If you’ve been following our blog, you’ll know that the Data Insights team here at Forrester has been tracking the evolution of US healthcare reform over the past three years and its implications in terms of consumer behavior, attitudes, and expectations. Our study began in July 2012, when we advised health insurance companies how to prepare for the flood of new customers entering the market. Two years later, my colleague Gina Fleming extended this analysis into Forrester’s Healthcare Segmentation, which provides a refined understanding of key customer profiles. Now, with our 2015 Consumer Technographics® Healthcare Survey just back from field, we can complement our understanding of the US consumer health insurance market with another layer of insight: the member’s journey to purchasing health insurance:
We're living in a time when smart, connected devices -- tablets, smartphones, wearable devices, Internet of Things (IoT) devices, and the like -- are being woven into the Business Technology (BT) Agenda of most companies. Nowhere is this trend more intimately applied to the customer experience than in healthcare, where devices near our bodies, on our bodies, or even inside our bodies are changing the way doctors, insurers, and other healthcare players think about patient care.
In a a major new report, Four Ways Connected Devices Improve Patient Care, we've researched how mobile, cloud, and connected devices come together to reshape the patient care experience. Technology innovations on the device and services side are creating new treatment options. And systemic changes to the healthcare system are creating both challenges and opportunities, which these emerging technologies can help address. For instance:
Busy doctors spend too much time on electronic health record (EHR) data entry. And when they use a traditional PC in the room with a patient, it's not always a great experience; one doctor told us he felt his "back was to the patient" too often. The solution? Moving to a Surface Pro 3 tablet, armed with better software, which allows the clinician to face the patient directly while still saving time -- and gaining accuracy -- on EHR data entry.
As the healthcare industry depends increasingly on software to drive the change to value-based care from transaction-based compensation, the future of global healthcare is increasingly bound to the technology that will deliver:
Integration solutions that will allow stakeholders to share information about populations and individuals across the ecosystem.
Cloud-based solutions that will allow services to reach scale without the need for the contemporary care system or health insurance vendor to grow infrastructure.
Branded medical services, such as oncology advice engines that allow a regional cancer specialist to deliver a better quality of care because she will have, for example, access to the most advanced protocols for her patients via smart software powered by companies such as IBM but with the built-in expertise of our great medical centers such as Memorial Sloan Kettering Cancer Center.
The Rise of consumer health repositories will work against info sharing in the eco-system - crossing the divide between protected data owned by covered entities, under various global privacy laws such as HIPAA, and consumer controled data subject to the corporate policy of various business entites such as Microsoft, Apple, Samsung, and others will remain dificualt and cumbersome.
If the healthcare industry exhibited symptoms of dysfunction, the US government administered a wave of treatment in the form of the Patient Protection and Affordable Care Act. October 2013 marked the opening of online insurance marketplaces, and set the stage for the act's requirement that most US residents have health insurance coverage. As a result, the industry has witnessed cessations and regenerations, and the pulse of consumer sentiment has fluctuated. Now, one year on, we’re due for a checkup.
At a macro level, US online consumers’ perspectives on healthcare reform today are largely consistent with those immediately preceding open enrollment under the federal law: Individuals continue to be skeptical of policy changes. However, at a micro level, subtle yet fundamental shifts in the consumer mindset signal a gradual evolution in perceptions of healthcare.
Our Technographics 360 research approach, which synthesizes Forrester’s ConsumerVoices Market Research Online Community insight and aggregated social listening data, shows that the conversation about healthcare has shifted from politics to experience -- and, in particular, to a focus on cost:
By all accounts, we’re approaching a new order of integration between technology and medicine. Real-time medical diagnostic data obtained from our mobile phones will soon be integrated directly into our electronic medical records where clinicians can use the data to make more-accurate (and potentially dynamic) treatment plans. Hospital staff can communicate and react to changing patient conditions faster and with less disruption to the patient experience than ever before, thanks to increasingly integrated mobile messaging systems and other mobile applications (for both the patients and clinical staff).
Applying big data analytics to PHI promises to improve patient outcomes and lead to more efficient —and less costly — patient care. It’s hard not to feel a level of excitement as this convergence of healthcare, mobile technology, and big data progresses at an accelerated rate. However, with all of this new patient data being collected by insurance payers, medical providers, and third-party services, healthcare employee endpoints have become an especially vulnerable source of data loss.
■Healthcare records are five times as likely to be lost due to device theft/loss.¹ If you’re a CISO at a healthcare organization, endpoint data security must be a top priority in order to close this faucet of sensitive data. Consequences will increasingly be more than just a mere slap on the wrist with fines, as consumers fight back.
Last week, Aetna decided to decommission CarePass, its consumer data aggregation platform. It was initially much heralded; however, this development highlights some of the fundamental problems with the health plan’s early forays into this space. I have outlined these issues in my new report, “The Unfulfilled Promise of Plan-Owned Digital Health and Wellness Platforms.” The report went to publication before the CarePass development was announced, but this decision is not at all surprising and validates many of the fundamental challenges with early platforms identified in the report.
The decision to unplug CarePass underscores the fact that there are lots of hurdles for enterprises when it comes to growing digital health as a business. What’s interesting about CarePass is it actually cycled through several different business models during the course of its evolution – ultimately repositioning the business model late last year to go directly after employers. With this pivot, CarePass essentially became a “bring your own” wellness tool servicing the traditional book of health plan business. This may have been the best approach for CarePass, but it came late in the game. Insurance, as a whole, is going to change dramatically over the next three years — with exchanges, defined contribution, etc. Given the competing priorities and the struggles to gain adoption, CarePass may have been doomed before the final pivot back to the employer. However, CarePass did a lot of things right and the CarePass team should be congratulated for their forward approach to the market.
For those of us who write and think about the future of healthcare, the story of rapid and systemic change rocking the healthcare system is a recurrent theme. We usually point to the regulatory environment as the source of change. Laws like the Affordable Care Act and the HITECH Act are such glaring disruptive forces, but what empowers these regulations to succeed? Perhaps the deepest cause of change affecting healthcare, and the most disruptive force, is the digitalization of our clinical records. As we continue to switch to electronic charts, this force of the vast data being collected becomes increasingly obvious. One-fifth of the world’s data is purported to be administrative and clinical medical records. Recording medical observations, lab results, diagnoses, and the orders that care professionals make in binary form is a game-changer.
Workflows are dramatically altered because caregivers spend so much of their time using the system to record clinical facts and must balance these record-keeping responsibilities with the more traditional bedside skills. They have access to more facts more easily than before, which allows them to make better judgments. The increasing ability of caregivers to see what their colleagues are doing, or have done, across institutional boundaries is allowing for better coordination of care. The use of clinical data for research into what works and what is efficient is becoming pervasive. This research is conducted by combining records from several institutions and having the quality committees of individual institutions look at the history of care within their institutions to enhance the ways in which they create the institutional standards of care. The data represents a vast resource of evidence that allows great innovation.
Recently Dr. James Merlino, Chief Experience Officer at Cleveland Clinic, sent me a late-stage draft of his new book, “Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way.” I started reading it over the weekend and could barely bring myself to put it down.
If you’re at all like me, you have books you read for your job, and books you read for pleasure: This book ticks both of those boxes. It’s an important work by the leading voice in patient experience. It’s also a gripping personal narrative that changed my perspective on every doctor-patient interaction I’ve had in my life.
Have you ever had a doctor patronize you – dismiss your questions and concerns as if you’re an appointment that needs to be completed as quickly as possible – and not a person? Or maybe you’ve had the opposite experience: a doctor who made you feel heard and cared for.
More importantly, have you ever wondered why there’s such a big difference in your patient experience from one physician or nurse to the next? You won’t wonder any more after reading this book. And you’ll also know what can be done to make patient experience consistently better across the entire medical profession.
The age of the customer coupled with the onset of the Patient Protection and Affordable Care Act (a.k.a. "Obamacare") means that many new customers will enter the US health insurance market. One outcome of the legislation is an opportunity for health insurance marketers to acquire new customers and engage existing customers — and Forrester wants to help them seize this moment. As such, we have created a consumer healthcare segmentation to identify unique groups of US consumers as well as their healthcare needs and attitudes to help health insurance marketers target new customers, engage existing customers, and innovate exciting healthcare tools and programs.
Our report, “Introducing Forrester’s Consumer Healthcare Segmentation,” explains each segment and how to attract or engage them. The segmentation includes both insured and uninsured consumers, representing the entire US online adult population. The graphic below shows each of the segments and their relative size.
Some highlights from the report, which is based on a survey of more than 4,500 US online consumers:
Fitness Trackers are young and love to use wearable devices; in fact, everyone in this segment uses one. The majority agree that that their health and wellness are priorities for them and they try to eat a healthy diet, but close to half believe that they are so healthy that they don’t need health insurance.
There is a great deal of wildly divergent and sometimes seemingly fabricated information on the size of the US and global healthcare market. For 2014, here are the numbers that I will be using, with my sources, and assumptions and notes.1