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Health care as an industry has been moving toward improving consumer engagement and patient or member experience for quite a few years now. The ongoing pandemic and the criticality of virtual and new care modalities has, of course, illustrated the importance of focusing on consumers more than ever.

Eighty percent of consumers, in fact, indicated in Deloitte’s 2021 Global Health Care Outlook that they intend to participate in more virtual visits post-pandemic. The same report found that 75 percent of consumers want to determine and work toward health goals with their providers, and 60 percent of physicians indicated that they are transitioning more to prevention and wellbeing than sick care.

“Moving away from a historically paternalistic industry to a very consumer-centric industry is a big leap. But we need to make that leap because before the pandemic everybody assumed that virtual health wouldn’t work since there was relatively little adoption. Well, we blew through that assumption pretty quickly in about April of last year,” said Urvi Shah, Senior Manager of Life Sciences and Health Care at Deloitte.

Shah spoke during the Health Evolution virtual Executive Briefing, Health care engagement: What to expect of next-generation consumerism experience. In addition to Shah, the webcast included Mike Butler, former President of Providence and Michael Serbinis, CEO, League.

To meet changing consumer demand, organizations will need to invest in technologies, and new patient-centered models, including, but not limited to, digital front doors, a concept that existed before COVID-19 but has since become part of the health care lexicon. During the webcast, the experts discussed the following elements of developing a digital front door strategy:

    • Recruiting talent outside the health care industry
    • Looking to the top 50 health care organizations for lessons learned
    • Breaking the incumbent attitude that health care can solve everything
    • Envisioning the digital front doors of the future

Recruiting talent from outside the health care industry
When Butler wanted to accelerate digital initiatives at Providence, one of the first moves he made was hiring Aaron Martin, a serial entrepreneur who at the time worked at Amazon and left to become the health system’s Executive Vice President and Chief Digital Officer.

To date, Providence has invested in 26 startups and spun out four: DexCare, which offers an access optimization platform, Xealth, for prescribing and monitoring health apps and content, the Circle Women’s Health Platform that was acquired by Wildflower Health and the patient engagement startup Twistle, which Health Catalyst acquired.

“There’s a real advantage from the business perspective as this is really an opportunity to move forward in solving all different kinds of things, creating more customers for life and, ultimately, growing market share,” Butler, who retired from Providence in late 2020.

“Organizations need the talent and know-how for many different aspects, such as strategy, program management, specialty expertise around marketing, as well as the technology for targeting and engagement,” Serbinis said. “All of those need to be on the table for organizations going through one of these transformations.”

The challenge when pursuing that talent is that many other organizations are also doing so and that has created a scarcity of people with the right skills for building digital front doors. “Google’s looking for those people. Amazon’s looking for them. Those organizations are willing to pay a high price,” Serbinis said. “We’re all looking for that talent. Every provider and payer across the country is looking and there’s not enough.”

And there are of course learnings to understand from within health care as well.


I’m hopeful digital tools and virtual care capabilities that evolve over the next several years are going to help reduce disparities moving forward.

Urvi Shah, Deloitte



Looking to the top 50 payer and provider organizations for lessons learned
Health care CEOs investing in digital transformation can look toward the top 50 or so leading health systems and health plans for lessons learned when considering how to leverage technology.  Leaders need to move away from the idea that their market is in their EMR to potentially consisting of all the consumers in a given region, state or even the entire country.

“I see this going on across payers and providers, consumer health organizations, employers, everyone is building a version of the same thing, a front door for health care,” Serbinis said. “From a consumer standpoint, the idea of my own personalized health journey, access to care, navigation and payments, the idea of quickly accessing my health profile, or my health data, these things fit together.”

Organizations that are leading the way with digital front doors are in varying stages of development, but the common questions being encountered include: What should this project look like? What should the roadmap be? Why, exactly, are we doing it? What are our business objectives? How will this help grow the revenue base, manage costs, initiate new lines of business or explore new business models?

“They want to reach the consumer more broadly. Not just during and after an episode of care, but more throughout the course of their health journey, throughout the course of their life,” Serbinis said. “They’re seeing competition coming from many new entrants, even competition coming from Amazon offering care services, and that’s only going to continue.”

Serbinis said other considerations include how best to leverage digital technologies, direct contracting, Medicare Advantage and consumer health organizations.

“There are slightly different roadmaps depending on the business objectives, but everyone is moving faster,” Serbinis said.

That accelerated pace of innovation will mean evolving from long-standing processes and old ways of thinking.

Breaking the incumbent mindset
Beyond recruiting talent from outside health care and learning from the top organizations within the industry, a considerable challenge is shifting away from traditional ways of thinking.

The time has come for CEOs and their teams to determine the best way “to put aside that inherent incumbent attitude that we can solve everything ourselves as an industry,” Butler said, adding that at Providence the change in mindset started about eight years ago.

“Some still believe they can do a lot of it on their own, but the surface area is just too broad and many are looking for partners to accelerate that work,” Serbinis said. “There are many different ways to partner and it’s one of the barriers or stumbling blocks that organizations really get stuck on at the start of one of these transformations because there’s this idea about what they need to own internally and keep under their control. That just wasn’t practical in banking and retail, it’s not practical in entertainment, and it won’t be practical or even doable in health care.”

Shah said that partners can work with organizations to understand where to focus.

“Partners can help organizations determine what actually makes the most sense for their customers or target audience to identify the best use of funds, and priorities in terms of building the broader digital front door because that can be very broad,” Shah said. “Partners can also help chart a roadmap in a way that actually makes sense based on what’s working in the industry, but also in a way that’s agile enough to change as the industry changes.”

What’s more, despite its success at establishing what is now a $300 million venture capital business, Butler reflected on what the organization perhaps could have done differently.

“Having left Providence, this is a lesson learned from the work that I do today: I think we could have brought in some really interesting equity partners,” said Butler, who now serves as an operating partner at the equity firm Welsh, Carson, Anderson & Stowe. “That would have allowed us to really accelerate what we’re doing, given the number of companies out there that actually have a lot of experience in investing in the digital health space.”

Envisioning the digital front doors of the future
From his purview at League, Serbinis has a glimpse into the three- to five-year roadmaps of its customers and partners. What do those suggest? That health plans and health systems are beginning a shift toward digital front doors based on platforms, akin to Shopify for example, that essentially bring silos of data and services together.

Shah said she anticipates that the care experience will become more consumer-driven, with patients in the driver’s seat owning their data and being able to meaningfully access it to determine how best to engage with care services, rather than trying to patch that data together from multiple portals.

“I’m also hopeful that digital tools and virtual care capabilities and technologies that evolve over the next several years are actually going to help reduce disparities moving forward,” Shah said.

Looking even further into the future, Serbinis said that while digital front doors are table stakes in three to five years, the 10-year timeframe is where the transformation becomes truly exciting.

“The five-to-ten-year period is this model of reimagining a health care experience that is actually irresistible from a consumer standpoint with many reasons and many utilities to go to it all the time,” Serbinis said. “It will be before you show up for a point of care type experience or before you even have an issue you did not know you would have to deal with. This idea of making care irresistible in 10 years — that’s where we should be headed.”

Butler added that this work will ultimately be successful when every American has access to primary care that is driven through a digital experience.

“My hope is that the digital consumer model with guaranteed virtual primary care for every person will lead to the management of chronic disease protocols, and the digital feedback we get from customers will result in incredible predictability around quality of life,” Butler said.

Tom Sullivan

Tom Sullivan brings more than two decades in editing and journalism experience to Health Evolution. Sullivan most recently served as Editor-in-Chief at HIMSS, leading Healthcare IT News, Health Finance, MobiHealthNews. Prior to HIMSS Media, Sullivan was News Editor of IDG’s InfoWorld, directing a dozen reporters’ coverage for the weekly print publication and daily website.