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
Interest in customer experience at pharmaceutical companies has shot up in the past few years. This came home to me more than a year ago at our 2012 Forum For Customer Experience Professionals East, where every meeting I took was with one or more decision-makers at pharma companies.
But there’s another reason why I’m looking forward to Tony’s speech. In talking to him during the run-up to our event, I’ve gotten a good look at what he’s doing and why it matters to so many people. Because let’s face it: The prescription drugs we take go right to the most important experience in most of our lives — our health.
Why does customer experience matter to a life-sciences company like Lilly, and what is it doing to make it better? We recently put some of these questions to Tony, and you can read his answers below. I hope you enjoy them and that I get to see you in Los Angeles where we can all hear Tony in person.
Q. When did your company first begin focusing on customer experience? Why?
A. Lilly’s focus on customer experience actually can be traced back to the company’s beginning in 1876 when Colonel Eli Lilly went against the trend of the time and focused on developing products of the highest quality to provide the best experience for his customers.
At the beginning of 2013, approximately 153 million US online adults had health insurance coverage. While it serves the majority of US adults, the health insurance industry is unique in that only a minority of health insurance customers choose their health insurance provider directly. Forrester estimates that just 14% of US online adults — 25 million US adults — actively chose their health insurance provider in 2013.
However, with the onset of the Patient Protection and Affordable Care Act, otherwise known as "Obamacare," many new customers will enter the healthcare market. While we don't know exactly what portion of uninsured US adults will follow the mandate that all US residents must obtain health insurance, there is a large pool of potential new customers.
In fact, Forrester’s Technographics® data shows that 13% of US online adults (23 million adults) reported having no health insurance at the beginning of 2013. Of these uninsured adults, 47% don't have health insurance because they can no longer afford personal coverage; 25% left the employer that provided their coverage; and 15% never had health coverage.
With the employer mandate delays being the latest setback to U.S. president Obama's push for national healthcare, it's worth looking at how other countries are successfully tackling the same problem. The United Kingdom has had nationalized healthcare for years, and one of the things that makes this effort so successful is its approach to data collaboration — something Forrester calls Adaptive Intelligence.
While the UK hasn't successfully moved into fully electronic health records, it has in place today a health records sharing system that lets its over 27,000 member organizations string together patient care information across providers, hospitals, and ministries, creating a more full and accurate picture of each patient, which results in better care. At the heart of this exchange is a central data sharing system called Spine. It's through Spine that all the National Health Service (NHS) member organizations connect their data sets for integration and analysis. The data-sharing model Spine creates has been integral in the creation of summary care records across providers, an electronic prescription service, and highly detailed patient care quality analysis. As we discussed in the Forrester report "Introducing Adaptive Intelligence," no one company can alone create an accurate picture of its customers or its business without collaborating on the data and analysis with other organizations who have complementary views that flesh out the picture.
Who doesn’t know Walgreens? It’s an iconic American brand that’s been around for over 100 years.
But at Forrester’s Forum for Customer Experience Professionals in New York on June 26, Graham Atkinson showed us a Walgreens that’s totally different from the one we’ve come to know. Graham is the Chief Marketing and Customer Experience Officer at Walgreens, and he’s leading the charge to transform the company from one that traditionally differentiated based on location, location, location to one that differentiates based on experience, experience, experience.
In this video excerpt from his speech, he describes three initiatives that are currently underway:
Delivering the well experience.
Transforming the community pharmacy
Taking the Walgreens brand to the world
As always, we welcome your comments! And if you're interested in seeing more great speakers like Graham, check out our upcoming Customer Experience Forums in Los Angeles in October and London in November.
How many of you suffer from at least mild “cyberchondria"? Do you run to the computer to Google your latest ailments? Are you often convinced that the headache you have is the first sign of some terminal illness you’ve been reading about?
Well, Symcat takes a new approach to Internet-assisted self-diagnosis. It provides not only the symptoms but the probability of getting the disease, using CDC data to rank results by the likelihood of the different conditions. It then allows users to further filter results by typing in information such as their gender, the duration of their symptoms and medical history. No, that headache you’ve had all week is likely not spinal stenosis or even viral pharyngitis. But if you’ve had a fall or a blow to the head you might want to consider a concussion.
As Symcat puts it, they “use data to help you feel better.” Never underestimate the palliative effects of peace of mind.
I had the chance to ask Craig Monsen, MD, co-founder and CEO of Symcat, a few questions about how they got their start with the business and their innovation with open data.
What was the genesis of Symcat? Can you describe the "ah-ha" moment of determining the need for Symcat?