NetSuite’s Role in Digital Transformation for the Healthcare Industry

NetSuite’s Role in Digital Transformation for the Healthcare Industry

Introduction: The Imperative of Digital Transformation in Healthcare

The healthcare industry is undergoing a profound transformation. In an era of rising costs, aging populations, and increasing complexity, healthcare organizations are seeking ways to deliver better outcomes at lower costs. At the same time, patients are demanding more personalized, convenient, and transparent care experiences. Digital technologies offer a powerful lever for addressing these challenges and enabling healthcare organizations to thrive in the digital age.

Despite the imperative of digital transformation, many healthcare organizations struggle to implement change. Legacy systems, siloed data, and entrenched workflows can impede progress. Regulatory requirements around data privacy and security add further complexity. Choosing the right technology platform is critical to overcoming these barriers and laying a strong foundation for digital innovation.

Enter NetSuite – a cloud-based enterprise resource planning (ERP) solution that is empowering healthcare organizations to accelerate their digital transformation journeys. With its robust functionality, industry-specific customizations, and scalable architecture, NetSuite is helping healthcare providers, payers, and life sciences companies to streamline operations, improve financial management, and deliver better patient experiences. 

In this blog post, we’ll explore NetSuite’s role in enabling digital transformation for the healthcare industry. We’ll examine the key challenges facing healthcare organizations today, and how NetSuite’s cloud ERP platform is helping to address them. We’ll dive into specific use cases and success stories that illustrate the power of NetSuite for driving healthcare innovation. Finally, we’ll look ahead to the future of digital health and NetSuite’s ongoing role in shaping it.

The Challenges of Healthcare in the Digital Age

To understand the role of NetSuite in healthcare’s digital transformation, it’s important to first examine the key challenges facing the industry today:

Rising Costs: Healthcare costs continue to soar, driven by an aging population, chronic disease, and expensive new treatments. In the U.S., national health expenditures are projected to grow at an average rate of 5.4% per year through 2028, reaching $6.2 trillion. This unsustainable trajectory puts pressure on healthcare organizations to find new ways to bend the cost curve while maintaining quality of care.

One of the key factors driving rising costs is the fragmentation of the healthcare system. With multiple providers, payers, and other stakeholders involved in a patient’s care journey, there are numerous inefficiencies and redundancies that can lead to higher costs. Lack of coordination between providers can result in duplicative tests and procedures, as well as preventable hospitalizations and readmissions.

Another cost driver is the increasing prevalence of chronic disease. Conditions like diabetes, heart disease, and cancer are not only becoming more common as the population ages, but they are also more expensive to treat than acute conditions. Managing these chronic conditions requires ongoing coordination between multiple specialists and care settings, which can be difficult to achieve in a fragmented system. 

Additionally, the rise of precision medicine and personalized therapies, while offering great promise for improved outcomes, also comes with a hefty price tag. Many of these cutting-edge treatments, such as gene therapies and immunotherapies, can cost hundreds of thousands or even millions of dollars per patient. As these therapies become more widespread, they will put further upward pressure on healthcare spending.

Complexity: The healthcare ecosystem is incredibly complex, with multiple stakeholders – providers, payers, patients, government agencies, and life sciences companies – interacting in intricate ways. From referrals and pre-authorizations to claims processing and revenue cycle management, there are numerous pain points where inefficiency and errors can creep in. Coordinating care across this fragmented landscape is a persistent challenge.

One of the main sources of complexity in healthcare is the sheer volume of data that is generated at every stage of the care journey. Electronic health records (EHRs), claims data, lab results, imaging studies, and patient-generated health data all contribute to a vast and ever-growing data pool. Managing this data effectively is critical for delivering high-quality care and driving operational efficiency.

However, much of this data remains siloed within individual systems and departments, making it difficult to get a holistic view of the patient or the organization. Interoperability between systems is often lacking, which can lead to data duplication, errors, and delays in care delivery. Extracting insights from this fragmented data landscape requires significant time and resources.

Another layer of complexity comes from the web of regulations and compliance requirements that healthcare organizations must navigate. From HIPAA and HITECH to Stark Law and the Anti-Kickback Statute, healthcare is one of the most heavily regulated industries. Staying compliant with these evolving regulations, while also adapting to new payment models and quality reporting requirements, is a constant challenge.

Consumerization: Like other industries, healthcare is being reshaped by the forces of consumerization. Patients increasingly expect on-demand access, price transparency, and seamless digital experiences from their healthcare providers. Meeting these expectations requires healthcare organizations to transform their care models and embrace digital engagement.

The rise of high-deductible health plans and cost-sharing arrangements has turned patients into consumers who are more actively involved in their healthcare decisions. Patients are shopping around for care based on factors like price, quality, and convenience. They expect to be able to search for providers, compare costs, and book appointments online, just as they would for any other service.

At the same time, patients are becoming more engaged in managing their own health through wearables, mobile apps, and other digital tools. They want to be able to access their health information, communicate with their providers, and receive personalized guidance on their care journey. Providing this level of digital engagement requires healthcare organizations to invest in new technologies and rethink their traditional care models.

The COVID-19 pandemic has only accelerated these trends towards consumerization and digitalization. With social distancing measures limiting in-person interactions, healthcare organizations have had to rapidly adopt telehealth and remote monitoring capabilities. Patients have become more comfortable with virtual care options and are likely to continue demanding these convenient, accessible services even after the pandemic subsides.

Compliance: Healthcare is a heavily regulated industry, with an array of laws (such as HIPAA, GDPR, and HITECH) governing data privacy, security, and interoperability. Ensuring compliance with these regulations, while also maintaining agility and innovation, is a delicate balancing act for healthcare organizations.

One of the biggest compliance challenges facing healthcare organizations is protecting patient data from unauthorized access or breaches. With the increasing digitization of health information, cybersecurity threats have become a major concern. Healthcare data breaches can result in significant financial penalties, reputational damage, and loss of patient trust. 

In 2020 alone, there were over 600 healthcare data breaches of 500 or more records reported to the Department of Health and Human Services (HHS) Office for Civil Rights. These breaches exposed the sensitive information of over 26 million individuals. Cybersecurity experts predict that healthcare will remain a prime target for hackers, given the high value of healthcare data on the black market.

In addition to data security, healthcare organizations must also comply with regulations around data sharing and interoperability. The 21st Century Cures Act, for example, requires healthcare providers to give patients access to their electronic health information through standardized APIs. Implementing these requirements can be complex and costly, especially for organizations with legacy IT systems.

Compliance with evolving privacy regulations like the GDPR and CCPA adds another layer of complexity. Healthcare organizations that serve patients in multiple jurisdictions must ensure that their data practices meet the requirements of each applicable regulation. This can involve significant changes to data collection, consent management, and breach notification processes.

Data Challenges: Healthcare generates an enormous volume and variety of data – from electronic health records (EHRs) and claims data to genomics data and patient-generated health data. Yet this data often remains siloed within individual systems and departments, limiting its usefulness for generating insights and guiding decision-making.  

One of the main challenges with healthcare data is lack of standardization. Data is often stored in different formats across different systems, making it difficult to aggregate and analyze. Even within a single EHR system, data may be entered inconsistently by different providers, leading to quality and accuracy issues.

For example, a 2020 study published in JAMA Network Open found significant variability in how COVID-19 symptoms were documented in EHR clinical notes. Out of 212 different symptoms mentioned, the most common symptom (fever) was only documented in 43.5% of notes. This lack of standardization makes it difficult to use EHR data for research, quality improvement, and public health surveillance.

Another challenge is the sheer volume of unstructured data in healthcare, such as clinical notes, imaging studies, and patient-reported outcomes. This unstructured data contains valuable insights, but it is difficult to extract and analyze using traditional data processing methods. Advanced technologies like natural language processing and machine learning are needed to turn this unstructured data into actionable intelligence. 

Even when data can be successfully aggregated and analyzed, healthcare organizations often struggle to translate these insights into meaningful improvements in care delivery and operations. Implementing data-driven changes requires buy-in and coordination across multiple stakeholders, from frontline clinicians to executive leadership. Building a data-driven culture and governance structure is a significant change management challenge.

Finally, healthcare organizations often struggle with data governance and management. With data spread across multiple systems and departments, it can be difficult to establish clear ownership and accountability for data quality and security. Developing a comprehensive data strategy that addresses these governance challenges is critical for successful digital transformation.

An ERP Platform for Healthcare’s Digital Future

The challenges outlined above are daunting, but they are not insurmountable. By leveraging the right technology solutions, healthcare organizations can turn these challenges into opportunities for transformation and growth. 

This is where NetSuite comes in. As an industry-leading, cloud-based ERP platform, NetSuite offers a comprehensive suite of applications for managing healthcare operations – from financials and supply chain to billing and patient engagement. NetSuite’s healthcare-specific functionality, built from two decades of experience serving the industry, allows organizations to tailor the platform to their unique needs and workflows.

Several key capabilities make NetSuite a powerful enabler of digital transformation in healthcare:

Unified Data: NetSuite breaks down data silos by centralizing information from across the organization into a single, real-time view. This includes data from EHRs, ERPs, CRMs, and other systems. With a unified data foundation, healthcare organizations can gain insights into operational and financial performance, identify areas for improvement, and make data-driven decisions.

NetSuite’s unified data model is particularly valuable for healthcare organizations that operate across multiple locations or service lines. By consolidating financial, supply chain, and patient data into a single system, NetSuite provides visibility into performance at both the individual entity level and the organizational level. This enables healthcare leaders to identify best practices, standardize processes, and drive operational efficiency across the enterprise.

For example, a multi-state behavioral health provider used NetSuite to consolidate financial data from over 100 clinics onto a single platform. Previously, each clinic had its own instance of QuickBooks, making it difficult to get a holistic view of financial performance. With NetSuite, the provider was able to streamline financial reporting, reduce manual data entry, and make more informed decisions about resource allocation and growth opportunities.

Cloud Architecture: As a cloud-based solution, NetSuite offers healthcare organizations a scalable, secure, and cost-effective alternative to on-premises systems. With automated updates and built-in disaster recovery, NetSuite reduces the burden on IT staff while ensuring that the organization always has access to the latest features and security measures. The cloud model also enables remote work and collaboration, which has become increasingly important in the wake of the COVID-19 pandemic.

Moving to the cloud also allows healthcare organizations to shift capital expenses to operating expenses, freeing up resources for investment in other digital transformation initiatives. With NetSuite’s subscription-based pricing model, organizations can scale their usage up or down based on their needs, without having to worry about the costs and complexities of maintaining on-premises infrastructure.

The flexibility and scalability of NetSuite’s cloud architecture has been particularly valuable for healthcare organizations navigating the uncertainties of the pandemic. For example, a medical device company was able to quickly adapt its NetSuite environment to support a rapid shift to remote work and e-commerce. By leveraging NetSuite’s cloud-based inventory and order management capabilities, the company was able to maintain business continuity and even grow its online sales, despite the disruptions of the pandemic.

Automated Workflows: NetSuite automates many of the manual, error-prone processes that plague healthcare operations. For example, NetSuite’s order and billing management capabilities can streamline the revenue cycle, reducing denied claims and accelerating cash flow. Automated workflows for procure-to-pay and inventory management help to optimize the supply chain, ensuring that the right supplies and medications are always on hand.

NetSuite’s workflow automation capabilities are particularly valuable for managing complex, multi-step processes like prior authorizations and referrals. By digitizing these processes and integrating them with EHR and payer systems, NetSuite can help healthcare organizations to reduce administrative burden, improve accuracy, and accelerate cycle times. This not only reduces costs, but also improves the patient experience by minimizing delays and confusion.

A large physician practice used NetSuite to automate its prior authorization process, which was previously handled through phone calls, faxes, and manual data entry. By integrating NetSuite with its EHR system and payer portals, the practice was able to submit prior authorizations electronically and track them through to approval. This reduced the average prior authorization processing time from 14 days to 3 days, while also freeing up staff to focus on higher-value activities like patient outreach and care coordination.

Financial Management: Robust financial capabilities are at the core of NetSuite’s value proposition for healthcare. NetSuite’s general ledger, accounts payable and receivable, and financial planning modules provide real-time visibility into financial performance across the organization. Built-in compliance features help healthcare organizations meet regulatory requirements around revenue recognition, lease accounting, and more.

NetSuite’s financial management capabilities are particularly important for healthcare organizations navigating the shift to value-based care. With NetSuite, organizations can track costs and outcomes at the patient level, allowing them to identify opportunities for cost savings and quality improvement. NetSuite’s budgeting and forecasting tools also enable healthcare leaders to model the financial impact of different care delivery and reimbursement scenarios, helping them to make informed decisions about risk-bearing contracts and population health investments.

For example, a large health system used NetSuite to support its transition to value-based contracts with commercial payers. By integrating clinical and financial data in NetSuite, the health system was able to track and report on quality measures, utilization patterns, and cost of care across its network of hospitals and physician practices. This allowed the health system to identify high-risk patients, implement targeted interventions, and demonstrate value to payers – ultimately leading to over $20 million in shared savings within the first two years of the program.

Patient Engagement: NetSuite’s patient portal and self-service capabilities enable healthcare providers to engage patients in their care journey. Patients can schedule appointments, view test results, and communicate with their care team through a user-friendly online interface. On the back end, NetSuite’s CRM functionality helps providers manage the patient lifecycle from end to end.

NetSuite’s patient engagement capabilities are critical for meeting the growing demand for consumer-centric healthcare. By providing patients with convenient, digital access to their health information and care team, NetSuite helps providers to build stronger, more loyal patient relationships. This not only improves patient satisfaction and retention, but also has the potential to drive better health outcomes by encouraging patients to take a more active role in their care.  

A large dental practice used NetSuite to launch a new patient portal and online scheduling system. By allowing patients to book appointments and access their treatment history online, the practice was able to reduce no-shows by 30% and increase patient satisfaction scores by 25%. The practice also used NetSuite’s marketing automation capabilities to send targeted email campaigns to patients due for preventive care, resulting in a 20% increase in hygiene visits.

Beyond these specific capabilities, one of the key advantages of NetSuite for healthcare is its flexibility and extensibility. As an open, cloud-based platform, NetSuite can easily integrate with other healthcare systems and support customizations to meet the unique needs of each organization. This allows healthcare providers to build a best-of-breed digital ecosystem, without getting locked into a single vendor or technology stack.

NetSuite also offers a robust ecosystem of healthcare-specific partners and solutions. From clinical trial management and revenue cycle automation to patient engagement and outcomes tracking, NetSuite’s partner network provides access to a wide range of pre-built integrations and industry-specific functionalities. This allows healthcare organizations to extend the value of their NetSuite investment and accelerate their digital transformation initiatives.

NetSuite Success Stories in Healthcare

To illustrate the impact of NetSuite in enabling healthcare’s digital transformation, let’s examine a few real-world success stories:

Coria Laboratories: A specialty dermatology company, Coria Laboratories faced challenges with disparate systems and manual processes that hindered growth. By implementing NetSuite, Coria was able to integrate its financials, inventory, order management, and CRM onto a single platform. NetSuite’s batch tracking and traceability functionality helped Coria meet FDA compliance requirements, while automated workflows accelerated key processes. As a result, Coria increased its on-time delivery rate to over 99% and grew its revenue by 40%.

One of the key benefits of NetSuite for Coria was the ability to gain real-time visibility into inventory levels and demand across its distribution network. With NetSuite’s inventory management capabilities, Coria was able to optimize its stock levels, reducing waste and ensuring that the right products were always available to meet customer demand. NetSuite’s demand planning and forecasting tools also helped Coria to anticipate future needs and adjust production accordingly.

Another important aspect of Coria’s NetSuite implementation was the integration of its quality control and compliance processes. As a manufacturer of prescription skincare products, Coria is subject to strict FDA regulations around product safety, labeling, and traceability. NetSuite’s lot and serial number tracking capabilities enabled Coria to maintain complete visibility into the movement of raw materials and finished products throughout its supply chain.