Healthcare Change: Value-Based Care & Transformation (Part 2)

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As explored in Part 1 of this article, ‘Systemic Healthcare Change: Value-Based Care & Digital Transformation’, the healthcare industry is experiencing a paradigm shift from a fee-for-service model into a value-based care (VBC) model in healthcare. Approximately 48% of key payers and providers have either made the switch or are beginning to implement VBC into their reimbursement model. With a promise for value gain for both patients and providers in a VBC model, why haven’t more providers made the switch to value-based care yet?

According to Forbes, one of the biggest hindrances within the healthcare industry is the lack of “design thinking”. Concerns range from disruptions of existing workflows to complex integrations with legacy systems and while yes, these concerns are not entirely unfounded, this transformation doesn’t live solely in IT or administrative support.

To put it simply: designing complex patient-centric products supported by cross-functional teams isn’t so easy. but taking a holistic approach to such products is essentially the only way Hospitals and private practices should look beyond departmental silos to understand how systems – process, technology, people, data, and culture – work together through an end-to-end experience. Value-based care in healthcare is focused on the patient and design transformation in the integration of this model; it considers the quality of the patient experience as a key success factor.

When strategizing digital transformation in healthcare, consider your existing business processes. Do they work together, cross-functionally, or rather separately, within their assigned, departmental silos? Chances are they don’t work across functions which results in rampant wastes of time and resources. Too often, organizations problem solves within the barriers of departmental silos and assert their specific, current pain points individually, instead of looking more broadly when designing for the future. This narrow, siloed perspective will likely not lead to the design of your next breakthrough innovation; it will at best only solve singular, granular problems in the here and now.

How Can Value-Based Care in Healthcare Help Reimagine the Patient Experience Within the Era of Digital Transformation?

We propose a new way of thinking – horizontally across departments and holistically. With Platform-based Design Engineering, we start with a prescriptive design that considers all your processes and how to best leverage your platform and technology to enable them. For example, think of your patient’s care journey, much like we do when customer journey mapping. How can existing processes be re-designed to better support the patient and provider?

Appointment Booking

As consumers become more accustomed to digitally booking everything, from their grocery pickup to dinner reservations, healthcare patients seek a similar convenience in online appointment booking. We try to avoid entering the labyrinth of touchtone prompts required to book an appointment over the phone, a task usually limited to business hours. Consumers are more inclined to online booking for convenience, ease in entering their personal information, and flexibility in viewing multiple appointment openings at once. A recent 2020 consumer survey found a 69% increase in consumers using patient portals or third-party sites to book appointments online, with a 33% decrease in preference for scheduling over the phone.

Online appointment booking aides medical administrators as well, with the onus on patients to confirm their appointments through automated reminders and digital check-ins. We see manual tasks being eliminated from the already overburdened staff’s schedule.

Digitizing New Patient Registration

Once your appointment is booked, you arrive at the doctor’s office only to be welcomed with a 15+ page packet of forms. Now, how many of us can honestly claim to have perfect penmanship? Chances are your p’s could look like q’s and your insurance claim is denied a month later due to a data error. Research shows that 61% of claim denials are due to simple technical errors, mostly made when transferring paper forms into digital logs through manual entry. It could be a case of patient penmanship, or an accidental transposal of numbers. Not only has this simple error led to headaches down the road, but it also costs healthcare organizations valuable time and money correcting an avoidable error.

Of the many processes in the healthcare industry, the check-in process is often the most time-consuming and cumbersome. An average of 64 minutes is spent in a doctor’s office just filing paperwork and waiting to be seen. What if we could eliminate the risk of inaccuracies, while also streamlining the experience?

Through digitizing your patient registration process with forms supplied pre-visit, you will not only ensure higher accuracy in patient information, but also save your administrative team valuable time. This eliminates the need to manually enter information or follow up to correct inaccuracies in the future. Considering paperwork routinely lands at the top of most physicians and healthcare administrators’ frustrations and is often cited as a cause of burnout, streamlining these activities when possible is key to improving the overall patient and provider experience.

Improving Care Coordination and Understanding of Patient’s Needs

About 23% of patients with a chronic care condition see four or more doctors within a year, making care coordination a vital part of their patient journey. For successful, high-quality care, it is important for communication between their care team to be as accurate, and smooth, as possible. When a patient joins a practice or primary care physician, a patient’s electronic health record (EHR) is crucial for their new provider to understand their patient’s prior care, current medication, and procedures to prevent duplicated efforts, medication errors, or both. Through digitization and improved interoperability of patient’s data, their EHR will be thorough and up to date, improving the overall quality of care a patient receives. This reduces medical errors due to miscommunication or missing vital patient data and lowers the overall cost of care to the provider.

With miscommunication being one of the leading causes of medical errors, we need to ask ourselves: how these processes can be streamlined to better serve all the stakeholders involved? The answer is cross-functionally maximizing efficiencies and ensuring the best patient health outcome. By centering on your process design from an end-to-end customer, or in this case, patient perspective, you can bridge these processes to perform more effectively and efficiently. Breakthrough industry innovations do not come from a deeper industry vertical expertise, but rather from horizontal thinking, new platforms, and prescriptive design.

Interested in the industry shift to value-based care and the fundamentals of VBC? Read our previous blog ‘Systemic Healthcare Change: Value-based Care & Digital Transformation’ by Camille Super to learn more about value-based care in healthcare.

Industry innovation isn't created by deeper vertical expertise. It's built through exceptional process design and platform capability knowledge and expertise. For a demonstration of innovation by deploying technology best suited for your organization, visit our City of Innovation library. Be sure to watch our "Behavioral Health Patient Experience" demo leveraging the ServiceNow platform to see Platform-based Design Engineering in action!