Emerging technologies help healthcare providers, payers deliver better patient/member service, ISG Provider Lens report says
“New technologies are creating a culture of innovation and cost optimization that promises care improvements.”
The 2024 ISG Provider Lens Healthcare Digital Services report for the U.S. says the industry is using AI and other digital tools and services as part of overall transformations to increase efficiency, improve outcomes and offer better patient/member service. New approaches such as value-based care (VBC), which prioritizes patient outcomes over traditional fee-for-service models, require advanced data capabilities.
“Healthcare providers and payers in the U.S. are expanding patient-centered care and service models to enhance everyone’s healthcare experience,” said James Burke, partner at ISG. “Smarter use of data is a key part of this transition.”
Both public and private payer organizations are implementing solutions based on generative AI (GenAI), machine learning (ML) and data analytics to extract insights from vast datasets, the report says. Using those insights, they are building more capable claims processing and personalized customer interactions. Electronic health record (EHR) providers are also transforming their systems, migrating to cloud platforms for scalability and flexibility while introducing interoperability for data-sharing among healthcare providers.
With an increasing focus on patient/member experience, payer organizations are using GenAI, ML and telehealth to improve overall service efficiency and delivery, ISG says. User-friendly digital portals and AI-powered chatbots make services and information more accessible, furthering omnichannel strategies that let members interact with care providers wherever and on whatever device they choose.
New technologies continue to improve the handling of healthcare financials. The report says enterprises are implementing modular and AI-informed revenue cycle management (RCM) systems. AI-based predictive analytics help healthcare providers identify potential denials of coverage before they occur and proactively try to resolve the issues.
Cloud-based ERPs and electronic health records (EHR) have significantly changed the operations of U.S. healthcare providers, increasing scalability and removing infrastructure costs, ISG says. Cloud ERP and EHR platforms also let providers quickly implement digital capabilities such as scheduling, billing and patient records access and make them available on any device.
“Efficiency is a major benefit of the digital transformations taking place in U.S. healthcare enterprises right now,” said Jan Erik Aase, partner and global leader, ISG Provider Lens Research. “New technologies are creating a culture of innovation and cost optimization that promises care improvements.”
