Healthcare marketers from around the country recently gathered in Las Vegas at the Healthcare Marketing and Physicians Strategy Summit. The week of insightful presentations covered a myriad of topics including AI, web design, patient acquisition, and everything in between. One of the very first sessions on Thursday was centered on a topic that continued to bubble up in several other presentations. Throughout the duration of the event: cross-functional collaboration, key themes from the sessions included:

• How a partnership between Marketing and IT can spark a re-examination of patient experience strategies centered around an EHR
• What makes provider data management an important component of an organization’s digital strategy 
• Why patient online scheduling requires a multi-faceted approach that includes more than just the patient portal

Marketing-IT Collaboration Spurs Re-Examination of EHR Centric Patient Experience Strategy

The session: The MarCom & IT Partnership featured leaders from Penn Medicine, Mass General Brigham, and MultiCare Health System. Their discussion circled the importance of the relationship between Marketing and IT and how it’s integral to positive patient experience. While oftentimes IT is at the forefront of technology purchasing decisions, Marketing generally has the deepest expertise around patient experience. This can cause a disconnect between strategic decisions for digital solutions that make sense from a financial perspective, but may not be optimal for consumers interacting with said solutions. 

This can be especially prevalent when it comes to building experiences “in house” or utilizing functionality offered by an existing EMR—versus partnering with a vendor with deeper expertise, or a more consumer-friendly experience. The overall sentiment of the session was encouraging Marketers to get a seat at the table with IT. When these teams work closely and build a meaningful partnership, decisions can be made with both perspectives in mind. 

Several other sessions echoed this sentiment about working cross-functionally, including two focused on provider data management and online patient scheduling.

Investment in Provider Data Management is Critical to Power Digital Patient Experiences

Jeff Stewart, VP of Strategic Marketing at CHRISTUS Health led a valuable session, Simplifying Complexity: A User-Centric Approach to Drive Innovation for Your Provider Directory.  This session centered on Jeff’s experience with the importance of provider data management powering a successful provider search experience. He opened by telling the story of how CHRISTUS initially tried to build their own provider data management solution. The home-grown provider directory was intended to power a new and improved website, the launch of which fell below expectations. When CHRISTUS launched its new website and provider directory, they were immediately flooded with messages from frustrated clinicians noting discrepancies within their online profiles. Clearly provider data accuracy was still an issue that they needed to solve. Their conclusion was that they could not do this on their own. CHRISTUS Health would need to look for a partner to help get it done.

CHRISTUS Health intended to use the voice of the consumer as their guide while embarking on a thorough digital transformation. Jeff underscored that a project like this does not lay solely on Marketing’s shoulders. It requires ongoing input and collaboration from stakeholders across the organization—executive leadership, clinical team members, and of course, IT. CHRISTUS ultimately chose to partner with Kyruus Health to streamline provider data management, adding a key component of their tech stack along with Epic, MERGE, and a few other vendors.

Online Patient Scheduling Improves Access and Operational Efficiency for Organizations of All Sizes

While we would like to think that online patient scheduling may be table stakes for most organizations at this point, research tells us a different story. In a recent consumer survey, when asked why they did not schedule their last or most recent appointment online, 40% responded that they did not have the option to do so. This highlights a large gap in functionality that many organizations need to address to meet patient preferences for digital self-service. Consumers are looking for convenient options. When they can’t find what they’re looking for on your website, they may turn elsewhere for care.

Leaders from Cedars Sinai and Austin Regional Clinic teamed up to share each of their strategies for patient online scheduling. Their presentation, Online Scheduling Secrets: Simplify Access, Enhance Engagement, Reduce Workload, interestingly told stories that were largely the same. Incredibly, despite the fact that they are so different in size and complexity, their methods are quite similar. 

While both organizations do have a patient portal that they aim to direct patients towards, they understand that there are still, and always will be, a cohort of patients who will not log in to the portal. This highlights the need for organizations to also offer an unauthenticated scheduling experience. This experience will capture both new patients, and those existing patients who struggle to remember a username and password. 

The other strong similarity between these stories was the cross-functional nature of the program. A project like this cannot sit solely with IT, or Marketing. Instead, it should reach all areas of the organization, especially the clinicians. Bringing clinicians into the process early allows leaders to build trust that providers will see the right types of patients. Notably, they will not lose control of their schedules if opened to patient self-scheduling, as research shows that this is one of their top concerns. Both organizations started with smaller subsets of providers when they launched, and scaled after they were able to showcase success.

Collaborate Early and Often for an Optimal Patient Experience

If there were one key takeaway from HMPS ‘24, it would be to make sure that teams are collaborating cross- functionally early, and often, for maximum success. It is not enough to be brought in, or pull others in, once a decision has already been made. Let patient experience be the guiding force for decisions and make sure to navigate these projects jointly.

Looking for tips on how to launch & scale patient online scheduling at your organization? Join us for our upcoming webinar sponsored by HMPS on May 16th at 12:30pm ET.

The healthcare industry is undergoing a digital transformation. Patients increasingly expect the level of convenience and ease of access they experience in other aspects of their lives. To meet these expectations, hospitals need to provide digital self-service options. EHR-integrated provider search and patient self-scheduling are options that allow patients to find and manage care on their own terms.

This article explores how MEDITECH hospitals can implement digital self-service solutions that improve patient access. The discussion also covers the importance of meeting consumer expectations with digital solutions, the benefits of reducing administrative burden through automation, and the impact of consistent, accurate provider information on the overall patient experience. Finally, the article provides a crawl, walk, run framework that MEDITECH hospitals can use when implementing digital self-service.

Consumer Demand for Enhanced Patient Access

In today’s rapidly evolving healthcare landscape, patients expect the same digital conveniences they experience in other aspects of their lives. Scheduling a car service, booking a flight, or even ordering groceries can be done with a touch of a finger. Patients want to be able to find information about a provider or care option and schedule appointments anytime, from anywhere. 

A recent survey shows that over 70% of consumers consult the internet when searching for care. Furthermore, almost 40% prefer patient online scheduling over other channels. This growing demand for digital self-service is reshaping the way healthcare organizations run. Hospitals that fail to adapt will struggle to remain competitive and risk losing their independence. 

Kyruus Health, a leading provider of patient access solutions, understands the unique needs of MEDITECH hospitals and has Expanse-integrated digital tools that help attract new patients and easily manage workflows. With just a few clicks, patients can now access the right care without having to call the doctor’s office or wait on hold. More than improving only the patient experience, this also reduces administrative burden. Front office staff members, allowing them to focus on other, higher-value work.

Patient Self-Scheduling Can Generate Operational Efficiencies & Increase Patient Satisfaction for MEDITECH Hospitals

The healthcare industry has been slow to adopt digital self-service in comparison to other industries, but there are signs that this is changing. Consumers increasingly expect to be able to manage their healthcare online. Hospitals and clinics that fail to meet these expectations risk losing patients to competitors that do. 

The benefits of digital self-service for healthcare organizations are numerous. These tools can help to improve patient satisfaction, reduce administrative burden, and streamline operations. Reducing administrative burden is one of the most important benefits of digital self-service. By automating tasks such as scheduling appointments, hospitals and clinics can free up their staff to focus on other activities. More attention on higher-value work leads to shorter wait times, better quality of care, and reduced costs. 

Digital self-service can also lead to improved patient satisfaction. When patients are able to access their medical records, schedule appointments, and perform other tasks online, they feel more in control of their care. This can lead to increased trust in their providers and greater loyalty to an organization.

Improved Provider Search and Patient-Provider Matching

Easy navigation and accurate information are essential for an effective provider directory solution. Patients should be able to effortlessly search for providers, locations, and services based on specialty, insurance, and availability. An intuitive interface and user-friendly design contribute to a positive patient experience and ensure patients can easily look for and find the right information.

Source: Kyruus Health, Care Access Benchmark Report for Provider Organizations, 2023.

Regularly updated information on provider availability, qualifications, and specialties is crucial. Patients can make well-informed decisions about their healthcare when provided with accurate information, leading to better patient-provider matching. This not only enhances patient satisfaction as they are matched with the best care for their needs, but it also builds trust with providers as they are seeing the right types of patients come through their door.

24/7 MEDITECH Expanse-Integrated Patient Self-Scheduling

Healthcare’s digital transformation demands an elevated patient experience, encompassing ease of access, prompt response times, and convenience. Integrating patient self-scheduling with MEDITECH Expanse is a vital step in achieving this goal. It enables patients to schedule appointments at any hour of the day that is convenient for them. 

While patient self-scheduling is not a new concept, there are many organizations who have yet to adopt the capabilities. Furthermore, those that have, do not necessarily have an intuitive user-experience. A whopping 40% of consumers noted in a recent survey that they did not schedule their last appointment online. They could not do so because they didn’t have the option available to them. On the other hand, 26% said it was because the experience offered was difficult to use. It’s not enough to offer patient online scheduling, it must be offered in a way that is simple to navigate.

Source: Kyruus Health, Care Access Benchmark Report for Provider Organizations, 2023.

Patient self-scheduling should not solely be limited to an appointment with a doctor, either. Patients are increasingly looking for the ease of scheduling a variety of different appointment types online such as mammograms, lab tests, urgent care, and other service-based appointments. Providing an option for patients to self-schedule with advanced practice providers (APPs) for lower acuity cases can allow patients to be seen sooner—increasing patient satisfaction and helping MEDITECH organizations with capacity utilization by enabling clinicians to practice at the top of their license.

A Phased Approach to Integrated Search & Patient Self-Scheduling

Hospitals seeking to adopt digital self-service don’t have to do it all at once. Organizations may find it helpful to adopt a “crawl, walk, run” strategy. This approach breaks down digital implementation into manageable phases, ensuring a smooth transition for both the organization and its patients. 

The “crawl” phase involves laying the foundation for digital transformation by establishing essential capabilities. These initial steps familiarize patients, providers, and staff with digital tools while laying the groundwork for more complex functionalities. 

The “walk” phase focuses on expanding the range of digital services offered. As patients, providers, and staff gain comfort and familiarity with accessing care digitally, hospitals can extend their reach and accommodate more patient preferences, thus resulting in increased patient satisfaction and retention. 

Finally, the “run” phase entails continuously enhancing the digital experience to remain competitive and meet the ever-evolving needs of patients.

Overall, the “crawl, walk, run” strategy provides MEDITECH hospitals with a structured and realistic approach to digital transformation. By prioritizing a user-friendly provider directory solution, integrating patient self-scheduling, and adopting a phased implementation approach, MEDITECH hospitals can enhance patient engagement, streamline operations, and achieve greater competitiveness in the rapidly evolving healthcare landscape. Embracing digital self-service is no longer an option but a necessity for healthcare organizations committed to delivering exceptional patient experience and staying ahead of the curve in the digital age.

Attending the MUSE Inspire Conference in Colorado? Stop by booth 115 to learn how Kyruus Health can help you attract new patients and reduce staff burden. 

There is a growing expectation for convenience that spans across various aspects of daily life. Coupling that with desires for flexibility and tailored experiences significantly influences consumer interactions. This is seen across multiple sectors—including travel, retail, and banking. These industries have long embraced the shift towards catering to consumer preferences. Through technological advancements, it is easier than ever before to purchase a flight or deposit a check. So where are the healthcare solutions like patient online scheduling?

Healthcare, traditionally slower in adopting such consumer-centric innovations, has begun to recognize in recent years the importance of integrating technology to align with the evolving expectations of healthcare consumerism. This shift is evident as more healthcare providers invest in digital solutions, such as patient online scheduling, to enhance patient experiences and meet their needs for convenience.

Accurate Provider Data Improves Patient Online Scheduling

When patients find it difficult to access the necessary information that aids in their healthcare decision-making, they are more likely to switch to a different provider. This is particularly true if they encounter obstacles in easily obtaining information such as provider availability or insurance compatibility. This is what makes provider data management so foundational to an organization’s digital strategy. 

Patients tend to favor providers with a robust, accurate digital presence. Providers that integrate advanced digital tools, such as a user-friendly search and schedule experience that allows for filtering by various personal parameters, are better positioned to meet these needs. By offering such resources, healthcare providers can ensure that patients have a smoother, more informed experience that aligns with their expectations and needs, thereby reducing the likelihood of patients seeking care elsewhere.

Advantages of Patient Online Scheduling

For many hospitals, health systems, and medical groups, digital health tools that enable patient online scheduling are the top target for investment. The problem is that only a small percentage of these healthcare providers have such resources in place. A recent survey showed that when asked why they did not schedule their last appointment online, 40% of patients noted that their health system or medical group did not provide the option.

Why is the capability of patient online scheduling so important? Researchers have identified numerous advantages of automated patient self-scheduling, including:

• Labor savings
• Information transparency
• Cost reduction
• Cycle time
• Patient satisfaction
• Patient engagement
• Patient accountability
• Patient information
• Patient time savings
• Physician punctuality
• Patient loyalty
• Patient attendance

In addition to these benefits, patient online scheduling has proven to be a vital tool in improving care management and adherence and closing gaps in care. Briefer gaps in care often lead to better health outcomes.

Patient Online Scheduling: Perks for Healthcare Providers 

Convenience is a big reason over 80 percent of patients state that the availability of patient online scheduling is important to them when selecting a new provider. They have 24/7 access to their provider’s schedule and can book appointments—not to mention imaging, vaccines, and screenings—from the convenience of their phone, tablet, or computer. 

That flexibility doesn’t only benefit patients, though. When healthcare providers offer automated patient self-scheduling, they’re more likely to differentiate themselves from competitors. The result is better patient retention and higher revenue. 

What else is in it for hospitals, health systems, and medical groups? Reduced patient no-shows and delays, decreased administrative burden for staff, and more accurate patient-provider matching.

Patient Online Scheduling Helps Reduce No-Shows 

Patient no-shows aren’t just annoying for providers. They cost the healthcare industry an estimated $150 billion annually — 150,000 for solo physician practices. However, practices actively working to minimize no-shows can reduce them by up to 70 percent.  

Digital health solutions utilized to remind patients of an upcoming appointment help mitigate no-shows. They can also provide patients with instructions for checking in before their visit, adding another layer of engagement to decrease the number of no-shows and cancellations.

For practices that may have trouble filling last-minute cancellations, patient online scheduling may be able to help. By providing real-time access to a provider’s schedule, patient online scheduling tools allow individuals to take advantage of these newly available appointment slots in real-time, meaning practices don’t miss out on that revenue.

Patient Online Scheduling = Satisfaction for All 

Patient self-scheduling also mitigates common barriers to access, including limited hours of operation and long hold times. It takes an average of eight minutes for a patient to schedule an appointment over the phone. That’s compared to only one minute when booking via a digital health tool. Physician practices with longer wait times typically receive lower patient satisfaction scores. A recent survey showed that 22% of patients were put on hold for a long period of time when they last called into their healthcare organization to make an appointment.

Used in combination with patient online scheduling solutions, digital check-in tools help eliminate patients’ traditional waiting room activities of filling out paper forms and submitting insurance information. Another win for patient satisfaction! 

Patient satisfaction can play a big role in the effectiveness and productivity of practice staff—both physicians and non-clinician employees. Digital patient self-scheduling offers a better patient experience and enables better allocation of human resources. 

By reducing the administrative burden on staff, they have more opportunity to engage with in-office patients face-to-face. They also can focus on other higher-value priorities, both clinical and administrative—especially those that drive revenue.

More Accurate Patient-Provider Matching

When a patient receives care from a provider who doesn’t have the correct clinical expertise to meet that individual’s need, time is wasted on both ends. And, both patient and provider staff often are negatively affected. Employing digital patient online scheduling not only enables organizations to increase scheduling accuracy, it also confirms patients meet specific requirements before scheduling online, thereby ensuring a more accurate patient-provider match.

Kyruus Health’s Schedule solution can help your organization boost patient acquisition, conversion, and retention by offering seamless consumer patient self-scheduling with real-time appointment availability and direct scheduling into underlying EHRs.

In today’s fast-paced healthcare industry, optimizing the efficiency of front office operations is crucial for delivering exceptional patient care. From managing patient interactions to handling administrative tasks, front office staff play a pivotal role in patients’ satisfaction. Their care experience, when put into practice well, can help improve patient satisfaction for their organization.

Good customer service isn’t just for restaurants, retail, and banks. Consumers of healthcare are more selective than ever when it comes to who is providing their care. With the rapid emergence of healthcare consumerism, spurred in large part due to contactless care precipitated by the COVID-19 pandemic, patients aren’t stuck with a provider with whom they’re not satisfied.

Creating a Positive Experience to Improve Patient Satisfaction

A patient’s visit with their provider begins and ends at the front desk. This interaction can set the tone for the entire patient journey. It’s often an organization’s first chance to make a good—or bad—impression. 

Sounds easy enough, right? Make sure your front office staff is friendly and helpful to patients. Along with a high quality of care from the physician, your practice can improve patient satisfaction. 

There is a problem with this scenario. Unfortunately, it doesn’t take into account all the other tasks for which your front office staff is responsible. Along with patient registration and insurance verification, these team members typically have additional responsibilities. They must schedule appointments, answer phones, maintain records and accounts, retrieve patient records, collect payments, handle referrals, and much more.

Friendly and efficient frontend operations can increase practice revenue and also improve satisfaction for both providers and their staff. That’s why we’ve compiled a list of four ways to enhance the productivity of your front office staff.

1. Conduct Regular Staff Training

Your front office staff can’t stick to best practices if they’re not aware of them. That’s why you should regularly train them on the steps, policies, and protocols used to run your practice. Ensure that they don’t have to rely on guesswork. Clearly define each staff member’s responsibilities, and provide them with the tools necessary to fulfill them. Some organizations utilize a daily checklist. 

One of the most important aspects of proper staff training is the relevance of software and systems. While this includes electronic health records (EHR), it’s any software or systems that the frontend uses in their duties. By providing comprehensive training, healthcare organizations can help their staff become proficient in using these tools and technologies, which can lead to increased efficiency and accuracy.

2. Offer Patient Self-Scheduling

As we discussed in a recent blog, patient self-scheduling offers myriad advantages for healthcare providers, including labor savings, cost reduction, increased patient satisfaction and engagement, improved care management and adherence, and more. It allows front office staff to focus on other high-value activities, helps the practice fill same-day appointments, and prevents overbooking by providing a clear view of available time slots. 

In addition to promoting a positive patient experience by offering convenient 24/7 access to available appointments, patient self-scheduling can reduce the call volume for front office staff. One study found that front office staff spend an average of 8 minutes on the phone with each patient who calls in looking to schedule an appointment. When this is the only method available to patients who are looking to schedule, the phone lines can quickly become overwhelming.

3. Utilize Appointment Reminders

Manually contacting patients to remind them of an upcoming appointment is certainly time-consuming. It also isn’t an easily scalable process and does little to minimize no-shows and cancellations. 

Automated appointment reminders enable providers to communicate with patients using their preferred method, whether that’s a text message, email, or phone call. It can prompt patients to reschedule using a digital health tool instead of just missing their appointment, saving time for both the patient and your front office staff. Plus, your team members can use that extra time to engage with patients in-office.

4. Implement Digital Patient Check-In

Automating administrative intake processes with digital patient check-in lowers the burden on your front office staff. How?  It puts documentation in your patients’ hands, thereby streamlining workflows, saving hundreds of staff hours, and reducing data entry errors. Patients can use a personal smartphone or tablet to verify their insurance, sign consent forms and authorization releases, verify or update clinical information, and more, all of which update in real-time with the patient’s electronic health record. No more manual data entry from a clipboard into the EHR for staff. 

For those patients who may not complete this information before their visit, consider going a step further and providing QR codes in the office waiting room, so that patients can still complete all of their pre-visit forms without causing overcrowding and long wait times at the front desk.

Enabling patients to use digital patient check-in not only decreases wait times, which tends to improve patient satisfaction, it also helps clinicians prepare for a visit sooner, so appointments can be more efficient.

Each of these best practices also aids your front office staff in reducing duplicative processes, mitigating healthcare waste, automating repetitive tasks, and organizing patient data for easier access. They also help to improve the efficiency of your team members without the need for additional staff. Such benefits are especially crucial as the healthcare labor shortage continues.

Schedule a meeting with one of our team members to learn more about how you can increase the productivity of your front office staff and improve patient satisfaction overall!

Table of Contents:

1. What is Provider Data Management
2. Why Health Systems and Hospitals Should Invest in Provider Data Management
   • Reliable Provider Data is Needed to Power Multi-Channel Patient Access Initiatives
   • Facilitating Optimal Patient-Provider Matching Accelerates Demand Conversion
   • Managing Provider Networks Effectively Optimizes Capacity Utilization
   • Centralizing Provider Data Enables Seamless Care Transitions that Boost Patient Retention
   • Driving Operational Efficiencies and Growth by Maximizing Provider Data Utility Across the Organization
3. Why Health Plans Should Invest in Provider Data Management
   • Accurate and Robust Information Drives Member Attainment and Retention
   • Enhancing Provider Data Closes Gaps in Care Access
   • Addressing Data Inaccuracies Ensures Compliance and Reduces Risk of Penalties
   • Building Impactful Partnerships with Providers Relies on Effective Provider Data Management
   • Automating and Streamlining Provider Data Management Addresses Workforce Challenges
4. Accurate Provider Data to Power the Future

Provider data lives in many places within health systems and health plans. There is information in spreadsheets, credentialing systems, EHRs, health plan directories, and many other locations. The maintenance of this information becomes cumbersome and very time-consuming, especially with frequent updates and many users. 

As organizations look to drive digital transformation and take full advantage of new tools, centralized provider data management is critical. This solution resolves many of the data-oriented challenges healthcare organizations face today. Investing in a provider data management strategy offers organizations the ability to power enterprise-wide initiatives for patients, providers, and staff leveraging consistent data across access points—online provider directories, mobile apps, call centers, and more.

What is Provider Data Management?

Provider data is siloed. It often lives in multiple places across individual hospital departments, spreadsheets, and disparate databases. There are usually different stakeholders responsible for provider data accuracy—making it difficult to keep information up to date. When this happens, it often results in a poor consumer experience on an organization’s website. The information patients encounter such as location, or phone number might be wrong, leading to inaccurate provider directories and poor patient-provider matching. 

Provider Data Management is the consolidation of all disparate data into a single source of truth. Once the source of truth is created, business rules can be put into place around the governance and upkeep of the provider data so that it can be properly maintained over time. Organizations may consider establishing role-based authorizations to enable administrators to control what information users can see and edit. It’s even possible to set up approval workflows to ensure proper checks and balances occur.

Why Health Systems and Hospitals Should Invest in Provider Data Management

An investment in a solid provider data management strategy is foundational. Not only does it power the consumer experience on an organization’s website and mobile app, but it can also be leveraged internally for various different use cases. Consider these 5 foundational reasons to invest in provider data management as you make a business case at your organization.

1. Reliable Provider Data is Needed to Power Multi-Channel Patient Access Initiatives

In order to guide patients to the right care, the information that is presented to consumers about your providers, locations, and services must be accurate and consistent across multiple access points. Without a provider data management system in place, information is often out-dated and inaccurate. 

When a patient looks up a provider online and sees that they practice at a particular location, but then calls to make an appointment and learns that they are no longer at that location, it results in a frustrating patient experience. Consumers should have access to the same, accurate provider data regardless of where they are searching for care. Access should be consistent whether it’s on your website, via general internet searches, or a phone call into your organization. Providing this consistent experience to consumers across access points can go a long way in building trust.

2. Facilitating Optimal Patient-Provider Matching Accelerates Demand Conversion

Organizations must ensure that the provider directories that house profiles are not only accurate, but complete with information that matters most to consumers when making a selection for their care. Attributes like insurance accepted (94%), clinical expertise (89%), and appointment availability (89%) all help convert patients looking to schedule appointments.

Many patients also like to have access to additional provider data. Some additions could be their professional statement, a video, whether they are LGBTQIA+ friendly, and more. This information can be extremely important as they are considering whether or not it will be a good patient-provider match. Given the option, many patients tend to choose providers based on shared traits.

When a provider data management strategy is in place, this information can all be managed in a single location. Provider data that may not have had a true “home” before such as marketing information like a biography, picture, or video, can all be maintained in a more streamlined manner.  

Another key component of optimal patient-provider matching is ensuring that patients can easily search for a provider based on the specialty they need or symptoms they are experiencing. In many cases this includes lay synonyms such as “the sugars” for diabetes or “tennis elbow” for epicondylitis. Being able to layer on a robust clinical taxonomy that includes all of these different terms is a vital component of a well-rounded provider data management strategy.

3. Managing Provider Networks Effectively Optimizes Capacity Utilization

Given the current state of supply and demand issues in healthcare, it is more important than ever to have a clear view of your entire provider network. Consider leveraging a provider data management solution to help uncover and address gaps in provider types and services. Doing so can help you make strategic decisions about clinical recruiting to strengthen the integrity of your network.

When organizations have a more granular view into their network, they are able to adjust their access models to optimize capacity and improve appointment wait times. This might look something like, routing back to school physicals or flu shots to an APP such as a nurse practitioner or physician assistant instead of a primary care physician. This type of routing enables better management of capacity at an individual provider level, helping to ensure clinicians are not underutilized, overutilized, and/or misutilized.

4. Centralizing Provider Data Enables Seamless Care Transitions that Boost Patient Retention

Oftentimes when patients receive a referral from their physician or office staff, the information they are given is out of date, and the provider to whom they are referred may not be practicing any longer or may have left the organization. Provider data management can help solve this problem, as it can give all staff members accurate, reliable information at their fingertips. 

This can be especially important for referring providers, who may go to an organization’s website to view physician profiles before determining an appropriate referral. It is vital that the information included on these profiles is accurate, so that providers can make the best choice for their patients. 

Leveraging your provider data management system can help ensure a well-rounded view of an organization’s provider base. Having this accurate view will help empower clinical and administrative staff to guide patients during care transitions. Not only will they be able to connect patients to the most appropriate care, but they can do so in-network.

5. Driving Operational Efficiencies and Growth by Maximizing Provider Data Utility Across the Organization

At a time when resources are stretched thin, put your provider data management solution to work for you across the enterprise. This source of truth can be used throughout the organization in a myriad of ways, extending the utility of your provider data to internal assets such as call center operations,  learning management systems, intranet pages, and more. 

Maximizing provider data utility can help alleviate staffing challenges by eliminating the need for constant manual updates in multiple places, freeing staff up to focus on higher value tasks instead.

Having a centralized provider data management strategy is also extremely beneficial for organizations that may be in growth mode, whether it be organically or through M&A. Having a centralized, streamlined way to onboard the data for new physicians allows organizations to get them live on their website with accurate information much sooner then they would be able to otherwise.

Interested in learning more about provider data management for hospitals and health systems? Download our guide 5 Reasons to Prioritize Provider Data Management.

Why Health Plans Should Invest in Provider Data Management

Similar to hospitals and health systems, a provider data management strategy is essential for health plans to effectively power member experiences and internal processes. Here are five reasons why health plans should invest in provider data management.

1. Accurate and Robust Information Drives Member Attainment and Retention

When members search for healthcare providers online through their health plans, they expect a seamless and efficient process. However, they often encounter numerous obstacles such as outdated or incorrect information and a lack of comprehensive provider details like languages spoken, years in practice, and treatment philosophy. These deficiencies hinder their ability to find providers who align with their specific needs, leading to significant frustration among members.

A recent survey highlights that a vast majority of members desire more accurate and detailed information in provider profiles. Specifically, 62 percent of members are seeking more precise information, while 70 percent of Millennials and 64 percent of Gen Z members want more comprehensive details about providers. Enhancing the quality and accuracy of information provided by health plans can significantly improve member experiences, foster trust, lead to better healthcare outcomes, and increase member retention and acquisition. This improvement in service and information quality can also substantially boost a health plan’s financial performance, with potential gross margins ranging from $753 to $1,982 per attained enrollee.

2. Enhancing Provider Data Closes Gaps in Care Access

Inaccurate or incomplete provider data poses a significant barrier to accessing healthcare. Essential information like a provider’s gender, ethnicity, specialty, and experience is often missing from health plan directories, preventing members from finding a healthcare provider they trust and feel comfortable with. Discrepancies in provider data also result in “ghost networks,” where providers are listed as available but are not actually accessible. When members can’t find the information they need, they often delay or completely avoid seeking necessary care. One in three members have encountered inaccurate information in their health plan’s digital tools and 30 percent subsequently postponed or skipped care. This issue is compounded by the risk of members inadvertently using out-of-network providers, resulting in unexpected medical bills and increased administrative costs for health plans.

Another barrier to care is lack of online scheduling capabilities. Despite a strong desire among 80 percent of members to schedule appointments through their health plan’s website, over half have skipped care because this option was unavailable.

By integrating scheduling features and enhancing the accuracy of provider information, health plans can significantly improve member experiences, increase interactions with provider profiles, and thereby close care gaps.

3. Addressing Data Inaccuracies Ensures Compliance and Reduces Risk of Penalties

Recent regulatory mandates have been implemented to address the issue of poor data quality in health plans, emphasizing the importance of maintaining accurate provider data. For instance, the No Surprises Act requires health plans to verify their provider data quarterly and make necessary updates within two days. Non-compliance can lead to fines of up to $100 per day for each affected member. Additionally, the proposed REAL Health Providers Act aims to further tighten regulations by penalizing health plans for not correcting outdated information or removing providers who are no longer in-network, targeting the elimination of “ghost networks.”

While adhering to these regulations is crucial, the real challenge lies in how the updated information is presented to members. Many C-level executives in health plans recognize that enhancing the member experience is a significant challenge in meeting transparency mandates. For example, although health plans are required to publish machine-readable files with negotiated rates, this information often lacks the necessary context for members, featuring obscure billing codes that provide little value. Therefore, health plans need to go beyond mere compliance; they must ensure that the data is not only accurate but also accessible and understandable to members. This approach will make the information truly impactful, fulfilling more than just regulatory requirements and genuinely improving member satisfaction and trust.

4. Building Impactful Partnerships with Providers Relies on Effective Provider Data Management

Effective collaboration between providers and health plans is crucial for maintaining accurate and comprehensive provider directories. Providers rely on health plan portals to update their information, but they often face challenges such as inconsistent requirements and a cumbersome updating process. As a result, only 20 percent of providers feel confident that health plan directories accurately represent their facilities and staff. This disconnect highlights the need for improved systems and processes to ensure that provider information is both accurate and easy to update.

Almost all hospitals and health plans recognize the value in more detailed and robust information in provider directories. This is underscored by the fact that over a third of healthcare consumers are willing to switch providers for capabilities such as online appointment booking, which require accurate data. By investing in solutions that allow providers to directly and easily manage their profiles, health plans can streamline data maintenance, reduce labor costs, and ensure the accuracy and timeliness of the data. Establishing a centralized data repository can further enhance consistency across different channels, making updates more efficient and reliable.

5. Automating and Streamlining Provider Data Management Addresses Workforce Challenges

Managing provider data efficiently is crucial for health plans to avoid significant drains on resources. By addressing the root causes of inefficient data management and implementing systems that ensure data synchronization, health plans can prevent potential issues in downstream operations. A sophisticated provider data management platform can automate workflows and tasks, which not only saves time and costs, but also avoids the complications of developing such solutions in-house.

The accuracy of provider data across digital channels is essential, yet it’s important to recognize that many members still rely on direct interactions with providers or customer service to obtain healthcare information. Implementing a provider data management solution that offers real-time updates across all touchpoints ensures that everyone from call center agents to care navigators has access to the most current information.

Accurate Provider Data to Power the Future

As organizations look to embark on digital transformation, they will find that first investing in a solid provider data management strategy will help them be successful in the long run. Set your organization up for success with a digital experience that is powered by accurate, up-to-date information.

Learn more about Kyruus Health’s Provider Data Management solutions for health systems and health plans.