Every patient embarks on a journey when they receive healthcare. However, they are not on this journey alone. The experience is shaped, informed, and driven by multiple other journeys that providers and payers pursue alongside the patient. All these pathways are interrelated and can positively or negatively impact one another depending on how consistent and reliable they are. Having an infrastructure in place that can optimize each of the journeys and smooth out points of friction between them is critical to transform healthcare as an industry and make it more cost-effective, efficient, and value-driven.
The first part of this three-part series focused on the pre-visit aspect of the patient journey. This article delves into the visit portion, examining how the clinical, financial, and engagement pathways come together to move the patient, provider, and payer toward better outcomes.
Enabling service, error-prevention, and efficacy
The healthcare visit is the in-person portion of the patient journey and the time when providers have the most interaction with the patient. This phase presents a prime opportunity to influence the encounter’s financial, clinical, and engagement outcomes. It should be defined by great service and focused attention on the patient. Simultaneously, the employee experience should be a priority with emphasis placed on helping staff do their jobs more effectively and avoid error.
More than a decade ago, the Harvard Business Review published a seminal work that explored the idea of the service-profit chain. This theory creates a clear link between the front line employee experience and the ability of companies to attract and retain customers and grow. Incorporating this concept into the patient visit stage means that providers and payers should be doing everything they can to streamline and simplify the employee experience and provide meaningful data to aid in decision-making. By making employees’ jobs easier, organizations can free staff to engage with patients and deliver high-touch service and care. Moreover, empowered employees are motivated, engaged, and consistently perform at the top of their skill levels, which can not only spur patient and staff satisfaction but can help the organization operate more efficiently and effectively overall.
Taking a hard look at workflows is a good place to start
A key part of re-envisioning the patient visit involves reimagining core workflows. From a business perspective, this may include financial clearance, documentation and coding, sharing medical records, and claims submission. The goal of improvement in these areas should be to make sure that all the necessary information is present in clinical and financial systems before the patient leaves the facility. This improves decision-making and creates efficiencies that enable appropriate and timely patient care, simplify reimbursement, and prevent denials. From a clinical standpoint, there should be an emphasis on facilitating better decision-making. Not only does this work support high-quality, compliant care, it can also make that care more efficient, taking costs out of the system and getting patients back on the road to recovery faster.
Advanced technologies, such as artificial intelligence (AI) and machine learning, can simplify many of these essential tasks. On the financial side, such solutions can remove some of the cumbersome manual work associated with charge capture and documentation, boosting accuracy and efficiency. On the clinical side, disruptive technology can streamline key functions such as imaging. Using smart technology to read, triage, and prioritize radiological images, organizations can reroute workflow so that radiologists review the most clinically urgent studies first. This speeds critical information to providers and patients and can also serve as a helpful double check for radiologists, taking some of the pressure off staff and injecting more reliability into the process.
Leveraging a multifaceted infrastructure
- Quickly verifying medical necessity
- Fostering collaborative care
- Optimizing workflows for speed and scale
- Improving diagnostic speed and accuracy
- Accelerating treatment decisions
Transparent and responsive communication and data sharing are paramount to reaching these goals. Working with solutions that span patient, provider, and payer perspectives is crucial during this time to make sure every party has the necessary data and tools to improve performance. When those tools are rooted with innovative and emerging technologies, it can speed progress and effectively move the patient, provider, and payer further along their journeys. In addition, when processes are performed effectively during this phase, it sets up a smoother post-visit experience for all three constituents.