Saturday, September 23, 2023

Rising healthcare costs? Don’t blame doctors; Blame the outdated administrator

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Shreya Christina
Shreya has been with for 3 years, writing copy for client websites, blog posts, EDMs and other mediums to engage readers and encourage action. By collaborating with clients, our SEO manager and the wider team, Shreya seeks to understand an audience before creating memorable, persuasive copy.

CEO and chairman at Resilient Healthcareleading technology-enabled community-based care.

I was recently scrolling through LinkedIn when I came across a post with hundreds of comments from doctors. The post referred to an article written by an economist, in which he claimed that doctors in the US are overpaid. The doctors’ comments defended their income, with arguments ranging from logic surrounding the rising cost of medical education in the US to statistics pointing to excessive administrative costs in health care.

That economist’s article took a dangerous stance, as many expect shortage of caregivers by 2030. Here we have an industry built entirely on interactions between patients and healthcare providers, and non-providers argue that doctors should be paid less? The truth is that even if doctors weren’t paid at all, we’d still be spending more than… $3 trillion dollars on health care in the United States. And of course, if you were to remove doctors altogether, there would be no industry.

Rather than irresponsibly agreeing to the idea that we should cut doctors’ salaries, I looked for innovative ways to reduce administrative costs, which are estimated to be $1 trillion (subscription required) annually. Can we support our doctors, deliver efficient healthcare to our patients and reduce the costs involved? Can technology help us reduce inefficiencies and improve workflows?

Based on my experiences running a company that provides tech-enabled healthcare, the answers are yes and yes.

Workflow operating systems and virtual assistants

Because of the pandemic, my company, like many others, has adopted a work-from-home approach whenever possible. Working from home gave employees more autonomy in their day-to-day work, but also emphasized the need for us to better manage administrative tasks remotely. To achieve this, we implemented a working operating system/virtual assistant.

As a startup within a new healthcare sector, we focused heavily on workflows and models that would promote economies of scale. After some research, we went for a virtual assistant that uses micro-machine learning and tracks administrative keystrokes to reduce the time spent completing repetitive tasks. This tool automated our patient intake process and encouraged our back office to keep up to date. Productivity increased dramatically. We have also developed and implemented patient engagement platforms with automated scheduling modules and clinician routing software. This significantly reduced the need for back-office FTEs as we scaled up to rural markets six hours (and beyond) from our headquarters.

By deploying this type of technology on a larger scale, the administrative burden for payers can be reduced. Insurance companies have huge call centers to process claims and answer a litany of service requests. These requests become mundane and repetitive tasks for employees. Implementing micromachine learning technology in workflow operating systems could streamline this process, reducing the associated costs of performing the same tasks.

How it works

Work operating systems (OSs) are installed on employees’ computers to learn the processes they use to perform tasks. It remembers multi-step workflows performed by each staff member. It then produces a predictive model, allowing the virtual assistant to predict what the user will do next, then augment that experience with suggestions for the next step, pre-fetching historical business data.

Such systems are just one example of how AI and innovative software can reduce administrative costs.

Privacy and Compliance

According to an Accenture survey, nearly 1 in 5 health professionals (18%) said they would be willing to sell confidential data to unauthorized parties and about 1 in 4 (24%) said they actually knew about a colleague who had made a profit by giving a third party access to patient information. Work OS technology can notify hospitals and insurance companies when patient information is at risk of being sold by employees by tracking when data is downloaded to remote devices. Such violations are becoming more frequent, putting the healthcare organization at financial risk of fines and lawsuits.

Exchange of health information and patient responsibility

One of the most frustrating and time-consuming tasks for patients and doctors is calling an insurance company to request information or try to understand its coverage. In the past, patients provided physical insurance cards and matching IDs for administrators to scan into the system, verify benefits (sometimes over the phone), and request authorization. This outdated process offers the opportunity to reduce patient admission costs. More recently, I came across a system that exchanges information between hundreds of payers and automatically uploads patient insurance information to provider portals. Using various online payment processing systems also makes it easier to notify patients of outstanding bills and offer payment plans without incurring additional collection fees.

Final Thoughts

In an industry focused on reducing costs yet spending billions of dollars on administration, it’s important that we consider new, more efficient ways of delivering care, embracing technology to improve workflows and processes. Doctors and their salaries are not the problem; obsolete approaches to health care delivery. Business Council is the leading growth and networking organization for entrepreneurs and leaders. Am I eligible?

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