"For a frictionless digital consumer experience, healthcare providers and payers must work together."

Bill Krause, Vice President of Experience Solutions, Change Healthcare in conversation with Paddy Padmanabhan, CEO of Damo Consulting on the Big Unlock Podcast – “For a frictionless digital consumer experience, healthcare providers and payers must work together.”

PP: Hello everyone, welcome back to my podcast. This is Paddy, and it is my privilege and honor to introduce my special guest today, Bill Krause, Vice President and General Manager of the Connected Consumer Experience Practice at Change Healthcare. Bill, thank you for setting aside the time, and welcome to the show. Do you want to spend a couple of minutes talking about Change Healthcare, what does the company do, and what are your focus areas today?

BK: Change Healthcare is one of the largest independent healthcare technology companies in the U.S. We provide a variety of data and analytics-driven solutions and services that focus on clinical, financial, and patient engagement outcomes. We really occupy a unique space in healthcare with our focus on connecting the broad ecosystem. For example, we have deep and broad networks across financial and clinical areas that improve decision making, simplify billing, help with payer and provider processes, payment processing, and generally, help enable better consumer experiences.

PP: On this podcast, we focus mostly on digital transformation. What that means to healthcare enterprises, as well as to the technology provider community that serves the needs of healthcare enterprises. Change Healthcare recently announced a new platform that you have just launched. Can you tell us a little bit about what is the platform called? What kind of marketplace needs you are looking to address with the platform?

BK: Recently, we announced the availability of our connected consumer health suite. The solutions Digital Patient Experience Manager, Shop Book and Pay, Virtual Front Desk, and other capabilities, they really help providers to create more consumer-style digital healthcare experiences. We like to say we are helping providers with this platform power, the connected digital journey for consumers, from internet search through to the exam room. And our focus is around removing as many of the friction points that are typical with today’s healthcare experience across finding care, accessing, and paying for care.

PP: Let us talk a little bit about these suites of solutions that you have launched. In the Shop Book and Pay, you mentioned digital experiences and consumer empowerment and so on. When I look at the digital health solutions landscape, I see that you already have the big electronic health record vendors such as Epic, for instance, and their MyChart platform. And then you have a whole marketplace, called the digital health innovation, an ecosystem of startups that have identified an opportunity relating to any one single touchpoint in the online consumer experience. So, it looks like what you’ve done is taken many of those features, many of those needs, looked for the touchpoints, and kind of aggregated them all into a one-stop platform. Is that a fair way to state that? How exactly would you describe that?

BK: What I would say is our insight and what’s behind the solutions we announced is that what we see as the need is to remove, as I mentioned, like many places where consumers hit barriers in accessing care and using great digital to do that. So really, the analogy is we think about our examples, such as Rocket Mortgage or Carvana, Amazon Go, and others that have taken technology, and to your point, there are existing technologies out there serving different points in the healthcare consumer journey; but the unique insight was bringing these together dramatically, simplifying the process that a consumer goes through really to access the services or products that they need, and to do that in a way that works within the context of healthcare.

PP: So, give me an example of how this would work if I am a healthcare consumer. First of all, would I even be accessing your platform directly, or is your platform kind of sitting underneath maybe a health systems front end portal? How does this work as a consumer, what would the experience look like for me?

BK: There are a number of ways and a number of on-ramps for a consumer to enter this digital journey that we make available for providers. We have partnered with Adobe here and Adobe is a leader in digital experience. As a result of that, we have a variety of capabilities that can really customize the experience to fit the brand and styling and many of the other factors that our provider customers need to really reinforce their strategies. It’s never really been more important now in light of COVID-19 and the dramatic shift towards digital. But most consumers today are really struggling to understand what their financial responsibility is going to be, and their struggles with healthcare. They are struggling to connect together with the steps they need to take. So, a consumer would start the journey, perhaps on the web site of their local provider and they will be able to search for care, understand what care is available to them based on any number of services that are increasingly more shoppable if you will. And by that, we mean where consumers are more actively involved in the decision making around those services. So, they’ll enter through the provider’s web site. They’ll enter into the Shop Book and Pay experience, which is branded for the provider. They’ll locate the provider and the services that they need within their local area. They’ll be able to understand their out of pocket responsibilities, schedule care, and complete the pre-service journey in as simple a way as possible.

PP: And you mentioned Adobe as one of your partners. You also partnered with Microsoft in building the platform. Am I correct?

BK: That’s exactly right. This is bringing together the best of three very complementary companies that are leaders in their respective domain. Bringing together Microsoft’s leadership with cloud hosting and regulated industries and significant capabilities around making it scalable and serviceable across the market. So, one of our objectives here is to make these solutions available for the largest providers, but down to the smallest independent practices as well. And Microsoft has a great role to play in making that scalable. As I mentioned, the role of Adobe and really leading many consumer industries and powering the digital experiences that we all know and love and then change healthcare. And one of the important insights here is in order to make great progress in consumer experience and consumer digital transformation, you have to get access to the workflows and data and other backend systems that are necessary to bridge those silos, if you will. And that’s a great capability that Change Healthcare brings to this partnership on behalf of the customers we serve.

PP: So, staying on the consumer experience for a moment, I imagine that you have your first few clients or deployments already live or in the process of really going life. Can you maybe describe what the architecture looks like? You know, let’s say you’re working with a healthcare provider who is on one of the major electronic health record platforms, Epic or Cerner or one of them. How does your platform fit in that architectural construct? And also, are all the capabilities that you talked about, are they all built native in your platform or do you also have components that are maybe a white-labeled with other startups? How is this whole thing architected? If I look at it from an enterprise standpoint as a healthcare executive.

BK: Certainly. So, it’s architected in a cloud-native structure and with an architecture that allows us to on behalf of our provider customers, to integrate into their systems of record. If you think about just from an overall philosophy and approach standpoint, we view the provider has a number of systems of record that house data needed to support these consumer journeys, be it their electronic medical record or their revenue cycle system. Change Healthcare equips many providers across the industry with some of those systems like revenue cycle management. But those systems of record then interact with the systems of engagement. And that’s really where the Connected Consumer Health Suite plays the role it’s delivering to those providers – a scalable, cloud-hosted architecture that integrates with their data sources and powers for them those digital experiences that they need to support for finding and accessing care.

PP: One last question on the topic. Who pays?

BK: There’s a very simple model to this, which are the customers the providers pay for. And I also want to address another question you asked around third parties as well. But I’ll come back to that. But yeah, it’s a simple subscription model based on consumption that providers pay for and the benefit to them is multifold from operational efficiencies to really and most importantly, attracting and retaining their consumers. And that is really where the value that they receive out of this solution. But back to the other question. We have architected our platform in such a way as to incorporate third parties into the journey. We recognize that healthcare journeys can take many different avenues and providers need the flexibility to be able to accommodate those third parties we’re working with. For example, M.D. Safe, which is a great innovative early-stage company that helps to create a single billing experience for consumers prior to when they need care. So, it just dramatically simplifies what a consumer sees and understands their responsibility to be able to satisfy that responsibility. So, we’ve incorporated that capability into our Shop, Book, and Pay. And we’ve built our architecture and that’s, again, back to the role that Microsoft plays here as well with us and in a very flexible manner. So, it can be extensible over time-based on our customer’s needs.

PP: And it seems to me like the platform you built is one of the early examples that I see in the market of a comprehensive digital consumer experience platform. I see a lot of standalone solutions and one of the big challenges that my clients and all the others that I talk to face is about creating this seamless consumer experience. For the most part, the standalone solutions, they are kind of glued together in a somewhat brittle way and building the seamless consumer experience that we are used to from the Amazons of the world or in our personal banking experiences. Is that a fair statement and how do you think a platform like yours changes that?

PP: That is a fair statement and that’s very much been front and center of our strategy. And really the reason why we’ve partnered with Adobe to utilize the Adobe Experience cloud within this architecture. And our view on this is, again, our customers cannot be locked into perhaps more brittle, single service solutions that don’t allow them to really create and expand on the experiences their customers need. So, if I get underneath the covers of that statement, we’ve made a lot of investment to enable our providers. The use of a content management system that really is world-class and allows for a lot of flexibility. Again, back to customizing, to branding, to be able to create different experiences, to be able to deliver those experiences across any variety of endpoints that consumers will pursue and really bring all of that capability that’s instrumental in a digital experience platform approach, but also campaign management, the analytics to instrument all of the endpoints and engagements so that we can match across the channel and understand consumer behavior and how better to serve it. Again, tying back to the earlier point here, about how to remove frictions. If we don’t have those analytical insights on how consumers are interacting with those digital experiences, then it’s not possible to really effectively remove the friction points and optimize the experience over time.

PP: Yeah, interesting. So, switching to more general topics, what are you seeing in the market in the wake of COVID-19 in terms of acceleration of virtual care models, digital experience related investments in your client communities? Can you talk a little bit about what you’re seeing in the market in general?

BK: Certainly. And I would that there are the near-term imperatives that the market has been responding to, and then there are the medium and longer-term realities that our customers are now positioning themselves to address and all. And what I mean by that is the near-term imperatives, things like enabling virtual care so that patients could be served from that standpoint. I think we’ve all talked about that uptake in the industry, but also things like touchless check-in and minimizing any contact with staff where possible and moving things like forms, paper forms to electronic and delivery, etc. So, there’s been a lot of effort to really identify those gaps in the workflows and really plug those gaps as quickly as possible among our provider base. So that’s the near-term that we see. And I think that’s really true across all different types of providers. And then there’s the medium term, and by medium term I might mean 12 months. You know, for some people, medium is six months or so. But at the end of the day, that medium-term is around reimagining those, the pathways that consumers have got access to care and, how to deliver those digitally. And that ties back to a recognition that any barriers that the health systems or providers can see with regard to enabling easier access to care for their consumers. Those barriers now take a higher priority in terms of where their investment dollars, talent, and resources are going. So, we’re getting a lot of inquiries around consumer experience, strategy, and how to rethink the digital front door. The digital front door concept has expanded beyond perhaps the patient portal to other channels and modalities. So, I think it really created a big explosion of interest around the role digital can play in the healthcare system.

PP: One of the big things that people don’t talk about is that along with this shift to virtual care which has been brought on by a lot of restrictions on people coming into a clinic or a hospital for care. There is a big concern around how to take care of the population in their homes and the chronic care of patients, for instance. And we see that remote care and remote monitoring technologies are also having some sort of a renaissance if you will, or if not a renaissance, maybe accelerating. Is that also happening in what you see, along with improving access to care through virtual modalities?

BK: The short answer is yes. And there are few drivers of that. So, the recognition that increasing scope of care can be delivered in the home setting from the standpoint of now more consumers are being accustomed to that, just given the realities of COVID. But there’s been a growing body of evidence related to shifting care to the home and the value that delivers in terms of benefits to consumer’s quality of life, health outcomes, as well as benefits to the system from an efficiency standpoint. So those drivers as well, I think just continue to encourage that trend. So short answer is yes. We’re seeing that and it goes back to that reevaluation of the predominant models that our provider organizations are really funding and developing. And I think that will continue to play an increasingly large component of how consumers receive care and then how those providers are going to need to retool their system to support that.

PP: What do you see as the one or two big challenges that providers are facing today as they make this transition, as they get ready to accelerate? Because the acceleration of the transformation is kind of inevitable. You either accelerate or you get left behind. What are the one or two big challenges you’re seeing providers struggling with as they try to make this transition?

BK: You know, there’s a few things. One is the organizational capacity to support that transformation. Increasingly, providers are understanding their roadmaps that they want to pursue from a digital transformation standpoint. But the IT departments and teams are just taxed with a number of priorities on a number of fronts. So just that overall transformation burden and fatigue, that’s a reality that the industry faces. I think also, if we play this out a little bit, there’s a dichotomy around how or what maybe good looks like and really a recognition on what is the path forward. So, everybody recognizes the growth of telemedicine is needed and some of the other more tactical areas have to be addressed in the short term. But our industry has a record of adopting many different solutions. And in fact, you know, it’s not healthcare. It’s many consumer industries. But at the end of the day, I’ll come back to those models that were really breakout and drove substantial benefits, were the ones that brought together the journey and really streamlined the consumer journey. So, that’s a different paradigm. So, I think there’s an opportunity and there’s a challenge around that. And the challenge is really what does that look like? And when you start to get underneath that, you realize that a number of the steps in the consumer journey fall on the payer side. So, we can’t forget the payer’s role in this, whether it’s understanding from a consumer standpoint what doctors are in my network, and what are my insurance benefits for particular service, or any number of steps where the consumer is left with a fragmented journey. So, for provider organizations to address this holistically, they have to think about the role of the payer in this and how they can work together.

PP: Interesting. It’s been a real pleasure speaking with you. And I wish you all the best with the launch of your new platform. It sounds very, very interesting, and I will be following what is going on with the progress as you kind of make public statements about it. I look forward to having you back on the podcast, maybe a few months down the road, and maybe you can tell us more about your learnings from the launch of the platform.

BK: Thank you, Paddy. And I really appreciate you having me here today.

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Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity