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03/07/2014

Innovation opportunities: getting the job done for health care consumers


by Jason Girzadas, Principal, National Managing Director, Life Sciences & Health Care, Deloitte Consulting LLP

We’re coming up on the fourth anniversary of the ACA.With many of the infrastructure improvements settling into place, CEOs and board members should take stock of their organization’s focus and commitment to innovation.

A walking tour around any of the leading life sciences and health care industry conferences provides ample evidence of clinical, technological, and business model innovations. It’s not that innovation isn’t taking place. Rather, it’s that innovation needs to be redirected—how can we move the industry closer to delivering the “health care experience of tomorrow” that consumers are coming to demand? Engaged in more personalized and integrated interactions with other product and service providers, like banks and retailers, consumers are beginning to expect a similar type of responsiveness from doctors, hospitals, health plans and life sciences companies. As an industry, we need to redirect our focus to fulfilling the important “jobs” that matter to consumers. 

To illustrate the point, here are five scenarios that reflect what today’s health care consumers expect the industry to be capable of addressing.The scenarios encompass a broad array of “jobs” that need to be done to meet the evolving needs of various consumer segments.  These “jobs” should be seen for what they really are: innovation opportunities that industry stakeholders can use as the basis for assessing their progress in meeting the market’s demands and staying focused on the broader objective of transforming the industry.

Scenario 1: A 71-year-old man, Sid, who is a Medicare Advantage enrollee and under the care of multiple physicians, is newly diagnosed with advanced stage prostate cancer. How does Sid’s family reliably determine who the best providers are and assess the latest array of treatment options and their associated risks and costs?  How do they prepare for and manage the complex mix of clinical, financial and emotional issues that they and Sid will face?

Innovation opportunities: trusted and accessible sources of comparative information clarifying the “art of the possible” relative to the array of prostate cancer treatment options; integrative thinking and care program development related to the multi-faceted issues stemming from a life-altering diagnosis; coaching and navigation services for patients and their families outside of traditional case management 

Scenario 2: Bari and his family, whose second language is English, move across the country for a new job. They need to find a pediatric neurologist for their nine-year-old daughter’s chronic condition. How do they make that decision in an informed manner?

Innovation opportunities: trusted and accessible sources of comparative information on physician demographics; decision-making philosophies and approaches; service quality performance; clinical outcomes performance and relative pricing

Scenario 3: Sabrina, a 49-year-old woman, suddenly has a massive stroke and is incapacitated, leaving her husband and their three children alone to cope. Who do they turn to in the crisis to navigate the tragic, life-altering event?

Innovation opportunities: coaching and navigation services for impacted family members; provider-physician-health plan collaboration around case management and treatment alternatives; comparative performance information and information on trade-offs associated with alternative paths forward

Scenario 4: Ned, a 53-year-old man, needs to lower his high-blood pressure and lose 20 pounds. His wife bought him a new personal fitness monitor for his birthday to encourage him to take care of himself. How does he meaningfully incorporate this device into his life, involve his doctor in a meaningful way and ultimately, sustain his progress toward his goal?

Innovation opportunities: awareness and knowledge by the consumer’s physician of the personal fitness monitoring device alternatives; integration between the personal fitness monitoring device and the consumer’s clinical record; alignment of financial and personal incentives directed toward the consumer and aligned with the physician and health plan

Scenario 5: Yong, a 27-year-old college graduate, can’t find a full-time job. He works as a part-time bartender to make a living and spends his free time doing extreme kayaking around the U.S. and perfecting his social media persona. He’s purchased the cheapest plan on his state-based exchange and has no relationship with a doctor.  He’s worried about his high out-of-pocket deductible and what costs he might incur if something happens? Who should help? Where can he find it?

Innovation opportunities: access to the state insurance marketplace or equivalent; navigation support services and product understanding relative to benefits, out-of-pocket responsibilities; trusted sources of information integrated with social media platforms and relevant to lifestyle choices

The consumer-centric scenarios demonstrate the need for system-wide innovation and systems thinking if we ever want to close health care consumers’ expectations gaps. All industry stakeholders have fundamental questions to answer and opportunities to contribute to the “jobs to be done:”

  • Health plans and pharmacy benefit managers: provide navigation services across the broader consumer value-chain; be a trusted source of comparative information on service quality, clinical quality and price variability; provide enablement of secure, portable personal health records and information; radically simplify member communications
  • Health care providers: be a trusted source of comparative information on service and clinical quality; expand definitions of “continuum of health” and provide navigation and referral services; create interoperable platforms that enable mobile and social capabilities for consumers; redefine the next generation of the health system customer experience
  • Life sciences (pharma, medtech, biotech, distributors) companies: create integrated chronic disease platform/offerings linking consumers and caregivers, inclusive of clinical offering, service and technology enablers; be a trusted source of global comparative information on drug, device and other new innovations for both consumers and caregivers
  • Public health agencies: develop collaboration models that bring together the needs of safety-net providers with the capabilities of disruptive technology companies; create incentive models whereby disruptive technology companies participate in cost-of-care savings realized

The new playbook for innovation requires executives to identify the important “jobs to be done” on behalf of the health care consumers their health care organizations serve. This may now require a rebalancing of priorities and resources to accomplish the dual goals of building core capabilities and creating uniquely, differentiated consumer experiences.

Related thinking: Innovation to what end? Taking care of the "jobs to be done" for health care consumers

 

Jason Girzadas, Principal, National Managing Director, Life Sciences & Health Care, Deloitte Consulting LLP

Jason Girzadas uses his nearly 20 years of experience to help many of the nation’s top health care organizations navigate challenges including industry reform, implementing the latest technology, creating operating efficiencies and improving performance. Jason is the industry leader for Deloitte Consulting’s $1.2B LS&HC practice, ranked #1 by Kennedy and also serves as Deloitte’s relationship leader for Kaiser Permanente, where he is responsible for the full range of Deloitte’s advisory and technology implementation services.

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