Healthcare Provider Network Management

Part
01
of five
Part
01

Key Players in Healthcare System Scheduling

Key players providing scheduling for healthcare systems of doctors include NextGen Healthcare, PatientPop, NueMD, SimplyBookMe, and AdvancedMD. Each has been reviewed in some detail below.

NextGen Healthcare


Patient Pop

  • PatientPop delivers the only end-to-end growth platform in the industry and is used mainly by small practices.
  • This software offers online presence, automated marketing, and patient management features such as scheduling.
  • The company offers its online scheduling platform on over fifty websites including Facebook, Yelp, and Google. As a result, patients can book their appointments through these platforms.
  • Health staff is easily able to view and confirm appointment requests through this software. Available every day for 24 hours, PatientPop is said to boost appointment bookings and allows customization, where scheduling can be configured based on appointment reasons, providers, or locations.
  • It integrates with other scheduling systems, allowing patients to see available appointment spaces in real-time.
  • PatientPop not only generates and retains patient clientele, but reduces the burden on healthcare staff.
  • On Capterra, PatientPop has a rating of four and a half out of five and an estimated revenue of $38 million.

NueMD


SimplyBookMe

  • The SimplyBookMe software offers extensive medical scheduling on a fully functional website. It allows doctors and doctors' practices to accept appointments and send out reminders. They are also able to sell products on the platform.
  • The software is considered a mobile booking website, allowing clients to book online while still facilitating manual bookings from healthcare providers. Booking websites appear in the respective time zone of the clients and can be disabled. Appointments are also allowed through Facebook and Instagram pages.
  • Prices, as well as service duration times and wait periods, can be set by providers. The number of clients each linked provider can take at one time is also provided.
  • SimplyBookMe was given a four and a half rating from software experts Capterra.
  • It has an estimated revenue of $7 million.

AdvancedMD

  • The AdvancedMD medical office platform is a software suite developed for medical, physical therapy and mental health practices, as well as independent labs.
  • This scheduling software speeds up the movement of a practice’s front office, allowing workers to focus on more serious matters.
  • AdvancedMD allows doctors to view the insurance history of the patient prior to the appointment. It sends out appointment reminders as a way of reducing late arrivals and no-shows.
  • The software provides a snapshot view of the appointment schedule of each resource, provider, or location. It also allows for recurring appointments to be set all at once. Patients can be added to a waiting list, and providers are able to track office visits to better optimize patient experience and efficiently utilize staff and facility.
  • In 2018, AdvancedMD made $3.37 million in revenue and has a rating of four out of five from software experts TrustRadius.


Research Strategy

To conduct this research, we visited review, industry, and business websites to get a list of the key players in the healthcare system scheduling industry. Each website listed several providers of healthcare system scheduling. We reviewed each provider to see which ones can be considered key players. The team also checked which players were repeated in the five articles reviewed. We then selected companies that were mentioned in most of the articles. Some companies such as SimplyBookMe were mentioned in all five articles.

Capterra featured three of the five players, while FitSmallBusiness featured two. All five companies were mentioned on the review website TrustRadius and SoftwareAdvice. Our final source SelectHub listed three out of the five companies. The key players selected were therefore based on the reviews of the aforementioned sources. The team then used annual revenues where available, to support the expert opinions of these sources. Incomes for the companies were found using ZoomInfo and MacroTrends.

With our list of five, we then found the official product name and the company website for each. The website for each company also provided us with an overview of the respective scheduling services offered. Although the initially generated list contained more than five companies, we were unable to examine six due to time.

Another company, ECLIPSE, was mentioned in almost all the sourced article lists. Information about this company was scarce, and an official website was not found. As a result, it was left off the list of top five. Other companies found but not included in the top five were '10 to 8’, Phreesia, Epic, and SeriousMD.

Part
02
of five
Part
02

Key Players Company Analysis (1)

The annual revenue for NextGen Healthcare, a company targeting hospitals and healthcare providers, was approximately $529 million. Among its competitive advantages is the fact that it stores records of the diagnoses of past patients. In comparison, PatientPop and NueMD made an estimated $38 million and $7 million respectively and target the same industry.

NextGen Healthcare


PatientPop


NueMD



Part
03
of five
Part
03

Key Players Company Analysis (2)

The last key players providing scheduling for health care systems of doctors include SimplyBookMe and PatientPop. The revenues, competitive advantage, and target market of each have been examined below.

SimplyBookMe


AdvancedMD


Research Strategy

In this research we reviewed the remaining two key players as only five were identified in the previous research entitled 'Key Players in Healthcare System Scheduling.' For each player, we have provided the revenue, competitive advantage, and target market. Our research was focused on the US.
Part
04
of five
Part
04

Healthcare Network Management

As of 2017, healthcare networks in the U.S. are often turning over their network management to third-party vendors to have better security and visibility for the numerous devices in their growing networks, including personal devices from both employees and patients. Increasingly, healthcare companies have been turning to cloud-based network management solutions to handle the size and complexity of their networks, as well as their cybersecurity concerns for meeting federal and state standards for securing patient data. Companies like IBM, Microsoft, Apple, and Google have numerous options for managing and improving cloud-supported healthcare networks, which can better meet patient and healthcare employee demands for accessible scheduling on personal devices, as well as support the growing telemedicine market.

Growth among Third-Party Vendors in Healthcare Network Management

  • As today's healthcare networks become increasingly complex, the number of devices that a single network needs to manage in terms of access and data security can exceed the capabilities of a healthcare organization's internal network management resources, which makes turning to third-party vendors the best option, especially for larger organizations. Currently, the U.S. alone has over 6,000 hospitals that operate over 120 million devices connected to their networks, and the number of devices is only increasing.
  • In addition to navigating the complexity of their networks and the regulatory security concerns, healthcare network management needs to also meet the growing demand patients have for convenient, digital access to both personal health records and scheduling services. According to network management provider Experian Health, "66% of patients would switch providers for more convenient access, and 77% of patients think the ability to book, change or cancel appointments online is important?" This introduces even more devices that need secure access to healthcare networks, and healthcare organizations often turn to third-party vendors who can be better equipped to manage patient data to regulatory standards.
  • Increasingly, healthcare systems and organizations, such as the U.S. federal government's Centers for Medicare and Medicaid Services, have been turning to cloud-based solutions not only to provide device capacity/organization and patient accessibility that they need, but to also protect their health records from unexpected data loss, and "according to surveys carried out by HIMSS (Healthcare Information and Management Systems Society), a not-for-profit industry association, between January and August 2017, the number of healthcare provider respondents using the cloud for backup and [data recovery] jumped from 38% to 60%."
  • Additionally, the HIMSS surveys have shown that "83% of healthcare organizations are already using cloud technology." However, these healthcare providers are still working on fully-optimizing the capabilities of cloud-based networks, including offering systems and accounts that provide more "patient-centric, results-based, innovative, and personalized healthcare."

Cybersecurity Concerns Exceed Healthcare Companies' Internal Resources

  • According to Google, one of the leading providers of cloud-based B2B network management, cybersecurity is a major reason why healthcare companies are turning to third-party vendors that can provide cost-effective and security solutions. Healthcare networks "[experience] twice as many cyber attacks as other industries, on average, with 25 million patient records compromised in 2019," but the budget for cybersecurity represents only 3% of what healthcare companies spend on IT each year. As of 2020, medical data is on pace to double roughly every 2 months, so healthcare companies will increasingly rely on cost-effective cloud-storage solutions to manage their networks securely and efficiently.
  • Additionally, the advanced security features that cloud-based network management from third-party vendors can offer are needed to uphold regulatory standards from federal and state level legal regulations for how patient data is handled, including the Health Insurance Portability and Accountability Act (HIPAA) and the recently enacted California Consumer Privacy Act (CCPA), respectively
  • While HIPAA primarily pertains to only health insurance companies, hospitals, and clinics, among others, the CCPA has a "much wider in scope, covering all personal data created, processed, and transmitted by healthcare organizations." Currently, the CCPA's standards only concern health data of residents of CA, but similarly comprehensive patient-data protection standards are being lobbied for by both healthcare and IT industry leaders.
  • To handle the demands for better accessibility for patient health records & scheduling, management of more devices, and integration of telecommunication efforts, on top of cybersecurity concerns, healthcare companies have been unable to internally manage all these areas and are outsourcing the job to expert third-party network management vendors with cloud-based solutions.
  • On top of regulations concerns surrounding the security of patient data, "The U.S. Department of Health and Human Services (HHS) is also getting in on the regulatory bonanza, having recently issued a new rule regarding fines for blocking patient access to their medical data." This means that healthcare companies do not necessarily have the option of maintaining self-contained and managed networks in the interest of developing systems that promote patient access.

Cloud-Based Data Management: Cost-Effective and Convenient

  • Cost-effectiveness is one of the biggest advantages that healthcare companies are gaining from turning to cloud-based network management from third-party vendors. With the constantly growing number of devices in their networks, including on patient and employee personal devices, cloud-based data management provides a way that can be scaled up or down financially and digitally as needed to store, manage, access, and analyze data within the healthcare network. Healthcare companies can save time, money, and personnel resources by not building and expanding their digital capabilities in-house.
  • At the rate that the healthcare cloud computing market is growing, healthcare companies lack the internal infrastructure to keep pace with the need for ready-made systems that third-party vendors who specialize in network management already have. According to a recent report from BCC Research, "the North American healthcare cloud computing market was worth $5.7 billion in 2017 and is expected to almost double to $10.2 billion by 2022."
  • Companies like IBM, Microsoft, Apple, and Google already have "domain-optimized cloud solutions and infrastructures for the healthcare sector," which can be integrated into healthcare companies existed frameworks and integrate the business and personal devices that need to be connected to their systems.

Telemedicine Growth Increases Need for Specialized Network Management

  • Telemedicine has been a rapidly growing sector in healthcare, which adds a layer of complexity to healthcare network management and makes third-party vendors a more attractive option for handling this area. With each additional external system that needs to be integrated into a company's overall healthcare network, the challenge for the company's IT department to handle merging different systems increases. Third-party vendors can be better equipped to handle merging communications and network management "for physicians, pharmacies, imaging labs, reimbursement, and more."
  • Telemedicine alone requires several areas of network management, including the transmission of patient data from at-home devices, remote patient monitoring from patients themselves and employees in the field, as well as mobile health apps via patients' personal devices. In addition to these concerns, telemedicine can involve remote appointments that require separate scheduling from in-person appointments. Having a third-party vendor that handles overall network management makes it easier for patients to have access to both kinds of appointments under one system.
  • The mobile health component of telemedicine has the potential to be a particularly significant segment within overall network management, as it has been estimated that 65% of patient interactions with healthcare companies would occur through mobile applications as of 2018, and 80% of doctors already use mobile apps and/or smartphones.
  • The demand for integrating personal devices on the healthcare employee side of the equation has been growing as well, and "according to a just released survey of employees and employers by WorkJam, two-thirds of healthcare workers said they would be like to use their personal mobile devices to access information about scheduling changes and/or corporate training materials."

Examples of Third-Party Network Management for Healthcare Companies

  • There have been numerous instances of healthcare companies already successfully using third-party vendor products and services to improve patient access to their healthcare network. For example, Libertana Home Health has allowed "patients at independent living units in Valencia, California to [use Amazon Alexa to] connect with providers, schedule appointments, and set reminders about medications and other health-related tasks. The result was improved patient satisfaction, lower costs, less friction, and better outcomes. "
  • In another example, "Premier Health launched its online scheduling system for consumers last June. Since then, it's seen a five-fold increase in appointments last year. " The scheduling system has given patients access to next-day scheduling to almost 200 providers via the company's website and mobile app. These platforms have made it easier for patients to both learn more about their providers before and after scheduling appointments. Integrating these features has resulted in positive feedback and a high adoption rate among patients.
  • According to Experian Health, its healthcare network management services has resulted in a "43% reduction in call times." The vendor also says that it has allowed its customers to "move 30% of volume to self-service," which is a significant increase in efficiency and cost-effectiveness.
  • Another healthcare network management vendor, Validic, states that it currently offers both platform and mobile solutions [that] provide continuous access to personal health data from over 350 in-home medical devices and wearables — with a comprehensive toolset to administer and support programs, elevate critical data, onboard and enroll members, and manage device connections." Validic's services aim to streamline patient monitoring, appointment scheduling & management, as well as clinic and remote care workflows.
  • In one of the largest deals in between a healthcare company and a third-party vendor, "Mayo Clinic and Google recently inked a major new 10-year deal that will see the Minnesota health system hosting its data with Google Cloud — which in turn will help Mayo's clinicians and researchers develop an array of cloud and machine learning tools to help solve a variety of complex health challenges."
Part
05
of five
Part
05

Healthcare Provider Network Management Case Studies

Improved results in enhancing the experience of patients is one of the reasons why a healthcare company may opt for a third-party provider. The following report contains two case studies of healthcare companies that have opted to switch to a third-party provider, namely, Piedmont Healthcare and Prisma Health.

Piedmont Healthcare — Overview

  • Piedmont Healthcare is a large, non-profit healthcare system that serves over two million patients in Georgia.
  • Kyruus provides leading enterprise solutions for health systems that optimize patient experience across the different channels of access.
  • In order to link and enhance the patient experience "throughout the continuum of care," Piedmont Healthcare has opted to leverage Kyruus' healthcare system scheduling solutions, specifically the ProviderMatch product suite and the KyruusOne provider data management platform to link and enhance the overall patient experience.
  • Before the collaboration, the CEO of Piedmont Clinic, Ronnie Brownsworth, talked about the need for a system that's unique in its ability to provide them with full visibility into their provider network, as well as a solution that would enable them to keep their provider data up-to-date as time goes on. He says, "we recognized that operationalizing our clinically integrated network and retaining patients within it required us to start with unifying provider data across the network."
  • Piedmont Healthcare's VP of Experience, Katie Logan, spoke in detail about their collaboration — "We knew if we were going to differentiate ourselves in a big way, we had to take a holistic approach and not just improve access in a single channel."
  • A couple of reasons why Piedmont opted for a third-party vendor over their own system was that the former was able to better enhance patient access through individual channels and enable a consistent patient experience throughout their points of service and that Kyruus provides a multichannel solution that enables them to make things simple for agents, patients, and providers to find and schedule appointments with their preferred providers. They wanted a third-party vendor that would help them to both "unify key access points and make it easy for consumers to schedule online."

Piedmont Healthcare — Results

  • The results of the move have been generally positive for Piedmont Healthcare.
  • Piedmont Healthcare, with the help of Kyruus, was able to launch open online scheduling, with instant adoption from their new, as well as existing patients.
  • As a result, Piedmont Healthcare had experienced an 18% increase in "find-a-provider traffic."
  • Piedmont Healthcare has also achieved nearly a 300% rise in its online appointment bookings.
  • There are approximately 12,000 visits "booked directly online per month" as a result of their collaboration.

Prisma Health — Overview

  • Because of their merger, they needed to figure out a solution that would help them integrate the provider data that is stored in "disparate systems across the enterprise to gain a single view of the network and facilitate access for the more than 1.2 million patients who obtain care annually across South Carolina’s Midlands and Upstate regions."
  • As combining two health systems is no easy feat, they sought the expertise of Kyruus in providing them with an efficient solution. Prisma Health required a vendor that could address and solve the challenges brought upon by a merger such as limited visibility "into who is in the network and what they specialize in, which can hinder both patient access to timely care and overall network utilization.
  • Prisma Health specifically leveraged KyruusOne, a tool that "delivers unprecedented analytics health systems need to optimize their provider networks."
  • KyruusOne will specifically create a systemwide digital provider directory and "implement ProviderMatch for Access Centers and ProviderMatch for consumers to help patients find the right providers for their care needs across the system."
  • The robust data management solution provided by Kyruus, a well as the "unique enterprise-wide patient access platform, and experience working with top health systems across the US" were a couple of reasons why Prisma Health chose Kyruus Solutions as their vendor of choice.
  • Through the KyruusOne System, Prisma Health are able to consolidate their provider directories into a single robust resource that would assist in matching patients with the correct doctor or specialist according to their individual needs.
  • Through ProviderMatch, "Prisma Health will be able to offer consumers both visibility into appointment availability and the option to book directly online, delivering convenience while helping them navigate to the right providers."

RESEARCH STRATEGY

The first step of the research process was to identify several case studies of healthcare companies that are utilizing third-party vendors for their healthcare provider network management. By scouring through news articles, websites of healthcare providers, and websites of third-party vendors in the healthcare space, we were able to identify two healthcare companies — Piedmont Healthcare and Prisma Health, which then became the focal points of our research. Throughout the course of the research, we discovered that we were unable to retrieve information with regard to the results Prisma Health had experienced as a result of their partnership with Kyruus. We extensively explored websites, such as Kyruus.com, Bloomberg, and Healthcaredive in the hopes of obtaining insights that could shed light on the matter. After we've exhausted all our options using this strategy, we then went directly to Kyruus' official website. We attempted to gain access to their case studies page as well as their annual reports. Unfortunately, certain portions of the websites that may potentially hold are restricted and required us to fill in a form. We also visited their social media accounts such as LinkedIn, but this yielded no results. After an extensive search, we conceded that this information is not available, to the public at the very least.
Sources
Sources