5 Strategies Digital Leaders Use for Improved Member & Provider Experience


EXL Health’s webinar on clinical excellence through digital transformation revealed five key strategies innovators are now applying to improve member and provider experience, outcomes and efficiency in healthcare.

According to the expert panel, all industries have become more digital savvy out of necessity. The reason why is today’s consumer is ever-connected to a digital world that is always on, always at-hand, and ever in-tune with their personalized needs. Healthcare consumers are no different. Recent statistics bear this out.

  • By 2023, 20% of patient interactions will involve some form of AI enablement within clinical or nonclinical processes, up from less than 4% today.1
  • 7 out of the top 10 wrist-worn wearables companies have released algorithms for early infectious disease detection, including COVID-19 and the flu. 2
  • Approximately 132M people in the U.S. will use digital voice assistance one time per month in 2021. 3
  • 50% of healthcare providers will invest in robotic process automation over the next three years. 4

With the industry clearly recognizing the shift to digital operations, our panel touched on five ways healthcare leaders can enable a digital enterprise to enhance their member and provider experience

1. Take your cues from other industries

Healthcare tends to lag in terms of digital technology adoption, due to heavy legacy investments and strict regulations on the use of patient data. Still, other industries that are heavily regulated, such as financial services and utilities, have managed to adopt omni-channel digital engagement platforms and digital intelligence solutions that maximize the value of data, while playing within the lines. The fact that venture capital and private equity firms have invested more than $50 billion in the digital healthcare space over the past five years, with two thirds of that going into customer-centric initiatives, should signal that the time has come for healthcare to get into the game.

2. Focus on improving provider and member satisfaction

With the emergence of such technology advancements as 5G networks, intelligent input-output devices, robotic process automation, artificial intelligence, machine learning, natural language processing, open APIs and a cloud operating and storage environment that is more powerful, secure and reliable than ever, the stage is set for healthcare organizations to truly infuse digital solutions throughout their provider and member experiences for improved satisfaction. While the main focus of digital transformation was once set primarily on enabling operational efficiency, the new pull-through objective has now become improved user experience. Aim for enhancing the way members and providers interact with your organization, and collateral benefits such as cost savings, revenue generation, workforce productivity and even compliance will naturally follow.

3. Manage the rise in chronic conditions with digital personalization

Since 2011, Fast Healthcare Interoperability Resources (FHIR) have evolved to the point where sensitive healthcare information can be securely exchanged between authorized systems and professionals, opening the flow of diagnostic, clinical and administrative information. This is especially important as chronic conditions continue to rise worldwide. Effectively controlling these conditions long-term demands near real-time monitoring of patients, and personal monitoring devices connected to the digital world can make it happen in a secure, compliant manner.

"The beauty of conversational AI is to be able to get the solution into production within a short timeframe and start to see that immediate or quick ROI delivering value."

– Sherri Walsh, SVP, Global Operational and Chief Nursing Officer, EXL Health

4. Use all available data to know your members and providers better

Meeting consumers where they are on their healthcare journey through new and evolving engagement models is the fastest, most effective way to improve member and provider satisfaction, patient outcomes and operational efficiency. The goal is to fit within their lives by knowing and respecting their personal preferences. This requires a multi-channel/omni-channel environment that accommodates all communications options, with linkages to the full palette of personal data, including electronic health records, clinical data and engagement histories. Use tools such as automated data extraction, machine learning and conversational AI to facilitate self-service and support call centers. From claims intake and processing to appointment scheduling, benefits and eligibility, an end-to-end digital solution will streamline workflows and coordinate quality care.

5. Embed digital thinking into your enterprise culture

Digital transformation for the sake of digital transformation will quickly lead your organization nowhere, unless you engage your people in the broader vision. Strong leadership at the top is therefore a must. But you will also need champions across the organization who are empowered to push through roadblocks and lead by example. Communicate the program rationale and seek buy-in up front. Go slowly at first, aiming at quick wins to convert believers. As each proof-of-concept pans out, celebrate the wins and expand. Organizational change management is all about building trust, turning education and training into new skillsets, in a crawl-walk-run trajectory designed to take your team to the next level.

Prior to the pandemic, the healthcare industry seemed quite content to ride with the status quo. But since then, the drive to leverage digital technology has become more than a luxury, it has become an existential need.

To replay the webinar in its entirety, please visit the EXL Health webinar page. To discuss how to upgrade your member and provider experience on the wings of a digital transformation, contact EXL today.

"The pace at which we move will have almost nothing to do with technology. It will be almost entirely about organizational change management, organizational culture, and top-down mandate."

– Ankor Rai, Chief Digital Officer, EXL

1 Gartner: Gartner Healthcare CFO Survey, 5/20

2 IDC; IDC FutureScape: Worldwide Health Industry 2021 Predictions 10/20

3 Statista: Virtual Assistant Technology - Statistics & Facts, 9/20

4 Gartner: Gartner Healthcare CFO Survey, 5/20