Dr. Bob Lindnercofounder and chief science officer, Veda.
getty
It was hard to miss the issues Southwest Airlines had on their hands during the 2022 holiday season. While harsh winter weather grounded many airlines, Southwest was embroiled in a week-long companywide technology disaster. On the Tuesday and Wednesday after Christmas, a full 60% of all their flights—15,000 in all—were canceled during the aftermath of a winter storm that had been wreaking havoc for millions of travelers.
What was pinpointed as the cause of the shutdown? According to news reports, Southwest uses a dated system for scheduling attendants and pilots instead of a more modern digital solution. Bogged down by heavy use, their internally built and maintained technology failed and staff had to resort to call-in scheduling.
Facing hours spent waiting on the phone, airline staff was ready to work, but poor technology kept them grounded. As Chris Perry, a Southwest spokesperson, told New York Times opinion columnist Zeynep Tufekci: “Our systems were overwhelmed by the scale of the disruption. We had available crews and aircraft, but our technology struggled to align our resources due to the magnitude and scale of the disruptions. As a result, our crew schedulers tackled the issue manually, which is a tedious, long process that takes time and trained resources to accomplish.”
Outdated back-office administrative systems, however, plague more than just the airline industry. In this article, I examine similar tech issues facing healthcare—particularly, healthcare payers—and how to get started on avoiding a disaster.
How Outdated Systems Impact Healthcare Payers And Other Industries
As noted, Southwest’s out-of-date system was not customer-facing. Their website touts mobile boarding passes via QR codes and dependable inflight Wi-Fi. This is the case in healthcare, too: Member-facing digital tools often offer stunning technology and automation.
Meanwhile, administrative pieces, like keeping a complete and up-to-date provider directory, do not function at peak levels. Today, provider information—such as specialties, practicing locations, phone numbers and more—are collected manually via call centers or internal processes. Then, health insurance companies take the manual data to build and update their provider directories.
This hands-on process wouldn’t be so worrisome if there wasn’t a flood of constant provider updates. According to a report from CAQH and AMA, between 20% and 30% of directory information changes annually. With each piece of updated information, the risk of inaccuracy increases.
According to the findings that between 45% and 52% of provider directory listings had errors, with some individual plans having error rates as high as 98%. In other words, the manual and outdated processes could benefit from a back-end technology upgrade that boosts accuracy.
Outdated Systems Tied To Bad Business Results
A few bad customer experiences can be extraordinarily damaging to a company. Much like the stranded travelers who vow never to fly certain airlines again, inaccurate provider data can impact health plan member satisfaction and lead to insurance disenrollment.
According to a survey of Medicare members done in 2021 by Boston Consulting Group, 22% of those who select a Medicare Advantage plan switch health insurance plans in the next year. Unsurprisingly, the biggest drivers of satisfaction and disenrollment are directly related to provider directory accuracy. This is reflected in the Medicare Costs and Satisfaction Survey from February 2020, where the highest levels of enrollee concern when selecting a plan includes surprise billing and provider network availability.
What is the potential 2022 holiday winter storm of the healthcare world? Take another natural disaster as an example: a hurricane. Damaged clinics and hospitals can be closed for days or weeks for repairs. Meanwhile, patients need up-to-date information on where they can go for care. An accurate provider directory can not only lead to necessary care but an exceptional customer experience instead of a dreaded hour-long wait time on the phone while the member hunts down available care.
Technological Preparedness Is The New Status Quo
We’re past the era of optional administrative technology. While much of the tech focus in the healthcare realm was on member-facing software, creating state-of-the-art back-end technology was considered ahead of the curve and often largely ignored.
Now, members expect a responsive experience that enables a smooth customer service journey. Without modern systems, health systems are not only exposing themselves to risk during an unexpected event but they may not even be meeting the status quo. A high-risk event that impacts the healthcare industry is likely and health insurers should not wait to update their behind-the-scenes systems.
These days, companies have smaller teams and smaller budgets while doing more with less. When there are many things that need attention, tech leaders may find it challenging to prioritize behind-the-scenes technology updates, so budget and resources are typically roadblocks encountered by companies attempting to upgrade.
Because of these and other factors, any business getting started on updating systems should answer these three questions:
1. Who is going to do the work? It is difficult to enact change without a seat at the table. For meaningful tech changes to take place, there must be a specific individual owning the changes in a dedicated position.
2. Why are they doing it? If the updates are in response to a problem that occurred, complete a full analysis of what happened. With careful research, you can arrive at the root cause of the problem. Or, if there is a need to upgrade before issues arise, where do the stressors in the system exist?
3. What are they going to do? It can be tempting to jump straight into a solution for a specific situation but that will not fix future problems. Throwing more technology at something that has not been analyzed often means a bigger mess—and a mess that has had precious resources put behind it.
Updated software and automation are essential survival tools that free up resources while replacing archaic processes. Ideally, back-end changes take place before brand-damaging events occur.
Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify?
.