Most innovators, enlightened business leaders and change agents are on-board with a customer-centric belief system. It makes good sense. In addition to the exchange of dollars for services, customers are an excellent source of candor, ideas and insights. Recently though, after listening to a series of customer focus groups for nine hours on the topic of how they interact with health care, it seems that the people who we call patients, are ready to move faster, farther, and more creatively to innovate the future than we are. So…what if we actually put our healthcare customers in charge of innovation?
After completing a year-long, Voice of the Customer listening project, including thousands of lines of verbatim comments, input from hundreds of front-line staff members, and nine hours of focus group discussions with 60 participants, one thing became strikingly clear. We (the healthcare industry) think of patients, well as…patients. Yet our research is clear, when people interact with healthcare, they think of themselves, and are increasingly behaving, as customers. Houston, we have a problem.
With the advent of high deductible plans and more costs being paid out of pocket by the healthcare customer, they are weighing in on how care should be available and delivered. We have entered the age of the healthcare customer. They are seeking ease of access, options, control, information, fluid communications, price transparency, and alternatives to in-person care. And while focus group participants from ten years ago would have never described their time as being as valuable as that of a physician, that is not the case today. Health care customers want their time to be respected, too.
In light of the rapid emergence of consumerism in healthcare, Beacon Health System’s internal efforts to achieve enterprise-level operations, and the enormous amount of change induced by the Affordable Care Act, we worked to clarify how we recognize innovation, and landed on this. At Beacon Health System, we see innovation as…INSPIRED by CUSTOMERS, creating value as defined by them. Armed with clarity on innovation and the voices of our customers, we definitely have our work cut out for us.
Let’s say at 7pm you discover your middle-schooler has a high fever. Your options are to see if your doctor is on call (if you even have a PCP), go to an urgent care, or possibly the ER. Its a tough call, with little information to make it an easier call. In the current state, when a customer has a medical need, their thinking goes something like this: “Oh no, this is going to be difficult…I don’t know where to begin and I’m not confident I can get in…What will this cost?...What about insurance?...What if this is something really serious?” And so, uncertainty and stress prevail as the search for care begins.
A better future state might have the customer who is in need of care thinking along these lines: “OK. This can be easy…With Beacon, I’m certain to get the answers and care that I need…I feel like I am in control and have options.” In general, customers need more information, choices and control on accessing care, understanding pricing, and knowing what options they have. In addition to access, the insurance, co-pay, deductible, out-of-pocket thing remains a huge mystery. The challenge for health care is to provide information so customers can make good decisions for their care and their pocketbook.
While this will not be easy, it can be accomplished. Most of the technology, customer relationship and communication processes are already available. It is the simple matter of applying them to healthcare. (Think stunned Emoji here.) Maybe it is not so simple. Healthcare has a long history and the culture thing works against us. From inside healthcare, providers are born from a position of expertise, a history of highly controlled access, the orthodoxy that care is delivered in-person, relatively limited communications, the continued use of fax machines (yes, seriously), and a process that is cumbersome and low on convenience.
On the flip side, customers want us to understand that life is busy and most of us manage a large part of life with electronic devices. Our focus group participants said things like: “If I can schedule a haircut on my smartphone with ease and certainty, but can’t conduct the important tasks of managing health needs for my family and I, it’s a problem. In fact, it makes me wonder if you (healthcare) know what you are doing.”
Regardless of age, sex, state of health, or insurance coverage, focus group respondents universally agreed that healthcare is bad at communications. “When a doctor is running behind, a heads-up would be nice,” is a comment that originated, and was echoed, in every group. Customers though, do want a partner in their care, and they want it conveniently. They want more information, and they want simple and clear instructions. While these requirements are as old as consumerism itself, it is important to remember that consumerism is new to healthcare, and fiscal pressures of today are insisting on action.
Embedding a customer-centric philosophy, technology, transparency, and relationship management will require restructure and investment in new systems. Understanding and designing for patients as customers will require massive amounts of process reengineering. If managed in small increments, needed change will not occur. This problem cannot be solved on the margins. It requires an enterprise-level view…a fundamental shift, where healthcare leaders need every bit of humility, innovation and creativity we can muster as we change the assumptions, challenge the orthodoxies and begin to write a new playbook.
As drivers of innovation, customers are pushing healthcare closer and closer to their desired state. Although it may be a rough ride, healthcare is working to respond. In any case, the results of improved logistics, transparency, service and better health, is certainly worth it. As Beacon Health System moves into this journey, please join us in looking to the customer and thank them to keep the pressure on and move us faster, farther, and more creatively to innovate the future.
Lori Turner is the Chief Marketing, Innovation and Experience Officer for Beacon Health System, the nonprofit parent organization of Elkhart General Hospital, Memorial Hospital, Beacon Medical Group, Beacon Home Care, MedPoint Urgent Care and Beacon Health & Fitness. Beacon is counting on its innovation heritage, inspired leadership, and 7,000 talented associates and physicians, to move boldly to design the future of care.
As a practicing consultant in lean, Baldrige, process improvement, and balanced scorecard design I could not agree more. In addition, at this very moment of writing, I am waiting for my wife to come out of surgery as she is going to be the recipient of a new hip.
The whole idea of the "customer" is largely lost on healthcare, social service, nonprofit, and government. I have had senior executives of higher ed organizations lecture me on the fact that their students are not customers.
This experience with my wife's surgery has been an eye opener:
1) When the surgical assistant met with a group of us going through the same surgery he read his power point like a script, did not make eye contact with us until Q&A, and never even asked for names. And when I asked him a general estimate of cost he did not have a clue, in spite of assisting the surgeon in over 400 hip replacements a year. In fact, no one even has a clue as to what this thing is going to cost and my wife has been too embarrassed to ask.
2 ) This morning, the hospital staff were excellent. I could tell they were following designed processes and procedures. When the surgeon comes in, I was expecting something very different based on the rave reviews ... He walks in, does not say good morning, does not introduce himself to me, has a 4 day growth of beard, and a backpack full of patient files (I guess) with the side all the way open and he has to lean in such a way the files do not fall out. I can only hope he takes better care with a knife than he does with patient files.
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Lori, good article. I like you have learned quite a bit over the years, as one wise man once said rarely do your original ideas or insights survive the first encounter with customers. Customer's needs are dynamic and the sooner we learn to adapt to that and stay on the journey with them, the better the solution will be and it will survive.
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