Client Challenge:

How to become a leader in Digital to improve customer experience, increase patient engagement, and drive patient acquisition and retention

Our client was a major healthcare system by any standard, with $5.2B in revenue, 4,000+ physicians, and 30,000 employees. You’re ranked the #1 hospital in a very large metro. You’re obviously doing lots of things right. But you’re in a very competitive industry and you realize that there’s something you missed. A potential competitive threat but also an opportunity for transformation. Leadership had learned that 40% of their website visits were from mobile devices. That was a big surprise, and important for two reasons.

First, it shows how rapidly the market had shifted to a mobile access model (and that our client had some catching up to do) and second, this represented an opportunity for our client to assert digital leadership in their market through a unified patient experience, with a native mobile solution that would drive foundational loyalty and growth. A tall order, but it needed to be done. After exploring initial concepts with another professional services firm, they realized that they needed a firm with a deep understanding not only of Digital, but one who understood their business model and revenue cycle almost as well as they did. Our client’s Chief Innovation Officer asked PwC to help.

Approach:

Teaching the client to fish

Our client understood that the market was looking for a native mobile application that went beyond what they had been offering their users to date. While useful, their existing application lacked the level of integration and intuitive user interface that could help them extend their EMR capabilities and create a unified patient experience. Their patients were expecting more -- like wayfinding, finding a doctor/location, saving favorites, scheduling, e-check-in, clinical support, billing, etc. Further, the application would need close integration with the client’s business and clinical operations to deliver a comprehensive set of capabilities to patients. And the business needed robust analytics and ROI modeling to drive further improvements and to track longer term value. In parallel, the Chief Innovation Officer wanted PwC to help him build out a mobile application development organization, capable of taking over from us after the initial deployment -- “We want your team to work with us shoulder-to-shoulder to teach us how to fish.”

As is the case with most of our transformation engagements, it all started with a visit to a PwC Experience Center (EC). The first step was to have the client stakeholders from various departments engage with a multidisciplinary team from PwC in a customer journey mapping exercise in the EC utilizing PwC’s Business, Experience, Technology (BXT) methodology. There, we determined the current state of patient and caregiver experience in multiple contexts and talked about what the optimal experience might look like. PwC specialists with business process depth across the hospital revenue cycle and hospital operations identified points at which the patients would be interacting with various operational processes and what that might mean from an application requirements perspective. Our Digital Design and technology specialists also weighed in on design and implementation considerations. And as it turned out, PwC was able to bring to bear insights from similar solutions we had developed for other large hospitals. By the end of the session, we had reached consensus and were ready to start the development process.

PwC was able to immediately leverage a team of design and technology professionals both in the US and offshore who were experienced in software development for mobile applications using the scaled agile framework (SAFe™) specifically for patient access and enabling the revenue cycle. In parallel, our client began to hire iOS and Android engineers, testers and design and user experience specialists, so they could be involved with the development process from the beginning. Together with our client, we laid out a development cycle around the major application capabilities, things the client knew they wanted in the first release, and then broke that down into a series of sprints for our engineers. We then began designing and building in earnest. Within the first few weeks we were iterating on the design against our user stories from the EC session and soon went through preliminary build testing with end users to further refine the direction.

Within six months, working with our client, we went from a blank sheet of paper to a fielded unified experience application available on digital distribution platforms for mobile apps. PwC went from steering the design and development process to overseeing and coaching this work being done by the client’s own fully staffed team, now capable of ongoing development and maintenance. In addition to our joint development, we also worked with the client to create a governance model encompassing IT, Marketing, Strategy/Innovation, the Revenue Cycle team and Legal -- a truly comprehensive, multi-function governance structure. A solid next-generation foundation had been established.

Impact:

A solid foundation for improving patient experience, ROI and the client’s brand promise

This initial engagement was focused on helping our client build a next-generation foundation for patient engagement that would both improve patient experience and give them the ability to pull levers that had positive economic value that will accrete to the P&L. For instance, they knew that a better experience around scheduling could help them attract and retain patients as well as better fill latent capacity in clinicians’ schedules. Also, eliminating the cost of manual, paper billing through electronic billing is another potential cost savings. Our client wanted this in the market quickly, and as a team, we delivered. We also left them with what we call a “traceability matrix,” which will allow them to measure the economic benefit of adopting various app-related capabilities.

We still need to wait for things to play out, but within the first three months, the new application saw an adoption rate of over 64% month over month across a target distribution across 500,000 patients. This has created opportunities for value realization across clinical and operational functions as well as leverage for revenue cycle drivers. For instance, cost saving opportunities of $5M are anticipated from efficiency gains in physician offices, made possible through reduction in paperwork, and staff/physician time savings because of in-application access to information, messaging, and appointment scheduling features. Similarly, our client expects another $5M in savings from increased efficiency in clinical and back office operations. And finally, we’ve identified opportunities to increase collections by approximately $10M since the application provides an additional channel for co-pay authorizations at check-in as well as online bill payments for users.

But this is just the beginning. As a result of this engagement, our client realized that for the first time they could actually see the commonalities across their suite of products when it came to patient experience, validating their focus on a comprehensive digital strategy as a driver for elevating their brand in a competitive marketplace. By any measure, they are off to a promising start.