Over the years, global companies have chosen the path of digital transformation as the logical step forward in keeping up with emerging technologies. As such, these organisations look at partnering with digital service providers such as Virtusa to transform their product and processes. Virtusa is a global provider of digital strategy, IT services and engineering solutions to a variety of sectors.
Anthony Lange, Senior Vice President Healthcare and Life Sciences, shares his insights on what digital transformation means for healthcare, the steps taken by Virtusa in enabling healthcare providers to meet the increasing digital demands and how Virtusa’s post-pandemic risk strategy is helping these service providers stay ahead of the game.
“With COVID-19, the whole US$3tn healthcare industry is being disrupted and dispersed, and everyone's trying to figure out the shift from hospital to home and from service to value,” said Lange.
Global supply chains are now being pressured to work with resilience as opposed to the lean model they previously operated on. This puts the onus on companies like Virtusa, who’ve been tasked to transform some of the most crucial processes within organisations in a short amount of time.
Lange is no stranger to transformation. As someone who’s worked with Virtusa for more than a decade, he witnessed first-hand the shift of technology from a nice-to-have to a must-have capacity. A charismatic and team-oriented leader, Lange’s role at Virtusa changed drastically with the onset of COVID-19. Pre-pandemic, a large part of his role was based around travel, meeting clients and visiting site locations. This routine flipped on its head the moment lockdowns happened, but that didn’t stop Lange from working harder than ever and thinking of ways Virtusa could support their clients and partners through these unprecedented times.
“I don't think I’ve ever worked so hard in my life, and a lot of it was about our employees' safety and making sure they were in the right place, both physically and mentally. We spent a lot of time ensuring we’re doing things the right way as fast as we can and with the right logistics in place.” Lange prides himself on being a leader who is always available and says there is no other way to go about it. So, team calls and standups became commonplace, Lange quips, and while this was necessary to facilitate workflows, he believes it also did its part in ensuring the employees’ well-being was top priority at all times.
Lange believes he challenges the status quo every day in pushing the organisation to be better and do more for its clients and ultimately those that depend on their services. When asked about what motivates him, Lange said: “In my perspective, the healthcare and life science team feel honoured to be in this industry, because while a lot of the other industries work to make other people rich, what we are essentially doing is trying to save lives, and we save lives every day.”
Innovation as a service
Speaking of some of the ways Virtusa has driven transformation in the healthcare sector, Lange points out a few innovative products and technologies developed by his department as part of Virtusa’s ‘Innovation as a Service’ methodology. One such technology is vLifeTM, a cloud-based platform consisting of a comprehensive HIPAA compliant data lake with multiple data sources, pre-built APIs and AI/ML models. Offering niche tools that help users navigate even the most challenging needs, vLifeTM
is designed to help biopharma and medtech companies access and means to synthesise a large volume of sensitive Electronic Medical Records (EMR) data which was practically unavailable earlier.
Telehealth is another area that saw a huge boom in both necessity and innovation, with the onset of the pandemic as well as regulations around it loosening up, especially in the US. This put Lange and his team in full gear to support this almost overnight shift to home care – like building a portable dialysis machine that patients could now use at home rather than visiting a health centre.
Improving the quality of life for patients is ultimately what life sciences innovation is about, and the team at Virtusa continually innovate with this ambition in mind. Diving deeper into what the innovation roadmap looks like for Virtusa, Lange adds that a shift from professionals to platform is imminent. What this means is, whatever a PCP (physical care physician) traditionally does for their patients can now be provided as a service on a platform, thereby cutting out the need for in-person visits and opens the patient to a potentially wider network of care.
Power of dual partnerships
Partnerships at Virtusa are a critical part of their business, and Lange says there are essentially two kinds of partnerships that Virtusa builds – one is an enterprise platform partnership consisting of a host of digital vendors, and the other is their cloud-based partnership. As far as enterprise platform partnerships go, Pega is a primary partner that’s been with Virtusa since 2001. In a mature, long-standing relationship, Virtusa didn’t always have Pega as a vendor partner first. In fact, Lange says that Virtusa was initially contracted by Pega for their engineering services in order to build their brand. This then led to Virtusa using the technology that they built for Pega into their own operations. To this day, Pega and Virtusa continue to help each other in areas of emerging technology and engineering their products; it is this bi-lateral relationship that’s led to the creation of a life-saving Philips platform called “I’ve fallen, and I can’t get up”. Essentially, it is a 24/7 medical alert system that has fall detection capabilities.
Some of the other initiatives that Virtusa has engineered include ‘Provider Lifecycle Management’ – an end-to-end platform to manage prospecting, contracting, credentialing and servicing a provider in a payer environment; and the Appeals and Grievances platform, helping payers manage these processes as per government regulations.
Working with Virtusa is a collaborative experience for Lange and the larger healthcare and life sciences division. Speaking on how Lange manages the customer experience aspect of the business, he adds, “We are a medium-sized company, and we tend to be very collaborative in how we work. So when we partner with a client, we want to fit into not only their ecosystem of employees and partners but very deeply embed ourselves in their culture as well. We spend a lot of time trying to adapt to that different type of culture.”
On the topic of digital transformation, Lange believes that companies that are embracing the change are likely to benefit in two areas: the first is that they’re able to provide a better quality of life for their patients and end-users, and the second, a better working environment for their employees.
A focus on technology
Manu Swami, Head of Healthcare and Life Science Solutions, outlines his roles at Virtusa and how he is helping to drive solutions through technology.
Swami helps to drive Next Generation Solutions and GTMs for Healthcare and Life Science verticals leveraging the latest Data, Automation, Cloud and Experience technologies. He also forges industry partnerships with established companies like Pega, Salesforce, CSPs etc. and niches vendors like Onyx to Mareana drive solutioning for clients.
“My role is focused on delivering solutions and go-to-market strategy for the Healthcare Life Science segment for Virtusa. We invest in solutions to drive business goals for Healthcare and Life Science Clients” said Swami.
“My team is a composition of business domain experts and technology leaders who build solutions to drive up quality and reduce cost of care for healthcare and life sciences clients and effectively leverage our solutions to meet their business objectives. We focus a lot on our engineering capabilities as a key differentiator when we are working with different clients.”
Commenting on Virtusa’s market strategy, he said it is focused on four key pillars, which include;
- Hyper Automation for Business Processes across the organisation
- Leveraging Data and Insights across the business value chain.
- Drive experience for providers, members and employees
- Platform modernisation on Cloud
“Automation has played a key part for us in the past year in our go-to-market areas like service experience transformation and supply chain and due to the pandemic. Next Generation AI and RPA technologies have played a key part in managing volumes of interactions coming from different healthcare parties and reducing cost of the operations.”
“Connecting data across healthcare organisations is a key enabler to understand a patient's health. We have adapted our solutions driven by interoperability to provide personalised experience to providers and members.”
Predicting technology trends in the healthcare market, Swami says the sharing of information between different healthcare organisations will “drive big changes”. Healthcare will be provided eventually on the edge on personal devices and Artificial Intelligence (AI) will be playing a key part in understanding and managing patient’s health.
“As patients start to transmit information from devices they are wearing or healthcare apps, I think payers and providers are going to have much better insights on a patient's health, and they can tailor their products”
“The advent of AI has become real for a lot of our technology clients like IBM. AI is driving a lot of solutions to be learning driven which were traditionally driven by business rules , and I think this trend is here to stay in the healthcare and life science space,” he said.
Revenue Recovery and Contract Management
Lisa Stoudt, President of Revenue Clinical Solutions, a strategic partner with Virtusa is focused on delivering a complete end-to-end solution to the provider market. Providers need a full solution that combines Superior Technology with Clinical Expertise. Stoudt noted that this delivery model is unparalleled in the market today as the majority of companies focus either on the technology or separately the clinical components. Virtusa will bring the combined solution to the provider market which will enhance and grow hospital organisations revenue but also provides the clinical expertise to provide improved healthcare outcomes and operational efficiencies.
Stoudt has worked in senior and executive positions in both Provider and Payer organisations. Her expertise in building successful business units for some of the industry’s leading organisations has driven strong financial/operational results. After building numerous companies within companies, she developed and brought to market-Revenue Clinical Solutions (RCS). RCS delivers clinical products and services to both the provider and payer markets that focus on driving revenue back into organisations and providing new avenues of revenue opportunities while simultaneously expanding quality outcomes and deliverables.
Stoudt provided details around the first two combined products for Virtusa which will be Revenue Recovery and Contract Management.
Revenue Recovery is focused on Retrospective Medical Necessity Denials/Appeals and recovering revenue that is owed to hospital organisations. Stoudt discusses how millions of dollars are written off each year by CFO’s when unable to provide updated or correct clinical information back to payers. Stoudt discussed how critical it is for provider organisations who are writing off millions of dollars in the market today as hospitals are struggling financially. This is the main reason Revenue Recovery was the initial product to launch.
Stoudt references two key factors to consider for provider organisations:
- Denial write-off adjustments average 3% to 4% of net revenue, which equates to US$262 billion in initially denied claims for healthcare providers annually.
- One out of every five dollars of revenue cycle management (RCM) expenses are attributed to denials-related issues and to top it off, 67% of denials are recoverable while 90% of denials are preventable.
Utilising Virtusa’s exemplary technology capabilities combined with Revenue Clinical Solutions, clinical expertise providers will be provided an unparalleled solution to recover, grow and enhance their revenues.
Contract Management is focused on missed opportunities with Value-Based Contracts. Stoudt states millions of dollars are lost from shared savings and hospital organisations need the combined solution to be able to achieve the goals/initiatives that are required by payer organisations. Stoudt notes there are several key factors to consider for hospital organisations:
- Provider organisations are leaving potentially millions of dollars on the table by not ensuring that they have delivery models for their value-based contracts.
- Provider organisations can overcome these challenges and maximise their revenue by understanding the basics of payer contracts, diving deeper into contract language, creating a central space for contracts, and preparing for negotiations.
- United Healthcare reports that nearly $75 billion in annual payments to providers are now tied to value-based payment but frequently finds providers aren’t actually interested in working with them.
Stoudt focuses on how once again Virtusa brings the full solution to the provider market. The combination of technology and clinical capabilities drive the financial results that are desperately needed for hospital organisations. Stoudt states that this is especially true post pandemic with significant revenue losses to hospital organisations. Utilising Virtusa’s PLM Platform and implementing Revenue Clinical Solutions she noted that these solutions will deliver significant revenue back into provider organisations as well as drive improved and measurable clinical outcomes.
Stoudt discussed that currently in the market today there is a minimal effort to combine Technology and Clinical Solutions. All claim that they are the full solution to gaps in services, but in fact they are only part of the solution. By combining superior technology with clinical expertise, it provides clients with a COMPLETE SOLUTION.
- Revenue - It’s all about delivering financial results with quality outcomes
- Frequently clients state they have a solution but when you get additional details you find they have fragmented services and are not really getting to a full solution which would allow them to recover, enhance and/or grow their revenue
- RCS created clinical products that are focused on revenue opportunities. Combining these products with Virtusa’s superior technology capabilities will create significant revenue opportunities for potential clients
Virtusa is bringing new and creative solutions to the Provider Market. Stoudt states this is an exciting time to be delivering products and services to hospital organisations that will see an increase in revenue as well as provide opportunities to grow their revenue. Stoudt discussed how Revenue Recovery and Contract Management are the initial products to the market but other products are in development and will add to the technology/clinical suite of solutions