As the health care model changes from siloed to patient-centered, digitally enabled and demand-led, there will be growing pains: persuading consumers, clinicians and those charged with governance to adjust business and clinical processes to get the right care delivered at the right time, all of the time, in ways valued by the consumer.
Kristi Henderson spoke of the importance of long-term trusted relationships that are the foundations of personalized care. Drawing upon a care team’s shared knowledge of an individual and their personal network is how N of 1 interactions can become scalable. However, as she says, “It’s common sense but it’s not done because it’s hard and takes a lot of work. It’s an intentionality that’s not built into our operating model which is based upon appointments 15 minutes apart.”
Knowing the unique customer and enabling him or her to define preferences heightens the importance of design thinking in improving the clinician and consumer user experience across health care settings. Daniel Kraft emphasizes the importance of simplification, saying, “People don’t always want to be reminded of their health or be bugged” and that, for clinicians, “No one wants to jump through a bunch of hoops to collect data … the clinician wants insights and actionable information, not just raw sleep data.”
Several people spoke of issues with user experience in health care, especially about complex health IT systems. Transforming the experience is not just an issue of end-user satisfaction. It is achieving the right balance between users customizing how they consume information and the safety net of standards.
Rachel Dunscombe describes this well:
“We can't infinitely personalize and remain safe. What I’m asking for is both standardization and variation at the same time. Standardization to a set of ways of working, for example how blood pressure or renal function are displayed. But then personalization for the clinician to match their operating practices such as how they arrange the widgets on the screen to consume that experience. It's that combination of warranted variation that gives a great experience and standardization that brings safety.”
To this end, co-design with clinicians, patient and consumer groups is a hallmark of human-centered design, designing with and for people. The best outcomes arise through a participatory co-design process, where health care consumers and workers imagine what a better experience could look like for everyone.4 For example, co-design can focus on elements of education, access to data, interpretation of results and predictive insights to improve well care. In addition, agile design of smart buildings and virtual services, including modular facilities, hardware, software and networks, is required to meet future demand as new technologies, innovative new care models and different ways of working come into play.
Measuring consumer centricity
Increasingly, patient experience is a central outcome for health care organizations alongside clinical effectiveness and safety. Measuring and improving patient experience are vital steps in understanding and improving the quality of care. Value for organizations arises through clinical processes, along with a robust business case that links patient experience to financial performance, brand and reputation, patient loyalty, and employee satisfaction and retention.5, 6, 7, 8
Industry executives hold a strong interest in understanding experiences in the moment, as well as customer trust and loyalty. The generation of trust is important for brand equity and reputation, and for how consumers make decisions on where to seek care.
The customer experience metric, Net Promoter Score (NPS), is used by many interviewees; however, the NPS is only one measure used to gauge consumer experience. Other measures used included customer satisfaction surveys, mystery shopper research and benchmarking performance against peers.
Some organizations track whether patients are using the digital tools provided (e.g., hospital apps, remote monitoring or patient portals). This is important for clinical reasons but also for future data mining of customer activity, customer preferences and creating more finely targeted experiences for patients. Looking outside of the health industry to see how others are evolving how they look at and measure trust (such as financial services) may be one way the health industry can continue to evolve how it understands and builds on improving patient trust.
The advent of digital health at scale raises the bar on consumer engagement and loyalty. Patients value the interpersonal aspects of their health care experiences and need a reason to stay, especially in a digital health ecosystem where switching becomes easier. Digital tools make it easier for consumers to find alternatives and switch to get what they want. This raises interesting issues around the cost of switching — to what extent does exceptional service counter the attractiveness of care that may be cheaper or easier to access?
Central to this shift: trusted technology
As health systems become highly digitized and connected, integral to this is the circle of care or the personal trusted network that keeps people healthy and well. Technology is an enabler rather than the end game. It is the experience component that ultimately makes it possible to deliver better, smarter care. If experience is not thought about up front, then pockets of success are likely, when what is needed is wholesale improvement.
Other factors demand attention, such as who pays for experience — the consumer or the payer? Or should the provider regard it as a cost of doing business? Another key factor is finding the right blend of talent with the skills and capabilities to support a data-driven, consumer-centric smart ecosystem.
What this shift means:
The central role that health and wellness plays in people’s lives shows that the route to better health is through individualized and targeted treatments rather than a one-size-fits-all approach.
As a result:
Health systems invest time in bringing people together with the technologies and move from being digitally naïve to engaging and empowering consumers and clinicians through health and well-being as an everyday-lived experience.
A vision of a better, more engaged health industry
Leading industry executives share a strongly held vision that, in the future, health care will reorient around a truly shared sense of purpose between the consumer and the health enterprise.
EY’s view is that industry transformation will be built upon innovations and interconnected ecosystems that all work in concert to make health care simpler and more seamless. This is especially true for those that succeed in gaining and sustaining consumer engagement with their health and wellness across their lifespan.
It is clear that what makes for a good health experience is highly nuanced, and the creation of trust between the consumer and health care organization is foundational. Trust has to be earned, through close and supportive relationships that drive deep engagement and are built upon great experiences. Rather than just delighting in the moment, a systematic approach to deeply understanding what matters to people is instrumental in getting the health experience right. To this end, measuring and innovating to improve the consumer and clinician experience are key to enhancing the quality of care and to capturing data for more finely targeted N of 1 care built upon activity, sentiment and preferences.
We are well on the way to creating a digital-first health experience and weaving digital into every aspect of an organization. As such, smart health ecosystems of networked platforms will level-set the health industry in a new space, completely recasting the connectivity between the consumer and health and social systems. For health care organizations, this means reimagining the value proposition around trust and experience-driven engagement in a technologically advanced environment, building a future operating model around a digital-first approach to patient and clinician experience, and enablement of the back office.
Health care will not be transformed overnight. However, opportunities to initiate disruption abound through targeting areas where a focus on experience will make a big difference for the consumer and clinician. Most important is setting sights on the far horizon. Future-proofing through design means avoiding being locked in by the constraints of the business of today. This has only been accelerated by the impact of the COVID-19 pandemic, taking years off the technology adoption timeline.
Internationally, steady progress is being made toward creating ecosystem-style infrastructures built around the timely and relevant exchange of health data. Steps are being taken toward more open and interoperable systems in Estonia,9 the Nordic countries10 and most recently in England.11 While the health models vary, a commonly held vision is that of data that is sufficiently liquid to flow through the system. This data underpins integrated care platforms that incorporate social determinant, sensor and wearable data, along with health information into algorithms, making personalized, smart care experiences possible.
Sheryl Coughlin, PhD, EY Research Consultant and Lead Writer, contributed to this report.