Healthcare Consumerism: Why Providers and Payers Should be Thinking About Patients Differently?

If there is one statement on which we can all agree, it is that COVID-19 has made many lasting impressions on our healthcare industry. From the emergence of telehealth to “drive-through healthcare,” the way in which patients consume healthcare has forever been changed.

For many, the pandemic has pushed healthcare diagnoses and procedures out of the health system, causing many to eagerly wait for re-entry once conditions return to “normal.” 

Common procedures like joint replacements, cancer screenings and treatments, chronic kidney disease, diabetes, lung conditions…and the list goes on…have been asked to hold while the industry grapples with the crisis. 

With daily fluctuations in COVID cases and treatment success, ICU beds and the treatment of infectious disease is the industry’s current priority.

Today, the pandemic appears far from over. And while our nation’s health system is far more aware, educated, and capable of managing the pandemic. As patients re-enter health facilities, there is still work to be done towards a vaccinated public that will lead to the eradication of this vicious disease. 

Nevertheless, census counts are starting to bounce back. Patients are once again undergoing preventative treatments. And in some cases, elective procedures are starting to rebound. It will take time to get back to full capacity, but it would appear we are trending in the right direction.

Where Does Healthcare Go From Here? 

But as these patients begin to get reacquainted with healthcare, they can now evaluate their options with greater access to information to help inform their approach. 

Where do they go? Who should they see? What will they pay? Who is the best at delivery? What should their outcomes be? 

Defined as “consumerism,” this access to data and choice is the new normal for both providers and payers alike. 

The Future of Healthcare Technology  

This healthcare consumerism is being driven by a wave of new technologies designed to provide patient access to healthcare. 

From digital front doors to way-finding, the go-forward patient experience is changing. This change primarily comes from a digital wave focused on putting a patient’s data and health information on mobile phones, tablets, and wearables. These devices operate in harmony to help inform decision-making.

Healthcare Consumerism’s Impact on Providers

Review the strategic imperatives of any hospital these days and you are likely to find “patient engagement” and “patient acquisition” in the top 5. But why is this the case? 

The health system C-suite is increasingly aware of the strong presence of healthcare consumerism and the role data plays in healthcare consumption. 

Today, performance at the service line, diagnosis, and physician level are readily available to the patient. This informed consumer is increasingly astute at using available data to make informed decisions. 

Linked is the patient experience and the manner in which data and information is shared with patients. Web pages are quickly becoming passe, a relic of a bygone era. 

Engaging Patients Through Mobile

Today, patients are looking to health systems that provide integrated mobile applications that offer robust data and information on their phones, at their fingertips, often informing their care, their plan, and their obligations to pay.

Underpinning all of this is a digital experience made up of a number of mobile applications. These mobile apps not only brand the health system, but also provide a unique, customized user experience that creates stickiness and loyalty with patients. 

Aptly named, the digital front door is a concept of electronic patient engagement that reaches the patient before they even leave their home. 

This digital experience provides all relevant information including the patient’s name, address and health plan information. It also includes the reason for the visit, doctor’s name, procedural information, pre-procedure instructions, the location of the appointment, and even an interactive map that guides the patient to the location of their appointment. 

What’s more, all of this occurs in a simple, easy-to-use application that is pre-configured to the individual patient’s experience.

Digital Transformation is Key to Healthcare Consumerism

Digital transformation is the change from manual processes involving human face-to-face interactions to an electronic collection of applications. 

These applications are designed to streamline the patient experience, create efficiencies in data collection and sharing, and minimize manual processes and paper forms. 

Ultimately, what patients receive is a digital experience aligned to the preferences of their demographic and the way in which they prefer to consume information. 

Ready to start your digital transformation and prepare for the future of care? 

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Healthcare Consumerism’s Impact on Payers

Similar to providers, health plans (a.k.a., payers) are focused on patient engagement as well. 

But unlike providers, payers are focused on a suite of solutions centered around a patient’s interaction with their health plan. The goal is to help them navigate their wellness at the lowest possible cost while driving the best possible outcomes. 

Focus on Experience 

Payers are increasingly focused on improving the experience of their covered life (the patient who is a member of the health plan). 

This improvement is achieved by ensuring that patients are consuming healthcare via providers that are covered under their plan, leveraging pharmaceuticals that are on formulary, engaging in tests that meet medical necessity (and are therefore covered), and working with specialists that are also within the patient’s networked health plan.

The Role of Healthcare Technology

In addition, payers are increasingly looking to digital technologies to help patients with chronic conditions monitor and treat their diagnosis. 

They are also looking for ways to reduce the likelihood of comorbidities that are often attributable or linked to the principal diagnosis. Here, payers are increasingly turning to patient monitoring (for example, through wearables) to help discern a patient’s condition, reactions to treatments, and propensity to heal. 

The Health Plans’ overall goal is to create more healthy patients and improve the likelihood of favorable outcomes. All while reducing the costs of care whenever and wherever possible.

Similarly, payers are looking to digital transformation and mobile applications as a means to interact with patients. These initiatives are all focused on improving brand awareness, patient retention, and overall wellness.

Aligning Perspectives Around Healthcare Consumerism

So what does healthcare consumerism mean for the care continuum? 

Patients want a better experience and better tools that are tailored to their personal care experience — and that goes beyond just the treatment and payment processes. 

The technology driving the healthcare industry has become the cornerstone of success for payers and providers alike. 

From maintaining regulatory compliance and data-driven requirements to automating manual processes, sustaining a seamless tech-enabled experience is fundamental. 

In such a high-stakes industry, slow platforms, processing errors, or development bottlenecks are detrimental. 

Implementing best practices in automation, data processing, artificial intelligence, and cloud computing assist both providers and payers in delivering secure, cutting-edge platforms and solutions. 

Plus, healthcare organizations will be able to better exchange Electronic Health Information (EHI) and meet critical 21st Century Cures Act deadlines

At KMS Technology, we are committed to delivering compliant, cutting-edge healthcare solutions. We offer test management and automation, digital transformation, AI solutions, and more. 

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Digital Front Door: Opening Up a Better Patient Experience

In a world of digital care and consumerism, the power is in the hands of the patient. Consumers have become accustomed to choosing brands by comparing prices, accessibility, convenience, and good (and bad) reviews, and they expect the same experience when it comes to selecting their healthcare provider

The healthcare industry’s digital front door has become a strategic approach for bridging the gap between healthcare operations and consumer expectations. Meeting patients with a seamless technical experience at each point of their healthcare journey is now an integral part of the overall care experience and a vital component of bettering patient care, improving patient retention, and increasing revenue.  

At KMS Technology, we have over a decade of experience in providing innovative software solutions to the healthcare space. We’ve broken down the building blocks of what creates a powerful digital front door strategy and why your hospital system needs to adjust its strategy accordingly. 

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What is a digital front door?

To put it simply, the digital front door is a patient’s primary virtual access point

However, a hospital’s digital front door strategy goes beyond the website and patient portal. It’s offering patients convenience and accessibility at every touchpoint of the patient journey by incorporating the technology that they are already using everyday. This means creating the shortest distance for a patient to go from a quick Google search to scheduling an appointment at a facility. 

Patients want a seamless tech-enabled experience. As a provider with a robust digital front door strategy in place, this means a variety of accessible touchpoints including:

  • Online scheduling 
  • Online billing and payment solutions
  • Text reminders to set appointments and remember them 
  • Mobile check-in and registration without having to download another app
  • Customer surveys following appointments
  • Strong online reviews
  • 24/7 patient access with self-service convenience 
  • Virtual care strategy 

What does the digital front door mean for Payers and Providers?

From receiving care to paying for it, building a seamless technical experience involves both healthcare providers and payers from start to finish. 

Providers

Providers want to improve productivity while delivering better quality of care to their patients. Offering navigable self-service options means that less time is spent reminding patients of appointments and processing check-in papers so that the focus can shift towards efficiently routing patients to the right care based on their symptoms. 

An example is the difference between a patient having to call multiple times to schedule an appointment versus having the ability to set one up at their own convenience.

Cutting out manual hours with easily automated tasks translates to optimized schedules, maximizing revenues to meet financial goals, and reducing inefficiencies throughout the care process. 

Payers

Patients are increasingly looking for more transparency when it comes to making informed decisions about their care options, payments, and billing plans. 

Questions such as “Is my doctor in-network?”, “Is this surgery covered?”, and “Is it cheaper to go to the emergency room or urgent care?” are becoming increasingly common. 

When it comes to interacting with members to answer their questions, payers are looking to engagement platforms. If patients know that they can easily find and answer these questions online without having to call their primary care provider and wait on hold for hours before they receive an answer, they are more likely to digitally engage for future inquiries and requests. 

Offering a trusted, healthcare information platform guides patients to make better decisions for their health and finances, while maximizing operations and efficiencies for payers. 

Investing in Technology

A digital front door strategy requires consistency found through automation and differentiation achieved through innovation. Both providers and payers are looking to automated, cloud-based solutions that are accessible, responsive to patient needs, and easy to use. 

It’s also important to invest in the integrations of your hospital to create a cohesive solution allowing for better customization and support, helping hospitals to deliver on their promise of personalized care.

As patients have more access to care options, payers and providers who adopt will have a competitive edge over those who don’t.  

If you’re ready to improve productivity, increase revenue, and increase patient satisfaction, contact KMS Technology today.

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4 Healthcare Data Security Questions to Ask When Choosing an Outside Vendor

The information security capabilities of outside vendors have been painfully put on display through several large data breaches in recent years. 

Take Marriott for example. Starting in 2014, hackers stole data from 500 million Starwood Hotels users. What’s worse, they remained undetected in the brand’s system until 2018. 

The passport numbers, contact information, and personal data from these customers were breached, leaving Marriott with a massive loss in revenue and the departure of millions of previously loyal customers. 

Had this been a healthcare vendor, the implications could have been even more severe. 

But, how do you ensure your 3rd party vendor is diligent about healthcare data security?

Healthcare Data Security Questions You Should be Asking

We recognize that protecting patient data is a top priority. As an outsourcing company, we understand the importance placed on data security and confidentiality. To help you navigate the world of outsourcing within healthcare, we’ve put together a list of the top four questions you should consider when looking at outside vendors to handle your patient data. 

We’ve also included answers that are sure signs that the potential vendor stands for data integrity. 

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1. What are the employee training expectations and requirements that I should be looking for when considering offshore vendors to handle my patient data?

Our Answer: 

First, a good vendor will strictly adhere to the standard operating procedures of your organization.

They should also require extensive, continuous training on the latest U.S. Healthcare IT regulations for all healthcare resources. 

For example, the training and verification that we provide to our Vietnam team ensure compliance with Business Associate Agreements (BAAs) and other HIPAA guidelines governing confidentiality and patient health information (PHI). Part of the verification process includes:

  • Extensive background checks 
  • Cybersecurity experience 
  • Anti-phishing expertise 
  • Skillset development consisting of:

 

2. What are the latest US Healthcare IT Regulations a vendor’s resources should be trained in?

Our Answer:

 

3. What are ways an outsourced vendor should handle my patient data if their resources aren’t subject to U.S. laws?

Our Answer:

  • Fencing of patient data
  • Sandbox testing
  • Anonymized data sets
  • US-based deployment resources
  • Breach notification process
  • Insurance coverage
  • Protection of PHI/PII

At KMS Technology, we design and build software in conjunction with our customers based on intended use and rarely, if ever, need access to live patient data. 

We leverage years of experience with anonymized synthetic data and test all functionality within sandbox environments using data that has veracity but does not represent actual PHI. 

For implementations where access to PHI is unavoidable, we utilize US-based resources that are trained in and subject to US-HIPAA laws and regulations governing the patient health information and personally identifiable information. 

We also carry insurance specifically designed to address coverage for HIPAA and other confidentiality issues as dictated by law and most BAAs. 

4. What are standard governing laws I should ask the vendor about?

Our Answer:

  • OCR HIPAA privacy
  • Patient data security
  • Anti-breach
  • Breach notification rules
  • Confidentiality
  • Sunshine Act: anti-kickback
  • Stark Law

 

Ready to talk to an experienced vendor who understands the importance of data integrity?

KMS Technology specializes in serving healthcare and IT software companies who are looking to leave their mark on their industry. If you need support to scale or develop your solution, we are here to help. 

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KMS President Josh Lieberman named “Leader in Corporate Citizenship” by the Atlanta Business Chronicle

KMS President, Josh Lieberman, was honored by the Atlanta Business Chronicle as a  2020 Leader in Corporate Citizenship

This new award was developed through a partnership between the Atlanta Business Chronicle and the Corporate Volunteer Council of Atlanta

This image shows the award ceremony for the Leaders in Corporate Citizenship Award. A man stands on stage behind a podium addressing the crowd. To his left and right are two screens with Josh's photo and the KMS logo.

The program honors corporate leaders who integrate giving back into their core operating strategy. These leaders also embrace the positive impact social responsibility has on their businesses, customers, employees, and the Atlanta community.

Recognized as a Board Champion, Josh was joined by the KMS Team at the inaugural Award Ceremony, held on February 25th at the King Plow Arts Center. He was honored alongside executives from PwC and Sysco as well as other honorees across IBM, Fiserv, Aflac, Mailchimp, The Women’s Project, and more. 

 

Josh Gives Back to the Community

To celebrate this well-deserved honor, we would like to share some of the incredible work Josh has done for the KMS culture and the community.

When Josh co-founded KMS Technology in 2009, he wanted to ensure KMS would be a platform to give back to the community. Josh truly believes that company morale and focus starts at the top, and if he genuinely cares about the causes KMS supports, employees will too. 

He started by creating KMS Gives, the philanthropic arm of the company that supports various charities and encourages volunteerism among employees. Josh and KMS committed to the Pledge 1% organization, a nonprofit through which Josh and KMS have committed to giving 1% of KMS’s profits, 1% of KMS’s equity, and 1% of KMS’s time to the community.

One of the ways he gives back is with Per Scholas. In 2014, Josh was exposed to Per Scholas, a national workforce development non-profit that trains unemployed adults for careers in the IT industry. Josh was so inspired that he spent the next two years as the sole Atlanta champion, working with local foundations, community leaders, and church leaders to gather the support and funding needed to bring Per Scholas to Atlanta. Since opening the Atlanta chapter in 2016, Per Scholas has graduated and changed the lives of over 300 Atlantans. 

Josh and his wife, Dana stand with the Director of Per Scholas at an event at a fundraising event hosted by Josh.

He also empowers the KMS community to get involved with Per Scholas, hosting mocks interviews and networking events in the office with the KMS team. 

Of course, the work doesn’t stop there. In 2019 alone, Josh has given back almost 80 hours of his time to the community beating the 1% goal by 400%. He serves on the board of the Paideia School, Virginia Tech’s APEX Center for Entrepreneurs, and the Inter Atlanta Football Club

He has also encouraged KMS employees to give back an average of 29 hours each. With Josh’s encouragement, U.S. employees exceeded our Pledge 1% goal by over 150%. Vietnam KMS employees gave another 2,210 hours of their time in 2019. 

Josh has certainly built a culture of giving here at KMS, and we are so proud to see his hard work recognized. 

Congratulations Josh and here’s to another year of positive impact! 

Want to learn more about KMS or our software development services? 

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