There comes a time in every athlete’s career when they must come to grips with their inability to make a living at the sport of their youth.
My moment came when I watched my opponent hit a 240-yard 2 iron to ten feet. I wasn’t the best golfer on my team, and our team wasn’t the best team in the conference. My alternate reality bubble was crushed.
Here’s a reality check: digital disruption is real and it’s going to impact healthcare. A leader from financial services, retail, travel, and just about every other industry is probably wondering how this article from 2009 got into their feed. Well, healthcare technology adoption is running about six to eight years behind, and the consumer is finally becoming a focus.
Based on surveys and the discussions at the most recent Becker’s conference, I’m guessing most of you are already there. Here are some of the markers of the tipping point for those who are still in doubt.
The Patient Consumer
High deductible plans have changed the way people shop for healthcare. They have become consumers.
Consumers want convenience, choice, affordability, and experience. They are more informed than ever and are looking for information to support their choice in care. We no longer have a captive market.
Employers are Savvy Buyers
Let me tell you one of my favorite stories around the consumer trend. We had to present to an employer where our system was bidding against several Silicon Valley firms, vying to run their onsite health clinic.
The employer told us that they wanted us to run the clinic because of our clinical reputation, but hated the experience we put in front of them. They were standard healthcare offerings: a customized portal, a check-in application that looked like it was running on an AS400, and a clinical back-end that I think was written on Dbase IV. When we showed our technology to anyone outside the industry, they were amazed.
The key point here is that the employer outlined the experience and programs they were looking to deliver to their employees. The experience took center stage.
I recently selected health insurance for my company — an experience everyone should go through. Part of our plan was the availability of video visits with almost no wait.
The business model is interesting in and of itself. The first time my wife used the technology, her comment was, “Why would I ever want to sit in a waiting room again?” Seems like a good question. By the way, she didn’t seem to care when I tried to explain the reimbursement challenge with telehealth visits.
This doesn’t even touch on the cost pressure coming from our largest payer (the federal government) and emerging digital competition.
Emerging digital competition. That’s a pregnant statement.
It is important to note that Apple, Amazon, and Dr. Google aren’t positioning for how healthcare is delivered today. They are getting ready for how it will be delivered in the next five years. They don’t want real estate; they want the healthcare dollar as it becomes digital.
So what? Well, there are a bunch of implications. I’m just going to ask a series of questions to suggest some things to spark the conversation within health systems.
How much money are you spending on consumer experience?
We did an analysis of our IT spending every year. In my first year as CIO, only 2% of the budget was focused on the patient’s experience and 0% was on the consumer.
As my dad used to say, show me your checkbook and I’ll show you what you value.
How much of your IT staff and time are focused on the EHR?
My first job in healthcare was as CIO for a large health system. A phenomenon I wasn’t ready for was the status symbol that the EHR represented to the health system leadership.
At a roundtable of about 15 CIOs, each was asked to introduce themselves and we went around the table. The first person really set the tone.
He introduced himself, gave the health system revenue and the number of hospitals, and proudly stated that their system had chosen Epic. Around the table we went, with every CIO proudly stating their EHR. It got to me and I followed suit, but my EHR was considered the community college of EHRs to their Ivy League credentials.
While you are investing billions on back-end capabilities, your new competition is investing in experience. This isn’t wrong if it is done in the context of a larger strategy.
Who is your customer and what experience are they looking for?
Who is your customer? This is an interesting question for healthcare. Based on the volume of meetings and conversations today, would you consider your customer to be payers, physician groups, hospital leadership, or our federal government and their regulations?
Once we establish the customer, we may want to conduct a listening tour to figure out what they are looking for from their healthcare provider.
We spent several years of my tenure getting the display of the medical record just right in our portal. Here’s the problem, though: when we finally did a survey of people that would use the portal in our community, the availability of the medical record was ranked #7 on their list of priorities.
The moral of this story is that you may want to ask them what they want before you get too far down the road.
What do you offer the digital consumer today?
The consumer is carrying with them a whole new set of expectations. Their expectations are still low with regard to healthcare, but that is in the absence of alternatives.
The rise of digital alternatives, like the video visit offered by my insurance carrier, will begin to move money away from health systems.
How do you measure your consumer experience?
The funny thing about this question is that it starts further back: Who is responsible for measuring the consumer experience?
Without a clear organizational responsibility, it won’t get visibility, it won’t get funding, and it won’t get done.
The next couple of articles will continue to expand on what a digital transformation of healthcare might look like. You may want to ask a few of your peers these questions to gauge where you are at in the journey. The only wrong answer is the one that leads you to believe that digital disruption isn’t going to have an effect on healthcare.