For years, racism mandated that Black people and other people of color in the United States use back doors to enter restaurants, movie theaters, and other public places. While these practices have ended, digital back doors may once again make them and others second-class citizens when it comes to health. Digital back doors are technological processes and tools used in health care, such as racially biased algorithms, infrastructural limitations, and dirty data. These unwittingly exacerbate existing health inequities, which the World Health Organization defines as "systematic differences in the health status of different population groups." How are digital back doors created? Their root cause is human made, due to the development and application of technology by some health information technology (health IT) developers and clinicians who fail to fully or explicitly consider equity in health care.

The future of healthcare is being driven by digital transformation and innovation. Healthcare is evolving into a new era where almost everything is connected through digital technologies to improve the way that healthcare is delivered. Most things that need to happen before the patient walks into a clinic or hospital – from appointment scheduling to check in and digital intake forms – can be done using technology. This was true before the pandemic, but now almost every interaction within a healthcare delivery organization (HDO) starts with a call, click, or chat. As hospitals and healthcare systems continue to re-evaluate their patient engagement strategy, they need to intentionally design a hybrid experience.

Healthcare's digital front door pushed wide open during the pandemic, offering access with the touch of a smartphone or digital device. But some rooms inside a healthcare organization's "digital home" are only partially accessible--and typically, payment is one of them. When designed effectively, digital payment and financial communications can have a substantial impact on a hospital or health system's bottom line. A U.S. Bank survey found 44% of consumers will pay more quickly when notified about their patient account balance via email, text or automated phone notification. One in four would use a mobile wallet to pay their bill if they had the option, and about 1 in 3 wished their provider offered payment options via a money transfer service like Zelle or Venmo.

As COVID-19 began surging across the globe in the early months of 2020, it almost immediately flooded health care providers with challenges and demands the industry had never before seen. Suddenly doctors' offices were closed to patients, hospital emergency departments and ICUs were running out of beds, and healthcare workers were battling a new and unknown disease. Today, in the waning months of 2021, some of these pressures have eased, while others keep coming back along with the Delta variant. Either way, the insights they produced remain vitally important. Lessons learned during this stressful time have already inspired fundamental changes in healthcare--changes that are here to stay.