Patient No Longer: Why Healthcare Must Deliver the Care Experience That Consumers Want and Expect (Ache Management)

Through the Patient’s Eyes: Understanding and Promoting Patient-Centered Care

Chilling trend: A longer, deadlier pandemic

Delivering the care patients expect

• “Through the Patient’s Eyes,”  set the stage for a new, patient-centric paradigm in healthcare in 1993, and now “Patient No Longer” takes it a step further, challenging the healthcare world to look at patients as consumers.
• COVID-19 accelerated digital adoption and virtual care, expediting the consumerization of healthcare. 
• The following language shifts can influence how we perceive and deliver patient care.  They encourage us to increase outreach before, during, and after care.
  • Positioning → Brand
  • Patient Experience → Consumer Experience

Where digital efforts should fit in

• Leaning into increased demand for virtual care allows health systems to create a positive first impression and creating more business down the line if more acute conditions arise. 
• Health systems should weave digital efforts into the whole care experience rather than specific isolated moments. 

A different perspective on vaccine sentiments 

• Many surveys report a high percentage of respondents who oppose COVID-19 vaccination. NRC Health found in their recent study more optimistic findings — only 14% of respondents saying they will not get the vaccine. 
• Why the results are different: NRC Health offered a middle ground, “I’m going to wait and see,” which captured 25% of respondents. 
• It's important to design survey questions for neutrality and factor in the way people think, act, and feel. 

• Health workers, stuck in the snow, administer coronavirus vaccine to stranded drivers 
• Washington state hospital apologizes for prioritizing top donors for COVID-19 vaccine 
• Framing What We Do with a Noun or a Verb: Are we “___ing”? 
   

Need for speed

• COVID-19 has accelerated change, requiring health systems and their marketers to find new ways to move faster. Safety protocols and legacy processes can make it challenging to adapt to change.  
• Health systems can apply some agile marketing principles such as prioritization and iteration to serve COVID-19 demands but should be calculated in each iteration. 
• Because the stakes are so high for healthcare communications, each iteration must carefully balance exactness and speed, as each iteration could potentially reverse public trust.

Setting expectations for responsive branding

• Faster change means our brands need to evolve faster to remain relevant and avoid sounding out of touch. Continually test messaging to see what’s working and what’s not.  
• Health systems should consider diversity equity and inclusion as a central pillar of every branding conversation. Incident-based branding efforts can translate as insensitive and self-serving.  

On the horizon for healthcare marketers 

• COVID-19 has increased public demand for quality communications, and consumers will likely maintain these expectations in a post-COVID-19 world.  
• Informative, relevant, actionable content marketing will be an essential function for health system marketing and communications, and consumer expectations for quality content will rise.  
• Marketers may play a more strategic role in health systems because of familiarity with new technology and the ability to bring data to the table.  
• We will have to continue to act as technology educators as virtual care becomes more embedded in today’s healthcare system. 

The Principles for The No Normal Show  

Biden inheriting nonexistent coronavirus vaccine distribution plan and must start 'from scratch  

Live Updates: Biden Confronts a Confluence of Crises  

Vaccine distribution challenges

• With limited supply and visibility into future supply, health systems across the nation sit between a rock and a hard place when working to meet public demand.
• Widespread challenges include undefined priority groups, lack of protocol buy-in across the organization, and demands on health systems to "play cop" when adhering to vaccine protocol.
• Health systems are attempting to address these challenges by utilizing EMR databases and requiring PCP visits before vaccination, but these methods can exclude some populations.

Communications strategies to manage vaccine uncertainty

• Be transparent about your current supply, visibility into future supply, the number of administered vaccinations, uncertain waiting times, and your plan to educate the public readily available.
• Address how you plan to ensure equity in distribution. For instance, some health systems are partnering with community centers and faith-based organizations. 
• Health systems should adhere to "high-risk groups" defined by the CDC to avoid further fragmentation in vaccine communications.

The vaccine's impact on health equity

• Reports show African American populations are less likely to get vaccinated, and recent survey findings indicate that the problem isn't just access – it's identity.
• Industry leaders (predominantly white, male, middle-to-upper-class) took the vaccine to demonstrate faith in its effectiveness. The lack of diversity in these efforts creates an "us and them" dynamic, alienating populations who don't fall under the white, wealthy male umbrella.
• Health systems can address this gap by demonstrating successful vaccinations across different cultures and demographics.

• WHO infodemic management 50 actions tracker
• Johns Hopkins COVID-19 profiling by country
• The online competition between pro and anti-vaccination views

The Infordemic Landscape

• An infodemic is the widespread sharing of misinformation (false information spread accidentally) and disinformation (false information spread with an agenda) that makes COVID-19 interventions challenging.
• There is too much information on COVID-19, making it difficult for the general public to discern between factual and non-factual information.
• Frequent shifts in recommendations made by trusted leaders continue to damage the public’s trust in the information they receive.

Four tips for combatting misinformation

1. Get to know your audience by conducting surveys, performing social media analyses, and continue to refine how you listen to your audience based on your findings.
2. Distill science and research into a more understandable format to make information more approachable.
3. Build resilience to misinformation by educating the public on misinformation, how it spreads, and why it’s important to report.
4. Engage with local communities by working with religious leaders, employers, unions, chambers of commerce, and other trusted local groups to amplify good health information.

How social media affects the infodemic

• Social media can accelerate misinformation, therefore we must standardize how to respond to misinformation by analyzing how it is shared, how it jumps channels, and how interactions vary across channels.
• Around 67% of people identify providers as a trusted source of information while only 11% report social media as a trusted source.

• “The Fifth Risk” by Michael Lewis
   

Lay of the land as a New President Takes Seat

• Biden faces unusual constraints as he plans to enter office, including walking into multiple crises on day one: The COVID-19 pandemic will continue to get worse over the coming weeks, the U.S. is facing major economic issues, including a cybersecurity hack with details unknown by the government; continued racial injustice and concerns over global climate change.
• Despite the fact that Biden’s win is objectively decisive when compared to past presidents, one-third of the American population doesn’t believe that he won the 2021 election.
• Democrats theoretically have control of the Senate at this point.
• Although it’s in Biden’s best interest to move beyond the final events of Trump’s presidency without getting involved, this may be harder over the next 13 days as he finishes his term, and many discuss invoking the 25th Amendment.

New Key Players Enter Political Arena

• “Personnel is policy,” and the establishment figures that Biden nominates give insight into what we can expect from future policy

New Expectations for Healthcare Politics

• Biden will likely make moderate legislative proposals, and the more progressive proposals he makes will be done by executive action
• Under Trump, the healthcare industry faced issues such as Twitter attacks, inconsistent messages, and poorly designed executive orders; under Biden and his new Senate, appointments will elevate people already respected within the industry, we can expect to see more pressure and constraint on pharmaceutical companies and hospitals, and there will be a tighter focus on following proper procedures and providing consistent leadership

Biden’s Key Priorities

• Taming the COVID-19 pandemic through public health measures, vaccine distribution, and rebuilding public confidence
• Economic stimulus and folding other priorities –– infrastructure, climate, taxes –– into those efforts
• Strengthening the Affordable Care Act and in anticipation of a Supreme Court decision coming in the spring on whether or not it can be deemed unconstitutional based on a specific clause about taxes
• Restoring strength and security after a cybersecurity hack gives impetus to data privacy legislation
• Upcoming Healthcare Policy Highlights
• Continued debate over the Affordable Care Act, whether it is constitutional, and the impact on our healthcare system if the Supreme Court decision eliminates this insurance option for millions of Americans who are currently seeking care in the pandemic.
• Pharmaceutical marketing may be more at risk for taxation as the U.S. likely faces a $2 trillion deficit in 2021.
• Among other priorities, price transparency in hospitals doesn’t appear to be a high priority for Biden’s appointees.

• Mayo Clinic's Presentation Slides
• Five Long-Term Consumer Behavior Changes Due to COVID-19
   

Do We All Have an Equal Chance for Health? 

• How to Forecast the Future
• On an annual basis, Mayo Clinic looks for a collection of trends.
• Some trends are healthcare-related, and some are macro-related and are affecting every industry.
• They take the trends and predictions and determine how these impact their organization.

Five Forecasts for the Future

1. Accurate diagnosis, anytime, anywhere.
2. The patient will see you now – this means that we believe there will be a day when consumers will be much more in control of their health care, and providers will need to adapt to that.
3. Virtual visits will outpace physical interactions. Within two months of the pandemic, there were 2 billion virtual visits.
4. Today's reimbursement model becomes old school – Healthcare is one of the last industries to go through consumer transformation.
5. Research and education are game-changers.

Predictions from October 2019 into what 2030 Will Look Like 

• A massive increase in AI innovation.
• Cybersecurity from the standpoint of moving from attacks on individuals to attacks on hospitals and government entities.
• Big tech would not stay just in the realm of technology but will disrupt multiple different industries.
• Rise of consumerism – almost all consumers will feel a need to take control of their information.
• We're due for an economic downturn, and there will probably be two economic downturns over the next ten years.
• There will be job losses due to automation and technology implementations.
• Unaffordability is a big concern in healthcare.
• As they look at 2030, there will be a more significant increase in social division.

• ‘1619,’ a Podcast From The New York Times.
• Seeing White Podcast From Scene on Radio
• The Radical King book by Martin Luther Dr. King Jr.
• Stamped from the Beginning book by Ibram X. Kendi

Do We All Have an Equal Chance for Health? 

• Wealth, class, and zip code can define your health.
• For Norton Healthcare and its community, West Louisville is where the most disadvantaged population lives.
• Norton Healthcare had a mobile prevention unit that drove around the west area providing free services and one medical practice nearby.
• Having partners is very important in addressing racial injustice issues in healthcare. It will continue to take excellent partners to combat these issues.
• Some areas have been neglected for far too long and need our attention – this is not just happening in Lousiville, but all over the United States.

Impact of Systemic Racism on Health 

• Where there is a wealth gap, there is a health gap.
• Minorities continue to have higher rates of mortality and morbidity than white people.
• Black adults have a higher chance of diabetes, hypertension, and heart disease.
• Poverty affects housing, employment, education, food access, transportation, health services, and other social challenges.
• Norton Health utilizes community-based research and insights to identify needs and the appropriate action to serve their community best.
• Most health systems are not where they need to be with this issue – we need to be more open about where we’re at how we always strive to grow and move forward as an organization.

Five Health Imperatives 

1. Norton Healthcare Institute for Health Equity. 

• Founded on the belief that social class/zip code should not be the most likely determinant of health.
• Committed to removing barriers that prevent people from having the best health possible.
• New mobile units, points of care – improve access to care and establish care sites to manage chronic disease.
• Provide access to mental health resources.
• Committed to leading critical conversations focused on educating internally and the community.
• Dedicated to partnering with pipeline institutions to help identify/develop/increase the number of minorities in healthcare.

2. Ensure access to primary care for everyone. 

• Look at underserved areas and communities as well as underrepresented clinical providers.

3. Mirror the community within Norton Healthcare Leadership. 

• Redefine “leadership.”
• Evolve “officers and directors” quarterly meetings to a new “system leadership group.”

4. Help employees engage in matters of importance to the community. 

• Census, voting, community initiative support, etc.

5. Invest money to address needs in underserved areas.

• Foundation commitment to raise matching funds.
• Put these dollars towards initiatives that are helping underserved areas.

• A New Resource by ReviveHealth: Un-covered
• Why the “Missing Domino” Matters So Much
   

End of Year COVID-19 Updates 

• America is once again breaking the record for the highest number of COVID-19 cases within the last nine months.
• People think the vaccine is a "silver bullet," and therefore, are beginning to relax more knowing it is coming, but it's not the "silver" bullet, according to Sean.
• Some people reach a point where they care less about their own safety than they do about just not having to deal with it anymore.
• The Mask Up campaign lead by Cleveland Clinic has partnered with over 125 health systems to reinforce the civic responsibility that everybody should be masking up and social distancing.
• There is no "national plan," and every state is left to figure out a game plan, creating conflicting guidelines for consumers.

Why Marketing Governance Is Valuable 

• The idea of marketing governance is an active experiment – but has had a ton of value for our system in the last three years.
• There are questions about who needs to weigh in on things, and that's what marketing governance is built to do. Because the last thing you want to do is issue a new marketing campaign, unleash a new communication strategy, or change an entire website infrastructure, and have key leaders ask why they weren't consulted or informed.
• The idea is to take the organization's key leaders and put them in a room together once a month to discuss key marketing initiatives to get buy-in, guidance, and inform them of the upcoming activities for them to support.
• The meetings are productive, and at a minimum, it allows everyone to be informed and aware of what's going on in the marketing and communications world.

The Challenges of Marketing Governance During COVID-19

• COVID-19 became the number one priority for everyone, which meant the first few meeting during the pandemic's start went on pause.
• Eventually, this group could come back together and validate and approve a brand new internal communication effort for managers across the health system.

• Modern Healthcare Article: Insurers will owe massive MLR rebates next year, even if 2020 is normal
• Modern Healthcare Article: Michigan Blues partners with wellness center company
• The Changing Consumerism Landscape Webinar on November 18th at 12:00 PM CST
• The Value Crisis for Health Systems Webinar on November 19th at 12:00 PM CST
• The Case for a Post Health System Brand Webinar on November 20th at 12:00 PM CST
• 
  Key Takeaways

COVID-19 Predications 

• By the end of January, we could be seeing 2,000 to 2,500 deaths a day in the United States.
• There is a concern that the surge will continue to erode volumes in elective surgeries right so that preventative care elective procedures.
• Typically, providers see a surge in surgical volume in Q4, which seems extremely unlikely this year.
• Inpatient surgical procedures are down 18.6% from last year.

How the Election Will Impact the Hospital Industry

• The financial devastation that hospitals and health systems are facing will continue, even if theirs is a second stimulus package approved.
• Whether the new stimulus bills flow directly to hospitals or to consumers who then have money for discretionary spending ­– both of those will be helpful.
• But just like the first round of the CARES Act, the second bill will not be enough to close the financial gap for hospitals.
• Ultimately the message for marketers and hospital executives is like the saying about how “God helps those who help themselves”, and the stimulus is not going to save us from a terrible financial year.
• In the payor space, people are not going from commercial to uninsured; they’re going from retail to Medicaid.

Critical Areas Health Systems Need to be Thinking About 

• A new competition is that of the top of the funnel – i.e., CVS or Humana rolling out clinics, or even Walmart Health and Optum.
• The top of the funnel may not be high dollar services, but it has a tremendous influence on where those patients go for all of their other services.
• Hospitals have to be a lot better at engaging consumers by delivering care on their terms.
• Guiding principle: Offer quick services to people for something they need to do and removes barriers wherever possible.

Findings from a COVID-19 Vaccine Survey

• When it comes to determining if the COVID-19 vaccine is safe or not, consumers trust their doctors, health systems, and federal health officials more than anyone else.
• Hospitals will need to figure out if they require staff to get the vaccine before returning to work?
• Physicians must be involved in the system's external response to the COVID-19 vaccine and also their internal communications to increase adoption and credibility.
• Physicians and nurses agree that front-line healthcare workers should be the first to receive the COVID-19 vaccine when it becomes available. Still, most people said (68%) that they'd rather not be in the first wave.
• Doctors and nurses are just as hesitant – and for the same reasons as consumers.
• Consumers worry that the first approved vaccine won't be safe, that it won't be useful, and that politics have compromised the process. Health systems must find a way to cut through the noise and provide specific reasons for why it's safe to receive the vaccination.

Groups to Prepare Specific Messaging for

• Three specific groups were shown in the survey that you need to prepare specific messaging for when it comes to increasing the vaccines adoption:
  1. Adopters (yes, I will take the vaccine right away)
  2. Skeptics (no, I will wait)
  3. Rebels (no, I don't plan to get the vaccine ever)
• From an external standpoint, prioritize the skeptic's group, but from an internal perspective (like physicians), focus on the rebel group.
• There needs to be a specific communication plan for each group, especially within the health systems.
• Telling everyone to get a vaccine is not that simple – it's deeper than that; it is phycological. To evoke change, we need to understand what moves people and incorporate that into our messaging.