Increased care costs are majorly driven by rising medical inflation, wages, medication costs (PwC, 2023), and technology spend. Combined, these expenses threaten the trajectory of positive operating margins that were achieved in 2023.
However, if properly researched and vetted, technology also presents one of the answers to reducing and controlling costs, making the capital expenditure worth the investment. Data analytics platforms, for example, can deliver significant return on investment (ROI) across clinical, financial, and operational areas of healthcare companies. These solutions help optimize resource allocation, identify operational inefficiencies, build accurate financial forecasts, prevent fraud, and manage revenue cycles more efficiently, among many other uses.
With the market size of U.S. retail clinics projected to grow from $2.79 billion in 2023 to $6.36 billion by 2030 (Fortune Business Insights, 2023), providers realize the need to improve patient experience to recruit and retain patients, thus ensuring sustainability.
The pandemic led to an increase in the number of first-time users of tools such as telemedicine, which led to a greater demand for convenience and easy access to care and patient information. In this scenario, genAI is becoming a prominent tool among emerging technologies to enhance the patient experience. For example, this technology can clearly explain discharge summaries and treatment plans, as well as create translations, aiding both patients and caregivers while enhancing treatment adherence to deliver better patient outcomes.
Multiple efforts to safely share patient data between practitioners continue to be hindered by a myriad of factors. Some contributors to this hindrance are the rigorous competition paired with abundant mergers and acquisitions in the healthcare market (both for healthcare providers and technology vendors), the simultaneous usage of disparate systems, and the growing need for regulatory compliance.
This issue is being addressed by different groups: the Office of the National Coordinator (ONC) for Health Information Technology, for instance, has been actively involved in four major interoperability initiatives to drive healthcare information exchange, and other industry groups have collaborated to develop protocol standards.
These standards include Fast Healthcare Interoperability Resources (FHIR), Digital Imaging and Communications in Medicine (DICOM), and Health Level 7 (HL7). The Centers for Medicare & Medicaid Services (CMS) also released its CMS Interoperability and Prior Authorization Final Rule in January 2024, seeking to improve “health information exchange to achieve appropriate and necessary access to health records for patients, healthcare providers, and payers” (CMS, 2024).
Interoperability solution providers, on the other hand, are leveraging emerging technologies such as genAI to increase the quality of data, as well as to transmit it in a more timely and efficient manner. These advancements support better patient outcomes, positively enhancing the patient experience and satisfaction, and ultimately leading to better brand perception and increased revenue opportunities.
Furthermore, alongside the adoption of new tech and the formation of valuable partnerships, healthcare providers currently strive to build an organizational culture that supports transformational change, engaging in-house champions for change management and earning both end-user adoption and stakeholder buy-in.