How IT enables healthcare consumers to successfully navigate the system


Posted on: June 4, 2019 by Mary Sirois

As the saying goes, not all things are created equal. This rule of thumb definitely applies to healthcare consumers, since the different types of consumers (read patient, member, enrollee, customer, etc.) all have different needs, backgrounds, health goals and wants.

But what happens when healthcare consumers apply the same expectations to their care experience as they would with their retail experience? Healthcare providers and payers alike are challenged to meet ever-evolving consumer expectations with the transparency that the retail marketplace revolution has enabled.  Customers want to know cost, best clinical outcomes, options for where and how to receive care, available healthcare alternatives for diagnosis and treatment, the need behind constantly resharing information, and of course, want to know why processes simply aren’t easier. Consumers want to understand their illness, treatment options, and implications on their life, and that of those involved in their lives.

The retail customer mindset has unknowingly created a tall order for addressing healthcare consumer needs. In reality, the healthcare consumer is different from any other consumer. Healthcare consumers don’t access care because they want care, they need care. When the consumer or their loved one is sick or injured, they may face a confusing, fearful and financially crippling experience. Even with the technology investments made in the past 30 years, the process remains a mystery and a disconnected experience for consumers. The costs are astronomical, to the point that healthcare costs have been cited as the number one cause of bankruptcy in the United States.

Obstacles healthcare consumers can do without

  • Lack of access to care and access to knowledge about the best place to receive care.  There aren’t enough care facilities available to patients, and the ones that are available are not always right for every patient. In addition, knowing which facility is best when you’re in need of care can be confusing. Emergency room, urgent care clinic, neighborhood drug store, physician’s office. Which is best in terms of care needed, cost and insurance and hours of operation? The lack of access to care exists for many reasons. Facilities need to have clearly-defined purposes conveyed to the consumer and their care competencies known by the consumer, so patients can make well-informed decisions at a moments notice.
  • Not being able to conduct lab work in advance of a primary care appointment. Patients agree, it would be more than nice if standard practice was to dictate lab work in advance of primary care appointments, providing an opportunity for patient education and improved compliance. But instead, EMR is set up to bill on order, and because of this, accounts are credited if the patient doesn’t show up for their lab appointment, unfortunately putting blame on the patient.
  • Missing opportunities for service recovery.  Asking patients with needs for urgent care to stay on the phone to complete a survey is unnecessary to meeting the needs of the consumer.  Would it not have been easier to ask the simple question, “Did we meet your needs today?” If they respond with a yes, let the patient go about receiving the care they need. If the response is no, immediately route the call back to the call center to begin service recovery and assist the patient in getting the care they need.
  • Not having the ability to input information with convenience and ease online. Imagine a mother filling out her child’s information at the doctor’s office with three children in tow. She doesn’t have enough hands for the many things grabbing at her attention and filling out paperwork online in her living room before picking up the kids from school would have been ideal. In addition, earlier in her day, she created a grocery list for online shopping, and after the doctor visit she’ll go to the store’s drive through line to pick up her groceries with convenience. While retail and healthcare aren’t always the same, this situation makes a point that IT should provide ease, not create obstacles in its absence.

What healthcare IT looks like when it adds value

Healthcare leaders must change their approach to engaging and enabling consumers. In the data there’s medical history, listed medications, dates for appointments and locations for service and care. Data is knowledge and has the ability to ensure healthcare experiences are seamless. Healthcare leaders must leverage lessons learned in the retail space, but then rethink technological lessons in a way that’s engaging with healthcare consumers and patients at every step of the process.

In addition, have we turned that around to consider how we might support the consumer/patient population in understanding the new digital tools that might be used in the provision of care? Are we training patients through simulation and augmented reality to understand the use of tools such as in-home/remote monitoring devices or wearable devices such as diabetic monitors?

Consider the following questions:

  • Is this easiest for the consumer/patient?
  • Are we creating multiple modes of access depending on consumer preference (digital engagement versus in-person processes)?
  • How can we add value to the consumer experience?

Journey mapping

Working alongside their IT partner, healthcare leaders can leverage the data and metadata that is readily available within the multitude of systems of record to understand and improve upon the consumer experience. This is referred to as journey mapping. First, understand the consumer’s journey, including initial website interactions, call center processes and provider and caregiver encounters. Next, model, measure and track the experience to identify opportunities for improvement.

In understanding the planned care a patient might receive in a day, providers could anticipate scheduling procedures that required a patient to go without food and water after midnight, schedule that test early, and allow time to grab a meal between services. An organization could provide wayfinding to nearby food service locations, and even provide a prompt to rehydrate.

In another opportunity to be helpful, a provider might know that a patient has taken the afternoon off of work to receive care, and in the time following the appointment, could encourage a patient to receive care that could resolve a gap in care.

These are opportunities that journey mapping could uncover to allow organizations to provide a better consumer experience.

Consumer enablement and education

Atos, through our Breakaway Group, can help clients better educate their consumers and patients on the various process and technologies that might be involved in their care. The program offers simulation training with guarantees of technology adoption in the work place. Atos can assist in planning for different patient engagement and consumer enablement strategies, as well as provide industry-leading tools leveraging simulation, animation, gamification and even augmented reality to help consumers adopt digital tools that can improve their health and wellness.

Healthcare leaders must look outside of their own walls to consider how they are enabling the consumer to make informed, accountable decisions about their health and well-being. Process redesign, system utilization redesign and data utilization redesign are at the heart of moving to a consumer-enabled world.

While healthcare organizations must learn to leverage data and technologies whenever possible to best promote and enable the consumer experience, they must always remember the human-centric component to healthcare – the provision of care to improve health and wellness.

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About Mary Sirois

Vice President, Integrated Solutions Delivery, Value-Based Care and Population health, and member of the Scientific Community and member of the Scientific Community
Mary Sirois is responsible for developing and delivering consulting services related to value-based care (VBC) and population health to improve care quality, reduce care costs and engage consumers.  She is also responsible for looking across Atos’ technology portfolio to incorporate population health and VBC opportunities and solutions. Sirois also serves as a member of the Atos Scientific Community, a global network comprised of 150 of the top scientists, engineers and forward thinkers from across the Group. Through Sirois’ role at Atos North America combined with her experience as a physical therapist, she has more than 25 years of healthcare experience in operational and strategic planning for both health care delivery systems and innovative care environments. Specifically, her experiences spans leadership in organizational governance and change management, regulatory compliance readiness, strategic and operational planning, and budget development to transform and improve quality across the continuum of care. Sirois has served in numerous consulting leadership positions ranging from HIPAA to clinical informatics and transformation to population health management. She has held leadership positions at Healthlink, Divurgent, Medecision and Pursuit Healthcare Advisors, as well as served as Vice President of Clinical Transformation at Baylor Health Care System. She is focused on using her experience to help organizations leverage their digital technologies and competencies to create new business models to improve care quality, reduce costs and engage the patient.

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