By BETSY TAYLOR
Preston Gee
Preston Gee, CHRISTUS Health's vice president of strategic marketing in Irving, Texas, says progressive health care organizations are anticipating the convergence of population health management, where they manage defined pools of people, and the rising consumer engagement of patients who expect service-oriented, individualized care.
Gee began his career with Quaker Oats Co., in marketing research and new product development. He now applies approaches used by consumer-product companies and retailers in his work at CHRISTUS. Gee said the traditional mindset in health care — that patients are "receivers" of services ordered and bundled by experts — is giving way to an appreciation of patients as consumers. Consumerism, or the concept that given economic incentives, patients will shop for the best value, was baked into the economic model for high-deductible health insurance. Value-based care, the high-quality, low-cost care with reliable, improved outcomes sought by health care purchasers today, is a corollary of health care consumerism.
Where do population health and consumerism intersect?
More people are concerned about their health care costs. Population health is reducing our cost and theirs. Both population health and consumerism are all about the individual in that they cater to one's needs and wants. Other retail-oriented industries, for example banking, transportation and hospitality, have done a great job of tailoring their products and services to the individual through the use of big data and tools like predictive modeling and behavioral science mapping that help us generate information at a very individualized, very precise level. Similarly, health data will drive efforts to manage the health of populations; and with predictive modeling, health care providers will have a tool to be more responsive to individual health care consumers and to encourage them to safeguard their health. Population health is about keeping people well, and consumerism reaches out to people where they want to be reached. So, it is about responding to their needs and being as available as they need us to be.
How has CHRISTUS adapted its strategy with the increased focus on population health and on consumerism and value in health care?
We're in a fee-for-service world, moving toward accountable care, managing the health of defined populations. We understand there will be a convergence of those, but in the meantime, we have to navigate both worlds, just like every other health system. We want to provide better information to consumers/patients, so they are better managers of their own health when we're managing defined populations.
From our standpoint, we have a clear understanding that the world is shifting on us, so we have to view things from a different light. One of the ways it is shifting is that increasingly more care is being offered on an outpatient basis.
CHRISTUS Health is launching a number of urgent care centers and looking at our ambulatory care division and doing a great deal more in that space. That's critical strategy on our road map moving forward, being more of a player in ambulatory and outpatient settings, because that's where the game is shifting in most markets.
Let's talk about the impact of retail organizations selling health care services.
There are new models that are drawing away from emergency rooms. One subsegment of that is convenient care clinics. The model started in Minnesota, and there's been a proliferation of convenient care and urgent care clinics, whether it's at Wal-Mart, Rite Aid, CVS, Walgreens. They're in the pharmacies and the "big box" retail giants. In one of our markets, which isn't that sizable a market, these convenient care/urgent care clinics are almost as prolific as Starbucks. People like the ready access, they like the transparency, the ability to go in and out, get an appointment in short order.
Is it that much of a stretch to pose the question: Will Wal-Mart start offering MRIs one day? All you have to do is look around at the proliferation of convenient care clinics and new settings for immediate care and urgent care, and generally just realize that's where the game is going.
Wal-Mart is the largest retail entity in the world. Walgreens is the largest drugstore company in the world. These enterprises understand the consumers, and they have for decades. That's what they're all about, and we're competing with them. We've really got to up our game. They understand how to attract customers — through digital communication, emails, texts, etc. — give them a good experience, keep them in their community — their informational community — long after they've left a store. They keep informing them of their services to get them back for additional business.
Are patients more engaged as consumers than they were in the past?
We're seeing more consumer engagement than we used to. Historically, we've asked consumers: what's the major determinant for you selecting a provider, especially a hospital? It used to be that it was largely from physician recommendations. That still is significant. However, what we're finding in our recent research, which holds true across the markets we have tested, is that they'll ask their physician but then they go to other sources. More and more people go the web, to look at ratings, patient experience, testimonials, just as they are for other services or interests.
On the Internet, people are getting much more real-time analytical data from individuals who comment on or rate their experience with an individual doctor or health system. The savvy systems and organizations recognize that reputation management is dramatically different than it used to be. Organizations used to try to manage word-of-mouth. Now they're managing broadscale viral information that people share online and also through defined channels, like Vitals (a website that publishes millions of physician reviews written by patients), Binary Fountain (a provider of patient feedback management services and analytic software) and Healthgrades (which provides users with information about providers' experience, patient satisfaction and hospital quality). That's actually good — it keeps organizations on their toes to make sure they're managing the consumer/patient experience.
What strategies should systems be using related to reputation management?
In the past health care systems have operated somewhat under a cloak of complexity: health care can be too complex for patients to really understand how it functions. That's all being swept away. People are rating us on our navigability, our accessibility, our transparency, our quality. It's a great thing for the industry and something that's been lacking in health care until the last five to 10 years, though it's been in retail for many years.
Are there different ways health care systems should be collecting or analyzing data to better understand patients as consumers?
We need to ask what is going to be most applicable and resonant for the consumer/patient in terms of their experience in our facility or with our system. That means asking what is it that's really compelling to the consumer/patient.
Health care systems or facilities traditionally tend to wait for patients to show up on our doorsteps, give them the best service we can, and then wait for them to come back. We don't spend a lot of time mapping out the consumer's journey in our facility. Consumer-driven industries, like retail-oriented enterprises, such as banking, travel and entertainment, draw consumers in early and work to keep them informed about services they provide.
Health care system research tends to be more affirmative rather than informative — looking at areas like patient satisfaction. It's not usually about linking them to a system or keeping them in the loop about our portfolio of services, or cross-selling (services), like you have in other retail-oriented or consumer-driven industries. An example of affirmative marketing would be attending a women's cancer awareness seminar and receiving information regarding a mammography screening. Another example would be a woman delivering a baby at a hospital and then being encouraged to sign up for a women's affinity group through the hospital.
Preston Gee, CHRISTUS Health's vice president of strategic marketing, provided
Catholic Health World with additional details on how the system uses marketing tools and communication strategies to keep patients as engaged consumers.
To listen to audio clips of portions of this interview, please click on the following links. (Edited audio.)
Will you tell me about tools you mentioned like marketing automation that assist with providing appropriate information to patients about services they may be interested in?
What's an example of how a patient would receive information about services the patient might be seeking?