Closing Healthcare’s Greatest Gap | Part 4: The 5 Essentials of a Single Healthcare Continuum

The first blog in this series looked at Healthcare’s Greatest Gap, the deep structural divide between the two major sectors of healthcare: the $4.3 trillion healthcare industry (Getting Care) and the $450 billion well-being industry (Staying Healthy). In our second blog, we saw how the disconnect between these two silos of care is a fundamental cause of healthcare inefficiency in America. And in our most recent blog, we examined the fragmented consumer experience and business inefficiencies that stem from the tremendous growth of point solutions.

Now that we’ve diagnosed the problem, it’s time to ask the most pivotal question: How do we solve the problem of fragmentation in healthcare? More simply put: How do we close Healthcare’s Greatest Gap? The answer: Build a seamless, end-to-end connected consumer experience, a single thread of navigation, access, coordination, management and well-being services that stitches our fragmented healthcare system into a single, unified whole.

Here are the five capabilities required to deliver such an experience and close Healthcare’s Greatest Gap.

1. Provide Continuity of Care
   The foundation of a seamless healthcare experience is 24/7 virtual-care access to a high-value provider network. Handoffs from one care service or team to another must occur in the same experience without having to leave the app or platform. Directing patients to another website or app causes too much confusion, frustration and disengagement and is not an option.

2. Make Care a Relationship, Not a Transaction
   A personalized experience that increases engagement starts by connecting with members through their channel of choice (text, chat, phone, video, etc.). Real-time alerts for post-visit summaries, aftercare follow-ups, Rx pickups, low-cost options, in-app transportation coordination, upcoming appointments, etc., keep members informed and engaged. Other personalized features should include patient education, adherence to treatment plans, and referrals to board-certified clinicians, specialists and appropriate digital care. In addition, the speed and convenience of AI diagnostic technology requires a human component in order to gain the trust and confidence of consumers.

3. Integrate with Existing Partners
   The platform should be configurable to a payer’s existing workflow and connect via APIs. Integration of third-party vendors on a single white-labeled platform addresses the fragmentation caused by point-solution proliferation while promoting the health plan’s brand.

4. Get Everybody Working From the Same Page
   Shared intake and data exchange, including patient health information across different digital apps, should flow seamlessly into one panel, allowing a member’s entire care team to work from the same page.

5. Support Virtual-First Health Plans
   Legacy nurseline services today lack the ability to provide follow-up support. Once the call ends, members must navigate the next steps alone, often leading to a disjointed, inefficient, and frustrating healthcare journey. A Digital Triage & Navigation Solution delivers the services of an effective healthcare navigator that guides and connects the member to the most appropriate care setting/provider in one seamless experience.

Why This Matters

In a recent survey, 81 percent of consumers said they were unsatisfied with their current healthcare experience and were interested in using a unified digital solution. And an estimated 65 million Americans will be covered by value-based health plans by 2025. That makes an integrated, end-to-end consumer experience that provides well-being, care navigation, and value-based care services across a seamless continuum even more of a mandate for health plans. Delivering the right care, at the right time, from the right high-value providers is now a business imperative.