The millenification of healthcare: 4 ways the millennial workforce is shaping the industry's future

Medical school training is incredibly important, not only because it molds the future healthcare workforce, but also because it can also provide a blueprint for where the industry is headed.

For Salt Lake City-based University of Utah Health Care, training the next generation of physicians is particularly integral to its mission, according to Vivian Lee, MD, PhD, CEO of the University of Utah Health Care, dean of the University of Utah School of Medicine and senior vice president for the University of Utah Health Sciences.

That's because University of Utah Health Care is the only academic medical in the state and one that accounts for a region spanning 10 percent of the geographical U.S., Dr. Lee said in a keynote address at the 12th Annual AAMC Health Workforce Research Conference in Chicago. Roughly two-thirds of the physicians practicing in the state got their training at U of U, making that question — how do we train our workforce to prepare us for the future — all the more salient.

"One of the most important values or principles we want our trainees to emerge with… is a very strong sense of how to deliver value," Dr. Lee said. University of Utah describes value as delivering the highest possible level of health at the lowest possible cost.

To drive this mantra home among today's trainees, who are mostly millennials, it is helpful to put yourself in their mindset, Dr. Lee said. This mindset is different than her own and that of many of her executive peers, she acknowledged. After all, when she asked her trainees, she found most thought Facebook founder Mark Zuckerberg was old.  

At the core of the millennial mindset are values of transparency, patient-centeredness and data-driven approaches to problem solving, according to Dr. Lee. As such, in teaching value-based care, medical educators need to think about it in terms of value to the patient, or even better, value to the consumer.

Drawing these values of consumerism, transparency and data into healthcare is what Dr. Lee calls "millenification." Channeling this mindset she outlined four companies that have captured the millennial spirit and can help provide direction for the industry in general.

1. Yelp-ification
Popular consumer review website Yelp embodies the millennial value of crowd-sourced customer feedback. U of U took this mindset to heart, launching a journey in 2008 that led to online star reviews of physicians by 2012. It was started by Dr. Lee's predecessor, Lorris Betz, MD, PhD, who felt the health system needed to launch an exceptional patient experience initiative because "medical care can only truly be great if the patient thinks it is."

U of U began collecting physician-specific data in 2008 benchmarked against the Press Ganey database. It then started sharing it privately with physicians and slowly ramped up transparency until its online launch in 2012, which has inspired many other institutions around the country to follow suit, Dr. Lee said.

2. Delta-ification
Delta Air Lines embodies the value of convenience by providing customers with an app to buy tickets, check in, download boarding passes, etc. In the spirit of Delta-ification, U of U wanted to make it easier for patients to make appointments — allowing them to schedule online or use its Epic MyChart for test results, physician communication and prescription refills.

"It's really not that impressive when you consider how the rest of life is, but for us it was really transformational," Dr. Lee said.

3. Zappos-ification
Online retailer Zappos has an infallible commitment to customer service and can serve as an example to many healthcare organizations that need to think about how to deliver a better patient experience, according to Dr. Lee.

In this vein, she cited three examples from one of her system's outpatient clinics. The first was in-clinic child care for parents who can't leave small children at home during their own physician appointments. The second was in-home newborn visits or well-child checks. This allows parents to keep their one- and two-week old babies out of the physician's office waiting room, which is full of kids with pink eye and runny noses, Dr. Lee said. It also allows providers to asses the child's home environment. The last example she gave that tailored care to the customer was U of U's same-day multi-disciplinary visits, which were originally designed for women but have since been extended to men, and cover annual labs, check-ups and skin checks.

4. FitBit-ification
The beauty of FitBit is it provides data back to the consumer, allowing them to improve and also providing a little bit of competition. According to Dr. Lee, U of U took FitBit-ification beyond feeding data back to patients and brought it to providers.

Based on what the system learned from its patient satisfaction transparency initiative, it saw providers were really responsive to seeing their progress compared to their peers. So in thinking more broadly about value, the patient satisfaction initiative led the system to provide physicians with data not only on patient satisfaction, but with data from the entire value equation, Dr. Lee said. U of U created a tool that can spell out the total cost of care for every component of every patient stay. Its surgeons were particularly fond of the idea and now have a special dashboard that shows them their supply costs, and they have gotten competitive with each other to drive these costs down.

To bring residents on this journey, Dr. Lee said it offers a portal entirely dedicated to process improvement, with videos and a platform to launch their own data-driven improvement projects. It has been incredibly successful with 61 training projects so far. Most are aligned with systemwide goals, but some are more personal, according to Dr. Lee. And that's fine with her — driving change is not a top-down effort, she said.

"Will we transform the workforce, or really will the workforce transform us?" Dr. Lee asked. "And to what extent is it our job to allow them to lead us through this very difficult time period of change?"


More articles on integration and physician issues:

2,000 physicians get behind Bernie Sanders' single payer health plan
$150M deficit at UC Berkeley could shutter primary care program
Medical school enrollment up 25%

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