Transform Care: Why Healthcare is Just Getting Started

The urgency of COVID-19 proved that the notoriously slow healthcare industry can swiftly remodel outdated ways of working to usher in change. With this newfound momentum, we’re finding that speed to market is becoming the priority as the red tape is being stripped away, and bureaucracy is bringing digital triage, virtual care and new patient-facing technology to consumers.

While healthcare’s modernization has lagged behind other industries, accelerating the move to value-based care, fundamentally transforming care services and improving clinical outcomes relies on leveraging digital tools, operational changes and collaboration with new entities across the continuum of care.

According to Frost & Sullivan, the telehealth market in the United States is predicted to increase by 64.3% this year – and sevenfold growth by 2025. The widespread consumer adoption of telehealth is one of many notable changes that will characterize our new normal, proving that the profound transformation of healthcare is only just getting started.

Recalibrating the Future of Health

According to the Change Healthcare-Harris Poll 2020 Consumer Experience Index, two-thirds of respondents said every step of the healthcare process is a chore.

Healthcare’s digital transformation is vastly different from retail, manufacturing, banking and other everyday experiences. While other industries are removing human interaction, like cashier-less checkouts, healthcare must leverage automation wisely to make humans more efficient by removing burdensome administrative tasks or streamlining the patient experience. The goal of integrating emerging technology like automation, interoperability, big data and analytics is to enable personalization and maximize providers’ time with patients for the best clinical outcomes.

The pandemic actualized how problematic existing payment models were, showcasing the benefits of financing care based on value rather than traditional fee-for-service. Providers see this as a long-overdue reform, increasing their facetime with patients to provide better care at a lower cost. Thoughtfully and rapidly shifting to value-based care is possible with dedication from healthcare stakeholders and alignment with providers, community organizations and payers. Just as the pandemic rallied healthcare with speed to market, the same level of collaboration can recalibrate the system to focus on healthier populations, greater care coordination and lower costs. 

The Road to Transform Care

The road to transformation begins with evaluating an organization’s current state through the lens of people, processes and technology. Building off this assessment, organizations must leverage consumer journey mapping within payer and provider ecosystems. By asking “what path are consumers taking today and what path should they take?” healthcare can create a strategic opportunity for a seamless, frictionless consumer journey.

For many organizations, it’s easy to get lost in the opportunity big data provides. Large payers and health systems have more data than most industries, yet hesitancy to broadly share data prevents the entire system from adopting a value-based care model that centers on holistic care, both in-person and virtually.

From experience helping organizations plan and execute digital transformation, successful transformations happen through taking action, rather than overthinking the strategy. Organizations can start small with one population or disease state, identify points for digitization and interoperability, measure for effectiveness and try again to optimize results for the entire enterprise. With proactive action, organizations can build on momentum to unlock the exponential growth potential of future-ready capabilities.

The Art and Science

Transforming care requires a careful balance of digital transformation and cross-industry collaboration. At our 7th Annual Healthcare Summit, Heather Cox, Chief Digital and Analytics Officer at Humana, shared how big data was key in transforming care delivery after discovering how food insecurity affected member populations as the pandemic took off.

“We were then able to use the power platform, along with our data and some good engineering resources, to quickly stand up a program so that between March and November, we delivered over a million meals to our members’ homes.”

While digital transformation was once implemented as a reactionary approach rather than intertwined into an organization’s DNA, future ecosystems need to be consumer-centric, interoperable and cognizant of the social determinants of health. Organizations with more visibility into health challenges and their attributed populations can avoid unnecessary spending and improve patient outcomes. By coupling value-based care models with the added visibility from data, providers can refocus on treating patients holistically.

Healthcare’s Future-ready Transformation

The need for digital transformation is more important than ever, but transforming long-standing processes is a series of strategic, incremental steps over time. As healthcare moves forward in a post-pandemic world, optimizing care delivery and creating a positive patient experience is not only important for the greater good but critical to a future-ready industry.

The world brought change, but from that change there’s new momentum to transform care and improve health outcomes in new ways. The transformation of healthcare isn’t imminent – it’s already here.

For more insights on transforming care, download our white paper ‘Healthcare from Everywhere’ or sign up for our monthly newsletter, EVOLVE.

About the Author

Jenny Alexander is a Principal at Emids with 20+ years of experience in population health, utilization and care management and healthcare business transformation. As a former social worker, she brings a unique perspective to healthcare consulting. Drawing on her earlier work with individuals and families in a community setting, Jenny has advised payer and provider executives in their efforts to improve the engagement, health and outcomes in those same communities. She is passionate about finding effective, innovative ways to address social determinants of health through data, analytics and community collaboration. Jenny is an expert at leading teams to empower clinical interventions, reduce medical cost and engage consumers their health and wellbeing. Be sure to connect with Jenny on LinkedIn.   

Christina Arenz is a Vice President with Emids and has 20+ years of healthcare IT experience. She has an in-depth understanding of value-based care, risk contract arrangements, population health and the ecosystems of payers and providers. She is an expert in leading large project teams, developing client solutions and managing client relationships at executive and frontline levels. Christina has successfully managed and delivered launches of start-up health plans and ACOs, successful value-based care operations and programs across the U.S., in addition to the transformation of health plan operations. She has a collaborative, out-of-the-box, client and solution-focused style that has helped clients achieve success and transform their business by identifying and bridging the gaps to make the complex simpler and help deliver better care. Be sure to connect with Christina on LinkedIn.  

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