It’s no secret that the healthcare industry is in the midst of dramatic change. From the constant threat of data breaches to ongoing efforts to harness medical information across various platforms, healthcare technology professionals have a long list of priorities and challenges.
Chief among them is reducing the administrative burden within the U.S. healthcare system. On average, Americans spend $9,700 annually on healthcare. Of that amount, an estimated $720 goes toward excessive administration costs, such as billing errors, Consumer Union reports.
Compared to other developed nations, the U.S. falls far short when it comes to effective healthcare administration.
According to an exhaustive report conducted by the Organisation for Economic Co-operation and Development (OECD), the U.S. spends 17.8 percent of its GDP on healthcare — a figure that’s just 9.8 percent in Australia. On average, administration accounts for 3 percent of total healthcare spending in OECD countries. In the United States, it jumps to 8 percent.
What’s driving these costs? Billing and insurance, says a February 2018 JAMA study. The research found that processing billing for the average primary care visit takes 13 minutes and costs the healthcare system $20. Meanwhile, the paperwork required for an inpatient surgical procedure skyrockets to 100 minutes and over $210.
The OECD acknowledges that healthcare technology is key to boosting administrative efficiency. Here, we take a look at five health information technology solutions that will be vital to bridging the gap.
Combat administrative burden through revenue cycle management products
Executives are turning to solutions that cut through the noise to streamline revenue cycles.
Globally, the healthcare market totaled $51 billion in 2017 and is expected to reach $90 billion by 2022, according to Research and Markets.
Fed up with billing errors and inefficient processes, healthcare executives are turning to revenue cycle management software to improve their processes and integrate revenue functionality within electronic health records. In fact, nearly 30 percent of hospital and health system leaders report that their organizations use at least three systems in addition to electronic health records.
Web-based revenue cycle management services make up the largest portion of this market today. However, as providers increasingly need access to health data from remote locations in real time, demand for cloud-based solutions is poised to grow.
Benefits verification is another huge missed opportunity. According to Managed Healthcare Executive, electronic benefits verification costs just 49 cents per patient, while manual verification costs over $8. Despite this disparity, a quarter of providers are still using manual processes, which can lead to costly billing errors.
Takeaway: By automating workflows, revenue cycle management software can give organizations the efficiency they need to better serve their patients, while dramatically reducing costs.
Rely on artificial intelligence to deal with data deluge
Emerging AI tech will propel the healthcare industry forward by effectively processing huge quantities of data.
Healthcare providers are surrounded by data. According to PwC, there were 4 trillion gigabytes of health data out in the world in 2013 — and that figure is set to grow ten times by 2020. Artificial intelligence allows us to make sense of this unfathomable amount of data. For example, machine learning, a subset of AI, can uncover patterns across large swaths of data to optimize the healthcare system.
Over the next decade, artificial intelligence will also drive important medical solutions. AI can dramatically improve the accuracy of screenings. It has already made mammograms 30 times faster (at a level of 99 percent accuracy). AI and analytics programs can work together to digitally represent human physiology, showing the projected evolution of a disease, allowing doctors to tailor treatment plans based on actual projected outcomes.
Savvy executives are also leveraging the power of AI to reduce inefficient and expensive administrative work.
Operating on Amazon or Google cloud platforms, AI can be used to automate bills and claims processing. When combined with robotic process automation, it can also help organizations eliminate redundant processes and automate patient support functions, reducing costs and labor.
Organizations like Beth Israel Deaconess Medical Center are already using machine learning to predict which patients won’t show up for an appointment. Once they identify likely no-shows, they can intervene beforehand.
Takeaway: By leveraging AI, healthcare organizations can automate and streamline administrative functions, improve clinical decision-making and even help prevent disease.
Use blockchain to improve record-keeping and claims
Blockchain offers a secure way to integrate healthcare data and streamline claims processes.
In an era of privacy breaches and hacks, protecting patient data is a top priority. That’s why so many health IT experts are excited about the promise of blockchain-based technologies.
Blockchain solutions offer a secure way to store all records for a given patient in a single, decentralized ledger. Because it’s a log of transactions that are duplicated across various decentralized locations, these ledgers offer a secure way to store and track data. The technology is uniquely suited to storing the data of patients who utilize multiple hospital and provider systems, acting as the “glue that holds together a highly fragmented healthcare record.”
Blockchain can also play an important role in the claims process. Because it works as an exchange based on validation, a claim can automatically be verified by the network. It works like this: a contract is first recorded and verified on the blockchain; then, when a claim is submitted, the blockchain will ensure that only valid claims are approved and paid.
Finally, blockchain technology can better prepare healthcare networks for audits. Because all the billing data is securely stored, it’s easily available as needed should an audit arise.
Takeaway: Clearly, blockchain technology has the potential to transform the way healthcare organizations store patient data. But it also offers big benefits for streamlining the claims process. And for health professionals looking to integrate data from multiple platforms, it’s the ideal solution.
Tap into the power of mobile apps
The computing devices in healthcare pros’ pockets aren’t just convenient; they’re also helping reduce the administrative burden.
Smartphones and tablets have transformed medicine, just as they have transformed almost every other field. According to the journal Pharmacy & Therapeutics, healthcare professionals use five main types of mobile apps:
- Health record access and maintenance apps allow providers to add information to electronic health records and view documents such as medical image scans.
- Communications and consulting apps allow professionals to communicate with their colleagues in other clinics or wards; for example, a HIPAA-compliant app called Doximity is billed as a “Facebook for doctors.”
- Reference and information gathering apps give professionals easy access to medical literature and other relevant resources.
- Administration apps allow providers to operate more efficiently; for example, an app called HanDBase tracks patients’ diagnoses, billing details, and other information.
- Medical education apps are increasingly being used in educational settings and in trainings.
These technologies allow various departments within the healthcare ecosystem to coordinate. Apps such as PatientTouch connect both clinical data with enterprise management. Care teams can share clinical workflows and communicate about the patient care plan, while simultaneously allowing administrators to track analytics.
Other apps are focused solely on integrating disparate workflows to cut administrative costs. One developer, DSS Inc., has created a suite of mobile apps that integrate electronic health records with other administrative systems.
Takeaway: Just over a decade since the iPhone debuted, smartphone apps are now ubiquitous. Their power can help healthcare organizations integrate workflows and reduce administrative headaches — all with just a few taps and swipes.
Streamline the back office with business-process-as-a-service solutions
BPaaS vendors can help organizations make sense of their data.
When the back office is bogged down in data, an organization can’t make strategic decisions. This realization is leading many healthcare organizations to seek out business process-as-a-service (BPaaS) vendors. Health Data Management estimates that 20 percent of commercial operations will sign onto BPaaS contracts by 2021.
These cloud-based solutions offer end-to-end process support, which includes both software and people processes such as contact centers. Payroll, finance and accounting, human resources and other functions are prime candidates for outsourcing, Becker’s Hospital CFO Report notes. Outsourcing these functions can help health systems cut costs, create global delivery models and provide secure data access.
Takeaway: Outsourcing expensive business processes can help healthcare providers focus on what matters most: providing the best patient care.
Bottom line: Healthcare administrative costs are no joke. Both hospital executives and IT leaders alike should be doing everything they can to reduce the administrative burden on the healthcare system.
Let’s recap some ways you can start:
- Combat administrative burden through revenue cycle management products
- Rely on artificial intelligence to deal with data deluge
- Use blockchain to improve record-keeping and claims
- Tap into the power of mobile apps
- Streamline the back office with business-process-as-a-service solutions
While not an overnight solution, gradually incorporating these changes can set your organization on the right path to efficiency, costs savings, and an improved patient and staff experience.