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Digital Transformation

Aim for Agility: Digital Transformation for Healthcare Payors

Here's how insurers can be agile and deliver that “gold standard" of patient experience.

Kevin Riley is senior vice president and general manager of Health & Life Sciences at Salesforce Industries.

When it comes to healthcare, every consumer expects their next experience to be as good as the best experience they’ve ever had. This means that whether you’re a small, medium, or large insurer you need to be agile enough to deliver that “gold standard.” In healthcare, it’s no longer a question of if or even why to transform, it’s a question of how to do it successfully and in the fastest way possible. 

Agility drives transformation. If your technology is not agile, then you can’t adapt. COVID-19 has made this all much more evident. During COVID-19 agility has become the differentiator. Insurers who had an agile system in place had no issues rolling out new projects despite a distributed workforce, whereas those still reliant on everyone being in the same room were faced head on with the urgency of the digital imperative. Building agility builds momentum. The minute you introduce an agile system, you can kick off a cycle whereby change happens in an ongoing manner over time. One agile project leads to another, building upon each other faster and faster, ultimately speeding up your digital transformation and increasing your competitiveness in the market.

This may sound like a tall order but healthcare companies both big and small are doing it on a daily basis. We’ve found that payors who are able to successfully build, launch, and maintain projects achieve a virtuous cycle of transformation.

Step 0: Agility 101 Customization versus configuration

Before we dive in, let’s first focus on what creates agility. Over the past decade, payors have used customized solutions to solve pain points and meet specific needs. When we talk about customization, we are referring to the classic way of writing code to fill gaps. Unfortunately, because customized software doesn’t automatically update, it requires costly maintenance, and over time results in disjointed data and outdated user experiences. In order to achieve true agility, payors need to configure their technology from the get-go — this means no more patches. Unlike customization, configured technology updates automatically, eliminating the need to make manual changes every time you touch the original product.

How does it work? It starts with a customer relationship management (CRM) solution based on the standard framework of a health insurance company — no customization needed. From the start, you can configure an experience specific to payors – including standard items like updating the enrollment process, underwriting, patient rating, and provider or broker management.

Step 1: Start your first project

Before you begin working on your first project, you need to align on exactly what that project is. It’s best to start by assembling your primary stakeholders so that they can come up with a consensus on the current problems you’re facing and build a vision for how to address them. Once you’ve done this, you’ll want to find a partner with deep knowledge in the healthcare industry so that they can help you develop a realistic plan and timeline for how your vision can become a reality. 

It’s important your partner both spearhead and communicate specific benchmarks and goals around how your digital transformation will accelerate value, drive ROI, and increase competitiveness in the market. It also may be a good idea to establish a leadership framework to help set the foundation and maintain a bird’s-eye view of the overall project. This could include an executive sponsor, steering committee, board, etc.

Step 2: Achieve fast time to value

Your initial launch will focus on the minimal viable product (MVP). The right partner should walk you through every step: key decision paths, solution wireframes, plans for change management, and training and certifications. It’s important to focus on all the details because laying the groundwork with this MVP will set you up for future agility and transformation. Building this foundation will also assure that your teams can work anytime from anywhere. This is especially valuable in situations like the ongoing pandemic where teams are distributed and launches have to happen regardless of each individual contributor’s location.

Step 3: Evolve for the future

Your initial project is undoubtedly important, but perhaps even more important is the world of possibility that it opens for you going forward. Once you’ve become agile, you begin to transform. Now that you’ve laid the foundation, your partner can help round out this groundwork with a host of cloud-based solutions that can be deployed quickly with automated migration and test tools, offering a lower total cost of ownership. Your partner can also assist with proper release management, including consistent support, ongoing roadmap planning, and adjusted goal setting.

Future forward

Now that you’ve successfully built your first project, you can repurpose that same framework to go forward with project No. 2 (and eventually 3,4,5,6 and so on). This constant iterating and ever-present evolution are how you achieve true transformation across all business lines and functions. In short, agility leads to transformation which ultimately allows you to sit at the top of the pack and achieve that “gold standard.”

Visit the Healthcare and Life Sciences Industry Summit Channel to learn how Salesforce helps healthcare organizations digitally transform.

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