5 guiding principles for consumer-driven ambulatory networks

When health system leaders are asked how they intend to make their ambulatory networks more consumer friendly, many point to their organization’s new one-stop ambulatory care center, on-line scheduling, patient portal or upcoming telehealth plans.

In other words, they refer to specific tactics or initiatives rather than describing an overarching strategy for consumer engagement.

When thinking about engagement, it is important to consider the full breadth of ambulatory consumers, including patients, but also employed and independent physicians who refer patients for care.

The innovations applied by niche and for-profit competitors — from store-front health clinics to online second opinion services — are transforming the ambulatory market, prompting consumers to expect a higher standard of care and service. To compete, health system leaders need to anticipate the needs of all stakeholder groups, including patients and physicians, and then design an ambulatory network to meet those needs.

Anticipating What Consumers Want
The following 5 principles provide a framework health system leaders can/should use to think creatively about consumer needs and desires:

1. Accessibility. While many ambulatory networks are taking steps to increase access, leaders need to think beyond just changing a policy or two. They need to embrace retail concepts of availability and convenience, and try to move as close to that vision as possible.

A comprehensive approach to improving access might include:
• Extend beyond the now common evening and weekend hours to provide same-day and walk-in appointments
• Offering virtual visits (e.g., FaceTime/Skype visits) for low-acuity issues
• Encouraging providers to communicate with patients via email, text, or phone about issues that do not require an office visit
• Offering on-site ancillary services (e.g., imaging, lab, pharmacy)
• Using intelligence from market analyses to pinpoint convenient care site locations

2. Innovative care models. While leaders need to be sensitive to various limitations and regulatory restrictions, they also need to empower staff to develop innovative care models that meet consumer-friendly goals.

For instance, organizations adopting team-based care are successfully addressing workload issues related to improving access. In these models, clinicians focus on “top-of-license” care. Complex patients are seen by physicians while lower-acuity cases are handled by advanced practice clinicians (i.e., nurse practitioners and physician assistants). Other team members, including case managers, social workers, psychologists, and nutritionists, (among others), assist with specific aspects of care. This multidisciplinary approach helps ensure that more patients can efficiently receive high-quality care.

3. Technology. As digital technologies become more ubiquitous, many consumers now reach for their smartphones to accomplish things they used to do manually or in person. In other words, technology can be a patient pleaser, particularly among younger patients, and is quickly becoming an expectation.

It is not enough to simply automate or digitize technologies. Tools need to:
• Provide easy access to patient health data
• Make direct interaction with a clinician more convenient
• Facilitate access to provider profile information (e.g., services provided, office hours, reviews)
• Allow comparative shopping and selection based on price, quality ratings, etc.

Offering a portal just to offer a portal will have limited success if patients cannot accomplish critical tasks, including registering, accessing lab results, or paying a bill from the device of their choice without any headaches.

Other technologies include wearable or home-based monitoring devices, such as digital scales and blood pressure monitors. These types of tools have the potential to help health systems manage the rising needs of Baby Boomers, and other seniors to manage chronic illnesses at home— but only if patients find them meaningful and simple to use.

4. Competitive pricing. With the growth of high-deductible health plans, consumers are becoming more price-sensitive. When healthcare shopping, more and more patients are asking whether a provider and/or location is in-network. To attract these patients, organizations need to focus on being included in insurance networks, including narrow networks, and becoming a preferred provider in tiered networks.

One way to win the favor of insurers, as well as patients paying out-of-pocket, is to lower costs (of physician and ancillary services such as imaging and laboratory tests), pricing below the market median, and making those prices readily available to consumers.

5. A service orientation. Exceptional customer service can be a differentiator. At a minimum, leaders should invest in staff training that emphasizes hospitality and customer service principles. Patients rightly expect to be treated with respect and kindness.

To further please patients, ambulatory networks implementing innovative ideas set them apart from the competition, such as:
• Money-back guarantees specific to service
• Information bars (computer kiosks and libraries) and free Wi-Fi
• Other amenities such as free food, drinks, and parking

Developing Consumer-Oriented Capabilities
Leaders need to assess their internal capabilities to determine if their teams have the skill sets, and bandwidth to successfully pursue these five consumer-oriented principles. In some cases, health systems may need to build or buy these capabilities. In other cases, partnering with others, including potential competitors, may be needed.

Meredith C. Inniger, MHA, Manager
Meredith brings years of experience in both healthcare consulting and healthcare operations to her work with Veralon clients. She has worked with academic medical centers, large community health systems, and independent hospitals. Her work focuses on ambulatory care development, strategic planning, and mergers and affiliations, and the development of clinically integrated networks.

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