Patient Centricity in Healthcare Outsourcing

It’s no secret that the Healthcare industry is undergoing massive changes, and that these include the solutions that outsourcing service providers are bringing to the market. Last week I caught up with HCL’s Healthcare head, Gurmeet Chahal to discuss these trends and current areas of focus for HCL.

Bill Huber: HCL has referred to something called “Patient Centricity” in describing its services approach in healthcare. Can you describe what that means in practical terms?

Gurmeet Chalal: As you know, right now, the healthcare industry is undergoing what are perhaps the most dramatic changes of any major sector. HCL looks at healthcare in light of this transformation and sees enormous potential for innovation, with a focal point for that innovation around the patient. We are achieving results by converting technology platforms, capturing and organizing data and providing services that are focused on transforming the insights from the data to outcomes for the patient with the goal of improving the patient’s experience. We believe that this ultimately needs to be done over the lifetime of care for the patient.

Our approach is based on connecting the insights obtained through HCL’s rich experience of working with both payers and providers, along with a heritage of working with the medical device industry, and of course, pharma. Utilizing technology, analytics and services, and leveraging our global scale and partner relationships, we are able to bring clinical insights together. At HCL, our culture is focused on “ideapreneurship”, involving individuals who take accountability on behalf of our customers. Part of this is how we use cross functional teams and have built the “4I” framework which enables us to stitch data into a unified fabric and build an intelligence layer on top through our understanding of business data and analytics. For example, think of a medication adherence strategy. If the patient is adhering to a prescribed medication regime, presumably the patient will benefit through improved health, the payer will benefit through reduced cost of care, the provider will benefit through improved patient outcomes and lower readmissions, and the pharma will benefit through improved market share. The combination of technology, analytics and services makes this possible through enablement of better monitoring, tracking and follow-up with patients and caregivers to improve regime adherence.

In addition to our aforementioned relationships, HCL has its own provider business in India. It comprises the country’s first nationwide networked multi-specialty clinics in affiliation with Johns Hopkins Medicine International. This provides us with our own unique insights that will fuel research that will become increasingly important for providers in the US as the Asian population increases here.

BH: You mentioned your “4I” framework. What is that?

GC: It’s about how you obtain and what you do with the right Information. The four “I”s refer to Intelligence, Interaction, Integration and Insight. So, we have a strong Intelligence layer, comprising patient segmentation, benchmarking, analysis and simulation and the like. Then we have an Interaction layer, which is multi-channel and includes social media, mobile, in person and web. Third, there is an Integration layer which collects and organizes information from multiple sources, including from Pharma, from labs, from providers and so on. For example, through a partner, we have built a platform that enables integration of data from over 160 medical devices in real time. Lastly, there is the Insight layer, which provides actionable care and business recommendations.

BH For you as a service provider, what is different about healthcare from other areas?

GC: We have a very strong domain-led technology which is consistent across all of our verticals. In healthcare, we believe that we are unique in the degree to which we work across the entire healthcare ecosystem. This gives us the capability to be front and center. An example is how we are leveraging our strong medical device expertise to create next generation solutions that benefit patient, payer, provider & the device manufacturer.

BH: How are regulatory changes driving increased use of service providers?

GC: The Healthcare industry is among the most regulated. New regulations do have impact on IT services consumption. As an example ICD10 had driven growth in IT services, and is expected to have an ongoing impact in areas like RCM going forward based on the complexity of codes. All of the quality, compliance and regulatory mandates require payers/providers to upgrade their existing IT infrastructure and in some cases to build entirely new capabilities.

BH: As applicable to your services, what are common priorities for both payers and providers?

GC: We believe that new business models are emerging that encourage the payers and providers to improve collaboration. The first is based on the need to drive distinctive customer experience management. This is what will differentiate both in the long run and drive patient retention levels
Secondly, to run effective care management, claims information is insufficient. The payers need to integrate clinical data, lab data, etc. This means that they need a flexible, agile and external focused operating model.
Lastly, both payers and providers have a string need to reduce cost while improving care quality, and to accomplish this while investing in new capabilities such as analytics, social, mobility and so on.

BH: What are the things that HCL is doing to address these priorities?

GC: HCL’s approach is twofold. First, we leverage our strong technology and process capabilities, and secondly, we are investing in frameworks and accelerators where we are leveraging domain experts. For example, we have come up with a solution that we call Member Experience Management. This allows our customers to build a multichannel engagement and communication strategy. It provides a framework the gives a single view of the customer and drives the customer experience. It includes a view of workflow, CRM, infrastructure, next generation CTI Similarly, we have a solution called population care management, which allows providers to engage and drive the medical protocols that they have designed for a population pool

BH: You offer services across infrastructure, applications and business services. Is there a natural evolution among these services when you are engaged with a healthcare client?

GC: It’s very rare that we see a customer take a big bang approach of bundling the whole thing. A lot of times, we get engaged in a business solution kind of discussion. For example, in a successful population health management program, you will need a specialized application, underlying infrastructure and analytical and business services. In these cases, it’s an integrated solution with all three layers. If you look at the conventional towers of ITO. There was a lot of application development work that was happening given the exchange readiness rush. Currently there is a surge in developing front end transformation and analytics capabilities. There is a recognition that a lot of cost can be saved by outsourcing basic infrastructure and in back office functions like claims processing. While there is need and desire to move on all tracks, depending on customers’ readiness there may be a phased approach.

BH: What are unique service levels for HCL associated with healthcare? Are any of these outcome-based?

GC: We have a number of outcome-based examples. One of the solutions that we have is a combination of applications and BPO in fraud, waste and abuse. The contract is linked to recovery through the process. Another example is revenue cycle management where a focusing on improving customer satisfaction year over year.

BH: Final thoughts?

GC: There is so much change happening in healthcare, but I believe that this is a great opportunity for healthcare to transform itself. There is a lot of change, but this is the opportunity to gain from this change. It is very rare to see any industry witnessing so much change at one time. On a recent airplane ride, I sat next to a retired IT executive. When I explained what I was working on, he said, “I’m really jealous. Your industry is going through so much. Through technology, you can make such an impact on the lives of humans. I wish that I had that opportunity.” That has stuck with me. We should be grateful for this opportunity, and it’s time to make that impact and gain from this change.

About the Author

Bill Huber is a sourcing industry leader and active proponent of helping to create professional standards and best practices. His areas of expertise include sourcing strategies, shared services and contract negotiations. Throughout his career he has been responsible for both business development and delivery of strategic advisory services in procurement, vendor management and operational transformation.