. A 2014 survey of 3,873 patients conducted by the Advisory Board showed the number one priority for patients, when selecting a primary care clinic, was convenience. Over 70% rated “I can walk in without an appointment and I’m guaranteed to be seen within 30 minutes” as the attribute they sought most when seeking care. In 2013, Cisco performed an international study of attitudes regarding virtual care and found that 76% of individuals would prefer virtual care over a visit to an in-person provider, and showed while 19% of respondents preferred to visit a provider in-person, 23% preferred a consultation or visit by phone.
Seeking convenient access to care, patients have turned to non-traditional healthcare providers such as retail clinics and direct-to-consumer telehealth providers. As a result, health systems are losing both loyal patients and downstream referrals. However, offering convenient access requires a significant change in provider organization scheduling, workflow, clinic hours and staffing without disrupting clinic workflows or leading to physician burnout.
One company addressing this challenge head on is Bright.md. Bright.md's "SmartExam" is a virtual physician assistant that helps primary care groups automate up to 90% of provider time spent on low-acuity conditions. Using online exams that are easily accessible by both providers and patients, patients are able to interact with their own health system and trusted providers more efficiently.
Learn more about the patient as consumer provider challenge and emerging technology solutions at HX360 during HIMSS16. Don’t miss the HX360 Innovation Pavilion plus cutting-edge programming led by world-class healthcare executives, investors, innovators and leaders like you.