Insurers' journeys to build a mastery in the IoT usage
Â
Create the Ultimate Patient Experience
1. A Vision: How People Should Access
& Experience Their Healthcare
Providers
2. Š Pale Rhino Consulting. All Rights Reserved. 2
Pale Rhino is an execution-oriented business consulting and technology solutions company focused on enabling
healthcare providers and payers to disrupt patient and customer experience and access.
Business Facts
⢠Founded in 1996
⢠Headquartered in the Philadelphia area.
⢠National presence and international reach serving clients on five continents and representing firms with a
combined customer base of more than 200 million
⢠Diverse workforce comprised of industry, global consulting, Big Four,
professionals
⢠Fast access to a powerful network of trusted partners with solid industry experience
⢠Unique blend of industry clients
About Pale Rhino Consulting
3. Problem Statement: It is difficult for patients to do business with providers
⢠Most stakeholders do not have easy access to their provider
⢠If someone encounters challenges when attempting to access a provider they are less likely to purchase healthcare
⢠The majority of access issues are non-clinical
⢠Detailed data and feedback about the majority of patient interactions with their providers is not captured
⢠The majority of a providerâs stakeholders are unaccounted for under HCAHPS
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HOW PEOPLE RATE THEIR PROVIDER EXPERIENCES
4
Ease of Access
Process
Transparency
Mobility
Customer
Service
Process
Efficiency
Process
Consistency
Clinical
Outcomes
Continuity
of Care
5. THE EXPERIENCES AND SATISFACTION OF MOST STAKEHOLDRES ARE NOT KNOWN
5
Patient
Personas
Prospective
Patient
Inpatient
Outpatient
Discharged
Patient
Former
Patient
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6. PROVIDERS DO NOT KNOW THE EXPERIENCE OF MOST OF THEIR STAKEHOLDERSâ
EXPERIENCES
6
HCAHPS Experiences
Non Clinical Experiences;
patients, family, friends,
parking, food service
Access, website, patient
portal, call center, CRM,
social media, scheduling,
admissions, 2nd opinion,
referrals, registration,
authorization
billing, collections,
payment plans, claims,
scheduling, therapy,
appointments,
discharge, disputes
Unsatisfied prospects
leave w/o buying
Unsatisfied patients
donât buy again or refer
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7. CREATING A PATIENT FOR LIFE: THREE DEFINITIONS OF PEM
7
Patient
Expectation
Management
Patient Experience
Management
Patient Equity
Management
8. MOST ACCESS EXPERIENCES ARE UNSATISFACTORY
MEDIUM
AVERAGE
SATISFACTIONOFPATIENTACCESS
EXECPTIONALPOOR
HIGHLOW
NUMBER OF ACCESS INTERACTIONS BY TYPE
WEBSITE
CALL
CENTER
IN-PERSON
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9. THE QUALITY OF MOST ACCESS/EXPERIENCES IS UNKNOWN
MEDIUM
50%
%OFKNOWNACCESSEXPERIENCES
100%0%
HIGHLOW
NUMBER OF ACCESS INTERACTIONS BY PERSONA
OUTPATIENTS
PROSPECTIVE
PATIENTS
INPATIENTS
DISCHARGED
PATIENTS
FORMER
PATIENTS
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MEASURING THE CLINICAL AND THE BUSINESS EXPERIENCES AND SATISFACTION
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Today: Single Channel Clinical PX
ImpactonPatientSatisfaction
HighLow
HighLow
Frequency of Patient Interaction
Tomorrow: Multi-Channel Business PX
(More Contacts by More People)
Scheduling
Refills
Triage
Set Payment
Plan
Online
Admissions
Dispute
Management
Wellness
Management
Authorization
Education
Register
Referrals
24 X 7
Access
Patient
Reminders
Post Discharge
Follow Up
Queries
11. A PERSONâS TOTAL EXPERIENCE INCLUDES THEIR SATISFACTION WITH ACCESSING THE PROVIDER
ACROSS MULTIPLE CHANNELS
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Online On the Phone In Person
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ACCESS & EXPERIENCE ACROSS THE CARE CONTINUUM
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Worried Well Post-Treatment
General
Public/
Shoppers
Staff
Patients
Clinicians
Pre-Treatment Active Treatment
Families
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MATURITY MATRIX: MOST PROVIDERS ARE EARLY STAGE 2
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Stage 1
TRANSACTIONAL REMOTE DISEASE
MANAGEMENT
STATIC INTERACTIVE
Stage 2 Stage 3
EMR PATIENT PORTALPROVIDER WEBSITE CUSTOMER PORTAL
DATA MOVES FROM PROVIDER
TO THE INDIVIDUAL
DATA MOVES TO AND FROM THE
PROVIDER AND THE INDIVIDUAL
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CUSTOMER (PATIENT) ACCESS/EXPERIENCE MATURITY MATRIX
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REMOTE DISEASE
MANAGEMENT
ONE-WAY TWO-WAY
TRANSACTIONAL/INTERACTIVE
â˘General Information
â˘Event Calendar
â˘Event Information
â˘Locations & Directions
â˘Physician Directory
â˘Request Appointment
â˘Specialties & Services
â˘Registration
â˘Scheduling
â˘Pay Bills
â˘Payment Information
â˘Order Medical Records
â˘View Medical Records
⢠Refill Request
â˘Donate
â˘Insurance Authorization
â˘Lab Tests & Results
â˘Support Communities
â˘Specific Content Per
Disease & Stage
â˘Caregiver Participation
â˘Health Trackers &
Reminders
â˘Secure Messaging
â˘Clinical Trial
Participation
â˘Granting of Proxies &
Access
â˘Disease Management
Tools
â˘Secure Live Chat
â˘Manage Medication
â˘Insurance Authorization
⢠Prescription Filling
â˘Post Treatment Follow
Up
â˘Interactive Disease Mgt
â˘Long-Term Treatment
Information
â˘Survivorship
Communities
â˘Automated test
transmission and
monitoring
CUSTOMER PORTAL, PATIENT PORTAL (EHR)PROVIDER Website
Stage 1 Stage 2 Stage 3
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CORE
OBJECTIVES
NONE BASIC DEVELOPING OPTIMIZED
Create Patient-
Centered Culture
No focus on patient-
centered
Recognition of need
and vision
Design principles
communicated
Leadership focused on
patient involvement
Patient input in
design of Access
and Experience
Patients not involved
in design
Recognition that
patients need to help
design
Contextual inquiry to
get patient inputs
Patients involved in
most access &
experience design
Transactional
Access &
Experiences
No online
transactions
available
Online Chat, some
functionality
Call Center/CRM &
rudimentary
customer portal
All current
transactions
completed correctly
Interactive Access &
Experiences None Chat Increased online 2-
way functionality
All interactions are
online and 2-way via
customer portal
Improved care
coordination None Functional EMR Patient Portal Patient portal linked
to Customer Portal
Effective population
health management None Chat People enter health
data
Daily
patient/provider
input and
monitoring via
customer portal
CUSTOMER (PATIENT) ACCESS/EXPERIENCE MATURITY MATRIX
LEVEL OF MATURITY
16. RECASTING PATIENT ACCESS & EXPERIENCE
Create Enterprise-Wide
Access/Experience
Strategy
Implement Interactive
Digital Access
Implement Effective
Voice Access
The innovation of patient access and patient experience encompasses three
components
⢠Create vision for access and
experience
⢠Inventory the existing strategy
and touchpoints
⢠Perform GAP analysis
⢠Define patient personas
⢠Build roadmap for change
⢠Assess processes to be included
⢠Develop change management
program
⢠Design and build Customer Portal
⢠Design and implement mobile
strategy
⢠Design and implement Social
Media strategy
⢠CRM requirements, selection and
implementation
⢠Determine Call Center strategy
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17. Schedule Appointments
Admit Online
Discharge Management
Population Health
Management
Reduce ED Visits
CUSTOMER PORTAL PROCESS AUTOMATION MATURITY
Authorization Registration Scheduling
Verify
Insurance
Complete
Forms
Receive QR
Code
2-Way
Discharge
Management
2-Way
Wellness
Management
Patients
enter data
Hospital
assesses
patient data
Patients
enter data
Hospital
assesses
patient data
Nursing
triage
Patients
need to
speak with a
nurse
Nurse
available on
chat and
phone
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18. THE 6 ROIs OF IMPROVED PATIENT ACCESS AND EXPERIENCE
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MOST PROVIDER WEBSITES ARE DYSFUNCTIONAL:
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WEBSITE/PORTAL DIAGNOSTIC Your Hospital
Is it easy to
use?
Can I do
anything?
⢠Built using UDX principles
⢠User Experience/ease of use
⢠Design reflects customer/patient expectations
⢠Use of personas and journey mapping in design
⢠Use responsive design to deliver compelling mobile experience
⢠Provides online chat
⢠Improved customer service, efficiency, lower cost
⢠Electronic fulfillment of digital services
⢠Customer self-service
⢠Ability to introduce new products and services quickly
⢠Faster and better self-service access to information
⢠Full-service, anytime/anywhere access for mobile users
⢠Dynamic personalization of information
⢠Ability to target sales and marketing
⢠Faster response to changing business needs
A WEBSITE IS NOT A STRATEGIC BUSINESS TOOL IF THERE IS NO CALL TO ACTION
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Pale Rhino OFFERINGS
Strategic Consulting, Guidance and Implementation support for the following areas:
ď Innovative patient experience engagement across the continuum of care
ď Customer Portal assessment, strategy, design and implementation
ď CRM & Call Centers
ď Social Media
ď eHealth initiatives
ď Mobile technologies
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Marketing
IT
Clinical
Operations
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DISRUPTIVE ACCESS & EXPERIENCE Continuum
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Enterprise-Wide Access/Experience Strategy
Digital Voice Process
⢠2-Way
Automation of
Manual & Paper
Processes:
⢠Authorization
⢠Registration
⢠Scheduling
⢠Admissions
⢠Triage
⢠Billing
⢠Disputes
⢠Claims
⢠Discharge
⢠Functional
Requirements
⢠Technical
Requirements
⢠RFP
⢠CRM Vendor
Selection
⢠Implementation
⢠Call Center
Strategy
⢠Customer
Portal
⢠Patient Portal
⢠Mobile
⢠User-Centered
Design
⢠Responsive
Design
⢠Personas
⢠Journey
Mapping
⢠Wireframes
⢠User Research
⢠Prototype
⢠Build
A Designed Experience Maximizes The Benefit For Patients and Providers
Access & Experience Optimization
Patient and Customer-Centered Design
⢠What do I want to do
⢠Can I do it
⢠Is it easy to do
Can I Access my Provider
⢠24 X 7
⢠Through multiple channels
Provider ROIs
⢠Increased Retention
⢠Increased Referrals
⢠Reduced Admissions (Ambulatory)
⢠Reduced Readmissions (Acute)
⢠Decreased Service Costs
⢠Improved Population Health Management
23. Phase 2: Design
⢠Create a Patient Touchpoint Inventory Map
⢠Interview stakeholders, patients, and
prospective patients to determine which
access points relate most to their
satisfaction
⢠Create access/experience Personas &
Journey Maps
⢠Create patient access/experience
effectiveness scorecard
⢠Determine which access points each
patient values at each stage of their
interaction with the hospital.
⢠Design Enterprise-Wide Strategy
⢠Develop an implementation roadmap
Ongoing Project Management
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In Scope
Phase 1: Enterprise-Wide Access & Experience Strategy
Our Approach
Phase 1: Assess Phase 3: Implement
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24. 24
Phase 1: Enterprise-Wide Access & Experience Strategy
Deliverables
Deliverable Description
Patient
Touchpoint
Inventory
⢠Inventory of the touchpoints used by patients and prospective patients to interact with the provider (in-person,
by phone, and online)
Personas &
Journey Maps
⢠Define personas for each patient type and create journey maps of those personas interacting with the
provider
Touchpoint
Scorecard
⢠Assess which touchpoints are most frequented and which ones have the greatest impact on satisfaction.
Enterprise-Wide
Strategy
⢠Define the providerâs enterprise-wide patient access and experience strategy
Strategy Road
Map
⢠Comprehensive patient experience improvement roadmap that includes:
⢠Key findings and observations
⢠Summary of requirements
⢠Improvement opportunities
⢠Cost/benefit analysis and ROI
⢠Implementation considerations & dependencies
Š Pale Rhino Consulting. All Rights Reserved.