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Healthcare’s Digital Back Door: One Term, Two Meanings and How (or Whether) to Use It

A back door showing computer code

We’re all about opening doors for consumers, members and patients in the healthcare space. We shared a three-part series on the digital front door designed to help healthcare organizations (HCOs) create cohesive experiences that are welcoming to consumers. But having a digital front door implies that a digital back door exists. And therein lies the problem.

The term “digital back door” is harder to define than its forward-facing counterpart. There are two main definitions in play in the industry. The first is fairly innocuous. The second is … well, very much not. And misunderstandings around this term could lead to far-reaching consequences for your HCO.

What does the digital back door mean for your organization and the industry overall? Which definition is the “right one”? Or does that even matter? Let’s dive into these questions together.

Digital back door definition, take 1

The first application of “digital back door” is simple. It comprises all the systems, tools and processes your HCO uses to remain present and relevant in patients’ minds after they come in both the digital and physical front doors. This can include:

  • Automation of follow-up appointments
  • Automation of referrals
  • Patient data monitoring
  • Patient education
  • Regular messaging touchpoints, both automated and scheduled
  • Virtual care
  • And many others

These are all good, positive tools to improve the experience for patients. And they’re nearly expected in the new consumer-focused era of healthcare. People are used to the way they receive services and goods in the digital age. Healthcare needs to conform to those expectations. Doing so not only helps HCOs meet consumer expectations but also helps them maintain market share despite the growing presence of healthcare disruptors.

Digital back door definition, take 2

The second application of “digital back door” isn’t quite as simple. It stems from Jim-Crow-era requirements for Black and other non-white people to enter doctors’ offices and other places through the back door (please note that there’s some harsh language on that linked webpage). As noted in the writings of Kim Gallon, PhD, MS, MLIS, and other researchers, today’s digital back door can also refer to tools and processes that lead to unequal treatment of consumers and patients. These can include:

These and other systems can lead to health inequities — which the World Health Organization defines as “systematic differences in the health status of different population groups.” And these too can arise from the consumerism model of healthcare. If we treat healthcare as a commodity to be bought and sold, according to this theory, those who have more money have more access to healthcare — rather than it being a basic human right.

For example, the push in recent years toward virtual care could lead to lower availability of care for those who don’t have reliable broadband internet connections (or any internet connectivity at all). There have been studies that show using certain algorithms to diagnose patients leads to Black patients being sicker than white patients despite both groups having the same level of risk and the white patients being identified for extra care. And researchers noted in one study that Black patients were more than twice as likely as white patients to have at least one negative descriptor in their electronic health record (EHR) notes, such as “resistant” or “noncompliant.”

What should I call it, then?

Because there’s ambiguity in the term — and especially because one of the definitions is so negative — we recommend not using the term if at all possible.

That doesn’t mean your work to improve ongoing patient relationships should stop, however. But we do recommend changing the terminology you use. One alternative we’ve seen and like is “patient relationship management” (PRM). This again borrows from our friends in the retail world and the well-known “customer relationship management” (CRM) model.

Secondly, make sure your HCO is working to foster a culture of diversity, equity and inclusion (DEI). Let your current and potential patients know your organization welcomes patients of all backgrounds, cultures, races, sexual orientations and more. This can be challenging, particularly in states where DEI initiatives have come under siege. But taking a stand will be important to prove to your patients that they can expect the same quality care from your organization as anyone else would.

Keep the door open for your patients

Whether you need help building the systems and infrastructure to maintain relationships with your patients after their appointments or you need help reaching audiences and patients from all walks of life, we’re here for you. Our experts bring a wealth of knowledge and experience in every aspect of healthcare, from intelligent automation to data and analytics to DEI and more. Contact us to learn more about our solutions.

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Michael Adkins, Senior Content Strategist, Digital Health Strategy

As part of Perficient's Digital Health Strategy team, Michael partners with healthcare organizations to create informative, conversion-centered content for a variety of applications, including websites and blogs. Michael writes content that highlights clients’ service-line offerings, expertise in unique treatments, differentiators in competitive markets and additional factors that are important to patients.

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