November 27, 2021

4 big moves to transform your health system with digital

change, transform

Spurred by Covid-19, we are witnessing the unprecedented digital transformation of healthcare, and health systems that don’t rapidly innovate to meet this “new normal” risk being left behind. While the core tenets of growth, financial stewardship, and quality remain the same, health systems must tailor their strategies to win consumer loyalty while delivering differentiated value.

Digital makes these shifts possible, forcing organizations to rethink and reconfigure their structure and operations. In short, health systems must move from “doing digital” to “being digital.” AVIA, a digital transformation partner for health systems, designed the 4 Big Moves to provide a roadmap for health systems looking to embrace digital and emerge as a leader in healthcare.

Big move #1: Own the onramp

Health systems can only provide a certain number of visits per day, and the consumer experience is centered around healthcare’s supply, not their individual preferences. With more disruptors and technology entering the industry, we’re seeing a shift in healthcare: Consumers who have a choice are likely to go elsewhere if they cannot access the care they want or need.

Our “Own the Onramp,” encourages health systems to create a flexible supply & demand model. In this model, consumer demand – not health system supply – is the driving force. To create a digital-focused onramp, health systems should consider the following:

  • Building out the digital front door: Create an integrated digital access point into the system, with consumer-centric capabilities to digitally search for and schedule an appointment, virtually triage symptoms, navigate to the right site of care, and access on-demand virtual visits. These capabilities can be surfaced through guided interactions like chat, text, voice, or a system’s website or app.
  • Envision the digital front door as a marketplace: This approach might include dynamic pricing for expiring inventory, merchandising to 3rd-party sites, transparency of services and pricing, and convenient payments.

Owning the onramp allows health systems to win on access by improving convenience and optionality for the consumer across their care journey, while optimizing existing assets and capturing share beyond geographical boundaries.

Big move #2: Hyper-personal care orchestration

The average health system serves most patients as if they are the same, making the best medical and administrative decisions they can based on snippets of information. This lack of personalization contributes to the challenge consumers face in navigating the complexities of healthcare. About 7% of consumers switch healthcare providers because of poor experience, translating to an average of at least $100 million in revenue losses per hospital annually.

Move #2, “Hyper-Personal Care Orchestration,” begins with establishing a strong data foundation to develop an “n-of-1 view” of the consumer. With this move, health systems can:

  • Stitch together data about a single individual (not a segment or population) across clinical settings, transactions, behaviors, and health information to deeply know the consumer.
  • Personalize digital interactions (text, chat, voice) at their digital front door. The latest digital technologies in this area actively learn from previous patient interactions, creating an ever-evolving personalized experience.
  • Orchestrate a broader, more comprehensive care plan, creating individualized, proactive care interventions that anticipate the needs of the consumer.

Move #2 will allow health systems to deliver a consistent, continuous consumer experience that allows them to win on loyalty, secure future revenue, and potentially gain additional upstream revenue.

Big move #3: Specialty care double down

Health systems traditionally competed locally for specialty care cases, a key driver of profitability and source of competitive advantage. They are now faced with new threats that seek to disrupt referral patterns and drive down prices. As consumers bear a greater share of healthcare expenses, they demand increasingly “shoppable” non-emergent specialty services, a demand that aligns with growing industry price transparency.

Big Move #3, “Specialty Care Double Down,” means investing in a digitally-enabled, frictionless specialty care experience for patients, providers, payers, and employers. It’s concierge-level specialty care involving the patient, specialist, referring provider, and care team, orchestrated by digital. To execute on this move, health systems must:

  • Leverage data to orchestrate expedited workflow and care paths in less acute care settings, even the home. New digitally-enabled models of care must be designed in a specialty- and disease-specific way.
  • Develop transparent communication and information sharing with the referring provider, informing them on the progress of care and eliminating friction. Specialty care referral leakage results in 10% to 30% in lost revenues, the equivalent of $160,000 per physician.
  • Buy, build, and partner to create digital solutions for surgical care orchestration. These tools guide patients through their care journey from pre- to post-op and aim to reduce readmissions, no-shows, same-day cancellations, and increase satisfaction of clinical teams.

Health systems that execute Move #3 will improve access, optimize their assets and footprint, and ultimately build the “service line of the future” that coordinates care across multiple specialties and sites of care, while improving patient, provider, payer, and employer satisfaction in an increasingly transparent and shoppable market.

Big move #4: New work

Traditional healthcare operating models are grounded in manual, labor-intensive processes that reduce operational efficiency and increase cost. Some industry estimates suggest 25% of total health system costs can be attributed to these largely administrative expenses. Tackling these issues systematically could reduce annual healthcare costs by almost $300 billion, enabling health systems to offer more value to payers and employers, and positioning themselves to be essential network providers.

Big Move #4 brings the concept of “new work” into reality, converting these core operating processes, work, and assets to automated platforms that optimize cost structures and deliver value. To successfully deliver on new work, health systems must:

  • Build an effective enterprise-level automation strategy, which provides an assessment of current back-office functions. These functions should be benchmarked compared to other digital-first industries, like finance or retail.
  • Complement human abilities with automation to exponentially shift costs out of the system, particularly in labor-intensive, error-prone tasks such as clinical staffing. Automation that complements workers can drastically reduce administrative functions while increasing the speed and reliability of tasks.
  • Get phygital” by integrating digital and physical operations. An operationally flexible service delivery model across both physical and digital mediums enables expansion in network coverage, improvement in patient acquisition and retention, and greater capital flexibility.

Executing on “new work” will yield sustainable competitive advantages, allowing health systems to win on margin by re-engineering their operating chassis and associated cost structure, ultimately making the health system essential to payers and employers.

Digital in action

These moves are indeed large and complex, but as the saying goes, the journey of a thousand miles begins with a single step. Health systems must act now on these Big Moves. Each of the plays in these moves can be architected into a roadmap that makes sense for the specific needs of an organization, with foundational items and quick wins that increase ROI from the get-go.

Photo: Madmaxer, Getty Images

This story is brought to you by MedCity.

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