The patient-centricity era: Five key areas healthcare organizations need to focus on

National Health IT Week is being celebrated all week. As we start to look into the future, it’s clear that healthcare IT will play a major role in the U.S. economy. The federal government spends a total of $82 Billion annually (Sasso, “Hillicon Valley,” The Hill, 9/13). Add in the amount that the state governments and the private entities spend, and the amount could run into trillions. The biggest question is, are we getting the bang for the buck or are we just not getting it? Also, if we take into consideration the millions of dollars wasted every year, we need to ask ourselves, understand the reasons, and have an obligation to fix this issue.

As we celebrate National Health IT Week, it’ll be important to keep in mind five key areas that healthcare IT organizations must focus on:

  • Patients’ data: There has been great interest among the patient community to manage their own health data, somewhat similar to how they manage their finances. Why should it be so difficult to provide up-to-date statuses on patient data that includes lab results, preliminary diagnosis, scans, etc.? Samsung just released a smart watch which aims to accomplish this, and Apple is rumored to do the same. It’s a safe bet that wearable medical monitors will play a large role in the future. However, for any of this to be of use, the patient’s data needs to available and the patient needs to take responsibility.
  • Robust websites: Hospital and insurance providers need to work with IT organizations to create websites that are more interactive and have more robust call to action items. Most hospital websites lack the basic functionality of “Request an Appointment”. It’s a shame to lose patients who are on your website and unable to book an appointment. The question is how hard is it to build ROI for hospitals to revamp their websites? It is very important to display the standard rates for all services offered by the hospital so that the patients can make a smarter decision. In today’s environment focused on transforming the patient’s experience, turning their static websites into more robust, fully functional, customer experience websites, should be a top priority for healthcare organizations.
  • State-of-the-art CRM systems: I am sure that everyone has gone through the pain of dealing with multiple departments within an organization to dispute a claim. The IT systems are so disparate and cumbersome that the operators have to look up for information on multiple systems to get the right information at the right time.
  • Real-time payments: Today, the average time it takes for processing a payment for the services performed is around 90 to 180 days. This is very hard to believe! On the contrary, with the inherent benefits of a real-time payment mechanism, if such a system is implemented, it would be much appreciated by the doctors and hospitals. Also, the highest volume of claims submitted range anywhere from $100 – $2000. So, with real-time payment mechanisms, the risk of overpaying is minimal and the doctors are still within your network. So the question is – are the IT systems capable of processing payments in real-time?
  • Medical Innovation: I strongly believe that the next medical innovation is going to happen in an area that closely relates to new cures and evidence-based medicine. Big data can play a major role here. However, most healthcare organizations are stuck and not making much progress in this area. It’s time that this changes.

We are in an era of patient centricity in healthcare. However, the healthcare ecosystem has a long way to go. It’s the responsibility of every individual within the healthcare IT space to think innovatively and not be afraid to present ideas to the senior healthcare leaders — ideas that will lead to better care management.


This article was originally published on Healthcare IT News on September 19, 2013, and is re-posted here by permission.

Baskar Mohan

Director - Healthcare Practice, Virtusa. Baskar has more than 18 years of professional IT experience with over 13 years of US project experience. He has worked in the Healthcare industry for the past 11 years both on the payer and the provider systems. He has extensive knowledge of the Blues and has worked with them in many corporate initiatives including the HIPAA 4010A1 conversion, SSNE and the NPI project. On the payer side, Baskar has worked on EDI and core claims systems. During his tenure at BCBSMI, Baskar has worked in EDI, Membership & Billing, Facility, Professional, Dental, FEP & NASCO to name a few. Baskar has also very good exposure to the government run Medicare & Medicaid programs and has worked for the Dept of Health Services, Sacramento, California. He also has executed a number of projects in healthcare related to BPM. Baskar is very knowledgeable of the Pega platform and in specific the Healthcare payer framework, Insurance Industry framework & CPM. More recently he has executed projects related Governance, Risk and Compliance using Pega for providers very specific to CoBIT & HIPAA. As a Chief Architect, Baskar is responsible for designing solutions for 5010 & ICD10 solutions. He has created go to market solutions to help customers transition to 5010 & ICD10. As a Program Manager, he is responsible for delivery & execution of all projects both onsite & offshore and currently manages a team of resources. As a Client Services Director, Baskar is responsible for revenues for healthcare book of business, assist the sales team with pre-sales, account radiation and client management. Baskar has experience working with global clients across, USA, UK, France & Netherlands.

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