What Makes Healthcare Different? (Part Two of Two)

What Makes Healthcare Different? (Part Two of Two)

The dramatic changes transforming the Healthcare industry are having a dramatic impact on outsourcing service providers, as payers and providers increasingly focus on new delivery models and the integration of disruptive technologies. I recently spoke with HCL’s Healthcare head, Gurmeet Chahal on the concept of “Patient Centricity” in today’s environment   Our conversation continues below, as Gurmeet discusses what makes Healthcare different.

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 health care, 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 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.