Cost escalation is a pressing concern in the entire healthcare ecosystem – right from payers, providers, and pharmacy benefit managers (PBMs) to employers and customers. Healthcare companies are plagued by the question: How do we drive down cost while enhancing the patient and member experience?
Presently, the applicability of technology in improving the healthcare customer experience is still trickling in. Dr Mohanbir Sawhney, Associate Dean of the Kellogg School of Management, quips, “In healthcare, customer experience is almost an afterthought. I appreciate why people are called ‘patient’, because one needs to be incredibly patient to access even primary care.”
The culprit is the gaping hole between investments and outcomes. Providers and governments dedicate huge amounts of spend into healthcare services, yet the desired exceptional experience rarely makes it to patients and members. Without transparency, providers are unaware of how costs are reflected and passed on to employers and/or customers, which can result in not just unsatisfactory customer experience but also poor patient outcomes.
Another issue is that some companies try to address customer experience hurdles by ‘nibbling at the edges’, so to speak, within generic solutions. Technology companies are very good at building technology platforms, which by themselves are extremely useful. However, many of these platforms are designed from a cross-sectoral perspective. The time has come where healthcare needs healthcare-specific platforms that comprise industry logic, industry workflows, and domain expertise.
Consider the example of Uber and Tesla. Uber disrupted the transportation industry, not by using generic tools to solve a transportation problem, but by focusing on the ride-sharing experience and building a technology platform that supported that goal. Today, they are crafting an ecosystem that allows them to expand into transporting goods with Uber freight, partnering with shipping agencies, and more. Tesla did something similar with transportation via electric cars by looking at the industry problem, i.e., charging infrastructure, battery innovation, and cutting-edge AI resources needed to offer autonomous vehicles and seamless mobility.
Dr. Sawhney likens this to the conundrum of brainstorming versus body storming, i.e., thinking about the pain versus actually experiencing the pain. The learning that comes from experience is invaluable.
Thus, in theory, tech investments in healthcare should drive automation and productivity like it has done in other industries. But healthcare challenges are unique, such as institutional and regulatory complexity, privacy concerns, adherence to HIPAA, and complex relationships between payers and providers or patients and employers, to name a few. Add to this legacy, archaic, and monolithic IT systems, and healthcare is left with cumbersome and slow processes, culminating in painful customer experience despite steep costs.
Yet, the promise of technology is vast. And the move to verticalization of platforms is catching on quick. Platforms create ecosystems because they bring together different players together where they share workflows, data, rules of engagement, contracts, standards, and more. They foster the creation of enterprise architecture that allows a single version of truth, thereby smoothening some of the challenges mentioned above.
To create patient-centric experience and outcomes, healthcare enterprises must:
· Move to a platform-based thinking to build ecosystems that unify all stakeholders and scale efficiency
· Follow an integrated, systemic approach that marries domain and technology expertise
For years, Infosys has been working with healthcare providers and payers and is well-versed with the industry challenges and complexities. Infosys has abstracted its learnings from such ‘body-storming’ to create a healthcare industry platform built with composable business objects. This is helping players reimagine healthcare delivery and patient experience to innovate for the future.
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