Companies That Shouldn’t Exist If We Did Our Jobs Right

In our previous piece, we talked about companies that wouldn’t exist if we as health systems were more effective at doing our jobs. In saying that, we don’t intend to be critical of other companies that act as online intermediaries. We’re, in fact, being self-critical as a health system. These companies are providing necessary services to consumers of healthcare that consumers find valuable. These companies are also filling in gaps that health systems have left open for them to fill. However, ultimately they are intermediaries that are providing services that we as trusted partners in health should also be delivering to consumers who are looking for health information and services.

At Providence St. Joseph Health (PSJH), our digital strategy is to deliver a 10 times better online experience compared to offline to our customers to entice them to work with us online, then create a compelling online engagement model around their health. The opportunity to serve patients online is vast. There are nearly 50 million health and medical searches that are conducted each day, and two-thirds of internet users search for healthcare information. Each of those searches represents an opportunity to build a personalized experience that provides solutions to the problems they may be looking for. We can do this is by owning the online patient journey as a health system.

The Patient Journey

The graphic shown represents the stages of a typical patient’s online journey. Each part of the funnel represents an opportunity for health systems to provide a great digital experience that creates brand loyalty. However, each one of these parts of the funnel also represents a place where other companies are playing the role in lieu of health systems.

The online patient journey starts with patients looking for information regarding their symptoms and corresponding conditions and treatments. This is where content providers like WebMD are serving up medical information to our patients. There is no reason why health systems like PSJH shouldn’t be the authoritative source of medical information for our patients. Health systems have the expertise and evidence base to provide the content that informs patient searches. In not developing our own sources of content, we as health systems aren’t owning the responsibility to inform our consumers and patients. There are exceptions. The Mayo Clinic, as one example, does a phenomenal job as being a reliable source of medical information for patients. That said, these exceptions are in the minority today.

Next in the patient journey are sources of information about physicians and clinicians. Directories like Healthgrades serve up relevant information about clinicians that patients care about as they search for care like provider specialty and scope of practice, and location. Review sites like Yelp and Healthgrades are providing reviews of our physicians’ and clinicians’ services. The data shown on these directories and review sites is about the health systems’ own employed and affiliated physicians. We as health systems should be the authoritative source for this information. Finally, companies like ZocDoc are creating marketplaces of our services on our behalf by providing consumers the ability to research physicians and book appointments online.

These companies have several features in common:

·       They are intermediaries in the value chain of healthcare. They are inserting themselves between the caregiver and patient.

·       They are delivering access, convenience, ease-of-use and information to our customers which we as health systems should be best poised to deliver ourselves, but are not.

·       By inserting themselves between the caregiver and patient, they take over ownership of customer data, which they then sell back to health systems and use to strengthen their positions as intermediaries. This data represents information we should own about our patients that will help us serve them more effectively through personalized online experiences. This data will be critical as the online channel in health care grows.

·       These intermediaries may eventually take over relationships with our consumers. The right partners respect the health system’s direct and sustained relationship with its patients and clinicians, operate in a complementary capacity, and truly offer products that the organization could not — and likely should not — develop on its own. That said, as their position becomes more assured through the use of the data they capture and the loyalty they build with patients by delivering a great service, the economics they offer to providers will go up.

The Path to Digital Success for Healthcare Organizations

When consumers are looking for information or want to transact with us, we as health systems should be giving them easy ways to do this online. Investing in our own digital assets and capabilities is critical to patient acquisition, retention and most importantly, satisfaction. Building on the patient journey above, the critical element to our success will be a combination of robust content, comprehensive and usable directory, and an online marketplace & transactional platform.

This isn’t to say that hospitals and health systems should never partner with external parties when it comes to the areas of patient experience, patient access, and provider data management and only seek to build this capability by themselves. That’s an impractical waste of money. Quite to the contrary, there are organizations who can be great partners in delivering on a healthcare organization’s care promise. The right partners act as complements, supporting organizational goals and enhancing health systems’ ability to deliver on commitments to patients without interjecting themselves between the provider-patient relationships. They have chosen to power the health-system’s digital relationship with their patient rather than act as an intermediary.

One example of a company we’ve partnered with in this complementary way is Kyruus, a leader in provider search, scheduling, and provider data management. Kyruus’ technology is helping PSJH improve patient access workflows in both our online and offline channels. We first partnered with Kyruus to enhance patient-provider matching within the then newly launched Access Swedish phone-based referral service. This increased appointment conversion rates up by more than 42% points within a year through a more accurate match of patients to our providers. We quickly expanded the relationship to support the launch of one of our employer-sponsored ACOs developing an integrated online provider directory across multiple provider practices. Since then, we have continued to broaden our partnership with Kyruus and now leverage their platform to build and maintain an accurate, comprehensive system-wide provider directory, power the provider search applications on our consumer-facing websites, and support our system Patient Engagement Centers. Providence Ventures is now an investor and we support them in thinking about how to improve their product. Kyruus has helped us not only drive more appointments, but also be found by patients digitally when they need us. One key part of our relationship with Kyruus is that the health system always owns the customer relationship in their business model. The customer never knows they are interacting with Kyruus technology and the health system owns all data collected about the customer.

As an example of content partnerships, we have partnered with Binary Fountain, a company that, among other services, takes our Press Ganey HCAHPS surveys, de-identifies them, and posts them as ratings and reviews on our Kyruus-powered provider detail pages. These reviews are bona-fide patient feedback about our providers. These reviews help prospective patients understand their potential fit with a physician they may be interested in engaging by providing feedback from other patients. Reviews are critical as consumers will now rarely choose a service online without ratings and reviews. These reviews also provide the added benefit of raising the provider’s free search rank because Google views the provider page as more relevant and authoritative due to the review content. Again, Binary Fountain has chosen to power health systems rather than compete or disintermediate them. The health system owns the customer relationship and the data. And again, Providence Ventures made an investment in Binary Fountain because of our ability to help accelerate their product development and add value.

Digital is the fastest evolving space for how we will help our consumers get the care they need in the future. The biggest challenge for health care systems in owning the consumer relationship is the rise of intermediaries who also want to own the patient relationship and data. The question might be: Do we as healthcare systems want to give over this digital relationship with the patient to third parties OR do we want to build our capabilities in-house and create sustainable competitive advantage for the long-term? We don’t view this as an either-or question at PSJH, however. We think we need to build a strong internal digital capability through partners AND partner with intermediaries where and when it makes sense on our terms. We will push these intermediaries towards terms that don’t create long term strategic disadvantage for PSJH. Depending only on intermediaries to enable a digital strategy, however, we believe is strategically dangerous.