RedCloud’s Thoughts on Healthcare Trends

Over the last 10 years we’ve seen some of the most dramatic changes (and debates) in the history of our American healthcare system, with broad agreement on the need for a better approach, no matter how diverse the plan to get there. All the policy debates aside, one constant throughout has been an underlying need to modernize the technology that supports our healthcare providers, insurers, and ultimately patients. As big players such as Amazon, Berkshire Hathaway, and J.P. Morgan seek to transform the entire healthcare landscape with their joint-venture Haven, providers and payers see the writing on the wall and recognize they must compete or risk falling so far behind they go the way of other traditional industries run out of town by technology.


While market pressures continue to increase on healthcare companies, in the last few years, this digital transformation has been slowed, if not frozen, in part due to uncertainty around the Affordable Care Act and its future shape and impact. However, across the industry, stakeholders are seizing on a current window to make investments in technology and systems that not only serve their customers and patients more effectively, but operate on proper platforms to adapt to future innovation and customer expectations.


As most of us, users of the American healthcare system, could report, this industry is far behind in modernizing its internally and externally facing systems. Healthcare insurers and providers are even further behind in updating supportive technologies – which have a typical lifecycle of 10-15 years. These technologies have a longer road to hoe than other industries when it comes to even getting back to digital parity, or better yet moving past expectations to innovation.


Stakeholders are seeking to combine a digital re-platform with smart, savvy business transformations to create a 360-degree view of the patient, both for providing better customer service and allowing customers to self-serve. Much like other functions, like buying airline tickets, banking (depositing checks, transferring/sending money), event ticketing and fan experience, or even getting a ride to the airport, healthcare is seeking to empower users to increase system-wide efficiencies, ultimately to drive down costs in a time when many companies are self-funded and margins are extremely thin. Additionally, the rise of hospital consolidation and regional partnerships creates another stark business need for modernizing platforms that can connect and/or merge with a strong back-end IT system.


Many of those legacy software and hardware systems are so dated that there is no longer manufacturer or product support, making that transition to self-service extremely difficult for customers. Whether consumers are seeking real-time (and understandable) information on health benefits, medical bills status, or pre-approval for procedures, legacy systems can have significant lag times, which runs contrary to the customer experience in nearly every other aspect of our modern lives. The level of complexity added by the rising need for consumer data privacy and security plus the needed digital transformation in healthcare seeks to get patients what they want, how they want it – instantaneously.


So, while this replatforming can seem like a daunting three to four-year cycle using a heavy lift of resources (both capital and human), insurers and providers can’t afford not to do it. The time is now to invest in the technology and business systems to bring healthcare back to the table for customers to experience the seamless, real-time experience they are accustomed to in nearly every other aspect of life.