The healthcare landscape is facing powerful and disruptive market forces that are rapidly dismantling norms and traditional business operations.
These trends are no secret to the industry and reach all facets of healthcare, from payers to health systems to life sciences.

We know the demands well: Consumers want more control of their care and increased transparency around cost of care. Health systems and payers are in a race to lower costs. Consumer experiences in other industries are bleeding into healthcare, bringing new demands for a simpler, more digital experience. And amid all that, the shift to value-based reimbursement is driving the need for unparalleled coordination of care and more sophisticated analytics. As health systems look to shape their future, they need to look for opportunities to differentiate themselves from the competition. In the face of these challenges, it is our opinion that building a more patient-centric system can bring providers squarely into the age of consumerism and establish the differentiating capabilities that add value for the patient and the bottom line.

The healthcare industry's complexity is holding health systems back from being patient-centric. 

Despite massive investments in the last decade to digitize health records, health systems still struggle to manage and extract from them—and connect that data to other technologies used along the patient journey. Disconnected systems often result in patient frustration as they are continually met with duplicate requests for personal information and even health information like medical histories. The result is a widely acknowledged poor experience leaving patients disengaged and sometimes distrustful of a system’s ability to provide care. Where other industries have used digitization to streamline transactional processes like online scheduling and combined billing into easy interactive, transparent experiences, healthcare continues to be weighed down by complexity.

Health systems not only struggle with ensuring a streamlined patient experience, but they are simultaneously confronted with care coordination challenges as they serve just a piece of the broader care continuum. Patients are left in the position to navigate their own clinical journey due to segmented experiences within a single health system and across multiple providers, payers, pharmacies, and networks. Poor interoperability and a relative absence of good data management leave no holistic view of the patient or their care plan.

Shifts to value-based reimbursement and shared risk models have further stressed the ability of health systems to execute when it comes to population health management. As the industry confronts the need for advanced population health strategies, the ability to not only understand but manage patient data is at the forefront. Real-time access to data, as well as predictive and outcome-based data, has emerged as critical to ensure care teams intervene and deliver the right care at the right time. Success is further compounded as health systems look to stratify risk and direct patient populations across multiple systems and post-acute facilities. Disparate reporting and analytics, gaps in real-time data, and a lack of clinical analytics make it difficult to manage populations and drive better quality and cost outcomes.

How a health system overcomes these challenges will be critical to their future success. While new vendors and technology solutions provide promise to resolving some of these issues, implementing new applications on top of an over-extended EMR will generally miss the mark. Effectively solving these challenges will take a more transformative and strategic approach that involves defining a new patient-centric technology architecture. This will put the health system on the right path to building a truly patient-centric organization.

A patient-centric technology architecture is based on 8 capabilities.

The health system of the future will look beyond the EMR and deploy new patient engagement, clinical-decision support, and integration capabilities that bridge the divide between patients and health systems to enable coordination across the entire care continuum. West Monroe has identified eight key capabilities a health system should enable to ensure they are driving toward a patient-centric architecture.  These capabilities will allow providers to resolve the pressing challenges they face today – leveraging actionable data delivered across the right touch points to enable consistent patient experiences and quality care outcomes.

  1. 360-Degree Customer Data a holistic view of the customer that provides the necessary data needed to enable personalized patient engagement strategies
  2. Digital Self-Service Capabilities self-service tools that empower low-cost and innovative experiences on par with leading-edge financial and retail services
  3. High-Performing Contact Centers highly effective front-line contact centers to transform simple service interactions into high-touch patient relationship opportunities  
  4. OMNI-Channel Orchestration workflow and omni-channel management capabilities that ensure coherent communications across channels
  5. Third-Party Integration effective third-party integration capabilities that power rapid ingestion of real-time clinical and non-standard data to power advanced analytics
  6. Master Patient Index sophisticated Master Patient Index and data quality capabilities to ensure clean, unified patient records across disparate data sources
  7. Predictive Analytics advanced analytics capabilities that allow care teams to move from reactive to proactive outreach that prevents adverse health outcomes and readmissions
  8. Performance Reporting real-time insight into clinical and financial metrics to provide a clearer picture of departmental and overall health system performance

What might not be apparent in these capabilities is the centrality of an INTEGRATION LAYER that spans all applicable data sources. The aggregation, access, and use of data will be central to enabling health systems to be successful in overcoming the aforementioned engagement and population health challenges. 

This new integration architecture will ensure data interoperability. It will connect in-house hospital and clinic data with vendor and health payer data. It will make that data accessible for decision support and numerous patient engagement channels. It will allow for more advanced population health analytics by enabling access to richer and real-time data that creates value.

How do I enable capabilities for my health system?

The strategy to enable these capabilities and establish a patient-centric health system will ultimately depend on the state of that health system.  No two health systems are the same and they all face various challenges. A good starting point is to assess your current architecture state against the eight patient-centric architecture capabilities listed above. 

Ask yourself these questions to assess your current state:

  • Have you identified the types of patient experiences you wish to enable?
  • Have you partially or fully enabled any of these capabilities to realize those experiences?
  • Can you properly integrate and aggregate patient data across all your applications and data sources?
  • Are you enabling the ingestion of new data sources in real-time to power meaningful patient analytics?

Once you’ve established where you are today against where you want to be in the future, developing specific initiatives and projects and aligning them to a patientcentered technology roadmap will help bridge those gaps and set you up for success.

Conclusion

The healthcare industry is facing rapid change on many different fronts: mergers and acquisitions, reimbursement strategies, consumer expectations, cost, care complexity, and more.  As health systems look to differentiate themselves, they should examine a patient-centric strategy – underpinned by the right technology – as a way to confront these challenges. 

Achieving that goal requires defining a corresponding patient-centric architecture to enable the capabilities required to provide a more connected patient experience and ensure the health system can ultimately deliver on greater efficiencies, lower costs, and better health outcomes.

Download PDF