By Naman Kher, D2M and Giri Rajaiah, DISYS
Whether it’s improved patient care, revenue capture, regulatory compliance, enhanced partnerships, accelerated time-to-market and more – it’s projected that 2022 will be a pivotal year for healthcare digital transformation. Top of mind for healthcare CIOs and technology leaders will continue to be how to make healthcare data help – and not hinder– a myriad of goals. With the many intersections across the healthcare workflow and data spectrum – such as patient, provider, payor, regulatory/legal, and collaboration with governmental and international health initiatives – each data touchpoint might provide actionable insight. However, left unchecked, this data presents the potential for exacerbating the issues that its retention is meant to avoid. Greater data visibility will make it easier for stakeholders across the care continuum to harness the potential offered by these insights, both big and small.
Pain point: 80 percent of healthcare data remains unstructured
It’s estimated that 80% of existing healthcare data remains unstructured. Adding to the complexity, healthcare (across all of the touchpoints and myriad intersections) was one of the sectors most impacted by the COVID-19 pandemic; disruptions amplified vulnerable processes requiring new solutions providing secure virtual interactions. That’s where digital transformation comes in.
What is “digital transformation?”
Digital transformation in its broadest sense relates to leveraging new technologies, talents and processes to improve business operations.
Yet, this is not a magic wand and two common pitfalls relating to digital transformation often hinder organizations. The first can be ignoring digital transformation entirely, which can result in eroded market share, lack of innovation, damaged reputation and care delivery. The second is the assumption that these tools alone drive transformation. Without also addressing People and Process – “the two P’s” – the potential to capitalize on technology advantages is greatly diminished. It’s critical that firms identify and develop skilled talent to leverage technology and challenge the status quo, thus improving user experiences.
For example, one of the nation’s largest laboratory system and a leader in clinical laboratory testing, performing more than 97 million diagnostic tests each year, was experiencing significant issues in their claims processing operations. Due to a lack of staff, only being able to work within a manual system, and resources, the organization was falling behind and unable to address follow-up for claims sent back for review. Claims processing was only being completed at a 10% rate, resulting in a loss of $750K in revenue. Not wanting to ignore the need for innovation, the organization explored a solution that would speed up the claims processing system presently while ensuring reimbursement for the lost revenue and scalability for the future. Maximizing the benefits of intelligent process automation, the organization used process optimization to identify and validate process pain points to streamline processes and integrate workflows from front & backend systems. The second part of the solution the organization implemented was process automation. A bot was developed to automate the end-to-end process to audit and resubmit outstanding claims to allow for consistent follow-up of pending claims and increased process adherence. By leveraging digital transformation expertise, coupled with intelligent process automation technology, the organization increased its process consistency by 89%, streamlined claims follow-up, increased revenue by $1 Million annually, and delivered a scalable solution that could be implemented in other departments of the organization.
2022: Challenges and Opportunities
Critical challenges facing global healthcare IT leadership include: the need to accelerate operational and technological agility; the ability to improve collaboration internally and across relevant partners in the continuum; increasing data visibility and streamlining workflows; and ultimately to serve as change agents (such as driving innovation and addressing new top-line digital market trends.)
Here are three significant areas of opportunity leaders can prioritize:
Streamline clinical communications, content and collaboration.
Across the provider continuum, more organizations are deploying solutions facilitating real-time patient data and seamless collaborations across care teams. Providing content relevant to patients’ lived experiences will support clinicians in their quest to deliver accurate and accessible healthcare information. These will be key to building stakeholder trust in an information-saturated climate. Again, it’s critical to keep top of mind any regulatory touchpoints (i.e. HIPAA) which may impact workflow and collaboration; thus robust data security is paramount.
Make sense of the data: visualize, analyze and act.
For drug developers and manufacturers, enhanced data visibility can drive improved drug development by identifying patterns and clinical study trials and predicting patient responsiveness to medication in the process of analyzing diagnostic results. Machine learning algorithms can be harnessed to analyze drug effectiveness viewed through the lens of optimizing future development initiatives. There’s promise in predictive medicine initiatives utilizing artificial intelligence in the analysis of tests and medical records and tracking the effectiveness of different therapies on patient groups over time. In this instance, the landscape is still complex – however, progress is possible with the right partners, especially those with regulatory expertise.
Leverage cloud-based solutions to expedite app modernization and development.
In 2021, several healthcare companies across the healthcare continuum including payors, providers, med devices, pharma and life sciences and healthcare technology, etc. deployed cloud-based DevOps solutions. A fundamental reason for adoption is to embrace digital technologies to provide more operational efficiencies to their business, better customer experience and agility to launch new products and solutions in the market. In these efforts, organizations were able to quickly promote customer facing applications and expose data and backend applications safely to enable interoperability. These efforts increased efficiency, collaboration and productivity – resulting in improved customer experience such as faster access to care, multiple safe options to engage (mobile, web, phone, etc.) and improved revenue generation through automation.
As we continue into 2022, global uncertainty and downstream market factors will continue to impact IT investments and involvement. As healthcare organizations move along their digital transformation and data journey, it’s worth keeping in mind that in order to maximize the touchpoints for triumph, and minimize the touchpoints for trouble. No matter the type of organization, the need to effectively leverage data inputs from multiple streams is critical. Within the 80% of globally unstructured healthcare data resides either the promise for positive change or – if not harnessed correctly – a continuation of unfulfilled potential.
Digital transformation is a powerful catalyst for change, but only if it’s coupled with process change and robust people skills.
Naman Kher is the Director and Head of Digital Transformation of D2M and Giri Rajaiah is the Vice President, Healthcare & Life Sciences of DISYS. For more than 25 years, D2M (DISYS Managed Services division), has delivered measurable results for its enterprise and quasi-government clients by building custom implementations to meet clients’ individual IT needs. In conjunction with product innovators and thought leaders, D2M continues to surpass the boundaries of technology and objective-based innovation. For more information about D2M, visit www.d2mservices.com.
The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.