Thursday, Mar 2, 2023

Creating a Complete Consumer Health Journey

Jaime Murillo, MDSenior Vice President, OptumLabs

HLTH Foundation

Building strong patient experience at every touchpoint


A consumer’s experience is determined throughout every interaction — online, in-person, on paper and by phone. When the experience is disjointed, inconvenient or consumer expectations are unmet, the consumer may either look elsewhere or withdraw. Whether it's the call center, the clinician, or a utilization review, it’s imperative that complete information and insight is available at everyone’s fingertips. This approach delivers a positive experience for the consumer and a rewarding experience for the healthcare workforce. 


As a health leader, it’s essential to:

  • Understand and map consumer social, economic and cultural preferences
  • Build communication pathways to match 
  • Know where to automate, offer decision-support or streamline authorizations
  • Set up portals, software and call centers for greater success
  • Track the lift in consumer and employee satisfaction


The vision of any healthcare organization should be to provide effective, engaging, affordable and equitable solutions leveraging big data, augmented intelligence, and clinical innovation for every customer.


True consumer satisfaction comes from having a system that is constantly generating new insights and identifying gaps. One that also:

  • Meets the needs of customers in a fast and convenient way
  • Uses technology to augment the capabilities of those who serve other customers
  • Offers a technology that is bias-free and empowers care equity
  • Prioritizes excellence and puts the customer first


Given this, what are ways health organizations can create a more complete picture of a consumer’s social, economic and cultural preferences? First, there is a need to understand that the healthcare industry is not that different from other industries when it comes to consumer behavior. It is a specialized industry; different on the acuity side, yet provides an environment where consumers are met on a timely and convenient basis.


Using data to shape a profile that guides a person-centered experience


Then, organizations can build data centers with a robust set of information that goes beyond clinical data. Subsequently, big data can be leveraged using artificial intelligence (AI) and machine learning (ML) to gain new insights that will allow users to learn more about every single healthcare consumer.


Prior to building a profile, data must go through a rigorous process to ensure their responsible use. This process includes identifying data sources, what to do with missing data, imputation methodologies, attribution and more.


Utilizing AI and ML, we can then generate new insights utilizing algorithms. These algorithms then need to be tested to ensure that any potential for bias is minimized. 


Designing more effective communication across healthcare


One of the major tools that is often a deficiency within healthcare is communication. Historically, healthcare has been provider-centric. Care is delivered in a brick-and-mortar place like an office, ER, or hospital. Secondly, it is delivered on an episodic basis, such as a visit every 3 to 6 months, an emergent visit or within a hospital setting. One additional barrier related to communication is that it has historically only taken place between a provider and the patient.


To optimize communication, there are 2 additional elements that should be incorporated: utilization of extended teams, both in a proactive and reactive manner when questions are asked, and proactively engaging people at home. 


Technology should also allow for an asynchronous, convenient, and timely exchange. The newer generations are quick to adopt technology, and older generations are assimilating to this concept faster than many thought. The COVID-19 pandemic is an excellent example of how this concept works in healthcare.


Effective communication takes a comprehensive approach. It's about who a consumer is as a person, where they live, and their environment. Beyond this, it entails their behaviors, preferences, needs, social needs, and social determinants of health. A final component is the clinical aspect, including genomics, for instance, or multi-omics. 


Building a sphere of service around the consumer 


Leaders need to see the full journey and then determine where to automate, offer decision support, or streamline authorizations. 


The full consumer health journey involves a multipronged approach. After all, the concept of loyalty in healthcare is based on customer service rather than on specific providers, as older generations have traditionally experienced. Consumers need to be engaged as soon as there is a need. Organizations need to be able to walk them through their entire lifetime health journey.


Herein lies a massive opportunity to utilize technology as the entry point, frequent touch point, avenue for maintenance, and a quick access venue. It is about changing the mindset of people who are accustomed to having a provider answer their basic questions to interacting with automated elements like chatbots or other forms of technology as the initial entry point. 


From there, they need to be able to access an automatic triage process to meet their needs in a timely and prioritized manner. And, it entails the ability to transfer that care outside brick-and-mortar buildings by digitally entering a consumer’s home and community to meet all their needs.


Health organizations must then engage in a cycle of relearning based on ongoing experiences to continually improve. 


The ultimate consumer experience goal


Channeling these strategies gives patients the power to see their full account, whole health snapshot and financial picture in one place. Health organizations now have the unique opportunity to deliver care in the most streamlined and patient-centric way imaginable. These advancements must be centered around the human element, where compassion and caring are palpable at every touch point.


Listen here to learn more tips for offering an outstanding patient experience. 


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