Five key focus areas for building a consumer-centric healthcare organization

If there is one thing that is driving fundamental changes to business models across industries, it is most certainly the ‘never-seen-before’ consumer centricity. A large share of credit for this new-found rigor around consumer centricity goes to consumers bearing more of the financial burden of their healthcare costs. In addition, pervasiveness of digital tools at the hands of consumers (mobile, social media and sensors/wearables) and digital technologies (analytics, cloud, interactive design, etc.) at the disposal of enterprises is paving the way for consumerism.

As more and more businesses move the consumer market to a digital one-Airbnb, Etsy, Facebook, Salesforce, Amazon and Lyft-they are raising consumer expectations to demand the highest experience, ease and access. Big box retail companies such as Walmart and Target are also influencing consumer demands as they play more active roles in the healthcare sector while retaining their winning approach to marketing to consumers. Thanks to these aggressive consumer-centric models, “Consumerism” is taking a different shape and form every passing day. The healthcare industry in particular is now taking this growing demand more seriously as consumers transfer these expectations to their healthcare experience.

The paradigm shift-from patient to consumer

As consumers start to pay more directly for healthcare, they require more visibility into where their money is going. They are also driving higher demand for the full consumer experience in all areas of interaction from website portals to personal interactions with healthcare staff. Emergence of this “consumer” is the most secular of the paradigm shifts that the healthcare industry is going through.

It is not just the immediate access to digital tools and technologies or the ‘consumer centricity’ shown by other industries that is causing this consumer mindset in healthcare. Government impetus on protecting healthcare consumer interests and empowering them with more choices through various legislations such as the Patient Protection and Affordable Care Act (PPACA) has a big role to play. Value-based care and value-based purchase programs/models are shifting the responsibility to patients while striving to provide better care for less cost.

At the same time, many commercial plans now require higher out-of-pocket expenses. This draws more attention from consumers around details of their healthcare purchases. They also explore more ways to offset higher costs through enrollment in daily wellness and preventative care programs. Incorporating their healthcare data from these programs into their conversations with providers means higher expectations/promotions from their providers around these topics. This is the start of converging complementary needs-population health management at the individual consumer level as well as the provider level meeting quality and contract needs. As patients become more and more responsible for their healthcare decisions, payments, and outcomes, it is only natural that they think more like consumers than just a receiver of care, the “patient.”

Key focus areas for healthcare decision makers

To address the new set of expectations from consumers, healthcare organizations need to take a radically different approach, while keeping in mind that consumerism as a trend is certain to redefine their business models. Cosmetic or front-end changes are not good enough in addressing the rise of consumerism; in fact, such efforts run the risk of quickly becoming counterproductive.

Achieving a simple, standardized, effective and efficient consumer experience across the care spectrum (wellness, prevention, illness, chronic care) and across the touch points (care evaluation, selection, access, consumption, payments and customer service etc.) needs a very well-thought-out, comprehensive strategy.

Next: Key strategies

Some of the key strategic considerations while building a consumer-centric healthcare organization include, but are not limited to:

•      Seamless integration with external stakeholders like payers, suppliers and distributors, pharma companies and healthcare services organizations.

•      Making employee engagement integral to consumer engagement

•      Demographics including geography, population profiling and community patterns.

•      New business models and opportunities centered around consumer wants/needs

•      Operational and ecosystem changes required for a smooth transition to a consumer-centric organization

•      Merging direct to consumer marketing and engagement strategies into a historically business-to-business shaped market

Aligning your data and technology roadmap

It is important to note that while digital tools and technologies are the table stakes to achieve a consumer-centric healthcare organization, traditional systems of records and channels cannot be overlooked. It is important to build a cohesive, well-integrated technology ecosystem to be successful. Integration of consumer data with electronic medical records (EMRs), enterprise resource planning (ERP), revenue cycle management systems, and other clinical and non-clinical applications is critical.

Here are a few other challenges/ opportunities that should be addressed as organizations build a consumer-centric technology stack:

•      Aggregation and governance of a high volume of data generated internally (within clinics and hospitals) and externally (transmitted by other providers, payers, third-party service providers and most importantly consumers themselves)

•      Handling of different types of data-structured and unstructured data (including streaming data, voice, device data, wearables data, biometric data, etc.)

•      Data analysis for various purposes including personalization, prediction, prevention and evidence-based care provisions

• ·      Enabling self-help (including self-care), bring your own medical device (BYOMD), integrating patient devices and applications with enterprise applications

•      Adopting an enterprise mobile strategy to manage one’s own app stores, integrations, device management etc.

•      Managing data privacy and security concerns; applicability of blockchain to manage some of these concerns

•     Creating space for new technologies that are consumer centric.

•     Constant review of usefulness of newer consumer/enterprise grade technologies is important to keep up with the market trends. For example, augmented reality, if the latest reports are to be believed, will have their biggest adoption in healthcare.

Developing an ecosystem framework

Becoming a consumer-centric healthcare organization first begins with defining the organization’s strategy and establishing a roadmap for the transformation. This includes discovery sessions with a focus on consumer journey maps and gap assessments-both functional and technical.

Once defined, strategic blueprints should be developed to identify the number of technology enablers. These include, but are not limited to, analytics, big data, cloud, enterprise mobility, user interface (UI)/ user experience (UX), Internet of things (IoT), integration and interoperability, information and performance management, digital application programming interfaces (APIs), and HIPAA and privacy/security compliance management.

Consumerism will redefine the way healthcare services are conceptualized, offered, priced, delivered and serviced in the years to come and preparation is necessary for both short and long-term planning. With EMR adoption behind us and data/analytics strategies coming into place, now is the right time to start thinking about a more comprehensive consumer-centric strategy and putting together building blocks for forward-focused, visionary healthcare organizations.

Sandesh Prabhu, MD, MBA, is assistant vice president, provider market for CitiusTech.

Abhay Singhal is vice president of provider markets for CitiusTech.

Kristi Jones is the director of product management for CitiusTech.