The Consequences of Downtime on Healthcare Insurance Patients

Special thanks to Julia Rehse, who came to the NETSCOUT family as an intern, for her exceptional work co-authoring this blog. She is returning to Germany in June and will absolutely be missed. Thank you, Julia.

A few seconds of downtime can cost organizations hundreds of thousands to millions of dollars. In healthcare systems, these disruptions can have additional consequences—such as postponed medical procedures, delayed treatment approvals, and drugs falling off formularies. Healthcare insurers are critical to this ecosystem because they offer essential health coverage and wellness initiatives to individuals, families, and employers. As you may expect, avoiding downtime in their service environments is incredibly important to insurance providers because it can significantly affect the well-being of patients and the functionality of healthcare systems.

A Scenario of How Service Performance Issues Really Affect People

According to a report by Towards Healthcare, the global health insurance market is projected to exceed around $3.02 trillion by 2032. Some of that growth is due to technology-fueled customer-focused offerings—such as telemedicine programs and virtual care platforms—as well as customizable plans that offer people more variety and control.

But in business, control in one area sometimes unintentionally leads to loss of control in others. For example, consider this scenario:

1. During a critical medical consultation, a doctor is frustrated because she cannot access her patient’s records through the insurer’s redesigned web portal. This prevents her from determining if a new prescription is covered and deciding on the best treatment for the patient.
2. The patient, learning about this, contacts an insurance agent by smartphone, but the audio is jittery and laggy. Now the policyholder is also frustrated because, once again, this situation is delaying care.

On the back end, the technical details behind what happened, although complex and multifaceted, become clear. In the case of the doctor, the delays were caused by misrouted traffic due to a load balancer issue, which overloaded a server and made the web portal inaccessible. For the patient, the voice service degradations were attributed to a configuration error in an ExpressRoute virtual network gateway exchanging IP routes between the carrier’s on-premises network and Microsoft Azure. This disrupted the performance of the Cisco Unified Communications Manager used in the carrier’s contact center, affecting voice and video services for a large geographic region.

Unfortunately, the doctor and patient were in that region.

Contact Center Downtime

Positive, error-free technology interactions with contact centers are incredibly important to healthcare insurers. Consumers often associate insurers’ customer service quality with business value.

As people age or their health deteriorates, their healthcare needs and preferences may change. Contact centers and customer service personnel play crucial roles in healthcare insurance delivery, often serving as a primary point of contact for policyholders and insurance providers. When customers need assistance, they expect a prompt response. If support personnel fail to deliver, or are unable to do so, customers can become frustrated. Downtime in contact center operations is a major problem because it can lead to delays in responding to inquiries and processing requests, impacting customer care and eroding trust.

Consider a scenario where, due to a service outage at the vendor, patients lose access to virtual consultations or telemedicine services covered by their insurance policy. This interruption could significantly disrupt patient care, especially for those who rely on virtual visits for checkups or follow-up appointments. In some situations, policyholders and doctors may need to work closely with an insurer’s customer service agents so patients can continue to receive necessary medical care or seek alternatives covered under the patient’s insurance plan. Any disruption in the contact center’s network that creates a service outage could prolong or jeopardize the swift resolution of those issues and delay the return of services to the policyholders.

Telemedicine: Just What the Doctor Tried to Order?

Driven by advancements in telecommunications, telemedicine has emerged as a popular solution for delivering healthcare or consultation services to patients in the comfort of their homes. In fact, health insurance providers are increasingly including telemedicine options—such as e-consultations, virtual visits, and remote patient monitoring—in coverage.

Stateside, especially in rural areas where access to healthcare services may be limited, and in countries such as Germany—where both public and private health insurance providers collaborate to manage the healthcare system, often for very remote populations—telemedicine can significantly improve healthcare service access. But ironically, for some of those tools to work, they first need robust infrastructure and networks.

In very isolated areas far from urban centers, access to high-speed broadband internet may not be possible, creating alternative markets for options such as satellite-delivered services. Although satellite internet can reach fixed broadband internet speeds, classified by the FCC as 100 megabits per second (Mbps) or higher, it can’t currently offer the speeds that cable and fiber can. This limitation is often the most challenging obstacle to telemedicine adoption in rural areas, particularly for services requiring live video connections between patients and providers. Communication between policyholders, caregivers, and insurance service environments should be closely monitored for any downtime to ensure patients and caregivers have access to the information they need when they need it. The infrastructure in some areas simply may not be advanced enough yet to support prolonged omnichannel interactions.

The NETSCOUT RX

NETSCOUT nGenius Enterprise Performance Management offers comprehensive monitoring solutions to improve downtime via network and application visibility. This level of assurance is vital for modern insurance companies. By strategically deploying NETSCOUT instrumentation, insurers can significantly improve mean time to repair (MTTR) cycles, ultimately reducing downtime in service environments and leading to more loyal and potentially healthier customers.

Read this case study to see how NETSCOUT helped a leading healthcare insurance customer improve visibility and MTTR of service disruptions in its complex hybrid environment and at edge locations.