27 Feb 2019

Why Care Coordination Matters in Healthcare

As we fast approach the golden age in medicine, driven by hard-fought advances in science and technology that enable treatments and outcomes that once were the stuff of science fiction. And yet for most patients, the care coordination process and their healthcare experience remains firmly, and frustratingly, stuck in the past.

The simplicity of visiting your GP, Healthcare Provider or Specialist, is complicated by all of its associated paperwork, insurance authorizations and administration, even a commonplace doctor’s office visit can be confusing and far more so if a hospital procedure is required. The end result is a distrust of the overall healthcare system for many, and a considerable population that is woefully underserved. This, despite Americans paying more for their care than patients do virtually anywhere else in the world.

Neil Jordan, general manager of Microsoft Health, says that the healthcare system has historically focused on the experience and satisfaction of patients last, rather than making it a priority. “We’ve grown up in a world where the expectation of the health system is that it takes action on patients, versus patients making their own choices,” he says. “While that is changing, there’s much yet to be done.”

In conjunction with adopting value-based care practices, which incentivize outcomes and efficiency, healthcare providers and payers are reimagining their practices to put patients and their experiences first. “They want to understand their patients more deeply so they can provide better service, but they also want to understand the demographics that enable them to manage and develop their own services,” Jordan notes. Providers should grasp what the patient is interested in from the minute they hit the hospital website, he says, echoing a practice of today’s successful retailers.

In fact, by adopting successful practices pioneered in sectors like financial services and the hospitality or retail industries, tomorrow’s healthcare journey will get a lot more streamlined, more understandable, and transparent.

Radical Transparency

For most Americans, the U.S. healthcare system is defined above all else by a fundamental lack of transparency. For instance, as a consumer, it’s fairly easy to research the particulars of something when considering a purchase, whether it’s electronics, a car, or a house. However, attempting to do the same for a healthcare procedure, especially one that is complex, is far more difficult if not impossible.

Radical transparency, not only in pricing but also in the choice of care itself, is fundamental to a new approach to healthcare. The solution lies in engaging the patient directly and openly with all of the available choices—including quality ratings, pricing and working with them to make the best possible decisions for their outcome. It’s also about communicating before, during, and after care in a way that is timely, orchestrated, and personalized. While that may not sound like rocket science, compared with most of today’s experiences, it’s positively revolutionary.

Customer Service Industry

Today it’s common for patients to be involved in a plethora of administrative activities, from upfront securing medical authorization for procedures to providing financial and insurance information.

Following even basic services, there are multiple levels of communication between provider and payer, manual clerical processes, coding, verification, billing and more, all requiring multiple people, hours of work and perhaps weeks to complete. It’s a cumbersome, mostly manual, friction-filled process, and the output is still largely confusing for patients, breeding distrust rather than confidence in the system. But introduce technology, and the process can be transformed.

Data-Driven Improvements

As financial services and retailers have learned, translating data into actionable information is the fuel for customer relationship management. Healthcare providers and payers are focused on rapidly doing the same. In the clinical realm, data interpreted using artificial intelligence (AI) and machine learning processes can allow for faster, cheaper and better patient outcomes when used with diagnostic imaging tools and an expert clinician.

From identifying and reaching out to patients with chronic conditions to simplifying patient statements, payers and providers are already using information and technology to create stronger ties with the patients they serve. But more can and is being done, particularly when it comes to reducing friction in the healthcare system.

A New Patient Experience

It is inevitable that, as with retail consumers, patients will elevate their expectations of service as they experience what’s possible when powerful data techniques are put to work. While everyone involved in the healthcare journey, patients, providers and payers, will benefit from better outcomes at lower costs, it is the patient who stands to gain the most.

GetReferd is inspiring a better healthcare system. Learn more about our platform.

About Author

Craig Ellis

Head of Sales Engineering, with a passion for Healthcare, CRM, Business Development, New Technology, Marketing and Gadgets. Business Technology Professional, working in the SaaS Industry for GetReferd, Healthcare Software - Closed Loop Referral Management. Helping healthcare organisations to connect General Practioners to Healthcare Organisations, for referring their patients in real-time, scheduling appointments and creating a better patient experience.
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