Health care organizations need to change their approach. Don’t treat consumers like patients, treat them like customers. Just like in any other area of commerce.
This statement by Herb Quinde, Director, Public Sector of Microsoft Corporation, caused a stir during our Town Hall session, Using A Data-Driven Approach To Coordinate Care – The Provider Organization Perspective, at the 2014 OPEN MINDS Technology & Informatics Institute. Ethics, impracticality, expense, privacy, and more were part of the ensuing discussion.
If you think that “consumerism” will become widespread across all payers and health systems, the next step is making the concept a reality. And, operationalizing this concept is a challenge. First a definition or two. What is health care consumerism? One definition is focused on putting economic purchasing power and decision-making into the hands of health care participants, “achieved by supplying consumers with the decision-making information and support tools they need, along with financial incentives, rewards, and other benefits that encourage personal involvement in altering health and health care purchasing behaviors” (see The Institute for HealthCare Consumerism). Or another definition is more system-oriented – “managed consumerism,” is “a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition, [varying] according to the nature of the illness, the clinical technology, and the extent of discretion in utilization…” (for more, check out the article, Managed Consumerism In Health Care by James Robinson in the November, 2005 edition of Psychiatric Services).
And, then there is the issue of what “customers get” in other areas of commerce. Most of the discussion veered toward the retail customer’s experience with services – the transparency for comparison shopping, rapid customized transactions, immediate communication using multiple channels, and the ability to customize solutions. The “best of breed” discussions included customer service at Amazon, Netflix, and Target.
For health and human services, I think the end goal is likely some adaptation of “mass customization” – the delivery of services by organizations with marketing and management systems that allow the flexibility and personalization of “custom made” services with the low unit costs associated with mass production. For most systems, mass customization involves the use of a range of technologies that allow the consumer to change the service delivery along the way. There are four kinds of mass customization according to Joseph Pine II’s 1992 book “Mass Customization: The New Frontier In Business Competition” – collaborative (organizations working in conjunction with consumers to develop customized service offerings); adaptive (service systems that allow the consumer to customize the services themselves); transparent (organizations customize services without overtly stating that customization is happening); and cosmetic (standard services are provided but are marketed in different ways to different segments of customers).
In health and human services, the operationalization of consumerism seems to require two components of mass customization. One is a consumer interface system that facilitates immediate and convenient communication, and access that is controlled by the consumer. The other is system design that allows consumer control of the services process with decision support and decision making options. But “how” to move the field toward more consumer-centric service systems depends on where you’re sitting in the value chain.
For payers (whether employer or government), the relative degree of “consumerism” starts with policy about financing and consumer coverage. How much transparency and selection for consumers? How much personal financial contribution? How much choice among payer-financed services? How much accountability for and access to self-management? What tools can be made available to assist consumers in making those choices?
For health plans and organizations engaged in population health management, the focus is on providing those tools that facilitate consumer communication and decisionmaking. How do consumers select professionals and provider organizations? How do consumers select among treatment options and support services? What self-management tools are available to consumers? How do consumers have access to self-management tools?
For provider organizations, the focus in on how to develop a service experience (including but not limited to a treatment plan or support plan) that meets the consumers’ needs and wants. This includes access to the organization as part of the selection process, convenient and timely communication throughout all parts of the service experience, and encouraging consumer participation in the design and evolution of the treatment and on-going management process.
Whether a lot or a little, I think the spill-over effects of service delivery in other fields will inevitably affect consumer preferences in the health care space. The key (like in any market) is understanding your customers and what they want – and developing a service strategy to match.