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Key Steps for Opening the Digital Front Door, Digital Transformation

The digital front door is anything but a door. It’s a wraparound patient journey that connects them to care across the continuum.

The digital front door isn’t just unlocked; it’s opening wide, and healthcare organizations that want to remain competitive need to figure out how to make it an entrance to a wholly connected patient journey.

“This is an industry that has long been considered a technology laggard of sorts over the years,” Mutaz Shegewi, IDC Health Insights research director, told PatientEngagementHIT in an interview. “Healthcare has always been slow to adopt cutting-edge technology and to keep up with its peers in the other industries.”

But in recent years, mounting pressures have changed that. The rise in chronic illness, the aging of the Baby Boomer population, and the shift to value-based care have pushed many organizations to rethink the way patients engage with their care and assess the role that health IT plays in that.

There have also been emerging challenges along the way, Shegewi noted, including managing the height of the COVID-19 pandemic and the vaccine rollout processes that followed.

And in the future, the industry will have to respond to new challenges that might not be a problem now, but are certainly gaining steam. The clinician shortage, especially in primary care, is set to burden the healthcare industry and put immense pressure on providers.

“There's also the long-term rise of consumerism that has already been taking place,” Shegewi added. “The expectations of individuals and healthcare have been higher and increasing over time, based on experiences in day-to-day life and in other industries.”

“When you shop on Amazon, there's a certain expectation you have around kind of the convenience of being able to select your product and the delivery time,” he offered as an example. “When you get a ride through Uber or Lyft, similarly there is an expectation of convenience.”

Importantly, digital transformation puts the patient in the position of power as a healthcare consumer.

“That status quo where healthcare was all about the paternalistic relationship between the doctor and the patient, where the doctor was the center of the universe—not anymore,” Shegewi asserted. “Healthcare is being heavily impacted by technology. The doctor is still a very important central part of that universe, but so are patients. So are care-seeking consumers. All of them should be empowered by technology that facilitates that relationship and takes it to a different level.”

“It's not the patient that needs to meet the service, or identify the touch points where they might be; it's the other way around,” he added. “That's what will drive the convenience necessary, the proximity that is necessary, the expectations that needs to be met.”

Although not the origin, the COVID-19 pandemic did have a big impact on digital transformation, Shegewi acknowledged. According to IDC Health Insights data, the average healthcare organization completed two years’ worth of digital transformation during the first two months of the pandemic. The industry is starting to catch up from that “laggard” status with better call center technology, online symptom checkers, and telehealth for chronic disease management.

But the digital front door is more than just an entry point—in other words, it’s not just the digital way patients first access and register for their care, although that’s an important part of it, too. According to Shegewi, the digital front door is a wraparound experience that changes the way patients get to engage with their care.

“A digital front door is anything but a front door,” he noted. “It's much more than that. It's a technology vehicle. It's a fabric. It's a layer that spans from and that scales that digital and virtual care journey to meet the patient where they are.”

Currently, most healthcare organizations are fixed in one part of the digital transformation, Shegewi said. That point could vary between organizations, but most have generally stuck with patient access points. This could refer to online appointment scheduling and digital provider directories, streamlined call center technology, digital wayfinding, or even digital patient intake kiosks or patient portal tools.

It’s not as though organizations are ignoring digital transformation—Shegewi noted that many clinicians recognize and advocate for the importance of virtual patient engagement—but they are hamstrung by competing patient demands and hospital capital.

Because at the same time this digital transformation is going on, healthcare facilities are also focusing on the social determinants of health and how best to drive health equity. And with a widening digital divide, it can be hard to reconcile how technology can help support all patients, including those with the most basic of needs.

“There's a huge educational piece to alleviating some of those challenges, both for providers and patients,” Shegewi said. “A provider must be made aware that there is a certain technological solution that can alleviate some of the social determinants of health.”

Take, for example, the rise of rideshare companies in the healthcare sector. EHR integration with platforms like Uber Health and Lyft helps patients with transportation barriers to connect to care. This is all a part of building out that digital front door, Shegewi said.

“If a provider is aware of that, it's more than likely that they're going to be taking advantage of that,” he explained. “If a patient's made aware of that and the benefits, and particularly sometimes there are incentives that go into that, they will probably be utilizing that too.”

That education piece can help guide capital investments, Shegewi added. Most healthcare organizations are playing with a limited budget that nearly always has to go toward infrastructure spending.

“But again, if you think about providers being decision-makers, being more educated on the benefits of cutting-edge initiatives and these new kind of pandemic driven use cases like digital front door,” Shegewi offered. “With that awareness, and with that understanding and with the proper buy-in and collaboration between teams, a lot of those challenges around digital transformation can be alleviated.”

To get there, organizations need to assemble the key stakeholders in digital transformation projects, ranging from clinical IT leaders, to business teams, to consumer stakeholders, to the patients.

“There needs to be an initiative to first, map and outline of all the existing digital touchpoints in the service and to identify any gaps,” Shegewi recommended.

This needs to be extremely patient-centric. Understanding patient and consumer needs will help organizations better understand where they currently are in the journey toward opening the digital front door.

It's going to be very hard for provider organizations, especially nowadays, to do everything at once,” Shegewi cautioned. “They might prioritize the front end, if there's nothing there already.”

Many organizations have already built out telehealth capabilities or a mobile app, but for those that haven’t, those are good places to start, Shegewi suggested. And for groups that do have a suite of patient-facing tools, they might want to consider the integration or interoperability hurdles that still exist so they can unify that digital front door.

From there, organizations can consider the health IT vendors with which they want to partner. Decision-makers should consider vendor technologies and capabilities, vendor references and other end-users, as well as success stories and case studies.

“It sounds like at times, every vendor has a digital front door solution,” Shegewi noted. “But when you look into it and you start to peel the layers of the onion, you start to identify that there are different interpretations of what a digital front door is.”

It is essential to consider that map the organization built with its stakeholders and see if the vendor can actually help the organization navigate. Those making the technology purchases should question the organizational vision, the capabilities being offered, how those tools can link with others the provider already has, and which tools are actually feasible—especially financially—for integration.

Finally, stakeholders and vendors should consider outcomes. Shegewi uses the mnemonic CQASE—cost, quality, access, safety, and experience—to assess whether something will work or whether it’s currently working.

This effort will hinge on consumer needs, Shegewi said. Although the digital front door leans on technology solutions, he explained it’s ultimately about humanizing the patient experience.

“It has to do with understanding the person, that's where it all begins,” he concluded. “It's understanding that at the heart of all this is, whether we want to refer to them as patients or care-seeking consumers, families in some instances, or perhaps even populations, there needs to be an understanding of the person. That will humanize the plan or the experience.”

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