Beyond the Virtual Visit: Building a Better Digital Front Door
As healthcare organizations focus on strengthening their virtual visit capabilities, they should be framing other digital front doors — doors that open into intelligent, patient-centered experiences, built on data from multiple systems harmonized through a platform.
During the COVID-19 pandemic, many healthcare organizations have augmented their telehealth capabilities to offer patients alternative access to care and avoid exposing them to the virus. It’s important to continue building out these virtual channels, given how eagerly patients have adopted them. Eventually, these virtual visit channels should be integrated into a broader digital front door strategy. Telehealth channels, portals and websites that are not integrated are not true doorways into the broader health system.
Any digital front door must lead to a rich ecosystem of well-integrated patient-centered experiences. The average healthcare system will have multiple digital front doors — from physical facilities that capture patient data electronically to video consults to apps. Regardless of which doorway a patient first enters, any doorways they access on subsequent visits should recognize them, anticipate their needs, offer a personalized experience, and collect and share data to continuously improve that experience.
Successful digital front door strategies require healthcare systems to become hyper-focused on the customer (that is, patient) experience. They must understand the expectations of their intended audiences and be clear about their goals of improving care access, patient engagement and efficiencies. Then they must constantly fine-tune both the digital doorways and the offerings behind them to achieve these objectives.
The experience design and the underlying delivery technology are each vitally important to a digital front door strategy. Experiences must meet patients’ expectations while also nudging them to adopt new behaviors that improve their health. Technology must support the experience, or else healthcare systems may implement modern systems and processes that patients simply ignore.
Human design principles for digital doors
Services delivered through digital front doors must meet a specific set of patient expectations. Patients want to be cared for with warmth and understanding; enabled to manage their own care; empowered with relevant, curated data and guidance; and recognized and known as a specific individual, not just a patient. To meet patient expectations, here are the minimum capabilities we recommend digital front doors deliver:
Intelligent, frictionless experiences. Patients want to be empowered to manage their care and make good healthcare decisions with relevant, personalized and curated information, options and advice. An intelligent experience helps accomplish this. Intelligence recognizes the patient’s context; predicts or anticipates the patient’s intent or need; respects the patient’s agency to make decisions; and adapts as the patient journey changes, continuously learning and improving.
Convenience. Patients want to incorporate their care plans and goals into their day-to-day activities as seamlessly as possible. One example of delivering on this is providing same-day access for primary and specialty care for high-worry conditions. This has been especially useful during the COVID-19 pandemic, with providers effectively triaging patients and directing them to appropriate levels of care. Another example is providing convenient connections to physicians and community support services.
Continuity of care. Patients want to be known across health networks that deliver comprehensive, integrated, whole-person care. This knowing manifests as recognition at each access point, with navigation aids across the health continuum. Patients expect consistent practices, standards and high-quality care at each access point, as well as easy coordination and communication among caregivers.
Affordability. Patients want clear information about prices and quality ratings.
Experiences at each doorway must incorporate these qualities — and flow into each other. An empathetic, warm experience at one doorway will be negated if the next doorway fails to recognize the patient or where they are in their healing journey. Ensuring seamless, intelligent patient experiences requires healthcare organizations to knit their many systems into a coherent ecosystem. That integration is built on data, and a platform is the best way to orchestrate data flows among many different systems.
The platform supporting the digital front door
The digital front door orchestration platform provides a uniform experience to patients and clinicians, drawing on data and capabilities in the underlying systems. The platform’s engagement layer creates a consistent look-and-feel across all the digital doorways, but that is only the beginning of the experience.
Cognitive layers, including artificial intelligence (AI), machine learning, analytics and natural language processing capabilities, help the engagement layer recognize patients, understand their context and anticipate their needs. The platform conducts data to and from the cognitive layers from dozens of systems and devices: lab, pharmacy, clinical documentation, care management, administrative, patient-generated and third parties such as payers and government agencies.
A platform-centric approach enables healthcare systems to incorporate as many existing systems as possible into their digital front doors and easily add new niche capabilities as required. Modern, best-in-class systems typically will integrate well. Older systems usually have closed architectures, and it can be difficult to create bidirectional data flows with these. A platform can mask some of these challenges while a healthcare system transitions away from legacy systems.
Managing the digital doorway as a product
Developing and maintaining digital doorways will be a continuing journey, more akin to a product management lifecycle than a marketing or IT project. To that end, healthcare organizations must assemble these components:
Multidisciplinary product team. System architects, cloud experts, clinical systems leaders, product engineers, CIOs, CFOs, marketing officers, digital officers, operations teams, and patient experience designers all must work together to create and maintain the digital front door. Digital doorway platforms unlock data silos and orchestrate new connections and dependencies. Organizations will need to design new patient-facing processes built on these more fluid data flows. It requires a team with multiple perspectives to ensure upgrades and changes to individual systems, and workflows enhance the seamless patient experience whenever possible and never degrade it.
Service design. Organizations must create service blueprints for all offerings behind their digital front doors to ensure they are supported by people, processes and technology. These blueprints must be granular. For example, if a messaging function is turned on, personnel must be available to receive and respond to those messages. Price transparency tools must be updated on a regular schedule.
Awareness. Healthcare organizations should explain the rewards of digital doorways to patients. These rewards include better experiences throughout the healthcare system because a patient’s medical record is available behind every door. Awareness campaigns may be as simple as posters in clinics and offices advertising availability of an app or even an app function, such as wayfinding. Personnel can also be trained to usher patients through digital doors by signing them up during office visits.
Support. Self-service help can be built into digital doorways. Nonetheless, some patients will prefer the human touch, and healthcare systems must have robust contact center capabilities to meet these needs. The cognitive layer in the platform can also assist service representatives to guide patients.
Measurements. Alongside traditional metrics such as cost and quality, healthcare organizations must use digital media metrics (monthly active unit and daily active unit measures, for example) to continually monitor and evaluate doorway performance. These leading indicators quickly show whether any doorways are underperforming and need investigation, such as additional user acceptance testing, or whether others need more capacity. Organizations can use these metrics to better understand how their local population responds to digital front doors. Some doors could be more closely tailored to the specific demographic group favoring them.
Digital front doors help patients access care in ways meaningful to them that are also efficient for the healthcare organization in terms of improving access to care, patient outcomes and efficiencies. A first step is for organizations to inventory how many digital entryways they currently have, especially new virtual visit offerings. Then they should evaluate the technologies being used to deliver these. Ideally, the virtual visits would all be delivered from one platform that can later support additional digital doorways. Otherwise, integration issues will become challenging in the future.
Given that patients see virtual visits as safe access points, healthcare organizations could prioritize transforming these into true digital doorways in preparation for eventually delivering the larger, connected experiences patients expect.
This article was written by Sashi Padarthy and Ashley Liewer of Cognizant’s Healthcare Consulting practice.