Digital Front Door 2021
A View Through the Eyes of Market Leaders

“We don’t use the term digital front door because it is overused. This area isn’t a door; it is a house. People can climb in through the windows or get in through the back door. We do not think of digital front door as a one-and-done entryway into the organization. There is a lot of connected tissue, and we are really considering the experience of interacting with our organization in a digital way.” —Chief product officer

Competing with EMR Vendors and Homegrown Capabilities, Kyruus, Zoom, Krames Carve Out Niches

KLAS asked organizations about 13 different technologies commonly identified as part of the digital front door. For many of these technologies, organizations tend to first look to their EMR vendor or build homegrown solutions. However, a few third-party vendors stand out for having gained traction. In this report sample, Kyruus has been adopted by both Cerner and Epic organizations for provider search/matching as well as self-scheduling. Kyruus manages the provider directory database, and organizations praise their EMR integration and how easily new and existing patients can find appointments online and self-schedule. While Krames is not typically used by respondents to deliver educational content directly to patients, they have found a niche in providing usable patient education content delivered through homegrown capabilities or other vendors’ patient portals. Zoom’s Epic-integrated video visit capabilities as well as their strong presence outside healthcare give them traction among interviewed organizations.

Most Epic EMR Customers Turn to Epic First for Digital Front Door Tools; Cerner EMR Customers More Likely to Use Vendor Partners

While third-party vendors see solid mindshare and adoption for digital front door efforts, most organizations’ strategies are built around leveraging their EMR vendor as much as possible. Nearly all respondents say as they continue to build their programs, they will look first at what their EMR vendor offers and then, as needed, turn to outside capabilities; even then, they are watching for future indications that their EMR vendor can meet their needs. Interviewed Epic organizations most often leverage MyChart and other Epic products for multiple digital front door capabilities—on average, they use Epic for around 7 of the 13 capabilities KLAS measures in this report. Adoption of native Cerner technology is more limited (on average, they are adopted for about 3 of the 13 capabilities), though Cerner EMR customers often turn to the vendor’s partners—including Amwell, Kyruus, R1 (Tonic Health), WELL Health, and others—to meet their needs.

Respondents’ digital front door definitions often focus on the patient experience and patient journey. When asked what outcomes they have achieved through their digital front door, most share provider organization–centric outcomes. One-third of organizations report that allowing patients to schedule their own appointments and prefill forms has reduced the administrative burden and can also lead to quicker delivery of care. As patients are encouraged to interact digitally, several organizations report increased use of the patient portal and improved mobile adoption. Financial ROI is demonstrated for some through reduced no-show rates and more appointments filled, helping organizations maximize potential revenue. Also, patients who self-schedule are less likely to miss their appointments. Through digital front door efforts, one-fifth of respondents have seen increases in patient satisfaction and convenience; this represents the most commonly mentioned patient-focused outcome.^†

Most organizations could not point to a single vendor who drives their outcomes, but rather they see outcomes as a group effort between various vendor technologies and their own organizational strategy and efforts.

† To better understand the perspective of patients and their needs, KLAS is currently working on a study based on the perspective of about 10,000 patient respondents and how they engage with technology. This report is expected to be released in the fall of 2021.

Create a strategy up front and define “digital front door” for your organization

“People have to determine their what; they can’t start with technology. Prioritization is required first, and they can’t think too short term. If they don’t have a long-term vision, their technology decision can be wrong in the end. People need to prioritize and see the big picture. Technology can’t drive the decisions. People have to create something to solve problems first and then iterate as they go.” —CIO

Keep the patient at the center and consider their perspective

“Others should identify what we call the moments in a patient’s journey. That was one of the first things we did when we were trying to craft our patient-experience initiative. We define a moment as any interaction that a patient has with our hospital in any form or fashion. The interaction could be digital, through the portal, or with the scheduling department, as examples. We define all of the moments and identify where we have issues and how to make things better, and then we work backward from there.”  —CIO

Ensure organizational governance supports your efforts and include key stakeholders from the start

“The digital front door is not just an IT thing. It should be driven as a business strategy. We should think about the digital front door across the enterprise and bring stakeholders together. We need a dedicated team and thought leaders so that each hospital, region, or service line is not embarking on their own digital strategy and so that we can make sure there is one customer-centric strategy. We need to put investment in that team. For systems like our internal platform that are growing or acquiring things, there is a big lift to rally the entire organization around a common customer experience.” —Chief digital officer

Consider the best technology strategy for your organization: Will you partner with vendors or self-develop? How EMR-centric should you be? How can you consolidate your vendor footprint?

“I would tell others to be very thoughtful and architect their digital front door so that they don’t get dragged around by the various players in the market. That is why we end up with so many pilot solutions that are not architecturally aligned. People need to focus on the architecture and the platforms. People need to work within the foundation that is already there with the EMR. Epic, Cerner, Allscripts, and other vendors are all talking about the digital front door, but they are still EMR vendors and can’t do everything. People should partner with one or two players to create a digital front door strategy that starts with architecture.” —CIO

Digital front door strategies are often led by people in a variety of roles. Even in instances where one leader was identified, respondents described strong collaboration with other stakeholders since the digital front door often involves many technologies and necessitates perspectives from marketing, clinical, IT, and patient stakeholders.

Most digital front door programs have been implemented in the last few years, and many respondents see this as a process rather than a formal go-live. Often, each capability can be released and have its success measured independently from that of other technologies being deployed. Organizations who have been live for several years often say the patient portal was their first step into a digital front door.

Just over one-third of respondents engaged a services firm for help with a variety of projects to support their digital front door efforts. These projects include technology integration work, digital front door strategic guidance, vendor selection, digital access experience optimization, digital marketing guidance, application development, change management, maturity assessments, and road map guidance.