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Advancements in consumer connectivity and digital technologies are seeping into every sector, including healthcare. Consumers have raised the bar on what they expect from healthcare providers and are increasingly using their individual ability (as well as their collective actions) to control how they manage their health, wellness and fitness experiences. While providers in all healthcare segments have made steady efforts to be more patient-centric, work still needs to be done to see the benefits of consumerism that has become the norm in other parts of their day-to-day lives.
As healthcare executives modernize their business strategies to address consumer health, they will increasingly need to acknowledge patients’ demands to access information, compare prices, schedule appointments, get references and pay for healthcare services—within a unified, omnichannel experience (See Table 1). The same thinking needs to apply to life sciences, hence pharmaceuticals, biotech and medical device executives need to move beyond traditional, antiquated communications in favor of more modern, digital engagement channels to engage with consumers. Many life sciences organizations are new to customer journey mapping as consumers traverse in and out of their branded experience and those of external partners. It will be important to draw in new skill sets and capabilities in areas such as experience design and cognitive engineering to step up their game.
Executives should immediately update their customer journey maps to include how consumers are taking advantage of healthcare ecosystems, especially those outside the provider’s solution platform. For example, patients will soon expect to book an appointment with a healthcare provider in response to an alert from a wearable device that will automatically transmit updated vitals to their physician in real time. Within the same experience, the patient might call an Uber to take them to a clinic or doctor’s office, then to the pharmacy and then back home. New systems will send health data to a network of other physicians, caregivers and the individual’s family based on the permission granted by the patient. Identifying a range of scenarios to map the end-to-end patient journey offers the opportunity to provide better care, strategically differentiate and fill gaps in underserved market opportunities.
Traditional approaches that view the patient experience through the lens of the provider will not be competitive. Every executive team must view its transformation effort through the desired consumer experience versus the provider’s operations and systems. A customer-centric approach will reveal areas of opportunity and needed investment in new processes and technologies. Identifying a range of scenarios to map the end-to-end patient journey offers the opportunity to provide better care, strategically differentiate and fill gaps in underserved market opportunities.
Executives need to shift cultures and mindsets and build skill sets to acknowledge the business impact from the empowered consumer. This means healthcare brand managers will need to assess their reputations with far more rigor while considering data and insights from customer measures of satisfaction and quality along with social media activity and third-party sources. Given consumers are known for freely expressing their opinions, brand managers will need to avoid reacting to news in favor of having standard processes in place to investigate and reform any systemic roots associated with positive and negative consumer experiences or ratings.
Mounting evidence of how individuals behave is underscoring the need for investments in consumer health. For example, in the U.S., more consumers are actively making decisions between competing insurance companies, particularly in public health exchanges established by the Affordable Care Act (ACA). This move has been even more significant in the Medicare and Medicare shift to private options, competing managed care organizations (MCOs). Although employer-offered multi-carrier private exchanges have not moved as quickly as anticipated, they are still enrolling millions of employees each year.
Other evidence points to the need to update a data exchange strategy. The steady rise of consumerization in all service industries—with the ubiquity of mobile devices and increased availability of medical information—emphasizes the need to make services more accessible. Consumers expect ease-of-use when they seek trusted advice and education from providers. All of this gets challenging when it comes to data, which is growing at unprecedented rates in both volume and variety. Executives should establish a position toward consumer data sharing, especially since electronic heath record (EHR) adoption rates have exploded in the U.S. and globally. Data and analytics leaders in healthcare organizations should also evaluate Apple’s FHIR-based health API, which enables iOS to function as a personal health record (PHR). Dozens of providers have adopted Apple’s Health API, which represents millions of patients. Other consumer-oriented digital tools, including GoodRx and Blink Health, help patients and caregivers reduce drug costs (whether or not they have insurance). In some cases, purchasing drugs outside of insurance actually saves the consumer money. Dozens of providers have adopted Apple’s Health API, which represents millions of patients.
More evidence of consumerization comes from consumer-direct health plans (CDHPs) with relatively high deductibles as a way to lower benefit costs and encourage cost-effective care utilization among beneficiaries. For example, a benefits survey from the Kaiser Family Foundation shows CDHP enrollment at 29 percent versus just 20 percent in 2013. Since these plans operate on high-deductible, low premium models, payers should design them with tools to help consumers spend wisely on services that will be most efficient and useful. Health savings accounts offer another way to actively save for services. Payers should consider letting consumers integrate these types of accounts into their CDHPs, helping them to save money specifically for healthcare expenses.
Technology can become a competitive differentiator by seizing the economics of connections. Given the rise in new platforms and ecosystems, executives should consider the following:
Given the ineffectiveness of previous attempts to influence control, many may push back on the consumer health movement. This time however, mounds of evidence suggest major structural shifts in the industry are coming given advances in consumer connectivity and high expectations to use personal technology to access just about everything. Given the industry’s traditional slow adoption of digital services, there is an opportunity to not just participate in the emerging ecosystem but use the consumer health movement to lead. CVS Health’s Aetna acquisition underscores the retailer’s seismic commitment to offer consumers a super-efficient, convenient means to access healthcare services across its 10,000 locations. Oscar Health and its partnership with Cleveland Clinic offers another compelling reason to invest in consumer health. Healthcare executives across the industry should carefully consider how they can team with and benefit from the investments being made by Google, Apple, Uber, Amazon and even Facebook as these players make sizable investments with the aim of making big profits from the consumer healthcare movement.
Senior Vice President Sales and Leadership
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