The digital tools are available and accessible, and organizations such as the National eHealth Collaborative (NeHC) are devising strategies and standards for integrating them into the U.S. healthcare landscape. The NeHC has mapped out a five-phase framework for guiding the development of the technological infrastructure that the industry will need to support consumer-centric healthcare. It suggests how the digital components of healthcare may come together in the coming years (see “The Patient Engagement Framework”).
The Path to Consumerization
As consumer-driven healthcare spreads, the fundamental nature of the industry will change—just as in other industries that have moved from B2B to B2C, such as banking and computers and electronics. The ultimate goal for insurers, care providers, and pharma companies alike is to drive initiatives forward until the industry reaches a tipping point. The new healthcare industry that results will be adept at influencing consumer behaviors. It will use sophisticated attitudinal segmentation to design and deliver personalized products and services, and its financial performance will be linked directly to care outcomes. Such an industry will motivate consumers to pursue wellness, and will provide them with access to healthcare when they need it via the channels that they prefer.
Of course, this vision will not materialize overnight. It will take years, perhaps decades. And it will require a sustained effort across the healthcare industry, investment, and the willingness and ability to change. But healthcare companies around the world are realizing that their current business models are insufficient to meet today’s challenges. As Aetna CEO Mark Bertolini told the participants at the HIMSS Conference in Las Vegas in 2012, “The end of insurance companies, the way we’ve run the business in the past, is here.” Consumerization is the industry’s future. The work will be hard, but the rewards promise to far exceed the effort: a high-quality, cost-effective, and user-friendly system that continuously improves population health.
In November 2012, the National eHealth Collaborative, a public–private partnership, developed a five-phase road map for the digitization of healthcare. It begins with “Inform Me,” an initial step during which consumers are provided with standardized forms and information about advanced directives, privacy, and specific conditions. The second step, “Engage Me,” provides patients with access to their electronic health records, fitness trackers, and other e-health tools. The third step, “Empower Me,” includes secure messaging between patients and care providers; the integration of patients’ personal data, such as genetic, behavioral, and medical history information, into the providers’ electronic records; and patient access to the quality, safety, and experience ratings of care providers.
Next, during the “Partner with Me” step, the penultimate phase of engagement, patients are given condition-specific management tools and access to care summaries to support their personal health maintenance efforts. Also, patient-generated information, such as personal preferences and wellness and home health device data, is added to their electronic health records. In the road map’s most advanced and final phase, “Support My e-Community,” patient engagement is enhanced with a fully interoperable platform that supports seamless information sharing between a patient and the entire care team.
Today, various players are at different stages of the road map, though most have yet to move beyond “Empower Me.” As companies continue the evolution, they will not only optimize individual outcomes, but also enhance health through the analysis of data and the identification and dissemination of best practices.
Reprint No. 00167
- Gil Irwin is a senior partner with Booz & Company based in New York. He specializes in business model and operating model transformations in the healthcare industry, with a focus on technology and operations strategy.
- Jack Topdjian is a partner with Booz & Company based in New York. He leads the firm’s North American healthcare technology and operations practice and global healthcare consumerization practice. He specializes in large-scale transformation and capability building in the healthcare industry.
- Ashish Kaura is a partner with Booz & Company based in Chicago. He specializes in the development of growth strategies and new business models in response to market discontinuities for healthcare and health-services companies.
- Also contributing to this article were Booz & Company senior partner Gary Ahlquist, partner Michael Ruhl, and senior associate Nate Holobinko.