Gabriel Perna | September 16, 2020
The consumer experience in health care has left a lot to be desired.
“We recently did a survey with the Harris Poll about what American consumers think about their health care experience. And perhaps not too surprisingly people were not pleased with what they typically experience when they access health care,” said Neil de Crescenzo, President & CEO, Change Healthcare. “One result of that survey was people felt that they had actually avoided seeking care when they needed it because of some of the challenges they encountered.”
With COVID-19 ravaging the health system, CEOs at leading health care organizations say the problem of consumer engagement must become a critical area of focus. For one thing, COVID has led to people delaying and avoiding care, meaning providers are going to face a wave of complex, sicker patients. Quite simply, providers must perform more effecitvely in allowing consumers to access care than they have in the past.
“For most people in health care, all you have to do is ask and you get told very quickly what’s wrong with your system and how you could do a better job for the people that you’re serving. Then you have to have the dedication to change the inertia of a very complicated process,” said Terry Shaw, CEO of AdventHealth.
Shaw and de Crescenzo were joined by Sreekanth Chaguturu, MD, SVP and Chief Medical Officer, CVS Caremark and Associate Chief Medical Officer, CVS Health, Ali Diab, Co-Founder & CEO, Collective Health, and Aimee Quirk, CEO, innovationOchsner in the Health Evolution Executive Briefing webcast, Powering Pandemic Response: Consumer-Focused Innovation.
The executives shared strategies in how they are engaging consumers during COVID-19 in various ways including:
The leaders also discussed the challenges and barriers to some of these efforts including:
Leveraging technology for care management
For Quirk at innovationOchsner, the consumer engagement tools used during COVID-19 have been a result of years of work unknowingly leading up to this pandemic. Many of the projects that the “startup within Oschner,” as Quirk describes it, operate are around engaging consumers in care outside the home.
“What we found was the investments we have been making over time in virtual care—obviously forward-facing telemedicine, urgent-care visits, virtual visits, and our remote monitoring programs for chronic disease, pregnancy, and cancer—the impact they’ve had is huge. And what we’re able to see is that these things we have been building over years, we experienced an accelerated rate of adoption, both from providers and consumers,” Quirk said. “We’re already seeing the value of that.
Chaguturu at CVS Health said that during the pandemic the company has been addressing key themes beyond simply serving as a testing location for patients. Those themes include improving access to medication, covering treatment costs, expanding mental health services, expanding virtual care, and enhancing care management. The latter two themes tie into each other, as CVS has expanded and promoted telemedicine and e-clinic visits.
Diab’s Collective Health, which operates a technology service platform for payers and self-insured employers, saw the emergence of virtual care during COVID. He said the virus was validation that its user-experience, consumer-friendly model worked. The platform is able to weave various elements of a consumer’s health plan together: virtual care, in-person care, inpatient and outpatient care, pharmacy benefits, and help them manage their care.
“We had seen virtual care already, but we really saw it accelerate in the early part of the year. With people afraid to go to the doctor, we turned the dials up in a way to make virtual care and telemedicine a lot easier to access,” Diab said. “We also saw people wanted to seek care for things that were more curious, so we turned up the dials of our care management system to encourage people to fill various gaps in care.”
To date, he said they’ve filled 40% of Collective’s population’s gaps in care. He said the building out an enticing user experience via technology with multiple engagement capabilities goes a long way in engaging consumers.
Focusing on care advocacy and preventive care
AdventHealth, based in Altamonte Springs, Florida, didn’t see a wave of patients until July and August, said Shaw. This allowed them to advance the concept of care advocates in their clinics once the COVID rush came.
“We actually have a group of people that works with a doctor’s office to help a patient get the care that they need to get through the virus. In case anyone hasn’t noticed, [the U.S.] health system is very complex and it’s hard to navigate,” Shaw said. “We’ve done this in the last four months, we’re up to 41 doctor’s offices, it’s amazing the information, the data flow and the weaknesses you find in your own system if you’re willing to put care advocates in the middle of the consumer experience.”
Similarly, Ochsner has been on a journey to create a more proactive system that personalizes the consumer experience, Quirk said. The virtual care environment the health system has stood up during COVID has helped bolster these proactive models, especially those centered on chronic care management. The rise they’ve received in net promoter scores during COVID suggests to Quirk that consumers want proactive care.
“The journey we’re all on collectively to deliver that and find the best way to do that, coupled with the clinical outcomes, is really important,” Quirk said.
Aimee Quirk, innovationOchsner
Improving vaccination outreach and medication access
One of the biggest areas of preventive medicine discussed during the briefing was on the area of vaccinations. Leaders are not just focused on how to engage consumers to eventually vaccinate themselves for COVID, but for other diseases as well. Chaguturu said there has been a 60% reduction in routine vaccines with patients avoiding the doctor during COVID.
“We all are going to be working very hard on improving consumer activation around preventative vaccine services. I’m using a variety of payer, provider, and consumer-based tactics to drive motivation,” Chaguturu said.“And when it comes COVID vaccines, we will really have to do a good job of explaining the benefits of these vaccines.”
CEOs agree that consumer education will be critical when it comes to vaccines, COVID or otherwise. Chaguturu said CVS Aetna uses personalized messaging to get people to vaccinate. “For flu vaccines, one person might care about convenience. It’s easy to get vaccines. Another person might be about safety. The third person might about co-pays. Understanding your members and having consumer-driven messages that are targeted to those individuals is important,” he noted.
Quirk at Ochsner and Shaw at AdventHealth both say that consumer-facing messaging is imperative in getting people to vaccinate for COVID, the flu or other diseases. For COVID vaccines, in particular, Shaw expects that consumers will be skeptical of a vaccine process that’s been rushed. All players in health care will have to work on careful campaigning to ensure the right messaging is used.
“How do you position this as something that’s good for you, good for your family, good for your neighbors and quite frankly, good for where you work and how you live your life? This will be important if we’re going to get to the heart and mind of people who actually have to take the vaccine,” Shaw said.
Improving access to COVID testing and prescription medications are other consumer engagement priorities for health care organizations. In particular, Chaguturu at CVS is undergoing 40,000 tests per day. They’re also working with pharmaceutical manufacturers as well as patients themselves to ensure there is continuity in filling medications. In this regard, the company spent time promoting free home delivery of prescription drugs to patients and continues to offer that until the end of the year.
For both medication and vaccine adherence, one of the biggest challenges health care organizations will face in achieving these consumer engagement goals is managing the supply chain. For its part in distributing a potential COVID vaccine, CVS is already getting ahead of the game by working with vaccine manufacturers whose treatments have been deemed most promising.
As de Crescenzo notes, there may be more vaccines available by the end of 2021 than there are people on planet Earth. Figuring out how to distribute those vaccines so they’re effectively administered across patient populations is going to be the supply chain challenge of a lifetime.
“Across all of our organizations, we have to think about how we’re going to manage the cold chain requirements that make sure we’re going to be able to administer the vaccine,” Chaguturu said. Further complicating things is that because of a shortage of raw materials, vaccines may be need administered in multi-dose packages, he said. “Once you open them, it only lasts a number of hours. Then it’s a matter of figuring out how to reduce waste in those vaccines.”
Another challenge, CEOs anticipate, is aligning incentives to maintain the consumer-focused innovations that have been deployed during COVID. Quirk said that while the pandemic has accelerated adoption of virtual care technology for proactive, chronic care management, health care needs to align incentives across all the various stakeholders to ensure it sustains.
“We’ve got a lot of the tools to do it and I think consumers are hungry and ready for it,” Quirk said. “We have to change to meet the consumer demand, but where we get tripped up is incentives. We have to figure out through innovative models and partnerships how we can align incentives and try to get that new model done and scaled.”
She also noted that a potential long-term challenge of increasing consumer engagement, both in COVID and beyond, will be addressing the digital divide. She notes that not everyone has access to a smartphone or an Apple Watch to engage in their care. However, there are ways to reach out to underserved communities.
“Whether system support, education, or cultural competency, we need make sure that this is a big area of focus. We know that that to have the impact that these new consumer engagement tools can have, they have to reach everyone,” Quirk said.