Deep Changes Drive IT Modernization in U.S. Healthcare

Providers and insurers are improving data sharing and cost control while shifting focus to better patient experiences and outcomes, ISG Provider Lens report says

Healthcare providers and insurers in the U.S. are using digital transformation and IT services to adapt to dramatic changes in the industry and prepare for the future, according to a new research report published by Information Services Group, a leading global technology research and advisory firm.

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“The implementation of value-based care is likely to be complex and contentious”

The 2022 ISG Provider Lens Healthcare Digital Services report for the U.S. finds that U.S. healthcare organizations of all kinds were not prepared for the soaring demand for care, hospital beds and equipment triggered by the COVID-19 pandemic and may continue to face effects on patient health for years. At the same time, the roles of healthcare providers and insurance companies, or payers, are converging as both look for more effective ways to serve the public.

ISG research shows that, in addition to focusing on convergence, the U.S. healthcare industry is engaged in achieving health equity, improving patient and employee experiences, modernizing IT systems and adjusting to the changing economics of healthcare.

Both payers and providers increasingly are examining social determinants of health (SDOH) to identify vulnerable populations and improve overall health outcomes for all people, the report says. This has led to greater use of electronic medical records, machine learning, natural-language processing, and descriptive and predictive analytics. With advanced data models and algorithms, the industry is combining SDOH with information on individuals to provide better early diagnosis and prevention.

“The importance of care ecosystems achieving efficient and secure health data interoperability to drive increased capability to prevent disease and improve population health cannot be understated,” said ISG Partner James Burke.

Healthcare receives low customer satisfaction ratings in the U.S., with consumers seeking price transparency, more access to care and better call center services and claims processes, ISG says. There is a growing demand for a digitally enabled healthcare experience in which, for example, representatives at a call center have access to all data about a customer’s past inquiries. This has led to more digital engagement initiatives to improve virtual care and personalization.

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Cost pressures are increasing due to several factors, including inflation and pandemic effects, sharpening the focus on operational efficiencies at many healthcare organizations, the report says. One emerging solution is value-based care, in which insurers pay providers on the basis of outcomes rather than services provided.

“The implementation of value-based care is likely to be complex and contentious,” said Jan Erik Aase, partner and global leader, ISG Provider Lens Research. “There are service providers that can help all types of organizations work through this.”

The report also examines other trends in the industry, including new federal data standards for health records and continued concern about cybersecurity amid ransomware attacks and the proliferation of remote medical devices.

For more insights into the challenges faced by U.S. healthcare companies, along with advice on how to move forward most effectively, see the ISG Provider Lens Focal Points briefing here.

The 2022 ISG Provider Lens Healthcare Digital Services report for the U.S. evaluates the capabilities of 36 providers across four quadrants: Healthcare Interoperability Services and Solutions, Payer Digital Transformation Services, Provider Digital Transformation Services and Value-Based Care.

The report names Cognizant, Infosys, NTT DATA, TCS and Wipro as Leaders in all four quadrants. It names Accenture, HCLTech and Optum as Leaders in three quadrants each and Deloitte, LTIMindtree and Tech Mahindra as Leaders in two quadrants each. Atos, Capgemini, CitiusTech, EXL, Firstsource, IBM and UST are named as Leaders in one quadrant each.

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