By Irving Loh, MD, Chief Medical Officer at Infermedica
Twitter: @Infermedica
As healthcare has moved from analog to digital along the entire care continuum, conceptual models have evolved that characterize how this transformation has altered the experience for all stakeholders, from patients, to providers, to support staff, to administrative and operational personnel. One of the biggest organic changes is how patients interface with the healthcare system, especially during the first encounter, in a space termed the “digital front door.”
Before search engines — the best-known example being Google — patients would use artifacts of the analog era: the phone book, or asking their friends, family, or neighbors for recommendations on where to go and whom to see for their ailments. Then Alta Vista, Netscape, and Google happened. By 2007, when the iPhone appeared, healthcare never looked back.
Although this shift toward more digital-forward healthcare has been underway for the last couple of decades, the pandemic certainly accelerated their adoption. Today, the vast majority of patients have figured out how to navigate the web to begin their journey. Even older patients who may have previously struggled or declined to participate in this technological revolution have either learned or turned to digital natives like their children, grandchildren, savvy friends, and social support groups to help them to the threshold of these digital front doors.
Breaking Down the Front Door
So what exactly is the digital front door? In analog terms, the digital front door to a modern healthcare system is like entering the foyer or lobby of an enormous office building where one seeks information or services, but isn’t quite sure where they need to go. They walk up to a (hopefully friendly) receptionist who figures out what they need and directs them to the place where those desired services may be available.
At the digital front door, patients can use chatbots, symptom checkers, search tools, and more to be directed to the appropriate care. The friendly receptionist of the analog world is a sophisticated natural-language-processing algorithm, which may understand multiple languages and automatically be conversant. Even before “arriving” to the facility, a preliminary assessment may have been conducted, a digital intake form provided and processed, and the appropriate appointments scheduled.
At its simplest, the front door is quite literally where patients enter into the formal healthcare system and have the opportunity to receive information, guidance, and hopefully ultimately the appropriate healthcare.
Benefits of the Front Door
The advantages of digital front doors are significant and vary by stakeholder. For patients, front doors can reduce delays in care by streamlining the process of getting the right care, faster. Advanced symptom checkers, self-scheduling options, expedited referrals to specialists, digitized intake forms, can be all seamlessly woven together at the front door to facilitate better navigation of the patient healthcare journey.
For providers, this technology — if integrated with the electronic health record — allows easier access to pertinent healthcare information at the point-of-care and more efficient scheduling of testing or follow-up appointments.
For healthcare systems, implementing front doors can help decrease healthcare costs by ensuring that patients are getting the right care at the right time and matching patient needs with the appropriate provider. Critically, it means that patients can avoid unnecessary care by not going to a higher acuity setting that generates excessive costs and overutilization. Additionally, anonymized data collection allows detailed analytics to be performed to continually enhance system performance.
Challenges of Implementing Front Doors
One challenge around implementing front doors is ensuring privacy, data security, and regulatory compliance. Digital front doors must adhere to HIPAA regulatory compliance in the U.S. and GDPR in the E.U.
Another challenge is that unlike using ATMs or financial apps, healthcare is a very personal and high-touch encounter. Credible empathy is not a programmable feature and remains uniquely in the realm of human-human interaction.
However, perhaps one of the biggest challenges to not only implementing, but getting maximum benefit from front doors is garnering buy-in among everyone within the healthcare organization. Still many physicians and administrators of all backgrounds and experience levels feel resistance to technology creep — despite its enormous potential value on their workloads and ability to deliver higher quality care.
Above all we’ve discussed, the real linchpin to implementing digital front doors is ensuring it can accurately and efficiently assess a patient’s presenting problem. Only then can the advantages noted above be realized. Continuous validation and improvement is a critical feature that must be relentlessly pursued.
Today’s digital front doors have great promise in improving the (often complicated) healthcare journey for patients, and as we emerge from the pandemic as a more digital-health-savvy world, now is the time to put this technology into practice for meaningful change in patient outcomes.