The Digital Front Door is So Yesterday

By Sara Vaezy and Doug Grapski

As is typical for the Gartner Hype Cycle, the 2019 hype was all about the digital front door (DFD) for health systems. Positioned as the mechanism to transform the consumer experience, the industry was enamored with its promise to accelerate digital transformation for health systems and enable a modern digital experience for patients. Many health systems hired consultancies and tasked them with transforming the patient experience that often resulted in complex roadmaps that were impossible to implement. Consumer behavior changes resulting from the Covid pandemic only bolstered the excitement. 

Today, it’s worth asking, “Has the digital front door delivered on its promise?”  Despite most health systems making progress in building out their digital presence and making improvements in putting services online – the simple answer is no. Health system digital experiences are remarkably sub-par compared to peer industry consumer experiences.  

• Most health system services still cannot be booked or managed online. 
• Consumers still can’t shop for care and can’t preview what a service will cost. 

• Outbound communications are not well coordinated. 
• Clunky EMR patient portals are still largely a default entry point into the health system. 
• Health system experiences aren’t integrated with core ecosystem partner experiences. 
• Health system digital experiences still aren’t omni channel. 

Why the Digital Front Door Remains Shut
Building technology in the healthcare industry continues to be challenged by regulations, security requirements, and the timeless problem of integrating into the electronic medical record. On top of that, we are talking about managing people’s health–which requires both accuracy and precision. This is why many investors and big tech companies can be heard saying ‘healthcare is hard’ – and that is often before they get into healthcare’s persistent fee-for-service business model constraints that aren’t always aligned with patient outcomes. 

At the root of being able to stand up any Digital Front Door or even any consumer facing technology in healthcare is knowing who a patient is and having them establish an authenticated user account.  This is required to deliver a personalized consumer grade experience on par with what has become the norm in other industries. Health systems have limitless data about their patients but have not been able to stitch it together in a meaningful or usable way. Clinical data is stored in the EMR, consumer data is stored in the CRM, marketing data is stored in the Consumer Data Platform (CDP), and financial / payor data lives with the revenue cycle team. On top of that, health systems do not have searchable inventory of their services further limiting the ability to shop for care and /or services.  

Identity is Key
While identity is a hot discussion topic for those in digital health, current solutions in market fall short of offering identity management for EMR authenticated experiences. The basic requirements to manage accounts, authenticate users, enable federation into third party partners, and lastly authorize users to access the Electronic Medical Record (EMR)—are not yet available. This is largely due to the blocker put in place by the EMR vendors who want to continue to own the consumer experience through a clunky patient portal–despite being tools designed for use by providers for care delivery at their core. EMR vendors play a critical role in delivering healthcare services, but they need to provide better application interfaces that can be used to power new patient experiences. 

To be clear, identity is not a new topic or problem to be solved for health systems. Solutions have historically tracked with the current state of innovation and needs of the market. As problems emerged, new solutions were created to meet the demand. This has resulted in a slew of digital front door vendors and health systems who have built custom patient experiences available through mobile applications and websites that are effectively handcuffed as patient identities are locked in the EMR as they don’t allow federation.  

Offering identity federation has become a consumer expectation in today’s digital first economy and is essential in removing barriers at the top of the customer conversion funnel. Google accounts and Apple IDs are industry leading examples of enabling identity federation and single sign on into an array of third-party applications and services reducing any barrier to access.    

Furthermore, existing digital front door solutions are challenged in synthesizing data required for personalized experiences across multiple consumer data stores (such as the CDP, CRM, EMR, etc.) that don’t speak to each other and often rely on separate identity solutions and corresponding account credentials. The promise of a seamless handoff to operations teams and self-service opportunities facilitated through digital front door were never realized as teams relied on different infrastructure. 

What Can You Access When the Door is Unlocked?
The promise of the Digital Front Door remains sound. But as an industry, it’s time to think about how to get the most of this tool by building it on a modern technology stack that enables the personalized experiences consumers are looking for. Building on a unified identity driven infrastructure lets health systems move beyond the standalone digital products and services in offering true omni-channel experience across the care ecosystem. Personalized experiences and recommendations could be surfaced by bringing together all the data elements currently available in the health system across the EMR, marketing technology, clinical outreach teams, call centers, and even revenue cycle teams. This would help health systems meaningfully improve their ability to engage with consumers between episodes of care and ultimately drive better patient retention and loyalty.  

PS – This approach doesn’t address the need for a searchable and bookable inventory of services that a health system can offer – that’s a topic for another post. The first step is to get the door open, so we can see what is on the other side.