Recently I was listening to Improving Doctor-Patient Communication In A Digital World on NPR’s Diane Rehm Show. There was an opening discussion about the challenges of health care literacy and communicating health care information – and a more specific discussion about how to use technology to improve communication. The discussion included a live call in-session and the callers were a predictably mixed bag – a man who tried his health care provider’s portal and gave up because it was so hard to use; a consumer complaining about the time it took to get test results from his provider organization and wanted them sent by email; a consumer who didn’t want to be compelled to get information unless it was out of the mouth of his primary care physician; a woman who spent the day consulting with her pediatrician by email about her sick child; and a self-described millennial who loved the new U.S. Department of Veterans Affairs texting program.
The call-in session brought some comments from the panel about whether or not digital communication would actually become the dominant mode of communication – and some of the challenges. One of the panelists, Robert Wachter, MD, professor at the UCSF School of Medicine and author of The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, made a statement that caught my attention – “Millennials are not going to accept the idea that they are going to take a day off of work to go and drive and park and see the doctor for a 12-minute visit when they could have got that at home.”
Which made me think, over time, will “good, cheap, and easy” really win the day in health and human service delivery models? And how close is the field to having options that allow consumers to “opt” for good, cheap, and easy? We have lots of examples of this version of consumer sovereignty winning the day in other fields (see Strategy Lessons From Walmart Vs. Amazon and Another Look At Consumer Sovereignty). But can making “using the health care field good, cheap and easy” actually move the market? I think the answer is “yes” and we are closer than we think to having robust options for consumers that could start to shift market share.
For example, there is the new mHealth consultation pilot that the Cleveland Clinic launched last summer – see Cleveland Clinic Goes Virtual With mHealth Consultation Pilot. As you may recall, the Cleveland Clinic made moves in 2014 to “set the standard” for customer service by guaranteeing that anyone could get an appointment for any specialty, in the same day (see How Far Are You Willing To Go To Improve Consumer Satisfaction? or watch their advertisement on YouTube, Cleveland Clinic Same-day Appointment). In their newest move, they are shortening the time to access even more through a partnership with telemedicine company, American Well – and providing consumers with a virtual consultation within minutes. Called MyCare Online, the app-enabled service costs $49 per consultation through a mobile device (to check this out, go to https://clevelandclinicmycareonline.org).
And Cleveland Clinic is not alone in pushing the boundaries on good, cheap, and easy. On the provider side of the health system equation, there are lots of new options emerging for consumers to get convenient virtual services:
- Walgreen Expands Telehealth Services To 25 States
- CVS Health To Expand Telemedicine Services
- Ohio Debuts Telehealth Stations From Rite Aid & HealthSpot
- MyTelemedicine.com To Deliver Virtual House Calls Via Phone & Video
- UPMC Offering ‘AnywhereCare’ Telemedicine Service Across Pennsylvania
And, there are payers recognizing the potential for increased consumer engagement and reduced cost:
- WellCare, Georgia Telehealth Partnership Open School-Based Health Centers
- American Well Provides Online Doctor Visits Through Blue Cross & Blue Shield Health Plans To Over Half The U.S.
- Humana & AMC Health Activate Post-Discharge Telehealth Program
- UnitedHealthcare Expanding Telemedicine Reach To 20 Million Members
- LifeWise Health Plan To Partner With Teladoc, Will Cover Telemedicine Visits
So what are the implications of a possible skew of consumer market share to the “convenient”? For payers, offering consumer convenience is important for consumer retention, consumer engagement, and reduced costs. They need to change payment policies for tech-enabled services and develop networks of professionals offering services online.
For executives of provider organizations and professionals, providing “convenience” the strategic implications and operational challenges are greater. The strategic issues are two-fold – losing consumer revenue to organizations that offer “easier” access to services and missing the cost advantage of tech-enabled services under performance-based reimbursement. To offer “on demand” services will involve reengineering their workflow from the initial consumer contact to the ongoing care for and communication with current consumers. This is a change that will affect scheduling, technology, and finances – and even more, the working lives of health care professionals.
These issues brought to mind the comments of David C. Mohr, Ph.D., Director, Center for Behavioral Intervention Technologies (CBIT) and Professor, Preventive Medicine, Northwestern University, in his 2015 OPEN MINDS Technology & Informatics Institute keynote address, 165,000 Health Care Apps & Counting: What We’ve Learned & Where We’re Going With Digital Mental Health. He said that to make digital health care technologies work, health care organizations and their professional teams need to communicate with consumers – when consumers want, how consumers want, and on the platform of the consumers’ choosing. That is a tall order for the health and human service field – but one that is likely to define success with both consumer engagement and consumer preference.