Building resiliency through a digital health ecosystem
Due to unprecedented challenges, interconnectedness within the health ecosystem has never been so vital. And today’s digital innovations will determine how we connect with consumers to provide and administer care moving forward.
See how five connective channels bring stakeholders across the industry together in support of a more resilient health system.
Intelligent data streams
Combine shared data, predictive analytics, AI and health expertise to provide informed insights.
Digital workflows
Coordinate across segments in real time using shared clinical, claim and patient data within existing workflows.
Care channels
Access health savings accounts, cost estimators, financial planning tools and digital payment options.
Financial pathways
Access health savings accounts, cost estimators, financial planning tools and digital payment options.
Wellness portals
Provide consumers access to health assessments, education, coaching and tools to stay healthy and connect with others.
Intelligent data streams
Intelligent streams gather data from disparate sources to automate complex analysis. With AI, these data streams can anticipate issues and direct activity along the most swift and accurate pathway. This can speed insurance verification and automate patient-generated health data (PGHD) collection. It can also identify underlying patient conditions, predict copays and accelerate claims and payment processing.
Digital workflows
Anticipating, scheduling, documenting, billing and referencing a consumer’s care experience is time intensive. Digital workflows speed information to everyone who contributes to patient care and finance. This enables up-to-date care coordination and scales the use of clinical best-practices. It also supports peer-to-peer review of physician performance and allows for the most informed decision-making.
Care channels
Health happens everywhere. Remote monitoring allows clinicians to monitor and support patients right when they need care. And telehealth allows providers to extend their reach, moving past ZIP codes to connect to any patient with a phone. Portals enhance the patient-provider relationship and make easy communication a tool for better health.
Financial pathways
The average consumer spends about $11,000 on health care costs. Financial pathways provide transparency and help them plan, pay and save for services. These pathways protect the consumer from financial harm. They also protect the provider from bad debt, and remove financial pain points, lifting consumer satisfaction scores.
Source: CMS National Health Expenditures 2018 Highlights
Wellness portals
Employees are more likely to take ownership of their health when they engage in catered services and connect with colleagues. Ultimately, that translates into improved outcomes and higher morale. This reduces their need for an acute care setting and lowers everyone’s costs.
Intelligent data streams
Health plans
Graph technology treats the relationships between data and data points equally. When paired with machine learning, call center representatives can customize services by predicting members’ preferences, helping to close gaps in care.
Providers
Internet-connected remote monitoring devices capture patient-generated health data. This can be shared seamlessly with clinicians for a more robust telehealth experience.
Life sciences
AI analyzes real-world data comprised of millions of records. This data helps identify on-the-market drugs like those that could have a role in the battle against COVID-19.
State government
Secure, instant access to health records streamlines patient information exchanges using FHIR standards.
New service-based modules replace custom-built options for data sharing across vendors and systems.
Consumers
Digital tools can check insurance eligibility, anticipate expenses and suggest lower-cost alternatives. These tools can also streamline prior authorization processes when patients get new prescriptions.
Digital workflows
Providers
Machine learning streamlines repetitive tasks, allowing providers to reclaim time for patient interaction.
Employers
AI provides individuals with relevant health actions through custom messages. This empowers employees and increases benefit program engagement.
Life sciences
Real-world data and clinician insights predict a patient’s eligibility for a study, simplifying clinical trial recruitment.
State government
Real-time data dashboards give agencies a holistic view of vulnerable populations to proactively meet their needs.
Federal government
Cybersecurity and fraud, waste and abuse detection play critical roles in stabilizing Medicare for both active and retired military personnel.
Care channels
Consumers
Secure platforms provide easy access to virtual health visits and ePrescribing to encourage preventive care.
Providers
Providers find new, permanent ways to connect with patients using remote patient monitoring and digital tools.
Life sciences
Consumer health data points inform predictive modeling and machine learning to anticipate and rank saving options. This provides simple, affordable and personalized pharmacy care.
Federal government
AI-powered risk assessments integrate medical and behavioral health data to trigger early interventions. This can help treat Veterans facing substance disorder, PTSD and suicide.
Financial pathways
Consumers
Easy access to pricing, saving and payment tools through a preferred digital channel empowers consumers to save and shop for care.
Employers
Gamification of wellness programs, enabled by wearable IoT devices, boosts incentive to join and lowers health care costs.
Health plans
Machine learning detects fraud, waste and abuse, while blockchain improves information exchange and removes friction in the payment process.
Federal government
Digital portals allow Medicare recipients to project medical and pharmacy spending. This helps seniors maintain their quality of life even as they battle or manage health issues.
Providers
Payer-provider connectivity helps verify insurance eligibility and speeds treatment approval. This accelerates point-of-service collection, reduces denials and improves patient satisfaction.
Wellness portals
Consumers
Virtual well-being, employee assistance and fitness programs equip consumers to take control of their health.
Health plans
Digital engagement platforms enable integrated health through tailored resources and IoT devices. Adding tools like cost estimators and educational resources can help members understand their share of the premium.
Employers
A digital gateway simplifies access to health needs — both mental and physical — and connects employees to their colleagues. This helps them manage chronic conditions through direct digital contact with clinicians and coaches.
State government
Medicaid and dual-eligible populations can quickly view eligible benefits and social services. This promotes holistic health as telehealth and remote monitoring become more routine.
