Nio Queiro from Hennepin Healthcare and Ranjit Pisharoty from Sutherland Healthcare were asked to present at the America's Essential Hospitals VITAL2018 conference (June 2018). The presentation discusses how to digitize the revenue cycle for the digital health and value-based care era. With Sutherland as its transformational partner, Mrs. Queiro goes through various case studies on how Hennepin has become a digital disrupter in the Minneapolis area.
3. 3 #VITAL2018
WHY IS HEALTHCARE SLOW TO EMBRACE CHANGE?
By nature and for good reason, the healthcare
industry is incredibly risk averse. As one doctor
said: “The moment we step into medical school, we
are trained to identify the most statistically proven
method for treating a particular disease, and we are
taught to not deviate from that path until a better
method has been found and proven.”
Source: https://www.theguardian.com/healthcare-network/2015/jan/23/barriers-healthcare-innovation
4. 4 #VITAL2018
…WHEN RISK AVERSION ISN’T SUCCESSFUL
Boston Children’s
Hospital reported $65.2
million in unpaid
collectibles in fiscal
year 2016, up from
$44.5 million in 2015
and more than doubled
from what it was in
2012!
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THE EVOLUTION OF THE PATIENT EXPERIENCE
Pre-Encounter Encounter Post-Encounter
Schedule by Phone Digital Registration System Pay by Mail or Call Center
Online scheduling and patient
liability estimator
Virtual Check-In Kiosk pre-
populated w/ Patient’s History
Online Payment Options
Mobile App w/ Personalized
Recommendations &
Reminders
Check-in via Smart phone w/
Chatbot Assistant and Visible
Wait Time Queue
Convenient Payment options
ex: Apple Pay / PayPal / Venmo
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NEXT STEPS INTO THE BRAVE NEW WORLD
The limit lies more in your imagination than in the technology available to us
Post-Encounter
• Patient self-driven
payment plans
• Easy online bill pay
• EDI 275 clinical
attachments
Encounter
• Document
management and
abstraction
• Patient clinical
trackers
• Virtual scribes
Pre-Encounter
• Make eligibility
information available
• Virtual check-in
• Real-time
comparative price
quotes
• Digital pay abilities
(ex: Venmo, Apple
Pay, PayPal)
Patient @ Home
• Cloud-based dialer
and follow-up
• Close the loop
• Clinical tracking
• Denial self-
correction
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HEALTH SYTEMS NEED TO DELIVER BETTER EXPERIENCES
Payments within 2 days are at approximately 15% and at 7days 39%
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HOW TO GET INSIDE THE EXPERIENCE
Design thinking seeks to
understand the patient,
challenge assumptions,
and redefine problems to
better identify alternative
strategies and solutions
that might not be instantly
apparent
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DESIGN THINKING: GETTING A 360-DEGREE VIEW
Successful design comes from seeing the
entire journey through the customer’s eyes to
create a holistic, 360-degree view:
• See what patients see
• Feel what they feel
• Identify pain points and opportunities for
improvement
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DESIGN THINKING TOOLSET
Mapping current interactions,
processes and tools to identify pain-
points and opportunities.
JOURNEY MAPPING
Developing new concepts with target
users using various prototyping
techniques.
CONCEPT DEVELOPMENTPATIENT PERSONAS
Identify key patient types to better
understand their problems,
requirements, and their overall story.
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HOW TO DEVELOP A DIGITAL-FIRST ORGANIZATION
• The C-suite must support digital from the
beginning
• Start a pilot for the right reasons – The ROI
will come afterward
• Start small and scale up
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SUMMARY AND RECAP
• Healthcare must shift from risk-adverse to
digital-first
• Automate everything you can…and then
automate some more
• Leverage analytics to turn data into insights
• Design thinking WILL reshape legacy
processes…and save you money
• Work with a change agent – Don’t go it alone
Read quote…does this sound familiar to everyone in the room?
Why is our industry so slow to embrace change? I recently saw this stat about Boston Children’s Hospital. I bet they’re not the only ones though with this problem. Does this also sound familiar to anyone in this room?
Unfortunately though, the “proven” path is paved with major issues for all stakeholders. Here are some of the troubling trends for health systems.
Nearly 90% of hospitals have E.H.R.s now- so why is there MORE paperwork?
-Move to create billing events as a byproduct of clinical record
-Automate tasks and create computer learning
-Create smarter Business intelligence and pro-active monitoring
Patients move to active consumer mindset
-Need for increased consumerism; patient estimation tools
-Easy scheduling
-Web site content and easy communication (texting, chatting, advice, health coaches)
-Health system created website ‘aids’ driving patients to you
Automate the last mile
Clinical claims attachments, once touted and left behind (275)
Payment posting distribution across multiple tax IDs
Claim status checking, small balance follow up, new digital automation
Prepare the world for the PERSONLESS BUSINESS OFFICE OF THE FUTURE
Look at efficiencies that can be gained in the treatment office
-Virtual scribes, documentation robots, AI for feedback/innovation
-Automated coding through a byproduct of clinical encounter using AI
-Find and treat through wellness portals that we then create content in E.H.R.
The only way to survive, a digital first mindset
The only way to survive, a digital first mindset
The only way to survive, a digital first mindset
The closer innovation gets to the C-suite, the more likely it is to dwindle from lack of support
WHY? Incentives are misaligned
Underlying information technology is underleveraged
And physician engagement is minimal
MDs are BURNED out, suffer from change fatigue, and are unable to process more information, they are overloaded
Assessment of potential financial returns depend more on subjective reference points than on their expected economic utility
Are there REAL dollars to be saved???- - YES YES YES THERE IS
EVERY time, every day in every situation
How do we know? We see it, we live it, and our customers ask us to help them fix it
Healthcare is natural risk adverse - By nature and for good reason, the healthcare industry is incredibly risk averse. As one doctor said: “The moment we step into medical school, we are trained to identify the most statistically proven method for treating a particular disease, and we are taught to not deviate from that path until a better method has been found and proven.” Compounding this issue is the fact that the majority of healthcare workers are increasingly time-pressed today, and so learning and adopting new systems, new methods of care or new devices often take a backseat to day-to-day patient care
Automate -> You can’t automate enough. Right when you think you’ve automated everything you think you can automate, you find the next layer and realize you have so much further to go.
Key closing point - The digital transformation of healthcare requires the re-engineering and re-imagining of legacy processes in order to create new ways of engaging and empowering patients
