Industry Voices—Addressing minimum disruption, process efficiency and customer satisfaction

Be the disrupter or get disrupted! That’s precisely been the mantra across industries for the past few years. The healthcare industry too was transitioning through the disruptive time pre-COVID, but the pandemic has pushed it into overdrive and exposed how digital transformation was long overdue. With evolving consumerization changing the way services are being delivered, today's healthcare stands at an intersection of scientific innovation, next-gen technologies and the need for new delivery and care models.

Barriers to healthcare delivery and access

Today’s informed patients—or, rather, millennials—are willing to play an active role in their treatment processes and lifestyle management and need instant gratifications. However, healthcare providers are struggling to meet their demands. Providers are looking for more visibility and control over cost and utilization. On the other hand, payers are looking for a more holistic approach with alternate payment models, coordinated care and value-based compensation. The increase in the aging population, need for low-cost virtual care models, high costs and rising chronic conditions have been further burdening the current healthcare model. U.S. healthcare spending is expected to increase from 17.8% of GDP in 2019 to 19.4% in 2027.

In a nutshell, there is a growing realization among healthcare stakeholders that the existing legacy infrastructure and processes are not working. The traditional care model is reactive, and the absence of customization options in the current healthcare system and payment models has led to inefficiencies in the healthcare ecosystem. To accelerate toward a consumerized and personalized healthcare model, the shift toward a new healthcare ecosystem is imperative.

Payers and providers must make the shift with technology as the key enabler

For better outcomes, the patient needs to be engaged in the healthcare journey. The existing fragmented, linear traditional value chain may no longer work, and a collaborative approach is the only way forward: solutions that unite patients, payer partners, providers and communities. However, achieving this would require the healthcare industry to reimagine the future of work as well as care delivery while investing in future-proof technologies like automation, analytics, AI/ML, cognitive, IoT and blockchain, among others. Leveraging big data analytics tools, EHR and EMR can be used to collaborate effectively with patients. Low-cost care models like telehealth are easily accessible, enhance chronic care and treatment outcomes, post discharge monitoring and so on. Digital technologies can be harnessed by providers to engage patients, improve efficiency in care management and optimize treatment options. On the other hand, payers can leverage next-gen technologies to build customer-focused products, perform real-time interventions, enhance care management and better handle disputes as well as streamline information.

Investing in AI and digital technologies is critical more than ever

Needless to say, the future of healthcare is fundamentally data-driven. AI can be harnessed to derive valuable insights from the voluminous data generated by the healthcare industry. With innovative medical intelligence, it is easier to take predictive measures and make real-time interventions across care and well-being. This can help connect the dots and make right decisions at the right time, enhance process efficiency and customer satisfaction, and predict potential complexities and risk profiles. In nonclinical operations, AI can help health plan administrators improve resource utilization, save time and increase productivity—thus helping organizations evolve and adapt to changing healthcare requirements. The entire healthcare ecosystem across providers and payers can use these lessons to implement the best possible solutions going forward to not just survive, but thrive in the post-COVID new normal.   

The way ahead

The need for operational efficiency and minimized costs, especially in the pandemic induced new normal, is going to drive widespread adoption of emerging technologies. As health systems and health plans reemerge from the response to COVID-19, a connected healthcare system that unites all stakeholders to provide instant response to crisis is the way ahead. AI and digital could be the key drivers in enabling better patient outcomes, optimizing costs and enabling proactive management along the patient journey.

Venky Ananth is a senior vice president and global head of Infosys’ Healthcare Industry Vertical.