What Matters Now: The Patient Healthcare Experience.

How digital content and new service models are re-making the patient healthcare experience.

Ken Allard
September 29, 2014

The healthcare industry is undergoing a period of rapid evolution. While recent focus has been on the seismic, structural shifts brought about by the Affordable Care Act, digital experiences—affecting everything from the actual delivery of medical treatments to how people manage their health—are having a significant impact. As health care providers compete for market share and patient loyalty, they will distinguish themselves not only by providing excellent, quality care but also by keeping up with rising digital expectations. In fact, one only need consider the botched rollout of the ACA exchanges to see how disastrous not meeting heightened user expectations can be.

In this report Huge will highlight how digital content and service models are simplifying and improving the patient experience, and we will identify the priority investments that organizations should be making today.

Digital Content

Content strategy and marketing is fundamental for provider success.

Executing a robust content marketing strategy will generate more qualified leads for all kinds of businesses and will have a higher ROI than most forms of paid advertising.  Dozens of outside publishers and technologically sophisticated marketers have started participating in the lucrative medical conversation to generate page views using advanced SEO techniques. Pharmaceutical companies are investing more heavily in content marketing as they seek to move their messaging away from individual products and focus on broader health issues such as disease awareness and prevention—a challenge for companies that still face high levels of consumer skepticism and distrust.

Because search engines are so heavily weighted towards rewarding local relevance in search results, many providers already perform well in their own local markets. For large hospital systems, however, the bigger growth opportunities lie in becoming the destination for specialized care for specific conditions or diseases. Patients seeking specialized care are often looking for expertise and treatments that are not offered in their local markets. Robust digital content driven by a long-term content strategy is critical for providers that are seeking to build a brand in a specific category. Yet, creating compelling patient-centered content is not typically a core competency for health care providers.

To compensate for this weakness, Huge recommends that providers collaborate with branded media companies. For instance, healthcare company Lilly Diabetes has partnered with Disney to create an online content hub and series of custom books for families with children who have type 1 diabetes. The site features articles, recipes, videos and expert advice as well the personal stories of other families raising kids with diabetes. Everyday challenges such as planning vacations and going to school post-diagnosis are addressed. As media companies look for new revenue sources and healthcare providers invest more heavily in their content marketing, expect more of these types of partnerships to emerge.

It is often difficult for patients to know what is medically factual or accurate.  They are overwhelmed with information of questionable quality, a challenge for physicians who are not trained to deal with “digital hypochondriacs” questioning their credibility. Providers who can create clear, trusted content can improve quality of care. A robust content strategy should focus on a user-centered model that holds the safety and interests of the patient as the key driving principles but still allows a dialogue between user and provider. Creating content that balances rich, accurate medical information in an easy-to-digest and comprehend format is crucial to success. Simply making content available is not enough if it’s not usable by patients across a spectrum of comprehension and health literacy levels. Healthcare providers should work with technology partners to build systems that allow physicians to curate the best and most relevant content, and simplify how it is distributed to their patients.

Creating clear, digestible digital content is a top priority.

Much of the health content available to consumers today has become a commodity, dominated by just a few players such as WebMD and the Mayo Clinic. While strong content is a strategic asset, creating great content isn’t typically a core competency of most healthcare companies. They now have an opportunity to speak to their unique strengths as providers but need to realize it’s about reaching fewer users with deeper, more relevant info than the commodity content already available.

One of the biggest challenges in creating a robust content strategy for healthcare providers is simplifying language so that most patients can understand it. Today, most medical literature is dense and impenetrable to the average patient. In a risk-averse industry, lawyers often overly complicate language to avoid liability. Yet when it comes to compliance, people who have a sixth grade reading level need to be able to understand it. For healthcare providers, it creates a need to delicately balance medical accuracy with plain language. Structuring content in an easily understandable taxonomy and with multiple formats—including text, images, and video—should be a priority for hospitals. In the long run, overly complex language may do more harm than good when it comes to patient safety. According to the US Department of Health and Human Services, just 12 percent of US adults have proficient health literacy. As a result, the agency estimates 77 million adults have difficulty with common health tasks, such as following directions on a prescription drug label or adhering to a childhood immunization schedule using a standard chart. Finally, providers can look to best practices in other highly regulated and complicated industries, like financial services, to inform their balancing of these goals and create a working model for legally approved, understandable content.

New and old digital content must be optimized for search.

Digital content and tools are the most effective way to offer consumers a wider array of choices and more effective information to help them understand and address their ailments. According to the US Department of Health and Human Services, better informed and engaged patients lead to better health outcomes. Patients need information about managing their own care and paying for it too. Factors like out-of-pocket expenses will increasingly dictate patient decision-making. More and more, this kind of information is available online. Patients’ needs for information are broad and persistent across their health care experience:

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Just as consumers do Web research before they buy items in retail, they increasingly try to educate themselves about their symptoms and their health care choices before they make a decision. Nearly three-quarters of all adult Internet users in the US looked online for health information last year.

In order to be found, providers must invest in creating content and other digital assets that are optimized for search. At a most basic level, this means extracting information that is often locked away in PDFs, but it also requires strategies for ongoing content creation and distribution.

Social media plays an important, but challenging, role in content strategy.

Social media has been a challenge for healthcare companies, which have been hesitant to fully embrace it without comprehensive guidance from the FDA. Yet, consumers increasingly look for recommendations from friends, family, and a plethora of social media sites. Eighty-eight percent of US Internet users look for health information and medical advice online. Social sites are clearly a massive opportunity to engage directly with consumers. This year, the FDA finally released two draft guidance papers for medical companies on the use of social media. The guidelines are designed specifically for FDA-regulated companies, such as medical device manufacturers and pharmaceutical companies. They emphasize the importance of balancing benefit information with discussions of risk. While the FDA guidance is a long overdue, it also only just begins to outline how healthcare companies should use social media. It still does not address the larger issue of how medical providers and healthcare companies should interact with users on these platforms with consumer expectations and needs in mind.

Now is also the time for healthcare providers to lobby regulators and form working groups with internal legal counsel to establish policies for content marketing and social media that reflect a patient-centered approach. Industry players need to anticipate and influence social media policy before regulators have the opportunity to limit innovation and improved patient care.

New Service Models

Patients increasingly expect convenience, choice, and utility in digital channels.

As user expectations continuously rise for digital experiences everywhere, providers struggle with significant challenges to providing a digitally enhanced, complete patient experience. Legacy technology, regulatory obstacles, security concerns, and cultural resistance make it hard for most healthcare providers to move quickly. But as other complex industries like financial services have proven, change is possible. Huge believes that providers who embrace a more consumer-friendly, digitally astute experience will benefit from improved patient outcomes, higher patient and doctor satisfaction, and better operating margins.

As large healthcare institutions grapple with digital change, third party, agile startups such as ZocDoc are building digital solutions for the less complicated pieces of the patient journey, such as finding a specialist and booking an appointment. Another company that harnesses digital to elevate the experience of seeing a primary care physician is San Francisco-based startup One Medical. For an annual fee (between $150-$200), patients can book a same-day appointment via an online or mobile app, get customized electronic medical records, and fill out forms online before they even get to the waiting room. With more nimble startups chipping away at simpler pieces of the patient journey, healthcare providers and hospitals must look for ways to either incorporate these technologies into their services or build differentiated solutions that fill in the gaps these startups are not able to tackle. And they must learn from other industries like retail, hospitality and financial services to make the digital shift.

Providing digital touchpoints throughout the user journey will keep existing patients engaged and proactive in their own care. Digital touchpoints will also be central to attracting new patients, who are more empowered than ever before in their own medical care.

The rise of the Chief Experience Officer reveals greater emphasis on hospitality.

Chief Experience Officers should lead patient-focused change with digital investments. Leading healthcare providers have hired patient experience teams, dedicated to making patients’ stays more comfortable. Huge estimates that there are about 100 employees with the title of Chief Experience Officer (CXO) for hospitals in the US—still a relatively small number but growing. All providers—big and small—will need to follow the example of these early adopters and look outside their industry for best practices, especially as patients distinguish less and less between the healthcare experience and any other digital experience.

The growing consumer demand for telehealth requires integrated mobile strategies.

As is well documented, the market for consumer healthcare apps has already exploded, with over 20,000 healthcare-related apps available today, up from 4,000 in 2010. Smartphones are now entreating users to work out more, eat less, sleep better and take their medicine. Given the near ubiquity of mobile technologies for both consumers and healthcare professionals, there is a big opportunity for better patient care along the entire value chain. This goes far beyond consumer healthcare apps and includes opportunities for telemedicine, remote monitoring, and more efficient and comprehensive patient data capture.

In the field of telehealth, the US Department of Veteran Affairs has been taking the lead, outpacing the private sector. According to the agency in 2012, half a million veterans received healthcare via monitors, videoconferencing, and a “store-and-forward” program that transmits images for remote analysis, growing 29 percent a year. About half of the veterans live in areas with limited access to VA healthcare.

Today the private sector is beginning to catch up, as more insurance plans support telehealth services to connect patients and doctors in order to reduce ER and urgent care visits. Telehealth has been used to diagnose and treat illnesses such as the flu, rashes, migraines, urinary tract infections, bronchitis, pneumonia, and diabetes. In the past year, several telehealth providers have started selling direct-to-consumer services.  Stanford University Hospital has been offering an eCare video visit for non-critical appointments and follow-ups since 2013.  To date, 28 states now require insurers to cover telehealth, though the inconsistency of state laws in this area remains a barrier to more widespread adoption for now.

Outside of the insurance marketplace, startups such as Doctor On Demand are betting consumers will pay out of pocket for video appointments with a doctor for routine illnesses and urgent care needs. While the benefit to consumers seems obvious, physicians are slow to warm to the idea. Many doctors still feel a video appointment can’t replace the experience of a physical examination but that it can be useful for follow-ups or consultations. But then, retailers were slow to embrace e-commerce, just as fitness instructors and financial advisors thought home exercise videos and personal finance software couldn’t replace their services. Another potential barrier is uncertainty around billing and reimbursement in the absence of an office or clinic visit. The lack of face-to-face interaction also brings up liability issues that are still unresolved. Still, a recent study showed potentially enormous cost savings, which could be enough to tip the industry towards wider adoption despite complexities.

The opportunities for consumer telehealth are still nascent but point to new ways for healthcare professionals to interact with patients. Telehealth, and other services and systems such as appointment scheduling and billing, allow for physicians to maximize their time with patients and focus only on high-value and revenue generating activities.

Healthcare providers, insurance companies, and medical device manufacturers need an integrated mobile and patient engagement strategy. While the technology is already available to propel telehealth into mainstream usage, the larger barrier is structural, including the industry’s low tolerance for risk and uncertainty on how to bill for a video appointment. However, the convenience for both the physician and patient, and cost savings could be quite substantial. Additionally, new telehealth technologies create opportunities for physicians to provide services remotely for underserved and developing markets with looser regulation. For instance, during the most recent Ebola outbreak, which claimed the lives of 144 healthcare providers thus far and infected another 157 to date, telemedicine is slowly being introduced to deliver patient care while reducing the risk of transmission of this highly communicable disease.

Ubiquitous information access and device usage will have an impact on patient care and safety.

Just as patients are using mobile devices to manage their own health, physicians are also using them to supplement care when they don’t have a desktop available. Both smartphones and tablets have proliferated in hospitals and doctors’ offices, with the number of point-of-care apps exploding in the past two to three years, including popular ones like Epocrates, MedCalc and UpToDate.

Another as-yet-unrealized but very real benefit of mobile adoption by doctors at point of care is removing paper from the prescription process. The ability to e-prescribe can reduce errors, the number of phone calls between the patient and pharmacy, and time spent. According to some estimates, approximately 30 percent of prescriptions require a pharmacy callback. If physicians can immediately query the price of drugs based on a patient’s insurance coverage, they don’t have to waste time changing prescriptions from brand names to generics once a patient discovers they can’t afford a drug at the pharmacy counter.

Upgrade wireless infrastructure and develop policies for device usage. 

With the increase in mobile usage at the point of care, Huge believes hospitals and clinics need to prioritize upgrading their wireless infrastructure. Many of the value-added services that digital technologies enable require access to wifi, which is still largely unavailable in hospitals.

Additionally, with the rapid adoption of mobile apps and devices for use within a clinical environment, medical leadership must begin to assess the impact of ubiquitous information access and device usage on patient care and safety. If the consequences of texting and driving are a potential analogue, then what are the implications of device usage and distractions in the hospital? Hospitals need to plan both how they enable lifesaving digital tools and services as well as create safety standards for quality of care. Providers also need to consider patient confidentiality and the security of the mobile devices that their doctors use in their practices. As user experience translates to activities such as bedside manner and the “hospitality’ elements of medical care, hospitals and medical providers should consider developing technology training programs for patient-facing employees such as physicians and nurses.

Launch active pilots and experiments with patient data gathered by wearable devices.

Organizations such as the American Lung Association offer games to educate children with asthma about their condition. Startups such as Mango have launched gamified apps for consumers to manage their medications and potential interactions. Apps such as Healthprize and Pillboxie encourage adherence by offering prizes for gameplay. The benefits are obvious, including higher patient engagement in care, stronger adherence to drug regimens and improved resilience. Health care professionals are also using simulation games such as Burn Center for medical training used in clinical practice.

In addition to managing treatment, games are used to promote wellness and behavioral changes such as getting more exercise, promoting healthy eating, improving cognitive abilities and even getting users to quit smoking. Often, these games rely heavily on social capital and norms as well as incentives to promote behavior modifications.

Today, just ten percent of American adults with Internet access own a fitness tracker, but the category is poised for explosive growth—not least because of Apple’s recent announcement of health and fitness tracking features in its new watch and as part of a new mobile app for its phones—as they expand beyond tracking steps and heart rate. Sensors are already being used to track breathing, stress and the onset of chronic conditions.

The use of sensors may propel past wearables like bracelets and sneakers into ever-smaller forms as chemical and fiber optic sensors gain popularity. Novartis and Google have teamed to create a smart contact lens that measures glucose levels for diabetics and sends the data wirelessly to a mobile device. Lively is a startup that uses sensors on pill containers, car keys, and refrigerators and cupboards that help older adults live independently longer. The sensors transmit data to the user, whose family can also see if his daily routine is normal.

Today, insurance companies are looking for ways to access the data generated by wearables, possibly upsetting the insurance marketplace. There is already a precedent for using gadgets to influence insurance premiums in the automotive industry.  For instance Progressive offers customers a small device to plug into dashboards to monitor their driving for 30 days to be eligible for a discount for safe driving. While there are many startups in the wearables space, it has also attracted heavy interest from the major tech companies, including Apple, Google and Samsung, who are engaged in a race to market. All three are developing data platforms that can aggregate and share health data collected from wearables. Samsung is building a biometric data bank dubbed Sami, while Apple’s Healthkit lets health apps talk to one another within the Apple ecosystem. Likewise, Google Fit was recently announced as an open platform for health tracking.

Employers have also been experimenting with wearable technology to lower healthcare costs. Software design company Autodesk buys Fitbit trackers in bulk and resells them at a discount to its employees. Oil company BP offered a free Fitbit Zip to employees who agreed to let the company track their steps over the course of 2013. If they made more than one million steps they gained points that could be used to lower their insurance premiums. The ACA also allows employers to offer greater incentives for healthy behavior.

For the first time physicians can extend their view of a patient’s vitals and treatment compliance beyond the parameters of just a visit.  This increases the scope of medical care beyond the examination room and office hours, creating a 360-degree view of a patient.  Aside from some potential challenges in billing structures and reimbursement, the biggest challenge for the healthcare industry as well as employers is tapping into the data wearables are collecting and using their API’s effectively. The data is already being generated—the challenge is plugging into it, figuring out what it means, and how patients will expect healthcare providers and employers to leverage it all without raising significant privacy concerns. Providers need to understand the landscape, what their patients are using to monitor their activity and be prepared to integrate their data into existing solutions.

While patients continue to adopt the consumer tools that could provide a 360-degree view of their health, building out the data warehousing, analysis tools and patient-facing experiences are skills that many healthcare providers do not currently have in-house.  More nimble startups as well as corporations like Nike have overtaken the wellness games sector, but there is still an opportunity for healthcare providers such as hospitals, pharmaceutical companies, and publishers to develop condition-specific tracking and gaming experiences in which patients can interact directly with qualified health professionals. There are opportunities to work with agencies and technology partners who have experience in broader consumer tech that can help build out these patient care tools, and train medical staff in how to extend the realm of care past the office.

Key Takeaways:

  • Developing the capability to create effective digital content should be the primary marketing investment for health care organizations.
  • Providers must invest in creating content and other digital assets that are optimized for search.
  • Executing a robust content marketing strategy will generate more qualified leads for all kinds of businesses and will have a higher ROI than most forms of paid advertising. 
  • Embrace a more consumer-friendly, digitally astute experience to improve patient outcomes, increase patient and doctor satisfaction, and achieve operating margins.
  • Chief Experience Officers should lead patient-focused change with digital investments.
  • The growing consumer demand for telehealth requires integrated mobile strategies.
  • Ubiquitous information access and device usage will have an impact on patient care and safety. Providers should upgrade wireless infrastructure and device usage policies.
  • Providers should launch active pilots and experiments with patient data gathered by wearable devices.