In the Know

Creating a 10x Better Digital Health Care Experience

03.23.2018 St. Joseph Hoag Health

Providence St. Joseph Health is transforming legacy approaches to health care by becoming ever more patient-focused and personalized through the use of technology. Aaron Martin, Providence St. Joseph Health’s chief digital officer, previously spent nearly 10 years as a leader at Amazon, and now he’s applying his consumer obsession lens of the world to health care. In this Q&A, Martin talks about the “10x better online health care experience” bet his Digital Innovation team is making to disrupt a staid industry and bring lower prices, greater choice and more convenience to consumers.

Q: Everyone is talking about disruptive innovation and the digital customer experience. Given your background with Amazon's model of personalized online experience, how does that retail model translate to health care? And in what ways does health care require a different approach?

A: First, let me explain Providence St. Joseph Health’s culture of innovation and this notion of innovation disruption, which essentially means that if we don’t try something new, someone else will. At our core, we believe caring for our patients’ health has to be simpler, especially for those who are poor and vulnerable. We’re committed to harnessing the power of digital technologies to better meet consumer health care needs wherever, however and whenever they want us to.

We know that consumers are paying more out of their pocket for health care through high-deductible coverage plans. So that naturally drives them to make health care decisions based not only on quality and reliability, but largely based on cost. From Amazon’s model, we’ve learned there are two things we need to build to create a personalized online experience with our patients:

First, we need to provide a transaction experience that’s 10X better online. We know we’ve got to make our digital transaction experience about 10 times better than the offline experience to entice our patients to interact with us online. It’s hard to change human behavior, especially if it’s only a marginally better experience. That means the digital experience has to be an order of magnitude better than offline to convince the typical person to try something new. Big innovations in the marketplace, like Lyft, Amazon or Google, created digital experiences that are orders of magnitude better versus the offline experience. Think about how you used to search for information before the internet and Google—it was labor intensive and you often had to go to a library and physically search through card catalogues. Google made it simpler. We’ve seen the same transformations with Lyft and Uber vs. hailing a cab. These innovative companies have all created a much better online transaction experience, and health care organizations must do the same.

Second, we needa compelling way to engage the customer, or in our case, our patients. Think of Starbucks … they have figured out ways to regularly engage me as a customer offline because I buy a coffee from them every single day. Their challenge is to make the mobile transaction experience even better, so now Starbucks entices me with ordering ahead to avoid lines. The problem we have in health care is we don’t currently have a “natural” daily engagement model since we typically only see a healthy patient two-and-a-half times per year and only when “something is wrong.” So, the second phase is creating a compelling reason for them to engage with us on an ongoing basis through a personalized health platform between episodes of care.

Q: Knowing those two areas are key, how has Providence St. Joseph Health begun to transform the online health care experience and build a dynamic online relationship with its patients?

A: An example of how we’re making the online experience 10 times better is the Express Care suite of services, which delivers care when, where, and how patients want it for non-emergency, low-acuity care. It provides easy-to-schedule drop-in clinics for low-level illnesses like fevers or urinary tract infections. Patients can also schedule a telehealth/virtual visit with a nurse from their smartphone, tablet or desktop, or can even digitally summon someone to their house, sort of like Lyft for health care.

A mix of Express Care services is available across our markets, and last year we had over 100,000 visits across the suite of services, with over 10,000 coming in as virtual visits. Net promoter scores, an indicator of customer satisfaction, for Express Care are in the high 60s for overall experience and in the high 80s for telehealth experience, putting the Express Care experience in the same league as major technology companies like Apple and Amazon.

This year we are upping the ante on simple as it relates to Express Care services. Taking learnings from the last year, we’ve got a team focused on improving the integration across our Express Care Retail, Virtual and At Home services. Previously, users had to sign-up for each individual service, and this is a clunky user experience. The integration investments we’re making will manifest in an easy-to-use mobile application that will use a single sign-in for users, thus making it simple for them to navigate across different convenience care options.

In terms of engaging with our patients between episodes of care, Providence St. Joseph Health has taken steps toward more frequent patient engagement across two platforms: Circle and Xealth.

Xealth is a company incubated within our digital team and spun out of Providence in June. Xealth allows clinicians to recommend anything non-pharmaceutical to a patient within their EMR workflow. Think digital content, articles and services. For example, there’s a health system in Wisconsin that’s prescribing Lyft rides using the platform for Medicaid patients to make sure they can make their appointments. Xealth is integrated to allow providers to easily prescribe through the electronic medical record (EMR), and to allow patients to easily access the information through their patient portal app.

Circle by Providence is our personalized pregnancy and parenting app that delivers relevant content, products, and services for women to help them manage their health and the health of their families. Circle focuses on building what is known as “the daily habit,” with women, who are often the “chief medical officer” of the family. We know women make 90 percent of health care decisions for the household, so we want to create a trusted relationship during pregnancy, throughout delivery and into the first few years of a child’s life. The app provides content, trackers, and to-do lists, while also offering an array of resources, including listings for classes and groups in our hospitals.

Q: How will Medicaid patients and other vulnerable populations benefit from the power of personalized care?

A: Helping those most in need has been at the forefront of our mind as we go through this digital transformation. A key area to think about is inconvenience in health care. The way that many health systems are set up today is inconvenient, and this inconvenience hurts the poor and vulnerable way more than those in middle or upper income.

Think about the single mom who has two young children and works an hourly job. If she or her child get sick and need to see a clinician, she has to take off work for a half a day, maybe find childcare, and either might not receive pay or could be putting her employment at risk completely. Receiving health care services has a huge impact on her economically in terms of lost wages, childcare costs, transportation, and the actual visit. With this in mind, my team is taking a lot of the same convenience offerings we built from a digital standpoint and thinking about how we modify and retool them to make easier for our Medicaid patients to use.

For instance, we know some communities where Medicaid patients use emergency rooms as their primary point of care. It makes sense if someone works during the day and can’t afford to take time off to see a primary care physician. They’re doing the perfectly rational thing.

We want to create a better health service offering for people in these circumstances, so we’re investigating and piloting programs focused on educating patients about how they can make an appointment online or schedule a home visit or an in-clinic visit close to their neighborhood. We’re also looking at where we can position some of these Express Care locations in Medicaid “hotspots” to make them more accessible to those most vulnerable.

The future of health care is ripe for disruption, and Martin’s Digital Innovation team is laser focused on being at the forefront of ushering in Health 2.0 where holistic solutions and convenience are central to the consumer experience.