A Human-Centered Healthcare Revolution

Photo by Nick Shotz on Unsplash

In our November 2019 post, we reviewed and summarized the first sections of Zeev Neuwirth’s book “Reframing Healthcare, A Roadmap for Creating Disruptive Change.” This set the stage for the broad scope of work that can — indeed, must — be done in order to shift the current healthcare paradigm. This month, we review the design aspects of the book in more detail.

First, to address a somewhat uncomfortable truth: the word for “patient” derives from the word for “suffering.” The premise of these sections is that it’s necessary to shift focus from the idea of the patient (the person as the sufferer) to healthcare consumer (the person seeking health and well being). This is the essence of human-centered design, the foundation of the book’s sections that speak to process as a means to redesign the system as we know it today.

The consumer approach is one of identifying a person’s needs on multiple levels — physical, emotional, relational and existential — creating and deploying a customized solution, and then engaging that person to create and sustain relevance.

Rebranding

The steps of the combined Reframe Roadmap and Marketing Mindset (reviewed in last month’s post) are sequential and iterative. Once you reorient your thinking and redefine the problems to be solved, the next step is rebranding.

A powerful brand is, at its core, about making people feel good about themselves in a specific context. It’ more than simply a creative exercise to build a logo and supporting assets. It’s your differentiating and disruptive attractor, your relevance and loyalty factor and your growth engine. But at its core, it’s an exercise in empathy: an attempt to relate to people, to understand and connect to their emotions and experiences, to define how your organization will help them feel better about themselves, their relationships and their lives.

Neuwirth outlines five technical principles to help clarify your brand:

1. Compelling storytelling: telling a focused story constructed of specific elements that help you connect your core narrative to the brand, and thus the minds, hearts and emotions of the people you’re organized to help
2. Connection and relationship building: brands are less about a service and more about the customer, who sees themselves in the brand messaging, behaviors and actions you promote.
3. Differentiation: your brand must represent something different, not necessarily better.
4. Reliability: this goes without saying, but is an important part of a healthcare brand promise. Without attention to quality, consistency and safety, your brand story will be shared in a negative light. And since no organization is perfect, admitting and immediately rectifying problems of reliability will go a long way towards repairing your relationship.
5. Authenticity: the “wisdom of the crowd” can sniff out inauthenticity. This changes over time, and must be a part of each successive leadership iteration of the brand.

He then details a process to rebrand primary care, whose value propositions have been diffuse, unfocused and diluted, trying to be all things to all people and falling short. Rather than seeing this as a criticism, this is an opportunity to unleash the potential: a market evolving into a hyper-segmented, modular brand ecosystem creating an interdependent network of connected brands:

• Complex/chronic care
• Condition specific care
• Wellness care
• On-demand and urgent care, and=
• Continuity care

In order to function as a multi-segmented brand, they need to be held together by a “coordinating platform,” which provides a backbone of services such as a shared electronic health record, quality and safety management, customer relationship management, billing and revenue cycle management, and the like. By changing the focus of primary care segments, consumers will know where to go for which service, and by receiving targeted services from each segment, will move within the system as their healthcare needs dictate. This is the realization of the customer-first brand promise, and is already happening in the U.S.

Redesigning

“People talk about our healthcare system needing to be fixed. The system isn’t broken. It’s just designed for the wrong thing.”

–Marcus Osborne, VP of Health and Wellness for Walmart

Design thinking is nothing less than elevating the human experience and condition. It leads to surprise, wonderment, delight and enthusiasm. Good design often goes unnoticed, but it always makes us feel competent, respected, even dignified. Consequently, a bad design saps our energy and leads to frustration. The design of experience is what we’re focused here, alongside the products and services that healthcare provides. And here’s why it’s important for you:

1. Patients have become customers, who vote with their hearts as well as their feet
2. Healthcare is shifting to a value-based payment model and outcomes-driven orientation; and
3. Design-focused competitors are already out there, who already deeply understand the principles of customer-only design and service delivery.

As such, redesign of healthcare must be approached from a consumer-oriented, demand-side perspective. Neuwirth uses the example of a University of Pennsylvania effort to save consumers money on their prescriptions by making a simple choice architecture change on their EMR: when a doctor ordered any medication for a patient, the generic equivalent would pop up as the primary choice. The patient could still specify the brand name medication, but that would take time, attention and energy. Within three months, this led to a generic prescribing rate of over 90%, saving consumers and their employers thousands of dollars per year in medication costs alone.

Design is not just an add-on for the purpose of attracting customers to the product or service; design is integral to the product or service itself. The book describes in detail nine design principles to consider as redesign moves forward:

1. Design for specific target segments, focused on the conditions and needs of niche consumers
2. Design for outcomes, but love the problem: with the end result in mind, move customers from reality A to reality B by resolving a deep issue for them that creates an improved state of being.
3. Design for outcomes that matter to healthcare consumers (and ask them what those might be!)
4. Design by starting with the customer and working your way backward to the product or service. This complements the previous two principles and focuses on the customer only.
5. Design with measurable results and outcomes in mind. And as we’ve seen, those results may change over time
6. Design for simplicity and ease of use, which is the foundation for -
7. Design for relevance and engagement: to the customer, the provider, the clinical validation and integration processes.
8. Design for customization and personalization in the delivery of care, and
9. Design for the behaviors you’d like to promote.

The goal of this section is to provide a foundation for consumer-only, iterative redesign of products and services, consistent with the promises of the rebrand process. This will make healthcare more convenient, accessible, responsive, respectful, personalized, empathetic and effective.

Reorganizing

Initially, one might ask how you can get worked up and passionate about reorganizing — but this may be the most creative, pivotal and innovative step of all, consisting of three categories:

1. Reorganizing into segmented brands, such as the primary care ecosystem,
2. Reorganizing healthcare systems into health systems, and
3. Reorganization through unconventional collaborations, partnerships and joint ventures.

The last two steps of the seven step process outlined in last month’s post comprise the build and launch phases of the work. Reorganizing and redirecting are the means by which all of the intellectual effort and property that have been created in the previous steps are realized and manifested and, as Neuwirth stresses, the means by which value propositions become value liberated.

If you do all the work up to this point but don’t manage your organizational inertia, you’ll be left permanently stuck on the launch pad. It’s the combination of these last steps — reorganizing and redirecting strategies, tactics and resources — that allows you to achieve large-scale, sustainable change.

The book then elucidates the necessity of reorganizing using the primary care shift to segmented brands as a way to address targeted aspects of population health, leading to new and more realistic payment structures that benefit providers as well as consumers.

The following chapters cover hypotheses and use examples of healthcare systems being reorganized into consumer-focused health systems, and the power and impact of innovative ventures that are leading to models for providers, payers and consumer-focused caregiving: too numerous to mention, but an excellent snapshot of the work of reorganizing already moving forward. A critical transformational movement in healthcare delivery, this last step may prove to be one of the most powerful healthcare innovations of our time.

Conclusion

Human-centered, consumer-only focus is the way forward for reframing healthcare. While none of it is easy or, sadly, inexpensive, it is an investment in the future of the health of our nation and of the businesses that make it work. Like other monolithic brands in the consumer space, healthcare must adapt to changing market conditions and consumer expectations (read: realities) as they define what health and wellness mean to them. By doing so, healthcare brands can shift to serve segmented markets that allow consumers to stay integrated, even loyal to your brand throughout their lives, and those of their families and friends. Emotional connection lies at the heart of it all.

We hope that this summary has inspired you to at least explore Neuwirth’s hypotheses and recommendations. Our recommendation, of course, is first to buy the book. Second, subscribe to the podcast. And third, take a deep dive into Neuwirth’s Website to better understand the critical need, the steps toward resolving the problems, and how this roadmap can not only change healthcare but also change society as a whole.

“The greatest danger in times of turbulence is not the turbulence; it is to act with yesterday’s logic.” — Peter Drucker

In the book’s conclusion, Neuwirth is looking for someone to pickup the Reframe Roadmap: CEO, Board, provider group, healthcare organizations of all kids. The book, and this blog post, are an invitation to embark upon a new path — to be active participants in an historic moment in the evolution of healthcare.

As we asked last month: how will you respond? How will we respond?

Originally posted December 9, 2019 at connect-cx.com