Since the onset of the pandemic, the healthcare ecosystem has been forced to adopt new guidelines, metrics, and digital capabilities out of necessity and growing patient demand. One such strategy which has emerged has been the “digital front door”. For many, this concept is now standard, but historically it was only considered and meaningfully implemented by market leaders. The digital front door, broadly, is a strategy for engaging patients at each major touchpoint of their care journey using technology they are already familiar with. A well-thought-out version of this strategy doesn’t necessarily fall into one single product or category, but rather, it leverages technology to effectively expand patient access, boost productivity, drive higher patient satisfaction, and ultimately drive revenue in a seamless and cohesive manner.
In this blog, we briefly outline how the notion of a digital front door evolved from a nicety among leading institutions to an industry standard, and talk-through an example framework to consider for healthcare institutions at the beginning of their “digital front door”.
A Brief History of Healthcare’s Digital Strategy
The word “digital” has been circulating in the healthcare vernacular for quite some time now. In the years since then, many industries have adopted and been re-imagined through digital technologies such as Amazon, Netflix, Twitter, Facebook, etc. However, the digital revolution seemingly didn’t show up on healthcare’s doorstep for a number of years – and it has not yet caught up with the rest of the economy. According to one survey, only 7% of healthcare and pharmaceutical organizations said they have gone digital, compared to 15% of companies in other industries. This discrepancy in part helps to frame the opportunity witnessed in healthcare during the height of the pandemic. With people stuck at home, an imminent need was born with regard to self-management and remote care; in parallel, across the remainder of the economy, people had already become accustomed to frictionless end-to-end digital experiences. And as a result, similar expectations and demands unsurprisingly began to brew in the healthcare sector. In combination, these pressures jointly surged healthcare into the digital age throughout the pandemic.
The Digital Front Door Strategy
The patient journey is much more complicated than purchasing items on Amazon or streaming a movie on Netflix, but similar digital strategies have taken shape. For example, we may consider a provider interaction along the following buckets: 1) searching, locating, and scheduling appropriate care, 2) pre-visit activities to facilitate efficient in-office experiences, 3) intravisit activities while the care is delivered, and 4) coordinated post-visit interactions to capture value, gather feedback, and effectively manage go-forward activities. Understanding this framework is crucial in how organizations think about the patient journey, beyond the four walls of the clinic or hospital. While there is no one-size-fits-all digital strategy, there are common elements and capabilities which leading organizations are already utilizing to differentiate themselves from competitors and better support their patients.
Prior to the pandemic, and in past decades, patients found physicians through word of mouth, referrals, and limited online resources. With the rise of platforms such as ZocDoc, Kareo, and Sesame, physicians are now able to advertise their services, receive reviews, and actively engage patients in new and meaningful ways. The natural progression of these services has included a focus on providing patients with a mechanism to filter and select the appropriate care resources based on highly personalized criteria through platforms like QualityCare Connect by Armada Health.
Further, the rise of these platforms has opened the process to provide patients with agency surrounding appointment scheduling with simple web and mobile friendly technologies. As such, finding providers, particularly primary care providers, through these means, has become second nature for today’s patients.
Services such as One Medical, Iora Health, and CityMD provide patients with direct access to physician schedules while simultaneously storing patient data and enabling seamless data transfer between providers in the same network. Features like online documentation verification, prior authorization, appointment logistics, and automated reminders tend to be included across all platforms.
At this point in the patient’s journey, an appointment is scheduled and pre-requisite documentation may be executed and shared back to the provider’s system of choice. Prior to a visit, there are check-in and attendance systems integrated across more holistic platforms, such as with One Medical, but increasingly into newer healthcare entrants such as Walmart and Amazon. Recently, one of the more common digital front door strategies for inter-appointment communication and medication adherence has been text/ email/ notification-based reminder systems such as is made possible by companies like Conversa Health. In many cases, these types of tools include a conversational AI integration such as HyroAI or ada to offload the burden on front-desk staff.
Additionally, to enhance the value of office-visits for patients, digital front door platforms have introduced intra-appointment capabilities, namely documentation solutions, such as Abridge, to more efficiently and effectively capture and share patient information during an interaction, care navigation platforms like GYANT, which, among other capabilities, enable providers to digitize and streamline patient journeys, and interoperability solutions like b.well, which aggregate patient data to create a longitudinal health record and facilitate personalized care.
Following a patient’s visit, there remain several areas for value creation by means of an effective “digital front door” strategy and platform. Many care management platforms such as Carbon Health, Tia, and Heartbeat Health – the latter two focusing on specialized care – provide features which may be leveraged to automate patient surveys and follow-up reminders related to a particular care plan, or jointly to facilitate the scheduling of required follow-up visits. These types of features ensure a comprehensive patient and provider experience across the entirety of a patient’s care journey. One of the most notable, but often overlooked features related to effective post-visit digital engagement is payment processing. Due to the strict security constraints including SOC I & II, PCI DSS, P2PE, and HIPAA, only specific entities are permitted to facilitate the transfer of funds between stakeholders across the healthcare ecosystem. Companies such as Cedar and Paytient provide payment platforms while organizations like Salcuro build bespoke financial systems to accept payments across multiple organizations and formats.
From Point Solutions to a Comprehensive Digital Front Door
To better understand how leading institutions are implementing the notion of a digital front door, consider Seattle-based Providence. Providence has been a leader among health systems taking an integrated approach with digital technologies to re-invent the standard of care by buying, building, and partnering with vendors to meet changing patient expectations. Along the framework outlined above, Providence has partnered with Kyruus to facilitate provider search and appointment scheduling, spun out DexCare to offer self-assessments and navigate the complexities brought about by new virtual care offerings, spun-out Xealth to enable digital prescription, device, and resource ordering for providers within an existing EHR environment, partnered with OpenNotes to facilitate patient-provider communication, and developed apps like Circle to guide patients through specific care journeys. While the above is not exhaustive, it should provide a reference point with regard to the extent by which new digital tools and capabilities may impact a patient’s experience.
Importantly, as the number of point solutions employed grows, so too does the relative importance of designing a singular, seamless experience for patients. In the case of Providence, each of the above, in addition to lab results, educational content, wayfinding among a plethora of other functions, are accessible via the Providence Health Connect App. The impact of Providence’s digital front door strategy is still playing out, but results to date have been meaningful. Notably, in response to the onset of the COVID-19 pandemic, the health system was able to rapidly re-purpose numerous digital capabilities and tools to meet the needs of their patients and the broader community – a feat which would likely have been farfetched only a decade ago.
In select markets, merger and build activity is catching up with point solution innovation to build holistic care management platforms across the digital front door continuum. Organizations such as Altais, Carbon Health, Oak Street Health, and Forward have created holistic platforms which configure with the likes of Epic, Cerner, and athena to provide a one-stop solution for patients and providers. As the market continues to contract with mergers and acquisitions, it’s important for patients to keep a look out for tools that will complete their care journey and broadly improve the digital experience from end to end.
There is no one-size-fits-all digital front door technology platform or strategy – different existing workflows, tech-stacks, budgets, populations etc. all factor into consideration as an organization works to craft a digital front door strategy. With that in mind, as the digital revolution continues to advance into healthcare, there are several factors to keep in mind for provider organizations trying to better serve their customers:
- When crafting a comprehensive digital front door by linking disparate solutions via a combination of buying, building, and partnering – what is most important is that the experience for patients is seamless, as opposed to an additional layer of complexity.
- The experience within the patient room, during the visit, remains the largest area of opportunity for additional value creation.
- Mergers and acquisitions will drive consolidation in what is currently a very segmented digital front door market, which will streamline purchasing decisions but could potentially reduce flexibility in the future.