As we’ve written about in several past Geneia blogs, the healthcare market - while generally seen as slow to move - is being pressured to conform to consumer demands in the way other industries already have. Technology companies have been able to dive headfirst into modernizing healthcare with a consumer-first lens, but the learning curve has been steeper for hospitals and healthcare systems due to existing practices, infrastructure and technology.
From a consumer perspective, the vision for what constitutes a modern hospital experience is becoming increasingly clear:
Patients are customers and expect the technology, personalized experience and convenience they see in other settings.
To create stickiness, health systems should provide a one-stop digital experience that integrates payer, provider, procedure and full network data to provide price transparency and quality ratings to patients so they can make the best care decisions for themselves and their families. Patients should be connected to their providers in a way that makes sense for their lifestyle, whether this means by phone calls, texts, emails or an integrated app.
Additionally, we’ve known for some time that EHRs cannot, on their own, promote patient-provider-payer collaboration or a complete, 360-degree look at individual patients, sometimes with dire consequences. Further, as a final step in improving the hospital experience for patients, analytics should be employed throughout the patient lifecycle to flag those in value-based contracts and ensure that patients with certain risk factors are getting the timely support they need to avoid progressing into a worse disease state.
The Gap Between Hospitals and Today’s Empowered Patient
There are numerous signs that hospitals are not yet completely aligned with these particular consumer demands. Kaufman Hall’s review of healthcare M&A activity in 2018 suggests that as non-traditional competitors become the “front door” of healthcare, hospitals “will increasingly assume the role of cost centers.” Lack of convenience cost savings and an inability to achieve the right site of care—that is, an incapacity to help customers avoid places like the emergency room for less-serious conditions—all play heavily into why hospitals are, again according to Kaufman Hall, challenged to increase their patient volume. In fact, in response to this study, Bruce Jaspen of Forbes maintains that Amazon, Walgreen's CVS, and Walmart are the ones filling a crucial gap for patients, providing accessible, lower-cost sites of care that negate the need for many trips to the hospital.
The Impact of Posting Hospital Prices Online
This particular competitive landscape has put pressure on hospitals to change, and quickly. CMS is aware that cost transparency and patient inability to pay for hospital services are major barriers to care. That’s why in August 2018, CMS announced that, beginning in 2019, hospitals would need to publish machine-readable prices to help patients understand basic costs while also enticing developers to create apps that easily help healthcare consumers navigate and compare various procedure or treatment options.
Given the current competitors and this CMS rule, why have hospitals not moved more swiftly to fulfill this consumer-centric vision of convenient care before retail outlets do? Though at face value the consumer-led vision for hospitals seems relatively straightforward given the existence of numerous patient-facing apps, physician cost and quality platforms, and healthcare payment and analytics solutions, hospitals have not moved as quickly towards a future-state care paradigm as consumers might like due to many, varied barriers.
But even despite such barriers, there are numerous hopeful examples of change as innovative health systems chart their own paths to improving hospital prices and experiences for patients.
- Take, for example, the fact that Cedars-Sinai patients can now access Aiva, a platform backed by Amazon Alexa, to use an Amazon Echo in their rooms. This helps them send requests to staff and control their TVs through technology they are already familiar with from personal use.
- Going even further are health systems that are trying dynamic, out-of-the-box approaches to care, such as Mercy Virtual. Despite a lack of Medicare compensation, the St. Louis area facility is entirely telehealth-based, serving hospital patients within the Mercy health system who might not have easy access to particular specialists otherwise.
Shifting the hospital paradigm to meet consumer needs regardless of geographical location may require this kind of innovation and risk, with health systems moving beyond established models of care.
Providers Positioned to Demand Hospitals Change
Finally, it seems likely that change will come to hospitals and health systems more rapidly as providers exercise their growing power, with modernization efforts sponsored by physicians who want a better, more cohesive healthcare experience for their patients. A recent study revealed that physicians made their affiliated hospitals an average of $2.4 million in revenue annually, suggesting that providers hold substantial financial clout. If providers want to benefit from value-based payment structures in which patient data is key, they will have a vested interest in encouraging their health systems to adopt the IT tools, services, convenient locations and broad ecosystems that serve and engage their end users.
The good news, then, is that despite a long-discussed gap between consumer and hospital vision, competitive forces are challenging hospitals and health systems to move in the direction of patient desires. With some hospitals willing to take risks—and physicians willing to support the IT demands of their patients—the gap between consumer and hospital expectations can continue to narrow.