Healthcare Transformation Will Fail If Personalization Is Not Respected

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Healthcare Transformation Will Fail If Personalization Is Not Respected


This is a collection of additional insights from industry leaders to Part 7 of an eight-part series featuring conversations from the Leadership in the Age of Personalization Summit.

Who knew the Monarchy could teach us so much?

For those of you who have been watching The Crown on Netflix, it teaches us how the Monarchy of the United Kingdom was almost dethroned until it eventually learned how to find its right balance between standardization and personalization as generational, societal and social needs changed. The Crown is a perfect depiction of the current philosophical and strategic challenges that corporations and their leaders are faced with and frequently questioning. For example: 

  • Do we focus on the current legacy of our brand(s) and our organization’s traditional approaches to how we operate and grow? (Standardization)
  • Do we start paying attention to the opinions of our employees and customers that have grown frustrated with our leaders in the workplace and brand(s) in the marketplace? (Personalization)
  • Do we begin to place a strategic bet in support of the new generational, societal and social realities that have not been taken seriously enough as we consider the ways we work during these times of rapid change and transformation? (Personalization)

The Crown should be mandatory viewing for leaders across all industries – but especially healthcare.  

Healthcare is in the process of shifting its entire financial model from volume (fee for service) to value (quality of care). But that shift cannot be achieved without each provider finding its right balance between standardization and personalization. 

Healthcare providers and leaders have been stuck in the standardization traps for years. In their defense, there are plenty of reasons why: government regulations and politics, exclusive workplace cultures, reimbursement models, cottage industry mentality, outdated leadership methods, etc. Those factors have forced executives to lead and operate in ways that have not always placed the individuality of patients (let alone employees) – at the center of their growth strategies. 

The strategy that will enable all other strategies is this: embracing a personalization mindset and operationalizing it across the enterprise. Without this mindset, reaching value will be impossible. And this value must not only relate to patients, but to their employees.

How will a personalization mindset immediately benefit healthcare providers? Here are a few: 

  • It will help organizations become patient-centered, something they’ve been talking about for years. The narrative around patient-centricity will no longer be just aspirational words, but rather lifesaving realities.
  • It will help organizations attract talent from outside the industry, bringing in much-needed outside perspective and innovative thinking.
  • It will help organizations get out in front of and ready for the Cultural Demographic Shift (CDS). Operationalizing personalization in healthcare is not only about how to deliver value-based care to populations that are susceptible to chronic disease states. It’s also about how providers invest in serving the younger, more culturally diverse generations whose parents haven’t historically felt welcomed into the healthcare industry. 

The industry and its patient populations can no longer rely on slow, incremental improvements. 

The bottom line is that millions of lives are at stake and we can’t allow standardization to get in the way of accelerating progress. The healthcare industry must learn to respect and operationalize personalization quickly – not only for the reasons stated – but also because all employers (large and small) are in now in the business of health

Where healthcare goes with personalization – so does American enterprise. Healthcare is in prime position to make personalization strategies the de facto reality throughout an enterprise.

Perhaps we are beginning to understand the severity of the issues at hand. 

In the spirit of respecting a personalization mindset, the following is a series of insights from leaders across industries upon their reflections from the perspectives shared from Part 7, Healthcare CEOs Address The Age Of Personalization With New Methods For Care Delivery.

Tom Jackiewicz: CEO, Keck Medicine of USC

Scaling Personalization to Provide Greater Satisfaction, Outcomes and Efficiencies

We’re in the midst of disrupting one of the most foundational aspects of medicine: the doctor-patient relationship. It’s hard to imagine something more personalized than this one-to-one interaction, but the surprising thing is that, if we get this right, patients will receive more personalized care, not less. Satisfaction, outcomes and efficiencies will all improve.

At Keck Medicine of USC, we’ve made tremendous strides in personalizing the pre-surgical experience through our pre-op clinic. Well in advance of surgery, each patient meets with a nurse practitioner who prepares them for surgery with a specific plan of action – from losing weight to changing medications to more effective pain management. Patients have better outcomes; we avoid last-minute cancellations, which results in more OR availability; and patients are discharged sooner with fewer complications.

However, it’s the outpatient ambulatory setting, where 97 percent of our patient interactions take place, that we are planning our biggest impact. Technology will be the quarterback, doing an initial screening to determine who can best serve the patient and how that interaction will take place. This is both a necessity, due to the physician shortage, and an opportunity, to take advantage of specialized care providers and new ways of connecting.

In the future, more patients will have virtual appointments, and it may not even be with a human. One study conducted at USC showed that physical therapy patients preferred an avatar over an in-home or outpatient clinic visit, and the results were excellent. 

At the other extreme, house calls may make a comeback as physicians are freed up to go where and when they are most needed.

For 100 years the standard of medical care has been patients seeing doctors in clinics. It’s time that patients got what they need from who can best provide it with more convenience, just as much care and even greater clinical efficacy.

Annette M. Walker: President, City of Hope Orange County

Engage and Emotionally Connect People to the Mission: Allow Them to Influence Outcomes 

Part 7 brought to mind many challenges facing our industry. No matter where you are or in what part of healthcare you serve, it is clear that in such a volatile environment, tactics and strategies change constantly. However, all successful organizations need an overriding, timeless strategy that engages and emotionally connects people to their missions. 

This emotional attachment is deeply connected to the purpose of the work and is as individual as the person performing it. Maya Angelou once said, “When someone shows you who they are, believe them the first time.” Our workforce is asking us to care about who they are – to see them as unique people, to understand them and to respect their inherent gifts and dignity. They are not asking us to manage them, but to create an environment that helps fulfill their own destinies and gives them the autonomy to advance our organizational missions in their own way.

Jack Cox, MD MMM

Focus on What Matters to the Patient

Personalization in healthcare delivery, as discussed by the knowledgeable panel of experts featured in part 7 (Tom Jackiewicz, Mark Laret, Victor Crawford), is essential for the health and wellbeing of our caregivers and as we move from volume to value financial models. Perhaps even more critical is the role personalization will play in the financial sustainability of healthcare.

Recent data from Modern Healthcare showed that healthcare costs in 2018 hit $3.6 trillion, 17.7% of the gross domestic product, a spending growth rate of 4.6%.* At this rate, the cost of healthcare will hit 19.4% of the GDP by 2027. We know that 50% of the CMS healthcare dollars are spent by the sickest 5% of beneficiaries. This level of healthcare spend is not sustainable.

When patients are asked what matters to them and thoroughly understand the options and potential outcomes, most opt for less healthcare rather than more. Our conundrum, as was mentioned, is the current payment systems reward doing more, not necessarily what is best from the patient’s perspective. Imagine how much healthcare costs could be used for health and wellbeing if the focus was on personalization of a patient’s wishes. Imagine how much better off our caregivers would be knowing they were working toward that personalized care.

*from Growth in medical prices inched healthcare spending higher in 2018, Modern Healthcare, Vol 49, No 47, December 9, 2019. PP 12-13.

Tim Alba, Partner: Caldwell Butler and Associates

“Do you see me, Do you know me?”

I am struck by a common thread from Part 7 that validates the questions posed in the book, “Leadership in the Age of Personalization”: “Do you see me, do you know me?”

Perhaps we need to start looking at the changes that our employees are making on the front line, at the moment of truth with the customer.

Corporatization of the provider segment through mergers and acquisitions has resulted in attempts to standardize processes. But Healthcare is still mostly a cottage industry, especially in terms of care delivery. The corporate office often loses sight of the personalization of the local provider as much as companies lose sight of the need of personalization needed for employees and customers.

We know we live in a changing world and we know the facts on population changes. In the age of personalization maybe the most important is “how many changes did you make this month?” Many top-performing organizations track the number of changes made by front-line leaders and staff, and include this information on organizational and executive dashboards. Change at the front line – changes that integrate corporate resources, data, tools and expertise – is one method to solve for staff and customer needs and recognize each as individuals. 

Clinicians are very good at personalizing the care of a patient based on the patient’s unique history and health status. Perhaps the organizations for these clinicians can follow suit and similarly develop solutions that are based on the employee’s and customer’s needs.

Josh Connors: Senior Director, Asset Analytics & Insights at CVS Health

Courage is the Key in Creating Cultures that Honor Today’s Age of Personalization

Aspects of what was discussed in Part 7 will touch different people in different ways. 

Excerpts from Dr. Tom Mihaljevic and Tom Jackiewicz distinctly demonstrated courage in the age of personalization. Leaders often underestimate the weight their titles hold and the significance of the doors they sit behind. When we understand these facts, leaders like Mihaljevic take simple yet significant steps such as removing titles from doors; and they allow people to be distinguished based on their character. This adds a tangibly human element and is emblematic of creating an inclusive culture.

The Enhanced Recovery After Surgery program mentioned by Jackiewicz shows how getting to know patients as people can have amazing outcomes. And, even when challenged with the boundaries of standardization looming, Jackiewicz knew that it was right to push forward with those willing, who happened to be younger and more open-minded. This will certainly foster a sustainable circular trust for this team.

Both examples show something all leaders have within their power – the ability and obligation to build a culture. Mihaljevic and Jackiewicz created individualized cultures within the historically standardized healthcare industry. A difficult task, but as the article states, culture can be taught.

Shabnam Vaziri-Sadri: Organization & Talent Development Director at Equity Residential

Embrace New Methods that Balance the Polarity between Standardization and Personalization

The new methods discussed for healthcare delivery could also be considered in the context of learning delivery. Our education system has long suffered from standardization. Every year, the standardized testing opens all doors to some, forces the majority to pursue a generic college education, and eliminates the chances of attending college for many intelligent students who don’t do well with tests. The standardized approach does not accommodate diversity in learning styles, and it goes against multiple intelligences. As a result, every year, a number of disillusioned students, fail standards and drop out of school.

Recently, a poignantly bitter outcome of the standardized approach revealed itself in a wave of corruption that was discovered putting college admission practices on trial. While the intention behind standardization might have been fairness, its results point to the opposite. Today, the effectiveness, credibility and fairness of the standardized education system are being questioned. Consequently, there is a rise in resentment toward traditional schooling, which is amplified by voices championing a more personalized experiential learning. Once again, we have a polarity to manage, and an opportunity to seek a happy medium.

Walter Fawcett: Director of Strategic Engagements at Arbela Technologies

The Tech Industry Gives us a Model for Making Big Changes

Forty years ago, leading companies were making long-term investments in mainframe-based computing technology. The projects were long and highly structured, and the systems were single vendor, hard to use, inflexible and single purpose. These systems were at the center of the standardized workplace.

Fast forward to the introduction of the personal computer. This innovation brought new concepts to the workplace. Systems became multi-vendor, multi-purpose, easier to use and much easier to personalize. At the same time Moore’s Law drove the logarithmic acceleration of technology change (i.e. computing power doubles every two years).

So how did the technology profession adapt? At the core was a change in methodology. 

In the old days, most projects used the “Waterfall” methodology which is characterized by very heavy upfront analysis and documentation followed by a highly structured, inflexible project plan. At one time this was fine, because the rate of change was slow. And today, this methodology still works well for some types of project like building a bridge or a skyscraper. 

But today in a systems implementation, things change so fast that if you spend six months doing analysis and design and then 18 months building the technology, the entire market will have moved before you are done, and the underlying technology will be 1-2 generations behind by the time you go live.

To address this situation, a new approach was developed, called Agile, which flipped system development on its head. Rather than creating structured project plans, Agile focuses on constant re-planning, self-reflection and continual improvement in short time cycles using the company’s objectives, core strategies and current conditions as guide.

Waterfall versus Agile is very much like standardization versus personalization. Waterfall is easier. Agile requires strong communication and understanding in cross functional teams; and it requires adaptability.

So how might Agile be applied to a common business problem? Think about employee reviews. The Waterfall approach would have a job description and an annual review. An Agile approach would be a set of objectives based on the contribution of the employee. The contribution would have a scoreboard that the employee and manager could look at daily and review in short time cycles (monthly). If business conditions change, so do the contribution measures. This creates engagement and adaptability, and demands that employee and manager are closely aligned on contribution measures.

The new approach is guaranteed to be uncomfortable, but if you stick with it, your company will be more effective, agile and competitive; and your employees will be more engaged because they too will see the results (“A Players” love a scoreboard because they love winning).

As you reflect upon ways your organization can adopt a personalization mindset, ask yourself, your team, and your organization the following questions:

  • Where do you see outdated standards in your industry and/or area of functional expertise now being influenced by personalization? What do you believe are the most evident areas of opportunity?
  • Why do organizations continuously find themselves stuck in the traps of standardization? Why are leaders having difficulty respecting the need to embrace today’s age of personalization? Why do you believe this is a vicious cycle? How can organizations and their leaders start to find the right balance between standardization and personalization?

As you all explore and address these questions – you’ll see what others don’t, do what others won’t, and keep pushing when prudence says quit.



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