Industry Insights from a Leader in Patient Experience: Improving The Patient Financial Experience, Healthcare Technology and AI

Industry Insights from a Leader in Patient Experience: Improving The Patient Financial Experience, Healthcare Technology and AI

As part of an interview series with healthcare leaders across the country, the Olive team had the chance to interview Mindy McNamara about the biggest challenges facing healthcare today. Previous to her current role as Patient Financial Experience Coordinator at Yale New Haven, she received a Bachelor’s degree in Health Care Management and a Master’s degree in Business Analytics and Project Management from the University of Connecticut School of Business.

Q: To begin, tell us about your background in healthcare and your experience at Yale New Haven Health.

I started at Yale New Haven as an intern with patient financial services and have since served in several different roles in the revenue cycle over the past 8 years. I’ve had the opportunity to help patients in self-pay follow up and financial assistance in the billing call center. Eventually I moved into an operational training position where I gained a global understanding of the revenue cycle. As the industry was evolving and patient’s behaviors were shifting, leadership created the Patient Financial Experience coordinator role that I am in today. Being in this role for a year and a half has given me the opportunity to drive cultural transformation, process optimization, and technological innovations to drive value throughout the patient financial experience.

Q: How are you adapting to the behavioral shift we’ve seen in the industry as patients increasingly think and act like consumers? What changes have you seen? 

We often hear people talking about the patient as the new payor or consumer. And over the last 5-10 years, as Netflix and Amazon disrupted their respective industries, people were redeveloping their expectations of what was considered a “good experience.” People want something that’s seamless, easy and gives instant satisfaction, and they need to know that what they’re getting – what they’re paying for – has value.

We’ve seen healthcare running parallel to that with the large number of people with high-deductible healthcare plans resulting in them having much higher patient financial responsibility. That shift is changing the way patients behave in this industry – they’re behaving more like consumers and expecting that same kind of personalized experience that Netflix, for example, gives them. It’s not good enough to just offer a great clinical experience, which is where we were 10 or 15 years ago, where if you had the best doctors, that was enough. 

We’re in a very different time now. People always ask, “How do you help the patients through the financial process?” The key is knowing your patients. At Yale New Haven Health, delivering personalized care is only significant if you understand what’s meaningful to that patient individually. We want our patients to know that we’re here to partner with them. For example, communicating with the patient in channels they prefer, like text messaging, or being able to pull in behavioral analytics to drive personalized communications and experiences at the times they are best received by the patient.

Q: Where do you see opportunities for Artificial Intelligence and other advancing technologies to enhance the patient financial experience? 

I think there’s a huge opportunity for AI and automation to humanize the patient experience. If at any point in the revenue cycle we can free up those tedious tasks that are holding up our most valuable resource – our employees – then they can be free to offer emotional support and meaningful interactions with our patients.

The industry can also get creative with how we’re using the automation and the analytics that result to personalize these experiences for our patients.

If you think from a patient perspective, receiving care is a vulnerable experience, whether they’re coming in with a child that needs stitches, or maybe they received a cancer diagnosis. Although those scenarios vary in levels of severity, the fear and anxiety can be overwhelming regardless. We need to be able to support our patients when they’re being bombarded with information, from medical records and scheduling, to meeting their doctor or discussing treatment. We need to remove the information that they don’t need and focus instead on customizing the experience and ensuring their experience is not overwhelming.

Q: You’re leading an initiative called “Super Service Behaviors”, tell us more about it. How is it impacting the culture at YNHH? 

Super Service Behaviors is a program we developed over the last year and a half. As we took a step back and looked at the industry we were critical about what is most important to our patients. Through all of our studies, we asked patients, “What most impacts your experience?” and what they consistently say are the people factors – did they listen to me, did they communicate in a way that I can understand, did I feel valued and respected? 

That trend tells us, our employees are the individuals with the greatest opportunity to impact the patient experience. We can use seamless technology or have a perfect patient portal, but we’re not going to continually achieve a best-in-class patient experience if we don’t start with our own employees.. 

Looking at the vision for the future of our patient financial experience, we partnered with front line staff across the revenue cycle to get their insights into what are examples or strategies that speak specifically to them. We custom built training off of their input and over a six week period, we went to all of delivery networks to host 125+ training sessions focusing on five core behaviors. And since then, we haven’t stopped. 

We’re hyper focused on the sustainability of Super Service Behaviors and have a number of different programs that using to reinforce that content everyday. Through the “I’ve got the power challenge” we challenge our staff to focus on a core behavior for one week a month and ask them to come back to us with feedback about how it changed their experience or interactions with not only our patients, but also our company culture — it keeps our teams focused and our employees and their patients are noticing the difference.

Q: How do you see the patient financial experience influencing the clinical experience? 

In my mind, there’s no question that everything we’re doing in the healthcare industry to improve patient financial experience is intrinsically linked to the clinical experience. If you go back to my previous example, anything that triggers fear or anxiety in a patient is both physically and emotionally taxing. There’s so much research out there that shows there are physical ramifications to negative emotional states that could impact not only patients’ current state, but potentially their clinical outcome. All of the work that we’re doing to humanize the experience helps build a relationship with patients and helps eliminate or reduce the negative emotions that impact their overall experience. 

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Industry Insights from a Leader in Patient Experience: Improving Patient Care, Healthcare Technology & AI

Industry Insights from a Leader in Patient Experience: Improving Patient Care, Healthcare Technology & AI

As part of a new interview series with healthcare leaders across the country, the Olive team had the chance to interview Brian Carlson about the biggest challenges facing healthcare today. Previous to his current role as Senior Director of Patient Experience at Vanderbilt University Medical Center, he was the COO/CEO of a physician group practice and a Practice Manager at Northwestern. Before that, he received a master’s degree in health services administration and an MBA from Xavier University.

 

Q: To begin, tell us about your background in healthcare and how you became Senior Director of Patient Experience at Vanderbilt University Medical Center.

I took the traditional route of college followed by graduate school, and in college I found healthcare was something I was very interested in. I considered doing pre-med, but ultimately got my undergraduate degree in psychology and went straight to graduate school where I got a master’s degree in health services administration and an MBA.

One of the greatest things about the program was the year-long required fellowship at a health system. That fellowship was where I could get mentored by a seasoned administrator and gain experience with how our complex healthcare system works in a protected environment. I didn’t have decision making authority, but I was put on projects to help advance the mission of the organization and got a lot of experience doing so. I think any administrator entering the field should really go through a residency or fellowship program.

From there, I got my first job in group practice management and then moved on to be COO/CEO of another physician group practice and then I was recruited to Vanderbilt in 2007. I started as an administrator for the Eye Institute and moved into the patient experience role in 2014, where I’m helping the system figure out how to create a consistent experience for the patients and families that need our help.

Q: In your opinion, what are some of the untapped opportunities to improve patient experience today?

The field of patient experience is evolving and I’m starting to think of it as just, “experience.” 

What I mean by that is that healthcare is complex to start with and dependent on the skills and expertise of our workforce to deliver care. So, the experience our workforce has every day has a profound impact on the care they’re able to deliver. In my mind, I’m broadening the term of experience because we need to consider the relationship between the patients and families that walk through our doors, and the experience our workforce is having every single day as they do their jobs. 

Healthcare is a calling – people come into this profession because they want to help people. But sometimes we get in our own way and make it difficult for those who are really skilled to do the most effective job that they can. The untapped potential is looking into the experience of our workforce and how can we help make that experience better, so they can do the best job possible.

Q: If you could eliminate one of the healthcare industry’s challenges overnight, which one would it be?

If I had to choose one challenge to eliminate, I immediately think of our need to, in a consistent fashion, share data across organizations and across individuals. We have so many restrictions on the way we can share data – and we have so much of it. If we could unmask that data, in a secure and safe way,  yet make it available whether it’s payer, provider, patient, or consumer space, and really cumulate that data, we could put some profound learnings into place to understand what it is that drives us as humans. 

Ultimately: How can we anticipate ahead of time if someone’s heading down a path, and how can we prevent that from happening? Thus decreasing the cost of healthcare.

Other industries have figured out how to share and use data in a constructive way to learn about their users. They’re trying to sell a product, but were trying to help an individual, so the opportunity is significant.

Q: How do you see artificial intelligence in healthcare impacting the patient experience?

Our ability to use our data in an effective fashion is what will enable us to learn from those past experiences. At the root level, it is the machine taking data to understand and predict what will happen in the future to improve care. Think from an experience standpoint – AI can help both internally and externally. 

On the internal side, how do we make our workforce processes more streamlined by using AI to automate repetitive tasks, to use the machine to generate some very basic administrative functions that today require people to do it manually, or become backlogged as employees never have the capacity to work through them. They do not always know what to work first, or they need to hunt and find additional information to assist them. Can we get the right data in front of the right eyes when it is needed? This could be in everything from eligibility checks to claims processing and to the front office functions. 

Within the clinical side, the possibilities are limitless from using AI to accurately diagnose and reduce errors to developing new medicines and treatments.  

On the external side, let’s consider the consumer space. B2C companies use data to predict habits around who will need what and when. In the healthcare space, you can start to imagine the experience where we know as a health system someone’s potential needs in a way that prevents, for instance, their need to go to the emergency room or prevents them from having to receive additional care down the road.

We recently conducted a study here at Vanderbilt, and the number one piece of feedback we received from our patients is that they expect that we already know them. I think our society has a growing expectation that if I provide you data or insights about me I expect you to do something with it.  There’s an expectation that healthcare is technologically advanced and an assumption that we have data to make predictions. While we’re heading down that road clinically with genetics and DNA, from an experience standpoint, we’re not there yet. The challenge to the industry is, how do we create a system of learning that can advance the skills of our providers to help predict and prevent problems in the future?

Q: Tell us about a person who mentored, inspired, or impacted you during your career.

I’ve been lucky to have so many individuals mentor me and impact me throughout my career, the difficult part would be choosing just one. But the common thread between them all is, availability – they’ve all willingly made themselves available to me over both successes and failures throughout my career. They were there to listen and understand, and then provided a direction or pose a question to help me move forward. Throughout my career, I knew I could reach out and call them, and they’d always answer the phone. They also built trust, and that trust was a two-way street. I knew I could be vulnerable with them and in turn, I knew they would always be honest with me. Lastly, they took pride in my work and I think got fulfillment in my success. As I’ve mentored people in my career, I’ve tried to bring those same attributes to the table, as well.

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Industry Insights from a Chief Data Officer in Healthcare: The Potential of Big Data, Healthcare Technology & AI

Industry Insights from a Chief Data Officer in Healthcare: The Potential of Big Data, Healthcare Technology & AI

As part of a new interview series with healthcare leaders across the country, the Olive team had the chance to interview industry leader Aaron Black about the biggest challenges facing healthcare today and the potential for data to transform the industry. Previous to his current role as Chief Data Officer at Inova, he was the Director of Informatics dealing with genomics. Before that, he lived in Columbus, Ohio for 13 years, working at Nationwide Children’s Hospital and is a Miami University Graduate.

 

Q: To begin, we saw you’re an Ohio native and have worked as a consultant and manager in a few different industries prior to healthcare. What drove you to get involved with the healthcare space?

It was somewhat serendipitous. I was working in consulting in Columbus, Ohio and there was a company that was doing mental health billing. They were an EMR company, and they were the only ones in Ohio who could bill Medicaid and Medicare. They were growing so quickly that they didn’t have enough people to implement their software. I was a data person and was doing a lot of conversion software implementations at the time – the area was exploding, so that’s why I got into the field.  

Once I was in the industry, I quickly observed healthcare was facing a critical accounting challenge – the way the industry billed, the way it charged – it didn’t match common practice across other industries. And with my accounting background, the current processes just didn’t make sense to me. I saw a misalignment there and thought this was an area where I could have an impact. 

Q: Can you tell us about the Inova Translational Medicine Institute that you’re currently leading?  What are a couple of examples of ways you’ve seen data analytics fuel innovation within the Institute?

The Institute is part of the Inova Health System, which is a community health system outside of Washington D.C., and was originally founded to look at the research that was being done in the genomics space.  At the Institute we focus on more than sequencing individuals, we are considering the expression of those genes or microbiome, for example. Including that scope of work has allowed us to evolve and take the data that we’re now able to get from our patients and apply it to clinical care. We find ourselves frequently meeting and addressing challenges on how we make our data part of how we tackle the harder problems when it comes to predicting, preventing and treating people after they’ve gotten sick.

We’re leveraging analytics to sequence individuals and very large sets of data. We have custom applications that run, analyze and make sense of the collected data. Typically, we’re looking for a needle in the haystack, so we use literature and bring all kinds of data assets together, and then use the minds of the scientists and doctors that are treating the patients to understand if this is something we can actually treat, which is where we meet a distinct challenge – just because you find something doesn’t necessarily mean you can treat it. This work is really the application of genetics in practice to improve the health of our patients.

Q: What do you think has been the biggest impact in healthcare coming from data science?

Two distinct impacts come to mind. One is the ability to make discoveries a typical analyst or human couldn’t make on their own without the help of data science. Today, in healthcare we manage vast and unwieldy data sets that Excel or other traditional data analytics tools can’t handle with the power needed to analyze the data efficiently and effectively.  If you can build software with the expertise of a multi-disciplinary group of clinicians, statisticians, and software engineers, then you can analyze data in ways we haven’t been able to do previously. 

Secondly, data science is a motivator to accelerate the collection of data – it’s not just a transaction anymore. It’s no longer collected with the sole purpose of billing – it’s collected so we can use it to improve care, and not just for that specific individual – also for individuals that will be treated 5-10 years from now. This is a long game. How are we going to use this data to win the war on a specific disease, for instance, 5-10 years from now with the help of faster machines and better data? This is where we’re going to see the biggest impact, and it’s already started to happen. We’ve been collecting this data for over 10 years now, and we can look at that from a biological level and compare it to the patient outcomes, which will in-turn accelerate the adoption of data science throughout healthcare.

Q: Looking into the future, how do you see artificial intelligence helping you accomplish more with data science?

The term artificial intelligence is so often used as a branded term today, it’s easily misconstrued. For me, the machine learning and analytics aspects of AI is where I see the industry heading. In the future I see machines working alongside humans – discovering how to take the repetitive actions out, the ones that don’t scale.  Analytics and machine learning will work in tandem to take on the repetitive, easier tasks, while people tackle the harder problems – like the rare diseases and the cases that just don’t make sense to us today. This advancement is going to refocus our people – the doctors and nurses – to take on the more challenging cases. 

We’ll really change the way our healthcare system works, what we spend our money and time on, and where we spend our focus: the areas where we can drive change and have the biggest impact. 

Q: What do you think is the key to improving interoperability in healthcare?

It’s incentives. Incentivizing people to interoperate. It’s not a technology problem. What’s the incentive for a provider to share their data with another provider when a patient is coming to  them? If they share that data, they might lose market share. Today, the industry fails to find an inherent benefit without further motivation. 

On the technology side, what’s the incentive for a provider to strive for interoperability outside of their vendor base? Interoperability means a lot of things too – people can call a fax or a courier interoperability, so how are we defining the term and how, as an industry, will we determine its success? And it can’t be everything. As an industry our challenge is to align incentives to that definition of success, then it must become a part of everything we do, rather than simply checking a box. 

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Four Ways Hospitals Are Cutting Administrative Costs: Part 4

Four Ways Hospitals Are Cutting Administrative Costs: Part 4

$1 out of every $3 spent in U.S. healthcare is spent on administrative costs – that’s a trillion dollars spent on administration. And while administration cannot be eliminated, it can be reduced. As a healthcare provider, reducing your administration time and costs can benefit your bottom line and help the entire healthcare industry.

If you’ve been following along, over the past three weeks we’ve covered three common ways that hospitals are attempting to tackle this problem, from hiring more employees, to implementing technology solutions, to hiring consultants. And in our final post of the series, we’re going to cover outsourcing as a strategy.

 

What Is Outsourcing In Healthcare? 

Outsourcing in healthcare isn’t new, but it is an increasingly popular approach. Outsourcing is when a healthcare system entrusts a third-party organization with a specific task or workflow – even entire job functions or departments can be outsourced. Anything that is not a core competency of a healthcare system could potentially benefit by being outsourced, with the right approach. For example, it is already common practice to outsource hospital food service, laundry, or laboratory services. 

But what about administrative work? How can that be outsourced? Outsourcing administrative work is becoming more common – one area where outsourcing has proven beneficial is medical billing. A professional medical billing company can take over and handle a provider’s entire billing process. But what are the pros and cons of outsourcing administrative work?

Tapping Into The Pros of Outsourcing 

The biggest benefit of outsourcing is that it frees up staff to focus on other initiatives, including patient care. For repetitive, menial work, outsourcing keeps employees from getting bogged down by the processes that interfere with the healthcare provider’s bigger-picture goals. But there are a lot of other benefits too: it can save money, reduce errors, and improve operations. 

Typically, outsourcing a task or process enables a healthcare system to take advantage of another company’s economies of scale. They will have developed a solution that is better and faster than how you are doing it, because it is their core focus. They will have the best technology, the most knowledge, and the focus to continuously improve. By leveraging another company’s expertise and specialization, a healthcare system can actually lower costs and improve the process through outsourcing. 

 

Cons of Outsourcing: The Process Can Be Difficult And Limiting

Outsourcing isn’t a magic potion that solves all administrative woes. Far too often, providers that outsourced certain functions even feel frustrated by its limitations. That’s because when you outsource, you lose direct oversight of the process. You have to place a lot of trust in the third party that work is being performed accurately and efficiently. A manager cannot walk down to someone’s office to ask a question or ensure that certain tasks are being completed on time. 

Outsourcing also limits your flexibility – organizations are often locked into a contract for a specific amount of time, money, and work. If internal priorities or needs change, your current contract may no longer work for you, but you could be stuck. It can keep your organization from being nimble and quick to adjust to change. 

Plus, outsourcing often comes with hidden costs, money and time. From legal fees to implementation or cancellation fees, makes sure you read any contract carefully and consider these costs when you evaluate potential savings from outsourcing. And even the best outsourcing company requires oversight and management from internal resources, which can end up eating more time than you anticipate. 

Lastly, outsourcing comes with additional healthcare privacy and security issues. The more people and companies that have access to a system, the more potential there is for a security breach. This is an additional risk to consider before outsourcing any administrative work.

Is Outsourcing For You?

Outsourcing has plenty of pros and cons, but only you can decide if it will work for your organization by understanding the potential pros and cons. And besides evaluating specific outsourcing companies, it’s also critical to compare outsourcing to other solutions, such as technology solutions. For a more complete list of potential strategies to evaluate when working to cut costs, make sure to check out our eBook, 6 Ways to Cut the Staggering Cost of Healthcare Administration. In it, we share six ways that healthcare systems are addressing these problems, the pros and cons of each, and how to choose the right approach for your organization. Download it today to learn more! 

Four Ways Hospitals Are Cutting Administrative Costs: Part 3

Four Ways Hospitals Are Cutting Administrative Costs: Part 3

If you’ve been following along, we’re on part three of our four-part series about different approaches healthcare systems are using to manage administration and costs. 

As healthcare grows increasingly complex, the mountain of digital “paperwork” continues to grow. It’s slowing down our organizations, overburdening our employees with repetitive, menial work, and harming the entire healthcare economy due to the wasted resources and money. But filing claims, checking eligibility, and all of the other various administrative tasks cannot simply be ignored. You may not be able to overhaul the system, but healthcare providers can streamline internal processes to save time and money.

Want to get caught up on the two methods we already covered? 

Part 1: Hiring More Employees

Part 2: Technology Solutions

This week, we’re discussing the option of hiring consultants. Many healthcare systems turn to consultants to provide objective perspectives and advice on potential internal inefficiencies and solutions. But what are the advantages and disadvantages of this approach?

At their best, consultants are knowledgeable experts that dive deep into your unique organization to find efficiencies. 

A good consultant will spend time observing, evaluating, and talking to staff to find inefficiencies and opportunities for improvement. They will work with you to develop short and long-term goals as well as strategies on how to get there successfully. This could include anything from reorganization, process engineering, or even implementing new technology solutions. 

They bring an objective perspective, creativity, and industry experience to your specific challenges. Consultants should have experience with and knowledge of cutting-edge technology, along with the pros and cons of each option, to help guide your organization to make the best decision. Their experience at other providers gives them a different viewpoint through which to judge your own organization’s strengths and weaknesses. And compared to hiring new employees, a consultant can be a cost-effective method for reducing overall costs, streamlining processes, and improving your bottom line.

Learning the Disadvantages of Consultants 

At their worst, consultants are expensive, time-consuming, and implement “solutions” that may not meaningfully move the needle. Most consultants require a lot of money up-front, without any promise or indication of what their output and impact will be. 

Here are just a few things to consider: if a consultant recommends that a healthcare organization implement a new software, for instance, the organization has to worry about licensing fees, software maintenance, integrators, implementation costs, internal expertise, managing potential break / fixes down the road, and more.

And even when implementing a new software could be extremely beneficial in the long run, the fiscal impact can sometimes be shocking – aside from the cost of technology and hours of staff time and resources wasted on the integration, if the technology doesn’t prove beneficial, the company has already made the investment. 

Whatever their solution, it likely requires enormous internal change for your staff. Before hiring any consultant, be sure they have had success in eliminating the healthcare-specific pain points your organization is experiencing, see what their timelines and solutions have been for other clients, and make sure it aligns with your organization’s needs. 

Consultants Are No Guarantee

Consultants can help cut costs, but it is no guarantee. Next week, in our final post in the series, we’ll discuss outsourcing as an option for reducing the administrative burden. Don’t want to wait? We’ve got our free eBook, 6 Ways to Cut the Staggering Cost of Healthcare Administration, that covers all this and more. Download it today to learn how other healthcare systems are tackling this problem and how to find a solution that will work best for your organization.