This is Digital, Episode 32: Digital's Role in Engaging Customers—Before They Need You

Q&A

Given that you’ve spent so long in healthcare, can you share how the industry has changed over time and what maybe what has surprised you with that evolution? 

Over time, I have observed a significant evolution in healthcare. Initially, during the mid-2000s, there was a strong focus on hospital-based medicine, with an emphasis on building hospital-based programs and adopting fee-for-service-oriented strategies. The primary goal was to maximize productivity and create systems to support this model, whether within the hospital setting or through government-supported programs. 

However, with the passage of the Affordable Care Act, there was a shift towards a more conceptual and financial perspective centered on value-based care. The emphasis moved from fee-for-service to a focus on caring for communities and populations. Additionally, the rise of high deductible health plans and increased cost-sharing among consumers prompted a different conversation in healthcare, emphasizing the need to provide more effective care to individuals. 

The evolution of healthcare was also influenced by the growing expectations of consumers for digital solutions, aligning with the digital revolution in other aspects of our lives. This shift coincided with increased venture capital funding in healthcare, particularly for software as a service offerings, which had a notable impact on the industry. 

On This is Digital, we've talked a lot about customer expectations and shifting customer expectations. Would you say that there was a bit of a tipping point with the convergence of the different factors that you were discussing? 

The transformation in healthcare hasn't been defined by a clear tipping point, but rather a growing lack of sustainability. While consumer expectations are increasing, the opacity of the healthcare system, its complexity, and the challenges associated with price and quality transparency have contributed to this situation. The economic viability of hospital-based care delivery became notably unsustainable in 2022, leading to significant financial losses for health systems. This ongoing process is more like a swelling issue rather than a sudden tipping point, and the healthcare system is becoming increasingly fragile.

I've heard you use this term around healthcare as a flywheel. Could you talk a little bit more about what you mean when you say that? 

The concept of a flywheel in healthcare is a relatively new but increasingly adopted model. In essence, a flywheel is a system designed to keep individuals engaged and returning for services. This concept has been well-established in other industries, such as Starbucks and Amazon, where they use a combination of personalized experiences, loyalty programs, convenience, and other offerings to keep customers returning. 

In healthcare, creating a flywheel is more complex because the aim isn't solely to encourage consumption of healthcare services. Rather, it involves providing care that is clinically appropriate, necessary, and makes sense for the individual's unique needs. Beyond clinical care, the flywheel approach extends to addressing a person's holistic health needs, not just limited to episodic clinical visits. This might include medication refills, vaccinations, seasonal illness information, over-the-counter medications, and more. 

The key is to understand individuals as whole people, taking into account their comprehensive health needs and preferences, and then provide the most relevant and timely services and information to keep them engaged with their healthcare journey.

Could you elaborate further on the significance of maintaining patient connections between visits? I'm reminded of the book "Younger Next Year," which emphasizes prevention and visiting doctors when one is healthy rather than waiting for problems to develop. Can you discuss the importance of this approach? 

Certainly, the concept of staying connected in healthcare is multifaceted. Firstly, it's essential to prioritize overall health and well-being. People often interact with multiple healthcare and health-related brands throughout the year, and the traditional idea of patients being solely "owned" by one health system doesn't hold true. Instead, we should embrace the fact that individuals should be free to engage with the services that make the most sense for them. Health systems should operate as connectors, bridging the gaps between various fragmented and decentralized options, rather than trying to centralize everything. 

The downside of a fragmented environment for consumers is the lack of a unified place for their health information. This often leads to the hassle of remembering multiple passwords for different services, resulting in a suboptimal user experience. In healthcare, there's an opportunity to create a single profile for individuals where they don't have to juggle numerous passwords but can utilize a single sign-on protocol for all their healthcare interactions. 

The key principle here is to focus on engagement, not entrapment within a single environment, while also enhancing the technical infrastructure to improve the patient experience. 

On the health system side, there are benefits as well. When health systems do not exclusively "own" the patient relationship, they need to reacquire patients every time they seek services, even if they've used the system before. With multiple options available, it becomes costly and challenging to maintain the patient's loyalty. Therefore, being top of mind for patients is crucial. This way, when patients require services, they naturally turn to the health system they trust, reducing the need for costly reacquisition efforts. This plays a vital role in ensuring the sustainability of health systems.