As patients become increasingly engaged in their care, health systems are developing strategies to court them.
The progressive ones are learning from industry trends outside of healthcare.
That’s the approach of David Chou, VP and principal analyst at Constellation Research Inc. and former CIO at Children’s Mercy Hospital. “I look at the trends, the mega-trends in the world from technology; I look at what all the folks are doing in retail, financial, and how I’m able to apply them from a healthcare lens,” he said, speaking in an interview at HIMSS 2019.
It’s not a new concept. For years strategists from such far flung industries as auto racing and hospitality have said that healthcare should learn best practices from them.
Aside from the paternalistic tone such advice often takes — “Sit down and let me tell you how to run your business,” — it’s tough to implement. “Most folks have trouble figuring out how to operationalize these mega-trends and how to apply them in a healthcare setting,” Chou said.
Recognize that healthcare is complicated
“The hospital is the most complex human organization ever devised,” Peter Drucker famously said.
In an article published in the Journal of the American Medical Association in 2016, W. Joost Wiersinga, MD, PhD and Marcel Levi, MD, PhD observed, “It might well be that the complexity of hospital organizations in which patient care, and often research and education, are fully integrated is too immense or unique to merely duplicate ideas from other industries.”
Moreover, healthcare’s success metrics are fundamentally different than those in business.
Wiersinga and Levi recommend consultants pay close attention to the underlying ideals of the healthcare profession before imposing a business model on medicine. “A health care delivery culture should incorporate the best of the business world’s process optimization and the best of professional medical values,” they said. “Health care professionals have a responsibility to live up to the best medical standards in everyday clinical practice.”
Consider what patients want, but don’t let it drive care
According to a survey published in the New England Journal of Medicine Catalyst in 2019, 96 percent of people think healthcare could learn from other customer-facing industries.
It identified several specific areas for improvement. First, patients want better customer service and care customized to their individual needs and preferences. Additionally, they would like to see new models of interaction and digital communication. Other concerns include quality, convenience, and efficiency.
Nevertheless, letting patient satisfaction drive care can have unintended consequences. For example, in a study published in the journal Patient Preference and Adherence in 2014, more than half of physicians surveyed said a focus on improving patient satisfaction ratings promoted inappropriate care, “including unnecessary antibiotic and opioid prescriptions, tests, procedures, and hospital admissions.”
Don’t sacrifice engagement for convenience
In retail, innovative startups such as StitchFix automate the purchasing experience. Customers simply import preferences, and an expert stylist selects clothing and accessories for them. Boxes are sent monthly. Customers keep what they want and return what they don’t.
It’s convenient. But it’s the model healthcare is moving away from — one in which the doctor knows best and the patient is a bystander to their own care.
“For decades, doctors have basically told patients what they should do,” said Kevin G. Volpp, Founders President’s Distinguished Professor of Medicine and Health Care Management at the University of Pennsylvania. “Part of why we have such low engagement rates is that while there’s some overlap between that and the patient’s own goals, in many cases I suspect doctors don’t really work that hard to figure out what the patient’s goals are.”
Instead, meaningful partnerships between patient and doctor create greater patient engagement and better health outcomes, key metrics in value-based care.
“An engaged patient is actively involved in the defining of, and realizing, their health-related goals,” said Namita Seth Mohta, MD, Clinical Editor at NEJM Catalyst.
Embrace trends that create long-term value
In the world of startups, the buzzwords are all about immediacy. Disrupt. Growth hack. Pivot. Fail fast. In healthcare, it doesn’t work that way. Think: breakthrough blood testing technology.
Frankly, it doesn’t always work in business, either. “Prioritizing short-term gain at the expense of long-term value can be costly,” Wiersinga and Levi said, pointing to the financial crisis of 2008. They argue that healthcare has a thing to teach the business world in this respect, “Medical professionals have learned to create value that goes beyond short-term gain.”
Chou anticipates long-term value in healthcare coming from the fall of patient portals and the rise of healthcare-specific patient engagement platforms.
“New channels of care delivery will transform existing business models,” he said. “Advancements in telemedicine, virtual care, and robotic surgery will drive down costs while improving access. Virtual care will continue its growth and eventually emerge as the preferred triage source for hospitals.”
As care continues to change, other industries may provide inspiration and even guidance, but no one knows healthcare better than the people who have devoted their lives to it. And the best outcomes result when patients truly connect with their providers. ♥
Pamela Ellgen is WELL’s Health Editor. She began her career in community journalism and is the author of more than a dozen published books. She is a graduate of Washington State University.