Health and Medical Devices … Our New Sixth Sense

April 17, 2013 by bobyurkovic

So many innovative technological enablers are surfacing. Small size, low weight, superior battery power, and affordability stimulate new inventions in the realm of devices. They are devices that connect with our smartphones, PCs and tablets. In the area of health care, biometric devices and applications support our wellness objectives and medical needs with remote monitoring and feedback. We gained a new sense; we have smell, touch, taste, feel, hearing, and devices.

Biometric Devices

Simple things, such as checking your weight in the morning, transform into a full check-up by adding a pulse and blood pressure measurement. Immediate feedback from biometrics devices provides useful information on how well a person if doing compared to a goal. Smartphones are in a stage of transformation as well. Their initial job was a phone providing voice communications in the 90’s, then providing entertainment with an emerging new application around control and monitoring. Smartphones and biometric devices are becoming multipurpose smart appliances with a capability of connecting with and controlling other devices. Communications plays a significant role but instead of voice, data becomes the primary focus. A micro-network of devices forms an intelligent device ecosystem with primary, secondary and tertiary controllers. This has already started in home applications. I control my Smart TV and HVAC system remotely using embedded devices at home. I also monitor my body vitals as well using my smartphone as the primary controller for secondary devices such as a WIFI scale and blood pressure device. I also listen to music, manage my email and calendar, and take photos on my new smart appliance. It integrated into my lifestyle and health will play a more important part as new solutions become available.

Biometric devices provide a wide range of capabilities at an affordable consumer price point. For consumers, immediate feedback is provided along with trend information to monitor progress at a point in time and over a period. In a way, the data feedback becomes an incentive to continue or modify what the person is doing as well as show where my ideal parameters should be. It shows if I do this action, I get see this impact on my health which can impact my lifestyle. With the Bluetooth 4 specification, biometric devices have become as easy as plug and play and have become as ubiquitous as cell phones became in the late 1990’s.

The next step is to take the health measurements from other personal health biometric devices, such as those offered by Fitbit, Jawbone, Lark, Basis, or Nike +, that measure activity with accelerometers, sleep data, and heart rate, and aggregate the data into a personal health dashboard. Make it accessible by PC, smartphone, or tablet and you have enabled people to take control of their health through useful information. Useful information translates to better health decisions.

Health Monitoring device – The Fitbit Flex due for May 2013 release

Medical grade devices are also available supporting critical health care applications for health care providers. If you have a heart condition, AliveCor’s heart monitor device attaches to the back of a iPhone with 2 sensors to take ECG readings. Your doctor may prescribe a device and an app to so a care provider can monitor at-risk or post-surgery patients. While this usage is not a typical lifestyle scenario, it can perform a life-saving function while allowing patients to continue their normal activities while away from a hospital or doctor’s office. The solution conforms to the patient’s lifestyle instead of a lifestyle conforming to a procedure. Enabling a person to continue their lifestyle creates a positive experience while achieving consumer centricity.

Data

Devices create massive amounts of data and massive amounts of devices create big data. Payers are in a unique position to act as a hub and aggregate the data. Earlier attempts to accomplish this with PHR applications had limited success by Google and others. Payers can add additional value by integrating claims data. Together, member’s get access to real time and trending information supporting a member’s lifestyle and their journeys through medical events. With this data, payers can see trends to assess risks and offer advice to members and communities before medical events happen.

For example, if the data shows a location in the U.S., such as a group of zip codes outside of Philadelphia, in age groups 30-45, who are white and Hispanic males and they have an increased risk for obesity and diabetes, payers can deliver personalized communications with support programs to increase awareness and modify behaviors for healthier living. Biometric devices provide data that feed consumer applications to respond immediately to the consumer’s activity in support of a complete engagement program that notifies, encourages, and rewards healthy behaviors.

The payer diversifies their offerings into this new space to enhance member value and an area to build relationships for engagement and retention. Content and information can be the new product for payers as they expand their portfolio. This increases the payer’s relevancy, enhances member relationships and provides a unique and superior experience that touches all layers of the HealthScape.

What devices are connecting you and your health? What device would change your lifestyle?

It may appear that payers lose some control to consumers but in reality, they increase cost control through member enablement. Payers need to trust and empower members to do the right thing for their health but payers must provide relevant information and decision tools to arm the members.

HealthScape Part 4

March 14, 2013 by bobyurkovic

The traditional interaction with payers has been around transactions. Find a doctor, pharmacy, look up my benefits, and look up a claim. This is a transaction layer in the consumer relationship. There is little opportunity to develop a relationship and generate consumer stickiness in this area. Consumers only go to the transaction layer to perform a transaction, which in a large payer, is about one to two times a year. The main reason that many members perform a transaction is because they are going through a health event, such as a sickness or medical condition, so members are already in a stressed state dealing with a personal or family health issue. Not the best time to generate a relationship. The best way a payer can generate a positive experience in this layer is to provide superior support for the member when needed. This translates to a flawless experience by offering a caring connection, managing administrative tasks and processes, and performing event logistics so members can focus on their health. To build productive relationships, payers need to go where the people are and when they are in a good state of mind.

The diagram below shows a representation of the HealthScape from a consumer perspective. There are three distinct layers around health and consumer involvement with the transaction layer being at the core. They are different in how often members interact in each layer.

HealthScape

In the transaction layer, people may interact several times a year with a payer performing a health transaction. In the wellness layer, people interact far more often such as one to two times a week depending in their personal plans for nutrition and exercise. In the lifestyle layer, there is potential for people to be involved in health everyday as it becomes part of a routine in a person’s daily living. In the lifestyle layer, a payer has the potential to achieve relationship nirvana – stickiness.

In the wellness layer, members are focusing on keeping, or getting to, a state of wellness. The big issues on their minds are nutrition, exercise, and healthy behaviors. They are focusing on their health to minimize the risk of being sick and to lead a productive life. The member starts to enter into a relationship with wellness providers and coaches to engage in healthy behaviors. Telephone coaching is an example of this. Wellness is one of many personal priorities a member manages so it may not be the top priority every day and throughout the day. For wellness to be embraced, a member needs to absorb a healthy thinking into their life on a daily basis; it has to be part of their lifestyle.

In a lifestyle layer, people interact, work, play and experience life every day. An example of health in the lifestyle layer, is the new devices that monitor our activity, sleep and nutrition. The Jawbone UP and Fitbit Flex are wearable devices providing biometric data to consumers throughout the day. The devices provide feedback to adjust consumer’s actions and behaviors in order to reach their desired goals. These devices are part of the wearer’s lifestyle and that lifestyle changes based on feedback they provide. If a person is at an office and sitting at a desk too long, an alarm goes off to let the wearer know they need to more active and move around. If this happens often, thinking is changed and a behavior formed leading to healthy outcomes.

Solutions in the lifestyle layer focus on supporting consumers in their quest for sustained healthy living.. It is important to help people approach health in a holistic manner and offer encouragement and tools in the areas of nutrition, exercise, stress, care, community, and healthy habits. Relationship maturity can blossom in the lifestyle layer. To assist payers in their vision to diversify, they can find opportunity in the lifestyle layer by offering tools to reinforce healthy behaviors and be more than providing health plans. The definition of health to a payer is about healthy living for members and not just paying a claim.

The same occurred in the banking industry. Years ago, banks just performed transactions such as deposit a check. Now banks offer rounded services such as financial planning for retirement, college, and family growth supporting a person throughout their life; supporting their lifestyle.

An extension of a payer’s offer could be to aggregate data from multiple biometric devices and offer services to their members such as a health dashboard with relevant content to support decision-making and behavior changes in pursuit of healthier living. As I mentioned under the engagement section, healthy behaviors lowers the causes for chronic diseases, which lowers medical costs in health care.

The Health Care Experience Part 3

March 12, 2013 by bobyurkovic

Experience + Job = Relationship
Let’s translate the concept to health care and engagement. Payers sell benefit plans that have become commodities. The payers “do the job” of providing benefits plans and services although the experience of purchasing and using them is less than desirable. Forrester publishes an annual customer experience index and health plans land in the poor to very poor range. There is no differentiation and a low barrier to change payers … and no relationship. Payers want to engage consumers and help them live a healthy life but consumers cannot be engaged at this stage; consumers need a relationship to become engaged. A relationship can be developed and nurtured once the experience and job to be done is high. At this stage, consumers are satisfied and open to a relationship with the potential to be engaged as the relationship develops. It makes sense to enhance the experience.

Let’s look at how payers process claims. We may be able to say they process claims efficiently, so the job gets done but how does it impact the experience with a member? A payer may say there is no member experience in this process; we just process the claims internally. They are right and wrong. They are right in that payers do not generate a member experience in this process? In lieu of a crafted experience, the member will start wondering what happened to my claim. Instead of thinking the process is going well, they may think the worst; we always do. So after a period of time, the member calls the payer to find out what is going on and the member is already at a frustrated stage. The call cost the payer three to five dollars. If we generate a member experience around the process, we can stop frustrating the member and not incur the cost of a call. What if payers provided a communication using a SMS or email message to advise members where their claim is in the process? Sound familiar? I love to see my tracking information from my Amazon orders to see how the order is progressing. Seeing activity or progress satisfies me in my wait for claims processing and results in a good experience for me. If payers communicated where a claim was as it traveled through the process, the member experience increases. They would know since the payer took the action first and generated a dialog around the claim event. This may sound like a reassuring voice such as, “Don’t worry, we are providing personalize attention to your claim.” Members would get to choose how much information they want and select their channel preference. It’s all about “me” in the world of the consumer. This is just one example of designing a good experience. With a positive experience and products that do the job; payers can build relationships with members through communications and interactions. This is the area that engagement is spawned.

To build relationships, payers should have to focus on the following:

Offer a product that does the job for consumers.
Provide a grand experience in two areas. A well designed user experience on all user touch points and also a tuned customer experience so that consumers are happy about interacting with the payer during their journey.
Extend their products to be more than benefit plans and also provide their members tools to help them in their pursuit of healthy living and enjoyable lifestyles. Do this and the “doing the job” indicator goes up in scale.

Building relationships aids in member engagement and increases retention. It is about the quality of the interaction and not quantity. The relationship is formed around common goals such as improving members health. If the interaction is pointless and without value, it becomes annoying to the member and the experience deteriorates.

Engagement is Good
Engagement, at a member level, has many benefits for, not only members, but for payers and the health system. At the engaged stage, payers can:

Modify member behaviors to lower causes of chronic diseases
Promote healthy living behaviors for members
Offer information and tools to help members make intelligent health decisions

Medical costs are increasing at an alarming rate each year so member health is a priority for payers and providers. The CDC says chronic diseases account for $3 of every $4 spent on healthcare and chronic diseases are preventable by modifying consumer behaviors. This is a perfect example of how consumer engagement solutions can help lower costs and decrease chronic diseases but a relationship must be built for this work. For payers to engage their members, they need to focus on two things: (1) the customer and user experience and (2) a product or service that performs what the member wants to do.

Consumer Centricity
Consumer centricity needs to be raised in priority just as cost management is a focus point for payers. Engaging members in healthy living and using self-service tools is important in lowering health costs and empowers the members in an era of consumer driven health care. So in the end, a sustainable solution to lowering health costs and having a healthy member base over the long term can be through consumer centricity. This approach takes time and is an investment in the health system and in its members.

If you are looking for low hanging fruit, focus on the customer experience. The fastest road to a good experience is remove pain points in services and products that touch customers … usability testing can provide shocking results. You can turn an annoyed customer into a satisfied customer by assessing online assets using a user experience discipline and updating the design based on the findings.

Some ideas are to offer consumer centered products and services aligned to personalized needs, tune customer experiences to build relationships, and engage members in healthy living and decision making with personalized programs. These are examples that can contribute to lower costs by improving member health and consumer engagement. Payers now have a raison d’etre and they remain relevant. Payer can use their big data repositories to help their members by delivering useful information and tools backed by a terrific experience. Why would it work? They took time to build relationships and trust with their members and shifted into a consumer mode of business. Moving to a consumer view is a graceful slide toward diversification since payers can provide solutions that accommodate members when they live the most; in their lifestyle.

How does this resonate with your experience at your payer? As a consumer, what are your expectations of your payer?

Connection between Experience and Engagement Part 2

March 8, 2013 by bobyurkovic

Doing the job
There is a need to combine experience and function into a consumer model and I believe there is a strong use for it in health care to achieve member engagement. An idea came to me after I read about the work of Clayton Christensen and a fellow researcher. It was an article on Milkshake Marketing from Harvard Business School published in 2011. Clayton’s claim is 95% of new products fail and companies need to look at products in the way that customers do, or how a product “gets the job done.” Jobs have functional, emotional, and social dimensions.

I was fascinated by this article and followed the role of a milkshake in the eyes of a consumer. The goal was to increase the sales of milkshakes. The study found that consumers bought the most milkshakes in the morning and for common reason. Consumers faced a long commute and needed something to make their commute more interesting. They were not hungry but would be by 10:00 am. The milkshake was thick so sucking through a straw gave them something to do. They were in business clothes and the milkshake was less likely to get their clothes dirty than a donut or bagel would … it was contained enjoyment.

Traditional marketing says to segment the market by demographics and product. Clayton’s argument was to segment according to jobs-to-be-done. Focusing on the job, they found that by increasing the thickness and adding chunks of fruit, they enhanced the job-to-be-done and sales increased. They also had another version, a treat for children with a thinner consistency so parents would not have to wait for them to finish it. This shows two jobs that needed to be done. Now add experience.

Experience
I noticed a correlation between a product’s job and the overall experience the person has with it. It seems more than just user experience (usability), but also involves the journey or customer experience of the event before use, during use and after use. I observed that products that were lean on features but robust on the experience were more likely to be adopted and succeed. The concept of consumers choosing packaging over content has been around for a while. We choose a laundry detergent because our family used it when growing up (brand) or the color of the package is striking (packaging). Not many people actually read and understand the chemistry of the ingredients (content). Maybe we are seeing a shift in consumer behavior and the new form of “packaging” is the experience. Personally, I sacrifice features to remove the hassles of product selection, purchase and use. To me, experience became the product differentiator if nothing more than to avoid adding frustration to my busy lifestyle. If a vendor has a useful product with a great experience, then I do not mind waiting on lines to get it either. Even the wait can turn into an interesting experience if we design the experience well.

The figure below shows a model for connecting the experience and functionality with consumer relationships.

Legend: Blue – product type, Red – consumer feeling, Green – consumer mode

We can use the engagement diagram to review three scenarios relating to the job-to-be-done and the customer experience.

Scenario 1 – High excitement and limited use

Product type Fad

Consumer feeling Excited

Consumer mode Courtship

A useful product that offers a great experience in purchasing and using it may show strong user adoption. The excitement may not be sustained over time as users realize the “fun” is gone and the usability of the product has waned. Remember the fads of yesteryear. Clothing can fit into the category of a fad. Articles of clothing that have lost their excitement include bleached jeans, penny loafers, and tie dye shirts. They were still functional, but a shift in the experience occurred. Experience can impact the functionality as well. If a style no longer creates a good feeling while wearing it, the clothing no longer “performs its job” to make the person feel good and it will be discarded for another piece of clothing. In this mode, you create a short-term relationship and the product seems more like a fad with a short product life cycle.

Scenario 2 – High use and limited experience

Product type Commodity

Consumer feeling Bored

Consumer mode Acceptance

A product such as phone service or cable TV from a cable provider that does just an OK job and provides a poor customer experience may not have a foundation for a relationship to develop. Forrester reports the customer index for cable TV providers is in the poor range. From a consumer perspective, most will put up with the cable TV provider and accept what they are given, but will jump to another provider at an opportunity if the product stops performing or if they are fed up with their experience. This industry has retention issues, which could be even more severe, were there more vendors offering services. The barrier to switching to another provider is low.

Scenario 3 – High use and high experience

Product type Valued

Consumer feeling Satisfied

Consumer mode Engagement

A service with great products and a satisfying experience, such as Amazon.com, provides a foundation on which to build a relationship … even online. Amazon ripped business away from brick and mortar stores and offers excellent customer service throughout a user’s shopping experience. They offer reviews of products, updates on orders, and an evolving shipping status in real time. The experience supports two tenants of consumerism … it is convenient and fast. Facebook is another example of a product that does the job without getting overly complicated and offers a good experience. Users of Facebook are truly engaged and we see this in how much time is spent on it. It has integrated into the user’s lifestyle … a powerful combination.

How do you think this concept applies to healthcare?

Is Customer Experience and Consumer Engagement linked? Part 1

March 7, 2013 by bobyurkovic

I call this health blog “Curved Roads”. Curved roads are not efficient; they take more tar to build. They are not the shortest way to a destination so they impact our gas use and they take more time to get somewhere. Yet, there is a grace and beauty in them as they follow the contours of the land and we enjoy them. Curved roads can offer an amazing experience for us. In healthcare, we forgot about the customer experience and we need some curved roads to remind us that efficiency is only part of the satisfaction equation. Consumer centricity needs to be embraced in a payer’s culture if payers wish to engage their members and providers.

LL Bean has been quoted in many industries. The L.L. Bean mission is to live this Golden Rule … “Sell good merchandise at a reasonable profit, treat your customers like human beings and they will always come back for more.” LL Bean’s definition of a customer is, “A customer is the most important person ever in this company – in person or by mail.” A simple understanding of consumer centricity. Do we treat customers like the most important person?

I’m going to spend some time over the next couple of weeks talking about this subject with a model that shows a connection. Are they connected?

An immediate answer comes to mind, “Yes, absolutely they are connected.” But how and why? What happens when you have a great product but a poor experience. Is it a commodity. Is experience the new differentiator? I have some ideas to share with you from a health care perspective.

Companies launch products and services to consumers with the thought that their product will offer so much value to the consumer without considering the bigger picture. It is a holistic view of the consumer experience that matters if consumer centricity is to be attained. The combination of a product’s functionally and the experience it offers sets a condition for potential consumer engagement and relationship development. Translating this to health care, it is important for payers in health care to focus on providing information and tools so members can do the job of managing their health while offering a connected experience to simplify and navigate the complex maze of health care.