How Specialty Providers Can Enhance Patient Care with Coordinated End-To-End Automated Journeys on the Innovaccer Platform

Team Innovaccer
Fri 1 Dec 2023
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Navigating the healthcare system is never easy, but it’s especially complicated and overwhelming for patients who require specialty care. A journey that begins with diagnosis continues along many touch points during and after treatment. Nurturing positive patient experiences at each stage is vital for improving clinical outcomes and financial well-being. Without a unified, end-to-end, data pl…. It’s impossible.

Consider the case of Henry. In one patient journey, despite having diabetes and hypertension, his risk of kidney disease goes unexamined and undetected until a series of acute events lands him in the hospital. Following discharge, he’s given a care plan that quickly goes off the rails because Henry can’t stick with the lifestyle changes he’s been told to adopt and the new medications he’s been prescribed. Despite having referrals to a few specialty doctors, follow-up and communication is spotty, and there’s no coordination across those care events. Henry’s kidney disease enters a new stage and a downward spiral.

In fact, Henry needs a highly personalized care journey to manage the progression of his condition, as the reimagined journey below illustrates:

This time, Henry is identified through data as a patient with a high risk of kidney disease before his condition becomes chronic let alone severe. A contact center representative reaches out and screens Henry for various lifestyle, demographic, and health risk factors, then sets Henry up on a coordinated series of visits, referrals, monitoring, and check-ins that keep Henry in better health and able to avoid a more acute stage of the disease.

For complex conditions like CKD, primary care providers (PCPs) often need to refer patients to specialists, such as nephrologists. While the patient acquisition is generally well-managed for specialty providers, effectively guiding patients to the appropriate care and engaging them consistently with proactive programs can be resource-intensive and require precise timing.

Most specialty providers have significant blind spots in understanding consumer behavior and clinical needs throughout the patient journey. The simple reason is that they lack crucial consumer/patient data. Many rely on some type of customer relationship management (CRM) software to manage patient scheduling and billing. But most lack integrated access to other sources of data and analytics (including population health, EHR, claims, labs, pharmacy, and social determinants of health (SDoH)) that would provide a fuller picture of the patient, their risk profile, their health-related social needs, and so on.

With a more complete and holistic picture, healthcare organizations can guide patients along their wellness journey, improving their quality of care through data-driven outreach and decision-making. This enables specialty providers to streamline workflows among care team members and generate reports that measure the effectiveness of outreach and engagement efforts.

For patients, this can turn an otherwise frustrating and uncoordinated experience of healthcare into a seamless journey. The foundation for this level of healthcare service rests on a unified data platform that enables access to all the relevant information related to the patient.

Top 3 Challenges Faced by Specialty Providers in Driving Personalized and Connected Patient Journeys

In the United States alone, approximately 50% of adults report having at least one chronic condition, and about 6% have three or more. These complex conditions often necessitate the involvement of a number of specialty providers, including cardiologists, oncologists, neurologists, and others. However, accessing and navigating care with these specialized providers can be a daunting task. The challenges faced by specialty providers in streamlining patient journeys go beyond logistical issues. These challenges are indicative of deeper systemic problems within the healthcare system:

  1. Siloed information: Patients often have to interact with multiple providers and specialists, receiving care services from hospitals, pharmacies, and labs. Unfortunately, these various sources of information do not often communicate with each other. Specialists must analyze patients' medical history and carry out test procedures to determine the appropriate care plan. However, due to the highly fragmented nature of patient health data, care teams struggle to obtain a comprehensive view of the patient's overall condition.

  2. Lack of data readiness: The data that is available lacks standardization, adding to the challenges in accessing that data across different systems and settings. Each data source, whether it's prescription data, laboratory data, claims databases, electronic health records, health registries, or patient-reported outcomes data, may involve different data elements, resulting in significant variations. Moreover, there are delays and inconsistencies in data updates across datasets, which can hinder effective decision-making.

  3. Poor post-treatment engagement: Specialty providers struggle to prevent readmissions due to a lack of communication during transitional care, exacerbating gaps in patients' understanding of post-procedure instructions or medications. One study reveals that 42% of Americans would be more likely to adhere to their prescribed treatment plans if their physicians provided encouragement and coaching between visits. Poor follow-ups result in missed opportunities to intervene at the appropriate moment and guide patients towards better outcomes. Addressing this issue can lead to a more seamless transition of care, improved compliance, and ultimately, better patient outcomes.

The Trail of Negative Outcomes: Addressing Disconnected Patient Journeys

Siloed information, lack of data readiness, and poor post-treatment engagement widen the gaps across patient journeys. In particular, specialty providers struggle to effectively manage the following issues:

  1. Missed early diagnosis: Chronic conditions like CKD, diabetes, and cancer often progress over time. Delaying cancer treatment, even by a month, can lead to a 6 to 13% increase in the risk of mortality. Better data and analytics would improve the accuracy of risk profiles

  2. Increasing readmissions: Lack of coordination and effective follow-up lead to higher rates of unnecessary readmissions, worsened conditions, and more costly acute care services.

  3. Poor patient experiences: Patients judge providers based on access, ease of scheduling, engagement, timely reminders, and receiving appropriate guidance between visits. Without holistic patient data, CRMs and engagement tools are less effective and can exacerbate patient frustration.

  4. Higher care costs: Inefficiencies, such as delays in diagnosis, poor post-treatment engagement resulting in readmissions, and increased staff costs, contribute to higher healthcare expenses for specialty providers. A study published in JAMA Network estimated the annual costs of waste to be $760 billion to $935 billion, with potential savings of $191 billion to $286 billion through interventions that address waste.

Empowering Specialty Providers: How Can Innovaccer Help Build Comprehensive Patient Journeys?

Innovaccer helps healthcare organizations establish a solid foundation with its unified data platform, which aggregates, cleans, and standardizes healthcare data into longitudinal patient records. Specialty care organizations must collect patient data from multiple sources and harmonize it into a standardized format. Accessing accurate, complete, and timely data from all relevant sources across care settings and sources, is critical t for enabling care teams to develop rich, actionable insights and integrated workflows.

When unified patient data is utilized within Innovaccer's proprietary applications, such as InJourney, that sophisticated, zero-code system empowers care managers and clinical teams to create personalized patient journeys. These capabilities also help healthcare organizations:

  1. Improve Patient Acquisition: Cultivate relationships with prospects through targeted outreach strategies, converting them into patients within your health system.

  2. Develop Personalized Care Experiences: Design individualized care experiences for every patient based on their personal circumstances, health-related social needs, lifestyles, socio-economic conditions, and health status including comorbidities.

  3. Increase Patient Retention and Loyalty: Tailored experiences ensure continuous, clinically-aligned engagement throughout the care journey. This includes educational emails, appointment scheduling support, timely inquiries and reminders, and more.

Innovaccer offers customizable solutions on top of its advanced data platform, which boasts plug-and-play capabilities. If you're interested in learning more, book a personalized demo with our experts.


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