Why Next-Gen Omnichannel is the Catalyst for Value-Based Healthcare
There’s no denying that value-based healthcare is revolutionizing how healthcare is delivered and paid for. In a way, it is the perfect storm: a shortage of providers coupled with a growing population of chronically ill patients has proven to be a much-needed catalyst to reimagine how care can be delivered and measured. For example, in the U.K., 75% of patients’ first level of interaction for health information now comes from online sources. With half of all adults—117 million people—having one or more chronic health conditions, healthcare organizations are expected to spend close to $6 billion on treatment and prevention of chronic illness. Could digital care be the panacea?
With increasing pressure from payers to lower costs and improve quality of care, healthcare providers have financial incentives to promote cost-efficient healthcare services and consumer choices. Pivoting away from traditional, capitated, volume-based care (fee-for-service) towards reimbursement models has sparked a movement that ensures payment is aligned with health outcomes. Currently, nearly 75% of providers participate in at least one value-based payment model, and over 60% expect them to become the dominant payment model in the near future.
This patient-centered, outcome-based delivery model needs to be supported by an open yet secure ecosystem of digital technologies that allows providers to establish objective measures of clinical quality to lower costs, improve outcomes, and improve patient access to care. This requires a cloud-based omnichannel solution that brings the right resources, content, and context together to deliver a 360-degree digital care communications experience. This solution should include the following:
- Converged infrastructure: Healthcare organizations must seamlessly converge technologies like UC, contact center, IoT and AI to better integrate care and intelligently manage the growing number of communication standards being employed. This blended health IT environment also enables providers to more immediately develop features and applications that meet different patient needs. Consider, for example, using third-party cloud applications and services to build a custom pre-registration service that quickly and seamlessly populates medical documents and patient information into the EMR system.
- An open data model: Providers need a powerful visualization of the patient journey across all channels, devices and departments to drive real-time responsiveness, anticipatory engagement, and intelligent communication at the individual account level. An omnichannel solution built on open data management allows providers to gather, collect and use data where and when that data is needed. Consider a patient looking for information on cardiovascular health on a provider’s website. The provider prompts a web chat session—in which the patient is now communicating with a form of artificial intelligence—and discovers that the patient is concerned if the chest pain he is feeling is associated with a near heart attack. When the chat session is escalated to a live call, the agent should not only have this information on hand but should also be able to see that this patient engaged in three chat sessions two weeks ago and exchanged several emails the month prior.
- Resource-matching: Patients must be placed with representatives who are best qualified to handle them based on such things as choice of channel, expertise, and past experience with a particular inquiry. Consider this scenario: a patient has an appointment tomorrow at 2 pm and doesn’t know if she should stop eating the following night because of a specific procedure that will be taking place. This patient can be routed to an agent with specific training on the procedure and all necessary requirements to help the patient navigate her current healthcare needs. Resource matching should be implemented across all channels and devices to get patients to the right person at the right moment to maximize health outcomes.
The question isn’t “if” but how fast the industry is digitally transforming to drive value-based healthcare (consider England’s NHS Five Year Forward View, which strives to have all care records digitized, real-time and interoperable by 2020). Healthcare entities are now being benchmarked for pro-activeness and the ability to prevent problems before they start. To proactively transform patient access and services, providers should consider adopting omnichannel solutions that have the necessary levels of agility, flexibility, and openness to deliver unparalleled patient care and value.