Consumers expect every brand interaction they have, whether at the doctor’s office or with their health insurer, to mirror the ones they have with companies like Amazon and Google: personalized, connected, and convenient. The healthcare industry, however, isn’t nearly ready to deliver on these connected experiences — not while data remains siloed across departments and organizations.
The need for interoperability — getting discrete systems and software applications to connect, exchange, and interpret data — remains an extraordinary challenge for healthcare organizations, yet it is critical to delivering on today’s consumer expectations. However, in order to provide a personalized and connected experience, payers and providers need a complete view of an individual’s interaction history across the healthcare ecosystem.
“This is not our application, but a partner’s application,” explains Umesh Rege, CIO of Capital District Physicians’ Health Plan in Albany, New York. “We use it to make sure chronic patients get the information they need and also to put this information into the hands of primary care providers who can encourage patients to use it,” Rege adds. The foundation for these and other new patient-focused capabilities is a single source of cloud-based data on which special-use applications or services, which are also on the cloud, can be layered.
From social determinants such as living conditions, access to healthy food, and proximity to doctors, to clinical records and lab results, many factors influence an individual’s health. Payer and provider organizations need to get a full picture, across the healthcare ecosystem, in order to improve outcomes and deliver personalized, connected, and convenient experiences.
A New Approach to Interoperability
For years, CIOs have grappled with the complexities of achieving interoperability, especially as it relates to updating or replacing legacy systems. Now, a new approach to healthcare information technology (IT) is underway. Instead of looking to replace or rebuild these decades-old behemoths, healthcare CIOs are transitioning to the cloud by “partnering furiously” with cloud-based solutions, according to a recent Harvard Business Review study, sponsored by Salesforce and Vlocity.
By layering in new capabilities, and integrating data via Application Programming Interfaces (API), IT teams can make more data available across a wider range of users and bring new services to market faster instead of spending precious time wrapped up in software development and complex integrations.
From Provisioning to Procuring
With the digitization of healthcare, the IT department is now more closely linked to marketing, service, clinical operations and healthcare initiatives. In response, the role of the CIO has shifted from operational director to innovation strategist. With this shift, CIOs feel an urgent need to achieve interoperability as a way to connect the healthcare community. Some feel that the only way to get there is to go from provisioning infrastructure to procuring services.
According to the Harvard Business Review study, “Traditional IT departments at health care organizations have neither the skills nor the budget to retrofit or replace these system behemoths to meet the demands of 21st-century health care consumers – nor should they even try,” says John Halamka, CIO of Beth Israel Deaconess Medical Center in Boston.
Today’s healthcare CIOs must double down on key industry partners and healthcare integrations to finally bring true interoperability, via an integrated engagement platform, to their organizations.
The biggest problem with archaic legacy systems is that they don’t process information in a way that’s conducive to the real-time necessities of today’s care providers and payers. Additionally, data is stored and shared across a number of different systems instead of a single platform that connects the payer and member experience. According to the Harvard Business Review study, 62% of healthcare organizations report that between 2 and 10 different software systems are involved when handling customer issues.
CIOs are now enthusiastically embracing the cloud in order to make data more available across a wider user population. In fact, the study indicates that 60% of organizations are specifically focused on expanding their use of cloud technology to drive greater efficiencies and expand services.
“IT’s role is to take business requirements, turn them into procured services, and do the plumbing to make sure those services become workflows,” says CIO Halamka.
Healthcare’s Expanding Partner Ecosystem
Innovative CIOs are expanding their ecosystem of partners in order to consolidate systems and integrate data into one platform, and that helps paint a more complete picture of members and patients.
Even when IT has excellent interoperability within their own organization, healthcare systems must still have a platform on which to consolidate and interpret member data and communicate with external affiliates (hospitals, labs, etc) — not just for greater operational efficiency, but to prevent overlooking vital health information while creating a connected member experience.
Through open APIs, data can be seamlessly integrated from one system to another so payers and providers can see an individual’s full medical history — reducing errors, allowing for greater value-based care, and ultimately providing a modern consumer experience that patients and members have come to expect.
About Kimberly Arnold
As the Global Lead of Payer Strategy at Salesforce, Kimberly guides Salesforce industry strategy and solutions for Healthcare and Life Sciences. She has worked with executives from over 40 health plans to take their performance to the next level. Kimberly brings over 25 years of business transformation experience with the last 12 years focused in healthcare. As the former senior director of Operations and Innovation at Blue Shield of California, Kimberly launched a custom quote to card solution on the Salesforce platform which integrated activities across 22 departments and reduced cycle times by 50 percent.