Building a more trusted provider-member relationship through digital tools

digital transformation illustration

The pandemic accelerated digital transformation — and innovation as a whole — in the health care sector, and there appears to be no slowing down. One of the clearest demonstrations of that digital advancement is related to care delivery between providers and members.

  • 84% of health care stakeholders say their organizations now require them to use digital health tools1
  • 79% of clinicians report that they choose to use digital health tools on their own accord1
  • 78% of hospitals and health systems plan to increase their investment in digital health2

Maximizing the value of digital transformation means building on the human connections that are crucial for quality care. A relationship with a trusted provider remains paramount to a positive health care experience, and improving the patient-provider relationship typically starts with fostering more personalized interactions. Clinicians, payers and health system leaders increasingly see the potential benefits of personalizing patient care, with improved patient satisfaction and better health outcomes.

3 key takeaways on digital transformation

  1. The acceleration of digital transformation in health care is enabling providers to build more trusted relationships with their patients.
  2. New innovative digital tools are giving patients and providers access to real-time data that can help inform medical care and healthier lifestyles and streamline administrative processes.
  3. Advanced analytics like machine learning (ML) and artificial intelligence (AI) are driving the industry’s innovation and digital transformation by helping physicians monitor, learn from and predict patient behavior.

Digital transformation occurring in the provider space

Three areas of focus emerge that are helping enable a more personalized member experience:

An innovation strategy in these areas is designed to help build on the trusted provider-member relationship and more quickly advance the overall care-delivery model that exists today.

At the end of the day, the value is about clinicians reaching out to members with clear and concise recommended actions to improve their health," says Craig Kurtzweil, vice president for advanced analytics at UnitedHealthcare. By gathering and integrating real-time data, as well as developing tools and technologies that leverage machine learning, UnitedHealthcare is helping providers guide members toward their next best action on their health journey.

Leveraging real-time data

New tools are giving patients and providers access to real-time data that can help further inform medical care and encourage healthier lifestyle modifications. For instance, a continuous glucose monitor (CGM) used in conjunction with a Fitbit tracker can help those with type 2 diabetes see how food, sleep and movement affect their body in real-time without more traditional diabetes management tactics such as fingersticks or frequent doctor visits. Providers with access to the data can track a patient’s daily trends to provide clearer direction based on the patient’s personal preferences.

“When you have that continuous feedback, you can start to really pinpoint the effects of the timing of meals, walks, the hours that you sleep and all of these micro-decisions that you make throughout the day,” Kurtzweil says. “Then, for a solution, you don’t have to change your whole world. You can just change a microintervention customized to your body and your data — which has a greater opportunity for success.”

Technology can also help providers identify patients who may benefit from other supportive care. Primary care physicians often lack the time and resources to evaluate their patients’ mental health during a routine visit. Providing patients with an app that can passively collect information on their mood and mental well-being can help providers identify those who may benefit from mental health services.

Developing tools for efficiency and simplicity

With the right tools, physicians can access critical information at the precise moment they need it. This may even include information they don’t know they need in making the best decision for a patient.

“Some doctors may still be using the old method of simply putting in an order without understanding the full impact on the patient,” says Dr. Gerald Hautman, chief medical officer for UnitedHealthcare National Accounts. Digital tools can help ensure that information about network providers, quality ratings and details regarding prior authorization are presented on the physician’s screen, when it’s needed in the moment.

UnitedHealthcare offers tools that enable physicians to access useful real-time information. For example, doctors and staff can view precise prescription costs, patient-specific coverage and clinically appropriate alternatives during a patient visit, thanks to technological integrations with electronic medical record platforms. This helps minimize prescription delays, unnecessarily high costs and other barriers that may lead to medication nonadherence.

Looking ahead, sophisticated algorithms have the potential to flag issues that physicians may have missed. The physician will still make decisions about care, but they would be supported by helpful alerts and information they may not have sought on their own. “This way, the patient is getting better care, but the payer also gets value because you’re getting things right the first time,” Anderson says. “It helps remove some risk that could be going unchecked.”

Harnessing the benefits of advanced technology

With one of the largest health databases in the nation, UnitedHealthcare is applying machine learning and artificial intelligence to help drive industry-wide digital transformation. “We are using this technology to design clinical solutions and products to improve care,” says Dr. Jaime Murillo, senior vice president and chief medical officer at Optum Labs.

These technologies are designed to help physicians monitor and learn from patient behavior. Passively acquired health data signals produce more information than a human can analyze. “But artificial intelligence and machine learning can analyze that higher volume of information, detect patterns and identify behaviors that need to be adjusted,” Murillo says. “Digital transformation is a huge opportunity for us to diagnose, but also to predict who is heading in a certain direction so we can act earlier.”

Machine learning is also designed to augment care-decision support for physicians. Algorithms can match individuals at certain points in the care journey and compare outcomes among those who took different paths. This can provide key insights and evidence for clinical decision-making.

“The algorithm starts to understand that, in this scenario, your probability of a good outcome is better if you go this way than that way,” Anderson says. “No one person can take in all these data points, but we can develop systems that can help us gather all the right evidence at the right time and apply it to making a better decision.”

Ultimately, a trusted relationship between a patient and provider is one of the strongest drivers of quality care and positive outcomes. The goal of digital transformation and innovation overall is helping create the most value within those interactions.

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