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Gartner Symposium/ITxpo 2014: The Digital Healthcare Model

The Influence of Digitalization on Patient-Facing Services

Sandeep Khare's avatar

By: Sandeep Khare

October 8, 2014 | EventsAnalysts

Here at Gartner Symposium/ITxpo in Orlando this week, “Digital Business” and “digitalization” are the buzz words that are consistent throughout the presentations. In a keynote session, Peter Sondergaard, Gartner SVP, Research, declared that we are now living in a “Digital Industrial Economy” with millions of new devices coming online every year. This connectivity is resulting in an explosion of digital data and is enabling people to interact with the machines and with each other in ways as never before. He encouraged attendees to adopt a “Digital First” strategy whereby physical assets can communicate and share data with virtual systems, blurring the boundaries between the physical and the digital world.

Similarly, in a session presented by Steven Lefebure, Gartner analyst and Managing VP, the focus was on the digitalization of the healthcare environment. The session emphasized how digitalization will allow patients/consumers to interact more closely (almost in a collaborative manner) with the payers and the providers, will create more transparency and will give consumers better control and insight into their medical data and overall health.

According to Steven Lefebure, the healthcare model consists of two major segments: Health Management and Care Delivery.

Health Management

This relates to the business of healthcare, finances and accountability. It is more incentive driven.  Key business solutions that fall within this segment are:

  • Patient/Consumer Engagement
  • Exchanges (Public and Private)
  • Billing, Claims, Revenue Management
  • Hospital Operations

Within Health Management, the digitalization of the patient/consumer engagement will be significantly influenced in the following areas:

Payer Engagement

Payers engage with the consumers by supporting their insurance needs; identifying needs and risks; providing preauthorization; simplifying claims, billing and administration; care management; and providing wellness incentives.

Provider Engagement

Providers may engage with the consumer/patient by creating digital ways to find the right network of doctors; setting up online appointment; providing personalized medicine; and performing diagnostics, care delivery, treatments, and drug therapy.

Consumer Directed

Consumers may want to control their own health care by using tele-assistance services; self-monitoring; nutrition, wellness, health clubs; and using online medical information resources.

Other Relationships

Consumers also might seek support in terms of social networks, communities, forums, pharmacies, care giver, family, etc.

Care Delivery

This segment relates to delivering the value of health and relates to the actual clinical practice of diagnosis, treatment and outcome. In contrast to Health Management, Care Delivery is more knowledge driven (think knowledge worker). Key business solutions that fall within this segment are:

  • EHR (Electronic Health Records) and HIE  (Healthcare Information Exchange)
  • Telemedicine and Telehealth

Digitalization of the Care Delivery capabilities has a potential to transform the way payers provide services and the way consumers consume those services. Let’s look at some the possible services that can evolve as part of this digital evolution:

Payers Engagement

Payers can serve the needs of consumers in the Telemedicine/Telehealth segment using a variety of channels, including the following:

  • Remotely by providing monitoring and diagnostics services.
  • Virtually by enabling consultation services with the physician/clinician, diagnosis prescription services.
  • On-demand by making labs, referrals possible as needed.
  • By pushing relevant medical information, educational material, self-care content, etc.,  on to the mobile devices (smart phone, wearable fitness devices).

Also worth noting – and another hot topic at this year’s Symposium is the role wearable technology will play. Wearable health monitoring devices can play a critical role in Care Delivery. By monitoring key body metrics such as blood pressure, heart rate, alcohol level etc., these devices can then generate alerts to the consumers or send out messages to the emergency responders and primary physician in case of a medical emergency.

EHR Evolution

EHR have the potential to transform from just a collector of data to a system that can act as a mentor. Such a transformation may lead to a major redesign of the underlying business processes and implementation of new rules/policies. Digitalize EHR systems may utilize the power of data mining combined with the latest technologies of predictive analytics to anticipate and predict the next course of action for the patient. Similarly, EHR systems can be designed to communicate with medical devices and hospital equipment to automatically check their availability (think Internet of Things) and then, based on a patient’s electronic record, generate necessary notifications for the nurses or physicians.

I believe the healthcare market is at the cusp of digital transformation and in some ways this process has already begun. Vendors deep into the healthcare field or those trying to gain a foothold need to realize the power of digital business and its implications for the end users. Organizations (product vendors, payers and providers) must realize that digital healthcare model is not just about storing everything in an electronic form or about automating the business processes instead it is more about how you serve your customers by leveraging the entire technological landscape of social, mobile, cloud and big data.

MicroPact’s entellitrak, a unified platform for Case Management and Business Process Management that is available with fully integrated Document Management, Natural Language Analytics, and Mobile Modules, is already serving the healthcare market as enterprises embark on the digital future.

Whether based on-premises or in the cloud, entellitrak’s Data-First™ approach allows it to be implemented immediately and configured continuously, enabling customers to get to work quickly while keeping costs low. To find out more about how MicroPact works with healthcare enterprises or to request a demo of the entellitrak platform, contact a member of our team.

About the Author

Sandeep Khare worked at MicroPact from 2003-2016, most recently in the Marketing department.