Making Healthcare Inclusive Part 2 (Patients Are Now Consumers)

07/09/2018 03:49PM

In Part 1 of Making Healthcare Inclusive, I addressed the importance of preparedness and readiness to the Cultural Demographic Shift and why there is a sense of urgency in how healthcare organizations respond to it. I introduced the idea that the key is seeing and serving people as individuals.

One step toward seeing people as individuals is to acknowledge that patients are now consumers—and by that I mean patients have expectations and will choose to go elsewhere if those expectations are not met. Organizations that don’t grasp the significance of this change will get left behind.

We’ve seen how thoroughly technology innovation can disrupt the status quo of everything from taxis to grocery shopping. It usually involves making something much more convenient for consumers by putting the focus on the people using the service rather than on the service itself.

In the past, when hailing a cab, we were at the mercy of the drivers—we had to call or wait for one to drive by, flag them down, give our destination and hope they were willing to drive us there. Today, with Uber and Lyft, the consumer has the control.

Consumerism is coming to healthcare.

Here’s an extreme example that was featured in an article by Sheila Marikar in The New Yorker (“The Apple Store of Doctors’ Offices?” January 16, 2018). A startup called Forward wants to “remake the way patients take control of their health” by bringing “the Silicon Valley bag of tricks to bear on the traditional medical exam—A.I., technology, proprietary gadgets, open and shareable data,” according to Forward CEO Adrian Aoun.

As reported by Marikar, Forward uses a body scanner to measure height, weight and body temperature in 45 seconds; replaces the doctor’s clipboard with a six-foot-long flat-screen monitor; frees the doctor from detailed notetaking with a system that listens and takes notes along the way; and replaces the universally hated paper gowns with what the article refers to as “athleisure apparel.”

That definitely sounds like an improvement over the typical visit to the doctor’s office.

Leaders of healthcare organizations (providers and payers) know that a certain level of consumerism is coming. But it’s obviously a challenge to make such big changes on the scale required to really shake up such a complex industry.

According to a Modern Healthcare CEO Power Panel Survey, reported by Maria Castellucci, December 9, 2017: “Hospitals and health plans are increasingly investing in consumer-oriented services” and “most healthcare executives currently focus at least part of their strategic plan on consumerism.” But the headline sums it up well: “The consumer is wielding greater power, but hospitals aren’t ready.”

What would “ready” look like? An organization would have methods for getting feedback from patients and their families (while care is being provided), about how they feel about the care they receive and how they’re treated. The organization would have processes in place to get to know patients as individuals, along with processes to share that knowledge with caregivers across the continuum (as appropriate, while maintaining patient confidentiality).

Consumerism is a fancy word for putting people first. It’s a process of learning about the people you serve—How do they feel about your services? How do they want to use your services?—and then adapting to them, rather than forcing them to adapt to you.

This is a natural follow-up to my previous article on how health organizations are responding to the Cultural Demographic Shift—my term for what happens when segments of the population reach critical mass or numbers sufficient to have a significant effect on what we do and how we act. In that article I shared responses from various industry leaders about how they are transforming their organizations to meet the challenges of inclusion and diversity.

Some of those examples of transformation seem to be taking on this consumerism trend head-on, so the topic seemed to warrant its own exploration. The people quoted here didn’t necessarily frame their examples in the context of consumerism, but the intention is clear: they’re looking for ways to make healthcare work for the individual.

A Series of Consumer-Friendly Features 

Novant Health is adopting consumer-friendly aspects in the electronic health record through its patient portal MyChart. That includes turning on features that appeal to consumers, like “integrating the application with FitBit and Apple HealthKit data so physicians and patients can track fitness goals together,” said Carl Armato, President and CEO of Novant Health.

Armato also said they conduct convenient electronic and video visits “that save a trip to the physician’s office, but still take care of our patients.” The organization also has opened additional medical clinics in underrepresented communities.

Novant Health also employs Transcultural Health Managers to serve as navigators. According to Armato, these individuals work with clinical teams to increase their cultural competence in addressing the demographic shifts occurring in the Novant Health footprint.

“As patients increasingly become savvy consumers of healthcare, they are looking for their healthcare provider to understand not only their practical needs but their personal and cultural needs as well,” said Armato. “And to provide care when and where they want it and at a price they can afford.”

A New Approach to Caregiver Relationships

Last year, UnitedHealthcare launched a new clinical model for the Medicare population. It includes a program called Navigate for Me, which offers a life coach—not just a health coach—for members suffering from two or more chronic diseases.

This program was mentioned in the previous article, with the life coach as an example of ways to look beyond episodes to provide continuous care. I mention it here as well because it’s an example of a company identifying a population of individuals—those with more than one chronic condition—and providing them something that goes beyond seeing people as patients (which implies a medical setting) and moves toward treating them as consumers (which acknowledges the fact that they’re doing things every day that affect their health in ways good and bad).

UnitedHealthcare also implemented a new hospitalizations program that includes putting people inside hospitals and skilled nursing facilities to work with providers and specialists—looking at labs, looking at reports, looking at discharge instructions—making sure there’s a coordinated approach to a member’s care, and communicating with patients and their families throughout.

“Everything goes back to our mission of helping people live healthier lives,” said Gyasi Chisley, Senior Vice President for strategy and payment policy and innovation for UnitedHealthcare. “It’s an opportunity to make the health system work better for everyone. It’s not just a race to see if UnitedHealthcare can do it. It’s a race to see if we can actually transform healthcare for the betterment of the United States and its people.”

Turning a Consumer Experience Into a Health Experience

CVS Health launched CVS y más, a version of a CVS pharmacy designed specifically with the Hispanic consumer in mind. Beyond a bilingual staff, the stores also offer features like a fully staffed fragrance counter; an authorized dealer and payment center for utility, phone and cable bills; 2,500+ brands and products that are popular with Hispanic consumers; and a redesigned pharmacy area with dedicated space for picking up over-the-counter products covered by their health insurance.

The idea is to make Hispanic consumers feel welcome and comfortable enough in the store, so they’ll use the pharmacy services more and begin to see the pharmacist as a resource for health information. Ultimately, CVS y más wants to earn the role of Latina Mom’s health destination.

In an interview for Healthy Hispanic Living, CVS Health Vice President, Chief Merchant - Tailored Offerings Vince Urrutia explained what the organization is trying to do: “One of our biggest goals is to connect Hispanic consumers into healthcare long-term.”

But he emphasized that it doesn’t stop with one community. “This applies across the board [with all communities],” said Urrutia. “When a company gets to know its customers on a deeper level and personalizes a store environment to a community, there’s power there.”

Separately, when CVS Health and Aetna announced in December their intention to merge, CVS Health President and CEO Larry J. Merlo said they intend to “remake the consumer healthcare experience” and “create a healthcare platform built around individuals.”

Throughout this two-part Making Healthcare Inclusive series, I outlined four core areas of focus within an organization: enterprise leadership, workforce representation, patient experience and preventive care. All four areas are interconnected and interdependent. In many organizations, the journey toward inclusion begins in the human resources department. But for it to truly be successful, ultimately it needs to be owned and governed by every department and functional area.

When we start responding to the Cultural Demographic Shift by solving for the unique needs of the individual at a broader, more holistic enterprise level, that’s when a new growth mindset starts to permeate the organization.

To evaluate your own organization’s progress toward inclusion and individuality, take this assessment.

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