Q&A on the provider back office and lessons learned from the pandemic

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Ingrid Stiver Senior Manager, Health Research Institute, PwC US October 22, 2020

Much of the legacy back-office technology and business processes used by healthcare organizations for financial, human resource and supply chain management have proved cumbersome and inflexible during the pandemic. Providers are evaluating their technologies and processes, considering quick transformation to meet continued needs during the pandemic and long-term transformation to prepare for the future. In this Q&A with HRI, PwC principal Mike Paul and director Win Fisher talk about what providers have learned about their legacy IT systems during the pandemic—and what can be done about them.

PwC Health Research Institute (HRI):

What gaps and shortcomings in providers’ back-office processes and technology did the pandemic bring to light?

Win Fisher, PwC director

Lack of visibility was a theme across the supply chain, finance and human resource functions. Visibility into the supply chain was a big issue. Understanding supply constraints or shortages is important, especially during a global health pandemic. Many providers had to use spreadsheets to get by; that’s not sustainable or scalable.

Real-time visibility into the financial state of the business was also an issue. Several providers experienced dramatic declines in revenue during the pandemic. Some service lines have recovered, but they can’t operate at their pre-pandemic volumes and also require additional costs to operate, such as increased use of personal protective equipment and enhanced cleaning procedures.

For many organizations, the ability to understand how the pandemic continues to impact the business and visibility into their financial performance day to day do not exist, as the technology and processes in place don’t support real-time reporting. Organizations need to know the impact of an event today on their business today, not 30 days later.

Mike Paul, PwC principal

The lack of visibility into the financial state of the business also makes it hard to manage the workforce. It is very difficult to forecast positions without knowing what the current state of the business looks like in real time, let alone being able to predict volumes in the future. 

Providers also lacked visibility into their workforce in terms of what was happening with employees working virtually, understanding which workers were out due to COVID-19, quarantining due to a COVID-19 exposure, out for other reasons, etc.

All organizations, not just providers, struggled with how to communicate with employees. They struggled to find a rapid and simple way to get the message to employees: when they should stay home from work, when they should come back to work, or how they should report illness effectively. For providers, this is even more relevant and urgent because many of their employees are involved in direct patient care. 

HRI: What did providers do early in the pandemic to close these gaps?

Win Fisher: Anecdotally, we saw a number of organizations stand up some pretty complex Excel reporting and dashboards to manage the supply chain and operations. The human resource departments saw a lot of manual communication early on: ad hoc Zoom calls, fire drills to get messages out to staff via email, town halls and fireside chats. 

HRI: What are providers doing now?

Win Fisher: Human resource departments are using technology to drive consistent communication and are changing their business processes to communicate with employees more frequently. For example, many are using push notifications to employees’ mobile devices to achieve this consistency and frequency.

Some providers are looking broadly at their back-office technology, some of which systematically let them down during the pandemic, and they are asking if there is a broad, strategic solution they can invest in, rather than just a point solution to get them through the current crisis.

Over the last few years, provider investments in technology have focused on clinical areas, like electronic health records. Some providers see the pandemic as highlighting the need and the opportunity to reinvest in the back office.

Mike Paul: Providers are considering how to simplify processes or accelerate automation to reduce their reliance on manual, outdated work. They need a modern technology solution that evolves with them as their business changes.

Most legacy applications would go through updates every few years. Modern cloud-based technology updates weekly in some instances. This enables providers to keep their technology up to date and extract the most value out of what can be a significant investment. In addition, newer technologies such as artificial intelligence are being built into new platforms, helping businesses increase efficiency and make decisions faster.

HRI: How are providers balancing long-term investments in the back office with what they can realistically accomplish now, given the limitations of the pandemic?

Mike Paul: Providers that have invested in upskilling of the workforce and in technology have had an easier transition to the new ways of working that the pandemic requires. Some providers are running their business remotely without decreases in productivity.

Organizations that are continuing their technology investments during the pandemic are seeing the results of those investments pay off in terms of better communications with their workforce and the ability to support remote workers, which results in an improved employee experience.

These organizations also are able to consider strategic and often larger technology investments, because they have the ability to work differently and implement technology in ways that have not been done in the past.

Win Fisher: There is an opportunity to take a strategic approach to the pain points highlighted by the pandemic. This is a significant inflection point that providers can use to make massive strides forward in their back-office technology strategy that might otherwise have taken years.

And providers might be surprised: Strategic transformation of the back office might not be as cost prohibitive as it was in the past and, in fact, may become a business imperative.

HRI: If a provider wants to consider a big transformation of their back office, where do they start?

Win Fisher: Establishing the team who will lead the transformation and a governance model for the project and the team are great first steps. Putting together a business case for the investment is also important. The team needs to understand what benefits will come from the investment and how to measure and communicate those outcomes to leadership.

Mike Paul: In addition to the business case and clearly defined outcomes, getting leadership involved early to set expectations is important. Back-office transformation, done correctly, can have a significant strategic benefit to the organization.

However, these projects require commitment from leadership, business owners and related stakeholders. Without this commitment, organizations risk incremental changes rather than big, strategic change.

In addition, the pandemic has created new challenges, such as the need to implement remotely. Providers embarking on a back-office transformation should ensure they have a business partner with the tools and experience completing these projects virtually, to help them navigate this new way of working.

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Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Ingrid Stiver

Senior Manager, Health Research Institute, PwC US

Erin McCallister

Senior Manager, Health Research Institute, PwC US

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