Creating the Amazon of Healthcare: The Road Ahead with Patient-centricity

Healthcare decisions have high stakes, not just because a huge amount of money is spent on it, but because people’s lives depend on it- quite literally. Not surprisingly, people want to make informed decisions while choosing a service provider. They evaluate all the information available on quality and costs before finalizing providers, payers, and treatment plans, which is giving rise to consumerism in healthcare.

However, healthcare has always been an issue of prime importance for the nation as well as people.

Why has the wave of consumerism pervaded healthcare just recently?

Healthcare dynamics have been changing, so has the consumer (patient) behavior. 

In 2017, the out of pocket expenses for patients amounted to around $365.5 billion, which is approximately 10 percent of the total healthcare cost. Out of pocket expenses have been growing for the past couple of years and the trend suggests that it will keep on growing, at least in the near future. Patients have to continue to pay a considerable amount of money in co-pays and deductibles. The more money they shell out, the more inclined they are to scrutinize the service they get. As a result, they would want to know about the treatments, procedures, and medications that they are administered, now more than ever.

Another factor that has been propelling consumerism in healthcare is the growing focus on health and wellness. The majority of the workforce in the US consists of Millenials. A study suggests that Millennials value health and fitness the most, after their family. They are responsible for the thriving global wellness market that is estimated to churn around $4.2 trillion annually. To achieve good health and fitness, Millennials rely heavily on health devices and mobile apps to monitor their health, receive alerts and pay their medical bills. Increased health consciousness and digitization are playing a significant role in fuelling consumerism in the healthcare world. 

Healthcare providers have not been able to keep up with the new demands though...

The trajectory of patient satisfaction has not been growing in proportion to the demands. Healthcare consumers want complete information about the physicians, medications, procedures, treatment plans, and outcomes, in real-time through a digital platform. 

Providers and payers agree that patient experience is a critical element in delivering quality care, but they still have not taken adequate steps to drive improvements. According to a survey, 58 percent of healthcare providers believe that digital tools can boost patient engagement substantially, but only 14 percent of them actually had the tools in place in their respective organizations. 

Payers are also falling short of consumer expectations, especially on the digital front. A study shows that people ranging from 22 to 37 years rate their healthcare insurers very low in communicating through applications. Insurers, along with providers are not up to speed with what consumers want.

Following the cues of consumerism to improve patient experience

The healthcare stakeholders need to take the hint and leverage the opportunity to make improvements in the care delivery process and patient experience. 

Here are some of the ways that can be done-

1. Improving a patient’s experience with the physician

With the advent of the EHR technology, physicians are not left with enough time to interact with the patients. Most of it goes into retrieving and entering data into the EHR which results in plummeting levels of patient satisfaction. Applications powered by AI and machine learning can solve this problem by integrating data from different sources and providing a comprehensive 360-degree view of the patient at the point of care. Physicians can cut back on the time spent on eliciting data, instead, use it more productively. This will not only improve patient experience but it will also drive better outcomes.

2. Providing a price estimate to the patients

With the CMS regulation that mandated hospitals to publish their standard rates and Seema Verma’s #WheresThePrice challenge, price transparency has been creating a lot of buzz in the healthcare world lately. It seems like some new reform is on the way that will strengthen the foothold of the price transparency agenda further. Whether the reform happens or not, a system should be devised that gives a clear estimate of the cost that patients are likely to incur.

Applications enabled by AI and Machine Learning can make it easy for physicians to access just the right information about a patient in real-time and make an accurate diagnosis. They can predict the procedures and treatments that the patients would likely go through. Giving the patients a tentative idea about the treatments and the amount that they would have to pay can make their healthcare journey a lot smoother. 57 percent of Americans have received a surprise bill at least once in their lives, according to a survey. Getting a price estimate in advance can help patients plan their finances better.

3. Improving accessibility to care 

Healthcare providers can offer applications to patients that can help them locate hospitals, schedule appointments, receive reminders and get a transport to the facility. By eliminating the hassle that a patient faces in getting an appointment and reaching the hospital, healthcare providers can improve patient experience drastically.

4. Creating customized insurance plans 

Payers also have an important role to play in enhancing patient experience. Using applications that can integrate patient data from different sources, payers can derive insights to formulate consumer-driven customized plans that would be more beneficial for their members. This will certainly spike the levels of patient satisfaction.

5. Simplifying billings and payments

Billings and payments is another segment in healthcare where lies a huge opportunity to make improvements. Defaulting in paying the bills not only lowers the credit scores of the patients and decreases their satisfaction levels, but it also increases the bad debts accumulated by the healthcare sector which contributes to the already sky-high expenditures. 

Providers and payers need to join hands and embrace new technologies and applications to make the process of making payments easier for the patients. The rising percentage of out of pocket expenses is only intensifying the urgency of this requirement.

We are still at a nascent stage in providing patient-centered care

The above list is certainly not exhaustive. There is so much more that the healthcare stakeholders can do to improve the patient experience. However, these steps could be a good place to start to address the immediate demands of the patients. 

In the value-based care model, delivering patient-centered care is an important attribute. Apart from increasing the levels of patient satisfaction, providing patient-centered care also yields more income for both payers and providers. 

So, neither is there a dearth of incentives nor an absence of technologies and applications to provide patients the kind of care and services they desire. What healthcare players need to do is take initiatives to implement the technology and move towards a better version of the healthcare system.

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This blog has originally been authored by Abhinav Shashank.