A mom wakes up in the morning to find out that her young son feels sick. She takes his temperature and pulse on her smart watch, which is connected to her health system’s patient app on her smartphone. Sure enough, he has a high fever and his heart rate is elevated. The app, connected with her son’s patient records, runs through his medical information and advises her to take him to the doctor.
Her son’s pediatrician is not in the office nearby that day, but another in-network doctor at the same building has openings, and the app notifies her. She opts for the convenience of the new doctor and taps on an appointment time. The app asks for consent to share her son’s medical information with the new doctor. After she gives it, the app tells her how long her drive will be, pulls up the directions, and checks her son in before they arrive.
This scenario may sound far-fetched, but the tools to make it a reality already exist. It requires an orchestrator to help connect the provider and the payor and to integrate the applicable third-party apps to help deliver one product that can offer patients this type of fast, convenient and seamless experience.
Now imagine that at checkout, the mother is told the visit costs $75, even though the normal co-pay is $25. She pulls up the app, and it shows her that the $50 difference is for a service that will go toward her remaining deductible. She pays electronically, and her deductible is updated automatically. The doctor has already electronically submitted her son’s prescription to the family’s preferred pharmacy, and on her way home, the app notifies her that it’s ready for pickup.
From start to finish, the mother and son have had a fast, convenient and seamless patient experience. The scenario is just one example of what can be accomplished when providers and payors come together to use cloud-based technology to put patients at the center of the care journey.
According to PwC’s 2022 Digital IQ Survey, two thirds of companies have realized value from digital investments to create better consumer experiences. Crafting a unified digital consumer engagement platform benefits all three stakeholder groups: consumers, providers, and payors.
1. Consumers
Beyond offering convenience for consumers, a cloud-enabled system can improve their outcomes. Having their medical, health benefit, and cost information at their fingertips enables consumers to engage in healthcare decision-making in a way that was likely impossible before. Digital tools can make it easier for them to communicate with their care teams; schedule and receive care when, where and how they prefer; and track progress toward their goals. In our scenario, the app could have just as easily given the mom the option for an insurance-covered video visit with her son’s regular pediatrician, automatically added it to her calendar, and connected her with the doctor’s office at prescribed time. It could have allowed her to use an enhanced camera on her phone to share photos of her son’s mouth and another app through which the doctor could listen to her son’s heart and breathing so the pediatrician could make a diagnosis on the spot. In all, digital tools can enable consumers to own their care journey and improve their health.
2. Providers
The ability for providers to offer a convenient, seamless care experience through an easy-to-use app can increase patient satisfaction and loyalty. Having patients’ medical, health benefit, and cost information on a cloud-based platform enables physicians to have richer conversations with patients and to assist them in making informed decisions at the point of care—which can improve care and the patient experience. Physicians also would be better able to help track patient outcomes and avoid unnecessary, duplicative or inappropriate treatments—putting them in a better position to succeed as value-based care continues to catch on.
3. Payors
Payors stand to improve relationships with members and providers by participating in the cloud-enabled system. Members would be more likely to seek care inside the plan’s provider network, giving the payor more power to control costs and care quality. Members also would be less likely to be surprised by higher-than-expected bills, which can improve their satisfaction with their providers and health plans. A reduction in unnecessary, duplicative or inappropriate treatments would likely generate payor savings, and their provider organization partners would be more willing to engage in value-based care arrangements.
At a time when consumerism and patient experience are the name of the game in healthcare, the ability to help provide patients with a convenient, seamless and high-quality care experience can offer a distinct competitive advantage. Not only that, but it equips consumers, providers and payors with tools that enable them to improve outcomes and lower costs.
Whether looking to personalize patient care or elevate your health plan’s value to your members, providers and community, it’s about focusing on delivering quality care outcomes. Ready to approach healthcare differently? Explore how PwC and Microsoft Cloud for Healthcare are helping deliver better experiences, insights and outcomes.