The Healthcare Consumer - Amazon S3€¦ · The Healthcare Consumer: Meeting Today’s Needs,...

st Annual NRC Picker Patient-Centered Care Symposium – Marriott Marquis Washington, D.C.

Washington, D.C.September 20–22, 2015

The Healthcare Consumer: Meeting Today’s Needs, Planning for the Future

Michele F. Crumes

AVP, Planning and Market Analytics

Strategic and Business Planning

MedStar Health

NRC Picker 21st Annual Patient-Center Care SymposiumSeptember 21, 2015

MedStar Health At a Glance

2

• Established in 1998 through the merger of Medlantic Healthcare Group and Helix Health

• MedStar Health is one of the 10 largest not-for-profit, secular healthcare systems in the country with a net operating margin of $4.62B

• One of the largest employers in Maryland & the Washington, D.C., region

• Economic leader that purchases more than $1.8B in goods & services

• Provides $316.3M in charity care & community services support annually



MedStar Health At A Glance

3

• 10 hospitals, a comprehensive network of physician offices and ambulatory centers and one of the largest home-care companies in the region

• 30,000 associates

• 8,400 nurses

• 6,000 affiliated physicians

• 1,700 employed physicians

• 1,070 residents and fellows

• MedStar Medical Group employs 1800 physicians

• Medical education and clinical partnership with Georgetown University

MedStar Health At A Glance

4

• Evolving our culture of Quality and Safety by transforming MedStar Health into a High Reliability Organization

• Investing in training and education for all associates and employed physicians

• Launched in 2009

• Offers MedStar Inventor Services (in collaboration with Cleveland Clinic), National Center for Human Factors in Healthcare, Simulation Training and Education Lab (SiTEL), Center for Digital Health and Data Science and Think Differently Engagements

• Translational nature of MHRI’s research – from bench to bedside to community –complements key clinical services and teaching programs

• Over 1,000 IRB approved open projects; more than 175 active principal investigators and 500+ publications/year

• Partnered with Evolent and UPMC to provide population health management infrastructure, capabilities and capacity

• Expanding programs and network development



MedStar Health Week At a Glance

• Admits more than 2,800 new patients

• Monitors over 1,000 patients in observation care

• Treats over 11,000 patients in our emergency departments

• Sees about 76,000 patients in outpatient services, including 28,000 in our physician offices

• Performs 1,500 ambulatory surgeries

• Delivers over 200 babies

• Conducts more than 4,300 home-care visits

5

MedStar 2020 – Vision

MedStar Health will evolve by expanding access and resources across the region, creating new business models with more focus on ambulatory, post-acute and primary care and evolving our focus from episodic care for sick patients to a coordinated, bundled network of care across the continuum for all patients.

6

Articulated the future direction, characterized as our “Distributed Care Delivery Network.”

Adapted from Sg2’s Systems of Care



7

December 2007

December 2014

Note: There are 2 Employed Physician Offices in Cumberland, MD, 1 Outpatient Rehab site in Salisbury, MD and 1 Outpatient Rehab site in Millsboro, DE not shown on the map.

Distributed Care Delivery Network

Growth in access points across the region from physician offices and ambulatory sites to hospitals joining the system in key markets.

Mom, What Do You Do At Work?

8



What is Strategic Planning?

• An organizational management activity that is used to set priorities, focus energy and resources, strengthen operations, ensure that employees and other stakeholders are working toward common goals, establish agreement around intended outcomes/results, and assess and adjust the organization's direction in response to a changing environment.

• It is a disciplined effort that produces fundamental decisions and actions that shape and guide what an organization is, who it serves, what it does, and why it does it, with a focus on the future.

• Effective strategic planning articulates not only where an organization is going and the actions needed to make progress, but also how it will know if it is successful.

9Source: Balanced Scorecard Institute

What Is Strategic Planning?The path we take from why we exist (mission) to what we want to become (vision).

10Adapted from AchieveIt “What is Strategic Planning?” Infographic



Why is Planning Important?

11

Reasons Why Strategic Plans Fail

• Planning for the sake of having a plan

• Not understanding the environment or focusing on results

• Partial commitment of leadership to strategic planning

• Not having the right people involved

• Writing a plan and putting it on the shelf

• Unwillingness or inability to change

• Having the wrong people in leadership positions

• Ignoring marketplace dynamics, facts or assumptions

• No accountability or follow through

• Unrealistic goals or lack of focus and resources

12

Source: Forbes.com “10 Reasons Why Strategic Plans Fail, November 11, 2011



MedStar Health’s Approach to Understanding our Consumer and Patient Market• Primary market research

• Focus Groups• In-depth Interviews• Internet Panels• Patient Journeying• Surveys

• CAHPS• Brand• Patient Experience (aligned with national standards)• Custom • NRC Market Insights

• Social Media Monitoring• Secret Shopping• Predictive Modeling

• Secondary market research• Expert consultant trend reports• Subscriptions to more than 50 online magazines, journals and newsletters• Participation in Learning Networks

13

Growing consumerism in healthcare is leading us to move to more advanced market research approaches.

14

Demographic segmentation

More advanced psychographic segmentation

Who consumers are

How consumers think, feel, and behave

Traditional platforms Digital platforms

Focus groupsIn‐depth Interviews

Internet panelsOn‐line Collaboration

MedStar Health’s Approach to Understanding our Consumer and Patient Market



Consumerism has been a key critical issue in healthcare for several years.

15

MedStar Health’s Approach to Understanding our Consumer and Patient Market

Consumerism and

Globalization

Meeting Consumers Needs for Today and

Planning for the Future

Designing Ambulatory

Care Facilities and Services

Designing the Physician’s Office Care Model of the

Future

16

Strategic Consumer Research Engagements

Strategic Plan MedStar 2020 Vision

System Annual Plan

Strategic Plan

MedStar Ambulatory

Services Annual Plan

System Annual Plan

MedStar Medical Group

Annual Plan

2007 2010 2012 2014

Findings from each engagement informed our strategic planning process.



The Impact of Consumerism in 2007

17

Common themes from research on definitions lead us to create the following definition for purposes of this discussion.

• Consumerism = approach to decision-making in a free market with information available

• Key elements:• Open exchange of freely available information

• Driven by consumer choice

• Emphasis on customer service, convenience and other attributes to attract consumers

• Economic purchasing power in hands of direct consumer

The Impact of Consumerism in 2007

18

The impact of consumerism on healthcare is that consumers bring value based expectations from their experience as consumers in other industries.

Consumerism

“Free market”

environment

InformedDecision-Making

Consumer preference/

behavior

Consumers are empowered to choose freely.

Consumers have a certain level of expectation of customer service, access and convenience.

Businesses become very knowledgeable about consumer behavior and preferences and package services and products to attract consumers.

• Economic purchasing power shifts from a 3rd party to the consumer.

• Consumers have “skin in the game.”

• Consumers’ opportunity costs increase.

• Globalization of markets.

• Pursuit/availability of information both on paper and on the internet.

• Data transparency is high (e.g., Consumer Report).

• Requires consumer to perform due diligence, determine the integrity of information they use and understand their rights as a consumer.



The Healthcare Consumer in 2010

19

• Participants expressed some frustration with getting appointments with the doctor, especially when they need to be seen quickly

• When a patient calls in with questions for the physician, the office staff acting as the “middle man” is met with mixed opinions

• Among the top annoyances for participants was the amount of time they had to wait before being seen by the doctor.

• Many tend to believe that their doctors do not spend enough time with the patient during evaluation

• Participants expressed the lack of efficient communication between providers and hospitals, especially when the entities are not in the same network

• Participants believe that patients need to be their own advocate or have an advocate who is proactive in order to receive better care

• The majority of participants expressed dissatisfaction with emergency rooms, centered around their long wait times and perceived poor-quality care

What is not working for patients or caregivers of patients…

• Affordable health care in general and more coverage

• Open-choice selection of doctors without the need for referrals

• Better and quicker methods of testing and getting results

• Sharing and accessibility of medical records and lab results through EMRs

• Improved communication between doctors, with an option to communicate with doctors electronically or through email

• Efficient transfer of patient information when seeing the doctor – streamline the paperwork

• Consolidate doctors into one geographic area for convenience and better coordination of care

• No longer use the emergency rooms as a source of primary care to shorten wait time

• A database with doctor and hospital ratings to help patients find doctors and hold them accountable for the quality of care provided

• Have a set of standards and best practices to maintain consistency in patient care among hospitals and doctors

• More doctors, nurses and hospitals to shorten wait times and improve the quality of care

• Ample doctor time with the patient for a thorough examination, diagnosis and answering questions


20

Common themes of what should be changed or fixed in healthcare services in the next ten years….




• People generally find their Primary Care Providers (PCPs) via referrals from friends/family/coworkers, or by referring to the list of in-network providers on their health insurance website.

• The biggest frustration people have with their physicians, and medical providers are:

• Wait times to schedule an appointment. This is a big issue for patients, especially if they are sick or concerned about a medical issue.

• Wait time once in the doctor’s office is also a major issue. • Communication with doctors and their office staff is difficult.

• Patients want their doctors and doctor’s offices to embrace the use of technology by using email, texting, online appointment scheduling, providing electronic access to their medical records, etc.

21

Even though focus groups were conducted to getting feedback about, and testing concepts among, several key target audiences for these new health care facilities, themes from 2010 emerged…with the volume turned up.


• I’m a customer

• Respect my time

• Treat me like a human

• Mind your office staff

22

The research conducted to inform the development of a care model that will attract new patients and create a stronger experience for patients revealed four key themes that came across loud and clear.



Patient and Consumer Focused Initiatives

23

High Reliability Organization

• By definition, a HRO is an organization, that despite operating in a high stress, high-risk environment continually manages their environment mindfully, adopting a constant state of vigilance resulting in the fewest number of errors.

• Five common principles of HROs include:

• Preoccupation with failure

• Reluctance to simplify

• Sensitivity to operations

• Commitment to resilience

• Deference to expertise

• Characteristics of a High Reliability Organization (HRO)

24

Patient and Consumer Focused InitiativesHigh Reliability Organization

Safety Huddles

Leadership Rounding

Starting All Meetings with a Safety Moment



25

Patient and Family Advisory Council for Quality and Safety

• MedStar has a System Patient and Family Advisory Council for Quality and Safety, a team of national leaders in patient advocacy and partnerships and advisory councils at each of the MedStar hospitals made up of patients, family members of patients, and people who work at MedStar hospitals

• The objectives of the PFACQS are to:

• Provide ongoing feedback to MedStar Health that addresses patient safety, quality of care or patient service issues

• Assist MedStar Health to continually improve the services it offers the patients and families who seek care at MedStar Health

• Strengthen communication and collaboration among patients, families and other non-professional caregivers, and MedStar Health professional staff and associates

• Promote information sharing between MedStar Health and the patients, families, and community it serves

• Aid in establishing MedStar Health organizational priorities in response to patient, family and community needs

• Promote patient and family advocacy and involvement

Patient and Consumer Focused Initiatives

26

Patient and Consumer-Focused InitiativesPatient and Family Advisory Council for Quality and Safety



• Network development aligns with hospital, physician and population health strategies with a number of projects in the pipeline

• One new multi-specialty center open with eight additional sites being planned over the next four years

• Eight urgent care centers opened in last two years with 12 additional sites planned over the next four years

• Two major ambulatory care centers in planning in the central Maryland market and downtown Washington, D.C.

• Two ambulatory surgery centers located within the multi-specialty centers

• Extensive outpatient rehabilitation network

• Radiation oncology sites complement cancer services in nine sites throughout the region

27

Patient and Consumer-Focused InitiativesAmbulatory Care Network Development

28

Patient and Consumer-Focused InitiativesThe patient portal allows patients to have access to their information.



29

Patient and Consumer-Focused InitiativesOn-Line Scheduling

• An enterprise-deployed, patient

experience tool developed by MedStar

Institute for Innovation (MI2) through

nurse-physician collaboration

• Its innovative dashboard allows real-time

visualization of patient experience within a

unit, hospital, or the entire enterprise

coupled with a communication system to

fix patient issues as they occur

30

Patient and Consumer-Focused InitiativesLeader eRounding



Patient and Consumer-Focused Initiatives

31

Physician Star Ratings have been integrated into the MedStar’s Find-A-Doc Profiles.

Opportunities:

• Continue to promote a culture of transparency with both internal and external audiences

• MedStar Health physicians are more easily found, and website becomes the trusted source for information about our physicians

Anticipating the Needs of the Future Consumer

32

Various market dynamics are continuously tracked and analyzed in formulating what patients, families and consumers will want and need in the future.

• Demographics

• Consumer Behavior

• Utilization

• Health Care Policy

• Economic Landscape

• Political Landscape

• Care Delivery Model Changes

• Workforce

• Technological Advances (Clinical, Digital, and Virtual)

• Competitive Landscape and Market Disruptors



• According to census data from June 2014, there are more 23-year olds, 4.7M of them, than any other age.

• By 2020, Millennials will account for one-third of the adult population.

• Millennials are the most educated generation in American history. Far more members of this generation are going to college than of past generations.

• Because of the sheer size of the group, they have the ability to reshape the economy and how businesses market their products to consumers.

33

Tracking the changing demographics of our market gives us insight into the behavior of future consumers.

Source: http://www.nytimes.com/2014/08/22/business/marketers-are-sizing-up-the-millennials-as-the-new-consumer-model.html?_r=1



34

Technological Advances



Anticipating the Needs of the Consumer

35

Technological Advances


36

KANYE WEST

While it’s not clear what the political landscape will be even in 2016, we have a Gen X’r who has already declared his run for President in 2020.

Question for consideration:

• How will the views of each political party change overtime and how might they impact healthcare reform?




37

There are new players in healthcare and outside of healthcare that are disrupting healthcare in part, because of unmet consumer needs.

Watson able to “see” with acquisition of Merge Healthcare


38

The desire for on-demand services has created a growing on-demand economy.

Question for consideration :

• How will the On-Demand Revolution change the landscape of health care delivery?



39


The Internet of Things will be transformative for healthcare.

• Patients can capture, analyze, and share personal health data through wearable technology.

• Health and wellness providers can offer more personalized treatments based on the available data.

• Individual health care consumers can connect with a diverse ecosystem of wellness providers, potentially leading to greater value and insight.

• The role of the traditional health care provider could change dramatically.

A comprehensive, intelligent monitoring system could enable a full range of health care services and treatments – wellness hubs and next-generation smart health dashboards among them.

Source: http://blogs.deloitte.com/centerforhealthsolutions/2014/09/the-internet-of-things-and-transformative-change-for-health-care.html#.VfuK1N9VhBc

Consumerism Framework for the Future

40

In planning for the consumer of the future, market dynamics will be looked at through a revised framework.

Consumer preference/

behavior

InformedDecision-Making

“Free market”

environment

Consumerism

Emerging Technology

Consumers are empowered to choose freely.

Consumers have a certain level of expectation of customer service, access and convenience.

Businesses become very knowledgeable about consumer behavior and preferences and package services and products to attract consumers.

• Economic purchasing power shifts from a 3rd party to the consumer.

• Consumers have “skin in the game”.

• Consumers’ opportunity costs increase.

• Globalization of markets accelerated by emerging technology.

• Pursuit/availability of information on the internet.

• Data transparency is high

• Requires consumer to perform due diligence, determine the integrity of information they use and understand their rights as a consumer.

• Consumers will want to interact anywhere at any time.

• They will want to do truly new things as disparate kinds of information (from financial accounts to data on physical activity) are deployed more effectively in ways that create value for them.

• They will expect all data stored about them to be targeted precisely to their needs or used to personalize what they experience.

• They will expect all interactions to be easy.

Source: McKinsey.com, “The coming era of ‘on‐demand’ marketing”, April 2013

The Healthcare Consumer - Amazon S3€¦ · The Healthcare Consumer: Meeting Today’s Needs,...

Documents

Transcript of The Healthcare Consumer - Amazon S3€¦ · The Healthcare Consumer: Meeting Today’s Needs,...