Healthcare Consumer Data: Barrier or Breakthrough?

by   |   February 9, 2017 5:30 am   |   0 Comments

John Nash is Vice President of Strategy and Market Development at RedPoint Global Inc.

John Nash, Vice President of Strategy and Market Development, RedPoint Global Inc.

It is a bit ironic that healthcare has become so fragmented, given that the root word of ‘health’ (“hal” in Old English) also means ‘whole.’ We have an opportunity to use customer data to make healthcare whole as originally intended – to interact with consumers, patients and members in a way that is much more personalized and engaging. This can be done in a manner that not only improves outcomes and patient satisfaction, but also drives more efficiencies for both payers and providers. For payers, there is an opportunity to create a personalized and branded connection with consumers, which is increasingly important given the greater number of choices in the marketplace. For providers, there are new opportunities to combine traditional data with wearable and medical device data, and leverage that data with analytics and orchestrated interactions to help individuals lead healthier lives with better outcomes.

Many industries are on a path to delivering these types of benefits through highly personalized engagement with consumers, yet the healthcare industry is lagging behind. Are the privacy issues with highly sensitive patient information a barrier to progress? Or is a broader view of consumer data exactly what is needed to break through the often conflicting goals of better outcomes at lower costs? When leveraged correctly, data is the key to delivering the type of personalized engagement that today’s healthcare consumers are demanding. Other industries have found paths to value with personalized engagement, particularly market leaders in retail, consumer packaged goods (CPG), travel and hospitality, automotive and media as recognized by Gartner research.

Healthcare shares similarities with these industries in that consumers are increasingly driving the engagement, and digital interaction channels have fundamentally changed how they can engage. This digital transformation and rising consumerism places pressure on industry participants to create highly personalized and engaging experiences. Given the right context and the right value delivered, consumers want personalized engagement from healthcare organizations, with rising expectations fueled by other consumer-oriented businesses such as Amazon, Netflix, Uber and their local bank that have increased engagement through mobile applications. There are, however, three key differences from most industries:

  1. Fragmented engagement – consumer engagement is fragmented in that it spans multiple entities, from payers to physicians, hospitals, pharmacies, pharmaceutical companies, medical device companies and health and fitness providers
  2. Lack of consumer understanding – the platforms in place are not built to process broad consumer data to foster the deep understanding required to drive personalized engagement – they were built to process claims for payer use, and electronic medical records for physician use
  3. Value migration – the core value streams are being turned on their head: shifting from fee-for-service to outcomes-based payments.

There are a series of steps that today’s healthcare organizations can take to get past these barriers, leveraging innovations pioneered by more traditionally consumer-friendly industries. The value is apparent, as research by Oliver Wyman noted, that more personalized health and wellness can deliver up to 40 percent better value and a 100 times improvement in the consumer experience, with some of these shifts already happening in the market.

Whether you want to drive analytics initiatives to make better decisions, or drive more personalized engagement, you need data as a raw material and the more data the better. Some of this will include big data in the form of social media data, interaction data and potentially device data. Healthcare has restrictions on data and healthcare consumers are also different in that many times they have chronic conditions that require them to manage their own care, which is 99.9% of the time outside of any one doctor’s office. It is because of this that they are often willing to opt in to programs that provide data for value in return, e.g. information and advice to better manage their own health.

There are parallel data restrictions in financial services, particularly the restrictions on the use of credit information for marketing purposes. Banks have created value for consumers even with these restrictions through either 1.) using third-party consumer data that is not restricted, or 2.) making a firm offer of credit to consumers when using credit data, i.e. delivering value to the consumers in concert with the use of data. Similarly, payers and providers can use third-party data to attract new customers, and use other data in the context of delivering value to the consumers.

The best consumer-oriented businesses have a deep understanding of consumer interests, needs, attitudes and preferences – all of which is captured in a customer data platform to drive analytics and personalized engagement. Healthcare payers and providers with initiatives to capture new market opportunities will make similar investments in a Customer Data Platform. The best platforms have a level of precision, scalability and agility to creates high value for the payers, providers and consumers.

Precision requires a unified, 360-degree view of consumers that is highly accurate across any silos (data, interaction, departmental and/or provider silos)

For payers and providers, this leads to less re-work and better understanding of consumers – leading to better consumer satisfaction, better outcomes and higher reimbursement

For consumers, this is the key to personalized engagement, leading to better plan selection, better care, better outcomes and lower costs

Scalability and agility require a platform that can handle any data type – structured, unstructured and semi-structured – at high volumes and velocity. The platform should enable a unified view of consumers without having to change existing source systems, and should enable the type of data in a Big Data environment – e.g. steaming data from web, mobile, or consumer devices, text notes that are semi-structured, and/or imaging data.

The customer data platform needs to support personalized engagement at any stage of a customer journey. Some data may be restricted at specific stages or for specific uses, with access rights managed in the platform. It is through these journey stages that the data is turned into insights and action that create value for payers, providers and consumers. The journeys can be configured to create value for consumers and for your organization, much as financial services have done to engage with consumers differently at various life events. Another example are best-in-class travel companies such as Xanterra Parks and Resorts, which personalizes engagement with consumers pre-visit, during the visit, and post-visit. For payers, data may drive personalized plan selection, enrollment, on-boarding, usage and resolutions. For providers, data may drive personalized care and care coordination for the 99.9% of the time outside of the doctor’s office, with highly personalized journey stages specific to an individual and delivered potentially through digital channels and devices.

Finding the right path in today’s market is difficult as digital health innovators have invested over $10 billion in new technology over the last three years, with analytics/Big Data, wearables and population health leading the way. Given the complexity, it is best to break your opportunities down and prioritize those that will deliver value the fastest. For example, pick the right conditions to treat, with the goal of improving population health one patient a time for those priority populations. Alternatively, orchestrate engagement over a few high-use channels, such as email, direct mail and web.

A customer data platform is the key to dealing with the fragmentation, lack of consumer data, and new value streams that characterize the healthcare industry. These platforms are also key to responding to the rise of consumerism in healthcare. Perhaps most importantly, data is the foundational element driving the breakthroughs that will create a vastly different healthcare market in the future, making it whole in way that was never originally envisioned, but is right for the time.


John Nash is Vice President of Strategy and Market Development at RedPoint Global Inc.

A seasoned business strategist and published author, John Nash has over two decades of demonstrated experience helping companies grow revenue, market share and profitability. As Vice President of Strategy and Market Development for RedPoint Global, John is responsible for developing market offerings; providing the vision, leadership and direction to create highly-effective, strategic programs and offerings to drive product adoption in key markets.

Early in his career, John spent 15 years at Accenture, where he was responsible for Offering Development and was part of the core team that established its Global CRM practice. John left Accenture to become VP Product Strategy for data technology innovator Seisint, Inc., a role he kept until joining financial analytics leader, FICO. John worked at FICO first as VP Product Strategy and then as VP Corporate Strategy, where he led enterprise strategy formulation, investment strategy, market intelligence and product portfolio strategy focusing on the banking, insurance, retail and healthcare sectors. While at FICO, he also co-authored a book, The Deciding Factor, the Power of Analytics to Make Every Decision a Winner. Prior to joining RedPoint Global, John was president and founder of Nash Business Consulting which focused on leveraging business innovation, technology and key capabilities to grow revenue, market share and profitability for its clients in the education, healthcare, and technology sectors.


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