A new era of health care: Technology-driven connectivity and the patient experience

Integrated tech for better care: ©Siasarts Studio - stock.adobe.com

Health care today struggles to deliver an efficient and coordinated patient experience that is responsive to individual needs. However, the future of health care can look remarkably different. In a fully tech-enabled world where real-time data, patient insights, and applications are accessible to providers, and data is seamlessly captured and distributed among payers, Health Information Exchanges (HIEs), and providers, the potential to reshape every facet of the patient journey becomes increasingly evident.

By envisioning this next-generation patient experience, we can see how a fully connected and collaborative ecosystem powered by innovation at every care touchpoint can deliver an integrated, intelligent experience that benefits patients and providers.

Appointment scheduling: Intuitive and patient-centered

It all begins with scheduling appointments. In a future characterized by connectivity and interoperability, patients can book appointments online with in-network providers through a simple interface. This feature isn't just about convenience; it's about precision. A certified triage algorithm directs patients to the most appropriate care setting based on their symptoms. For instance, if a patient reports chest pain and shortness of breath, the algorithm can assess the urgency and route them directly to an emergency department for immediate evaluation, potentially recognizing a life-threatening condition such as a heart attack. This ensures critical patients receive timely care, improving outcomes and potentially saving lives.

Language preferences are captured during scheduling, enabling equitable treatment and ease of communication throughout the patient’s journey. Patients requiring additional services, such as transportation, can apply for eligibility and schedule it seamlessly during the booking process. Access to services such as transportation is especially useful for patients in rural areas or those with mobility challenges who may have difficulty accessing in-person care. Additionally, payment information, including credit cards or health savings accounts (HSA), can be stored securely.

Altogether, these innovations create a smooth, patient-centered process that gets the proper care to patients with minimal obstacles, setting the tone for the entire journey.

Pre-visit: Comprehensive medical record at the ready

Before the in-person appointment, the power of connectivity and interoperability materializes. Clinical data from various sources, including the EHR, payer systems, and HIEs, is collected and aggregated, creating a unified medical record.

This is not a mere data-gathering effort; Generative AI (GenAI) processes and summarizes the information, surfacing the most relevant details for the provider to review (this can occur pre-visit or at the point of care and is flexible to clinical workstreams), which helps meet quality metrics such as HEDIS. For example, suppose a patient is visiting and complaining of persistent headaches. In that case, the AI might flag any history of migraines, note medications prescribed for this condition, and highlight any recent imaging results. Potential care gaps, such as open HEDIS measures—and suspected conditions, are incorporated into the summary, creating a richer context and an incentive structure that encourages proactive action for the upcoming visit.

For the provider, this preparation is invaluable. A visit template is pre-populated with key information and suggested actions, helping streamline the visit and ensuring the provider doesn’t overlook anything critical.

The patient also benefits from this pre-visit preparation. They receive a copy of their AI-generated medical record summary on their mobile device and optional questions they might want to ask their doctor in their preferred language. Furthermore, copays can be processed online, ensuring that patients know their financial responsibilities ahead of time. These automated outputs empower patients to participate more actively in their health care journey and engage with their care team, enhancing their understanding and comfort level and reducing stress at the point of care.

During the visit: Informed clinical decision-making

During the in-person or virtual clinical encounter, the provider has a comprehensive understanding of the patient’s health based on the AI-curated medical record. Relevant clinical data from the record can surface as actionable insights in the EHR at relevant moments, thereby reducing the time spent searching for crucial information, which allows the provider’s primary focus to be on patient care and creates a more meaningful patient-provider dialogue.

AI-powered scribe solutions capture and transcribe the interaction in real time, freeing the provider from manual documentation and data entry. AI-driven clinical prompts surface in the EHR and guide the provider to any issues needing immediate attention. For instance, reminding a provider to address unmedicated hypertension or optimize therapy for a patient with established coronary artery disease surfaces crucial yet unaddressed issues without imposing additional cognitive load. These AI-driven prompts can also help align provider behavior with value-based care incentives, ensuring that high-priority quality measures are consistently addressed, directly benefiting reimbursement opportunities.

Additionally, workflow automation further enhances the provider's efficiency. Prescriptions, referrals, and orders are automatically generated based on the information gathered during the visit. A holisticcare plan is generated and shared with the patient and any specialists involved, ensuring everyone stays informed.

Post-visit and follow-up: Integrated care coordination

The patient's journey does not conclude when the visit does. Provider notes are automatically converted into claims and submitted to the payer through real-time adjudication. By the time the patient reaches the front desk, the payer portion of the payment has already been processed, and the patient is notified if they owe a deductible. The patient is offered a payment plan if necessary, providing flexibility and reducing financial strain. This real-time processing also eliminates the common issue of surprise bills weeks after the patient’s visit and minimizes administrative costs. The seamless submission of claims and the alignment of care plans with payer expectations support financial incentives for both parties, reducing friction in reimbursement and promoting shared goals of reducing costs and enhancing patient care.

After the visit, technology continues to ensure a smooth, connected experience. An AI agent ensures continuity of care by contacting specialists, following up on pending consultations, and sharing results with the patient’s primary care provider. This proactive approach ensures continuity of care and helps prevent important details from falling through the cracks. Additionally, it improves outcomes, especially in cases where multiple providers are involved in managing various conditions.

The same AI agent engages the patient post-visit. They receive reminders and follow-up questions about their care plan, reinforcing treatment adherence, encouraging healthy behaviors, and closing the loop on care. If the patient has any questions or concerns, the AI agent is available to provide guidance, reducing the need for unnecessary follow-up visits or phone calls.

The impact: A streamlined, patient-centered future

Achieving true interoperability between payer, HIE, and provider systems unlocks a health care experience that feels futuristic, yet human. The patient journey becomes an orchestrated sequence in which technology manages complexity in the background, allowing each stakeholder to focus on health and quality of care.

Patients benefit from smoother, more engaging, and curated care delivery. From scheduling to follow-up, they have better access to their health information, greater engagement in their care, and fewer barriers to quality treatment. For example, a patient managing multiple chronic conditions would no longer need to manually coordinate between different specialists or deal with the frustration of incomplete medical records. Everything flows smoothly, leading to more informed decisions and better outcomes.

Providers are equipped with advanced tools that reduce time spent on administrative tasks, allowing them to focus on personalized, high-quality care and reducing burnout. With workflow automation and AI-powered support, providers operate in a health care ecosystem focused on value and can deliver more efficient, effective care.

As the U.S. works to improve its standing among high-income countries in health care outcomes, integrating interconnected technology offers a clear path forward. Technology-driven solutions can transform patient outcomes and the overall health care experience by addressing fragmentation, improving coordination, enabling dynamic reimbursement models, and reducing inefficiencies. However, realizing this vision requires overcoming challenges such as varying levels of tech adoption, provider resistance, and integration hurdles (not to mention costs). If we as an industry can overcome these challenges, we will see “sick care” transform into health care and a patient care journey that is proactive, informed, and personalized.

Oron Afek is the CEO of Vim