We’re seeing technology being used more strategically in our industry, including more of a focus on the healthcare consumer. Benefits providers are looking to connect online, through mobile, social media and other platforms. People are doing their banking from their phones, shopping online and looking for answers to their service questions on social media. Consumers want and expect the same types of service they have in their everyday lives from their health provider.
Comparing the U.S. market with Canada
In the healthcare and insurance industries, there are areas where Canada is at par: payment options such as direct deposit, along with web and mobile self-service for things such as filing a claim, checking your coverage or viewing claims history.
When it comes to adopting new business models and integrating modern tools to drive higher-quality care and lower costs, however, the U.S. is definitely ahead.
For example, many benefits providers will use data to identify those health providers with the best health outcomes for their patients. Plan members are encouraged to use those providers with the best outcomes because it is more likely they are satisfied and have fewer repeat visits—meaning fewer costs to a health plan. They are also using technology and data when it comes to strategic provider payment structures—such as paying providers based on performance, as well as using technology to invest in outcome-based or accountable care.
Managing our health
Harnessing data to create meaningful insights and solutions is important. There’s an opportunity to explore partnerships where we can use data we collect to better manage members’ health. For example, if we notice trends in claims for mental health issues, employers could take action by partnering with mental health professionals to provide information sessions or preventative supports at the workplace. We could also be partnering with providers to better track care—such as creating digital health alerts when members are due for a dental cleaning or physical. These types of proactive approaches could diminish health issues from escalating to absences or disability—ultimately meaning better health for members and lower costs to a plan.
Sharing information
We’ve seen some instances of stakeholders leveraging the cloud, which lets people use and share files and applications over the Internet, along with other social networks where they can share and comment on information—just as most of us do on Facebook and Twitter. But our industry adoption rates have been limited.
Some healthcare professionals have just started to use Yammer—which is like Facebook for business. Doctors, nurses and other providers will message one another for advice on a patient’s diagnosis or treatment—it’s healthcare consultation and sharing of information in real time. We could be leveraging some of these online social and information-sharing tools to more efficiently share information, especially when it comes to case management.
Supporting employee wellness
We’ve seen more employers wanting to provide wellness supports and incentives to their employees, but it’s always been challenging to measure their effectiveness and return on investment. We could be leveraging the habits of today’s consumers, who are using mobile technology to manage their lives.
There are plenty of apps and other online services available that combine wellness with data recording and analysis. You can use an app or online program to track your weight loss, the distance you’ve run, the calories you’ve eaten, your heart rate—the list goes on. Employers can use these not only to offer employees wellness supports but also to track their usage and impact. These types of apps can also better engage employees—they are interactive tools employees can actually use, rather than employees just being told they should exercise or eat healthier.
The road ahead
There are a lot of untapped opportunities when it comes to using technology strategically. We have the capability to better record and integrate data such as claim trends, incidents of disability and types of treatments being used—including drugs. This in-depth reporting—if utilized to create meaningful solutions such as disease prevention and intervention programs—can have a big impact on an employer’s plan sustainability, affordability and effectiveness.
It’s also important to note that our industry has not really been challenged with improving process efficiencies to the level we have seen in more competitive industries such as banking. But competitiveness in our industry is growing. So now is really the right time that industry stakeholders should be taking the opportunity to transform processes and services—and leveraging technology capabilities and trends is the smart way to do it.
Venky Kulkarni is chief information officer and vice-president of digital health for Medavie Blue Cross. Most recently, he was director of technology at Wellpoint, one of the largest health benefits companies in the United States. These are the views of the author and not necessarily that of Benefits Canada.
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