Healthcare must become as digital and consumer friendly as retail and banking

That's the view of a tech CEO who discusses problems with the patient experience and what may happen if hospitals and health systems embrace digital tools on the patient-facing side.
By Bill Siwicki
10:24 AM

Anthony Lucatuorto, CEO of Sphere, Powered by TrustCommerce

Photo: Anthony Lucatuorto

In a world where consumers can order dog food, schedule a haircut or buy a plane ticket with just a few keystrokes, patients often are left wondering why healthcare has to be so complicated – and why so many processes seem stuck in the past.

Today, as consumers grow more dependent on convenient and efficient online tools across retail, banking and grocers, patients are becoming increasingly aware of – and dissatisfied with – healthcare's digital deficiencies, which often create a time-consuming, confusing and overly complicated experience.

Anthony Lucatuorto is CEO of Sphere, Powered by TrustCommerce, a digital transformation company. He believes it's time for healthcare to let go of manual and inefficient processes and embrace more modern digital tools.

We spoke with him about what he sees as the problem with the patient experience, his suggestion that it is necessary for providers to adopt digital tools, what may happen if hospitals and health systems embrace digital tools on the patient side, and an example of a common patient process today versus how it would go in a highly digital environment.

Q. You say that in healthcare, patients often are left with a time-consuming, confusing and overly complicated experience. What's the problem?

A. Problems patients frequently encounter during the billing and payment process include high costs, surprise bills, a lack of understanding of what their payment options are, puzzlement about what they owe and why they owe it, and poor communication due to provider staffing issues.

For example, one recent consumer survey of 1,200 U.S. adults found 58% said paying medical bills is stressful, while 55% said simply understanding what they owe is a source of stress.

Most consumers don't anticipate these problems will ease anytime soon, as 48% said their healthcare costs had increased in the prior year and 59% said they are worried about paying their medical bills in the next year.

Healthcare is unique in that nobody pays the same thing for the same service. Insurance benefits, deductibles and out-of-pocket-maximums vary from patient to patient. Because of this, providers have a hard time giving estimates, so patients often are forced to make decisions about their care without knowing how it will impact their bank account.

This is improving with the help of legislation requiring estimates be provided, but in many cases this is still only available to patients who proactively ask.

These issues don't just affect patients; they also cause downstream problems for providers. For example, 40% of consumers said they won't pay a bill if they can't understand their coverage or how to pay it, while 28% said they had delayed paying a medical bill because they were confused by it.

This is only complicated by outdated collection methods. While electronic payments are becoming the default way to bill patients with many providers, paper statements with the return envelope for a check are still common.

Even if you prefer to pay electronically, having to remember the login for the patient portal and key in your card information is a time-consuming task compared to a more typical e-commerce experience where your card is stored on file or using a digital wallet like Apple Pay or Google Pay.

The good news is these payment technologies are being rapidly adopted but there is still a lot of work to be done.

Q. Why do you suggest it is necessary for providers to adopt digital tools such as self-service appointment scheduling, online payment tools and pre-visit cost estimates?

A. As the patient experience in healthcare evolves to mirror that of retail industries, it has become more essential for providers to provide patients with engaging and convenient tools throughout the care journey.

For example, providers should take steps to ensure patients have clarity about every aspect of their care, including pricing that is transparent and intuitive workflows for online appointment scheduling, reminders and payment plans.

Like any other business, if you don't adapt and provide your customer what they want you will be left behind. Patients have more flexibility and mobility than ever before, and they are showing it by leaving providers if they are not providing a modern, digital experience.

Here are three examples.

First, self-service appointment scheduling. This is the front door to any provider and making this easier should be top of mind for everyone involved. Patients need to make appointments when they or a family member are sick and oftentimes juggling it around a very busy home and/or work schedule.

People don't have time to call in during business hours, likely wait on hold, then wait to see if a future day/time fits into their existing availability. Additionally, since most phone-based scheduling needs to be done during business hours you could be putting your patients in an uncomfortable position where they are describing a very personal matter while in an office setting.

Online scheduling gives your patients the flexibility to schedule appointments 24/7/365 while giving them the privacy to do so without having to share personal details over the phone.

Second, online payment tools. As mentioned, there are still a lot of paper statements and checks being mailed to pay for care. This will probably never get to zero because healthcare doesn't have a demographic and you need to provide options to all types of people, but the world has already become much more digital with even elderly patients getting very comfortable navigating a mobile device. It also makes smart business sense.

Electronic payments happen faster and are less expensive to process. Every business should prefer getting paid faster and have funds deposited directly into your bank account without additional manual intervention.

And third, pre-visit cost estimates. For starters, this is now a legal requirement thanks to the No Surprises Act so if you are not providing an estimate you are subject to fines. Besides being legally required, it's just a good thing to do. Additionally, it allows the provider to have a conversation with a patient if the cost will be significant.

For example, putting the patient on a payment plan up front that meets their budget and getting the payment method on file helps the patient not stress about a surprise cost and helps the provider collect automatically without manual intervention.

Q. What do you believe will happen if hospitals and health systems embrace digital tools on the patient side that are flexible, modern and convenient?

A. Modernized, advanced payment platforms can make the difference between a positive and negative overall patient experience. Provider groups that take advantage of platforms that cater to patient demand for convenience and flexible payment options stand to improve their patient experience while improving collections through higher patient loyalty.

Additionally, digital tools such as flexible payment plans, pre-service cost estimates, and next-generation payment methods help improve access, affordability and convenience of care, which can lessen burdens on patients experiencing social determinants of health issues. SDOH exert influence on many health-related social needs, including financial strain, housing instability and poor quality, food insecurity, lack of access to health care, and inadequate educational opportunities.

Americans who experience SDOH face higher risks of exacerbating health conditions like heart disease, stroke, depression, cancer and diabetes, according to the U.S. Playbook to Address Social Determinants of Health.

Providing patients with digital tools such as payment plans, pre-service cost estimates and modern payment methods won't eliminate SDOH issues. However, by offering these tools, providers can do their part to help make SDOH a little more manageable for their patients.

Q. Please detail an example of a common patient process today versus how it would go in a highly digital environment.

A. We live in an always on-the-go world where we can do things on the fly. Maybe you are in a drive-through line and you remember you are out of printer paper, so you add it to your Amazon cart.

Patients and providers benefit from the same flexibility. With the right digital tools in place, for example, a parent can receive a reminder to check in for their doctor's appointment and pay a co-pay while they are watching their child's baseball game.

Further, in a modern patient payment experience, not only can a patient pay anywhere, anytime – they can pay using their preferred payment method whether it is a credit card, debit card or digital wallet such as Google Pay, Apple Pay or PayPal.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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