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How the CEO at Curative Accelerates Growth by Meeting Consumers’ Needs

Unlock. Create. Execute: A conversation about uncovering growth by delivering better health outcomes.

Growth is rarely easy – specifically, growth driven by customer interest and market demand rather than the temporary variety driven by acquisition, cost takeout or organizational restructuring.

Because markets are moving faster than ever, we believe sustainable growth results from:

  • Unlocking compelling customer insights to inform growth strategies
  • Creating relevant, impactful growth moves
  • Executing faster and more efficiently

Through this series of interviews with healthcare leaders, we explore the driving insights, key actions and anticipated impact of their recent growth strategies.

In this edition, we sit down with Fred Turner, chief executive officer and co-founder of Curative, to learn more about his unique vision and approach to driving change in the insurance industry.


Curative is a groundbreaking healthcare services company that created and launched the first-of-its-kind employer-based health insurance plan. Founded in 2020, Curative reengineered health insurance by providing unmatched simplicity, enhanced engagement and cost transparency with a competitive monthly premium and zero additional costs. Curative is all about building the next generation of large employer health insurance – focused on preventative health and removing barriers to care.

Fred Turner is the CEO and co-founder of Curative. Under his leadership, Curative has shifted from the leading COVID-19 testing provider to an innovator in health insurance, offering plans with no copays, no deductibles and no cost-sharing for in-network care (with the completion of a baseline visit). This model has achieved a 94% member engagement rate, far surpassing industry standards. Turner’s vision is to create a healthcare system that supports holistic patient health.


What Is the Major Unlock That Informed Your Approach and Strategy for Curative?

When Curative was founded in January 2020, we initially focused on improving sepsis outcomes but quickly pivoted to supporting COVID diagnostic testing. That work exposed us to two key learnings: one, we touched every type of payer and health plan and saw cracks in the system, and two, we learned that consumers have serious fear and anxiety when it comes to healthcare expenses. That fear may prevent them from getting care, for example a COVID test, even when COVID tests are fully covered. We knew we wanted to do something that would move the needle on U.S. healthcare, something that could drive meaningful change in the system.

“Our experience during COVID made us say, the payer dynamic is a real problem with the U.S. healthcare system, and we could build a payer that can drive preventative care and better long-term outcomes.”

We saw the untapped space, where there hasn’t been innovation for decades, as the employer market, which is where 50% of Americans get their health insurance. The U.S. has run a natural experiment over the past 10 to 15 years with High Deductible Health Plans. Fifteen years ago, about 10% of plans met the American Care Act (ACA) definition of high deductible. Today, we’re closer to 60%. Did it work? The answer is a resounding no. Consumers aren’t great at price shopping, and people don’t make rational decisions, particularly when it comes to emotional subjects such as health and their finances.

“The other substantial effect when patient cost sharing goes up is the deferral of care.”

The National Bureau of Economic Research ran a study that followed a group who moved from a low deductible to a high deductible plan over three years. In the first year, you see about a 12% reduction in spending, which looks great – like we reduced healthcare spend. The problem is when you dig into what is happening, you see people putting off primary care visits, checkups and screening tests – even though in the plan design, certain preventative screening tests, like colonoscopies, were covered at $0 out-of-pocket cost. The care that gets put off is lower acuity preventative care.

“If you have a heart attack, you’re still going to go to the hospital, no matter what your deductible is. What the high deductible plan does do is prevent you from getting the checkup that might have avoided that hospitalization.”

How Did That Insight Help You to Create the Curative Platform in a Relevant, Differentiated Way?

We’re trying to approach preventative care differently in terms of the value that we assigned to it. The typical way that an insurance plan looks at loss, or medical loss right now, is every dollar spent as $1. Whether you spend $1 on preventive care or you spend $1 in the hospital, it’s still just $1. The way that we look at it is that dollar spent on a preventative visit could avoid inpatient stays, emergency room visits or specialty drug use.

“Preventative care that keeps people well is a dollar significantly better spent than a dollar on a preventable hospital stay.”

We’re committed to making an investment upfront, to getting people engaged in their care early and then seeing that payoff downstream with lower ER, hospital or specialty drug use. Most employers get stuck in this cycle of deferred care, where the population’s health is decreasing and costs continue to go up. Curative flips the script. We make it easy for people to engage upfront. The cost sharing is zero, so there are zero out-of-pocket costs, no copays and no deductibles to go and access care – as long as you engage in a preventative health visit within the first 120 days of signing up for the plan.

“If you want people to engage with care, you have to make it really simple.”

And the only way to make it simple enough that people really understand the cost to them is to make it zeros across the board. That’s the fear that any engagement in care is bad because I might get a bill for it – that’s what we have to fight. We think the only way to reset people to see a doctor if they’re sick or in a preventive manner to avoid becoming sick is to build trust that those actions won’t cost them a dime. Our philosophy, the long game, is that we will have a higher spend in the first year because people will get the care that they need. But in the second year, we’ll get back to baseline and, by the third year, we’ll actually be saving money because this population will be healthier.

How Are You Proving That Curative Can Execute Results That Employers Are Looking For?

We’re still in the process of building trust with members and employers, but the engagement piece via a preventative visit is key. We get an hour of the member’s time to do two things: one, we aim to educate them about accessing their care through a Care Navigator session. How do they make appointments? What is a deductible? What’s a copay? How do you figure out what doctors are in-network? When should you go to the ER?

“We’re demonstrating that we want them to access the care they need versus an adversarial relationship that members often have with their health plan that doesn’t want to cover what they need.”

That kicks off the relationship in a fundamentally different way and drives a higher degree of engagement. Two, members then meet with a clinician who is looking for gaps in care. If we see a pre-diabetic patient, we want to get them to a primary care physician who’s going to manage their pre-diabetes or even reverse it, rather than letting that continue to full-on type two diabetes, where, if unmanaged, could lead to major health complications that result in tremendous expense – that’s bad for the member and for the health plan. In the longer term, we expect to be able to keep rates closer to flat by managing this care over time, rather than the typical 10% increases you’re going to get from BUCA carrier every year. We’re new to the space and want to make sure that we’re here for the long term.

“It may sometimes seem like moving the boulder of the American healthcare system is impossible, but I think with a lot of dedicated, smart people chipping away at it, piece by piece, we really can make substantial change.”


FINAL THOUGHTS

Growth has become more challenging to generate and sustain driven by customer interest and market demand. Even top performers can no longer rely on their past strategies to achieve the next phase of growth. Beyond well-known barriers like tech-driven disruption and fickle customers, less tangible factors such as lack of executive clarity and short-term thinking pose significant threats. Sustainable growth now depends on unlocking compelling customer insights, identifying impactful growth moves and executing strategies quickly and efficiently. Ready to accelerate your growth? Schedule a workshop.

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How the CEO at Northwell Direct Accelerates Growth with a Clinician-First Approach

Unlock. Create. Execute: A conversation about uncovering growth by disrupting traditional models.

Growth is rarely easy – specifically, growth driven by customer interest and market demand rather than the temporary variety driven by acquisition, cost takeout or organizational restructuring.

Because markets are moving faster than ever, we believe sustainable growth results from:

  • Unlocking compelling customer insights to inform growth strategies
  • Creating relevant, impactful growth moves
  • Executing faster and more efficiently

Through this series of interviews with healthcare leaders, we explore the driving insights, key actions and anticipated impact of their recent growth strategies.

In this edition, we sit down with Nick Stefanizzi, chief executive officer at Northwell Direct, to learn more about the company’s origin and philosophy around growing its integrated care network.


Northwell Direct is a subsidiary of Northwell Health, one of the largest healthcare providers in New York. Established in 2020, Northwell Direct offers a direct-to-employer health care network of more than 31,000 providers and customized wellness programs to support employee health. This allows employers to offer high-quality healthcare to their employees without going through traditional insurance companies. Northwell Health utilizes Northwell Direct’s provider network for its own employee health benefits, ensuring comprehensive and cost-effective care for its workforce.

Nick Stefanizzi is the CEO of Northwell Direct, where he is responsible for the strategy, operations, growth and financial performance of Northwell Health’s direct-to-employer organization. Stefanizzi has been with Northwell Health for 16 years, serving in various roles, including assistant vice president for HR innovation and organization effectiveness as well as director of management services for Northwell’s ambulatory network.


What Is the Major Unlock That Informed Your Approach and Strategy for Northwell Direct?

Northwell Health had its own insurance company (Care Connect) that was incredibly successful – but we were not prepared for risk adjustment, so that business venture shuttered in 2018. While that was challenging, what wasn’t lost was our belief that playing in that space was the right approach. At the same time, our organization started to grow. We’re the largest private employer in the state of New York, in addition to being the largest healthcare provider. Organically, we started to get inbound inquiries from employers saying, we’re having these kinds of challenges in our employee plan – can you help us figure this out as both an employer and a provider? We saw that we had an opportunity to do something different for the communities we serve. That was really the genesis of Northwell Direct. We then built a business around that concept, not only to meet employer needs but to disrupt the payer space.

“It’s our belief that a more direct relationship between those who provide the care and those who pay for the care is beneficial, and that today, payers have inserted themselves between those two entities.”

There’s still a role for the major carriers to play, but they don’t need to sit between us, and in fact, by working together with the employers and their employees, it’s our belief that we can better manage care and drive improvements in quality and outcomes.

We only work with self-funded employers in their benefit design. In New York state, that means more than 100 employees, and we don’t carry any financial risk, as we do not offer an insurance product. We’re on the hook for performance. Our focus is on delivering value, savings, efficiency and outcomes for our employers. The other thing we didn’t do was invest in building an insurance company. There are third-party administrators that have the capabilities needed to support an employer-sponsored plan, so why not partner instead of building it ourselves and going at it alone?

“We saw a business model that was ripe for disruption and employers who were hungry for support, grappling with the challenges they’ve had with their employee population and desperate to arrest a trend that had been moving in the wrong direction for over a decade.”

We saw an opportunity to build the platform differently with partners.

In Addition to Opening a New Line of Business, What Impact Did Northwell Direct Create for Your Key Audiences?

We’ve made a concerted effort to remove the traditional denials and hurdles in this space that don’t add value or drive for the member or material savings for the employer. While we can accommodate any benefit design requirements, we have examples of clients for whom, if their employees receive care within our tier one network, there are zero prior authorizations needed. And it doesn’t lead to higher costs. There is no statistical difference in unnecessary utilization or unnecessary testing.

“We take a clinical-first approach – what does the doctor believe is necessary?”

We trust that we have providers who are going to do the right thing by the patient and by the plan, and then manage the care intensely to make sure it’s as efficient as possible. It’s about administering consistently with the benefits plan but providing clinically oriented insights into how that benefit design can be enhanced to drive the right patient behaviors and the right patient choice of the highest quality, lowest-cost providers, and then wrapping the member with support that is integrated with and endorsed by the clinician. By taking a provider-oriented approach, our engagement levels are much higher. We’re able to share the care management information back with the provider so they can take a more holistic view. And lastly, what we can do locally that the national carriers can’t is get on the ground. If we have a member who is admitted, we will send a nurse care manager to their bedside to coordinate their follow-up care, their appointments and make sure they’re clear on what happens post-discharge. You can’t do that from a contact center across the country.

“Clinical-first, integrated care management, boots on the ground and a structural approach that is different in terms of our philosophy around denials versus provider enablement – that’s what we’re doing, and it’s fundamentally different from how carriers think about this.”

How Challenging Was It to Get the Business Running, and How Will You Execute Your Growth Future Plans?

It’s hard for health systems to get into this business because it takes investment, and health systems are struggling financially. They are under enormous pressure, there are a lot of competing priorities, and it takes a lot to stand up a new venture like this.

“You cannot do this by having somebody do it off the side of their desk.”

You have to build competency and capabilities. For example, we brought in people with skill sets that traditionally don’t exist within the health system. We’re selling an incredibly complex product in the insurance space, even though we’re not an insurance company. I have licensed brokers that work for me – that skill set and those broker relationships don’t exist in health systems. You have to invest in building the appropriate infrastructure. You need talent that doesn’t necessarily exist from within the organization, and you have to build capabilities. But you don’t need to do it all. Just pick one thing that an employer might need or have a conversation with a major employer in your region and ask what they would want help with and start there. Yes, there are competing priorities, competing investments and a tremendous amount of pressure, but I believe this strategy in the long term will alleviate those pressures.

In the next five years, we will expand the field of play and be a major regional player. There’s an opportunity to grow our network and the geographic footprint of employers we serve. In addition to that growth, we’re diversifying the ways in which we partner with employers. That means new products and services. That means rolling out digital platforms to augment our clinical capabilities. That means partnering differently, even within the insurance space. We’re going to roll out our own bundles and centers of excellence.

“I believe, fundamentally, there is a national opportunity here for health systems to partner together and for us to take the work we’re doing here, to line it up with the work that Baylor is doing in Texas, what Orlando Health is doing in Florida, what Providence is doing up in Washington and California, and for us to figure out how to stitch something together that would allow us to scale nationally.”

That’s a very complicated proposition. I don’t know exactly yet how it will come together, but I believe there are enough health systems that see this as an interesting space and that there’s opportunity for us over time to figure out how to make that possible together.


FINAL THOUGHTS

Driven by customer interest and market demand, growth has become even more challenging to generate and sustain. Even top performers can no longer rely on their past strategies to achieve the next phase of growth. Beyond well-known barriers like tech-driven disruption and fickle customers, less tangible factors such as lack of executive clarity and short-term thinking pose significant threats. Sustainable growth now depends on unlocking compelling customer insights, identifying impactful growth moves and executing strategies quickly and efficiently.

Ready to accelerate your growth? Schedule a workshop.

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Transforming Healthcare: Advocate Health’s Shift to Platforms 

In Conversation: Exploring the Journey of Building Momentum and Implementing a Platform in a Health System

Jeff Gourdji, Senior Partner at Prophet, spoke with a number of healthcare leaders to learn more about the challenges and opportunities for platform thinking in healthcare. Here, he speaks with Jamey Shiels, SVP Consumer & Digital Experience at Advocate Health, on the process of driving momentum for and implementing a platform in a health system. 

Deploying a platform approach will be crucial for businesses to thrive going forward. As our colleagues Ted Moser, Charlotte Bloom, and Omar Akhtar observe in their book, “Winning Through Platforms: How to Succeed When Every Competitor Has One” platforms illuminate parts of the customer journey that have historically been dark by enabling companies to have a better, holistic understanding of how customers engage with the organization. In the last decade or so, health systems have begun to observe customers during the “choose” part of the journey, but platforms could enable health systems to understand the “use” part of the journey and how to personalize it to consumers.     

In this illuminating interview with Jamey Shiels of Advocate Health, he shares how he overcame the barriers to building a platform – from driving organizational buy-in to clearly defining a set of metrics to measure key experiences. He highlights how a clear connection between patient needs and business requirements was key to demonstrating potential impact and showcasing the value for a health system in adapting a platform approach. 

What enabled you to align the leadership that platforms were the right move for the business? 

First, our Chief Marketing Officer at the time, Kelly Jo Golson, made [the LiveWell platform] a priority for our brand marketing and experience teams. She determined we were going to be a consumer first organization and platforms were the way to get there. She was able to onboard senior leadership to that vision and align support across the enterprise. 

Second, we built a consumer-first executive committee that allowed us to bring [together] all the key stakeholders that knew we were going to need — Operations, Medical Group, Finance, HR were all in the room with us as we presented the strategy, got buy in and support, and achieved goal alignment.  

Third, we developed a set of metrics called ‘ease of use’ metrics that measure different encounters patients have on the platform and allow consumers to give feedback. We created a closed feedback loop [that allows us to] make improvements that both benefit the consumer as well as the operational people on the other side. We also built those metrics into our incentive plan, so anybody in the organization who was incentive eligible was very interested in embedding the platform into their day-to-day work.  

How did the business determine implementing a platform strategy was beneficial for the reputation of Advocate Health and its success? 

Our challenge was– especially in healthcare – ‘consume’ means ‘use’ and doesn’t mean ‘choose.’ The idea of a patient as a consumer was difficult for some to understand, so we had to go upstream and find a way to understand consumer choice.  

We first aligned consumer insights to our core business metrics of awareness and acquisition. We wanted to go into market with a brand and an experience that would encourage consumers to choose us before [they] use us. 

The second step was in the form of acquisition. Consumers are looking for their wants and needs [to be met when] finding a physician. Therefore, we looked into some of the metrics that the operations team was using in the onboarding experience and connected those to the clinical experience to demonstrate if we lift consumer metrics, we can lift business metrics. That connection between what matters most to consumers with what matters to the businesses was key.  

“I think that’s where platforms can really play a role, by making those connections and making them much easier than they historically have been.” 

Was there a specific leader whose support was crucial in getting marketing, compliance, and clinical leaders on board with this initiative? 

The key leader was our Chief Operating Officer, who had accountability for the medical group, operations, and P&L for the organization and knew the different parts of the business that we needed to align with.  

A big piece [of getting alignment] was saying: ‘We want to co-create this with your team.’ We emphasized how we’re solving consumer needs as well as the business problems.  

Can you talk about the capabilities you built in the platform as you started to build momentum? 

The core functionality that needs to be in a platform is your EHR and transactional HR data. We wrapped that EHR data with a fledgling platform. That gave us the infrastructure to start to add features that improved the patient and clinical experience – and extended into health and wellness.  

We’re also working on integrating third party products into the platform for care-at-home and digital therapeutics. We want to create a true multi-sided marketplace for healthcare that connects health and wellness creators to consumers.   

What was the role of the clinicians in all this? What role are they now playing in advocating for the platform? 

Whether it was governance or co-creation, [clinicians] needed to have a voice in the room. We designed a partnership with a clinical leadership team [to drive] co-creation across the board. We asked: ‘How does this improve your work and fit into your day?’ The benefit is that now, when you go into one of our physicians’ offices, you’ll hear them talk about LiveWell.  

“We’ve seen continued uptake with LiveWell; it is now fully embedded in the operations of our organization.” 

What operational challenges were you solving for with platforms? 

There are three problem areas that we’ve looked at over the last few years: 

  1. Online scheduling takes call volume out. When you can message your provider in a secure platform it reduces call volume at the front desk, but you have to ensure you can manage and service the messages on behalf of physicians. 
  2. We have a mail order pharmacy that in our Midwest region generates 7 million calls a year related to prescription refill. We think we can take half of that out through new systems automation feature functionality in the platform.  
  3. E-Check-In, self service capabilities built in the platform make the consumer’s life easier and helps the frontline staff.  

Where is the platform going in the future? 

“We think the idea of platforms as a business model [in healthcare] for the benefit of consumers and the business is where the future is.” 

The challenge we’re facing from a healthcare perspective is the battle for the soul of the platform. Is that going to be the EHR? Vendors? EPIC primarily? Or third parties? Or are the health systems going to try to step up? Do you want to differentiate within your market, and do you want to deliver an exceptional consumer experience?  

“We’re going to go big into the platform space because we think it is the right decision for our business, and the future of business.” 


About Jamey: As Senior Vice President, Consumer and Digital Experience at Advocate Health, Jamey Shiels leads enterprise activities focused on creating a personalized and seamless consumer experience that improves engagement and health outcomes as well as business value through growth and cost-savings.  

About Jeff: Jeff Gourdji is a Senior Partner at Prophet and is responsible for leading client engagements across the firm’s range of solutions. As a leader of Prophet’s healthcare industry practice, Jeff works with clients across the healthcare ecosystem, including provider systems, payers, healthcare technology and life sciences companies. 


FINAL THOUGHTS

Transformation in healthcare is not a new topic but rethinking how a health system organizes itself to better observe, engage with, and deliver value to consumers is. Health systems that are infusing platform thinking into their organizations are starting to see the immediate return on those efforts – as well as the path ahead to greater impact across the communities they serve. Now is the time to activate and advance platforms in health systems, reimagine how an organization is set up to deliver a full continuum of engagement, differentiate against competitors and elevate the value delivered to consumers  

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Transforming Healthcare: The Power of Platform Thinking

Platform thinking is the path to consumer-centricity in healthcare – and the key to its transformation.  

Platforms are the key to illuminating the consumer journey. They allow companies to light the “dark” side of a consumer’s journey, the post-purchase “use” side, when previously, only the “choose” side was visible. As our colleagues Ted Moser, Charlotte Bloom and Omar Akhtar observe in their book, “Winning Through Platforms: How to Succeed When Every Competitor Has One,” platforms are the way to enable companies to observe, interact with and provide value to consumers as they engage with the organization. Many industries are already immersed in the platform race – from Amazon Prime’s offering (i.e., ecommerce, Whole Foods, streaming content) to Uber and Uber One (linking rides and eats). Even financial services companies are in the game with strategies from Chase, Bank of America, and more. So, how will healthcare players engage in this new value exchange? 

The beauty of healthcare is we know more about our customers than pretty much any other industry. It’s about how we use that knowledge to personalize, drive conversion, and close gaps in care.

Jeremy Rogers, Executive Director, Digital Marketing & Experience, Indiana University Health

Broadcast connection reflects the one-way communication that marked most of the 20th century. With the launch of the internet, websites and digital analytics, businesses were able to shine a light on the “choose” side of consumers’ engagement. While it’s often the darker side of the consumer journey, the “use” side that reflects the greatest value – both for business and for consumers.  

(Lighting the choose and use journeys graphic Int. 1.2) 

In the era of platform connection, health systems have an opportunity to capture and deliver greater value to their consumers. And the stakes couldn’t be higher. In healthcare, the data and knowledge gained by this level of consumer engagement could have profound effects not only on that patient and their care delivery, but a systemic impact on how to manage disease states, reduction of challenging SDOHs and improved health equity. Currently most health systems are focused on patient portals and transactional engagement, making this transformation feel daunting, elusive, or even operationally impossible. 

Healthcare is behind, and we all acknowledge this. Think about the hospitality industry and how their rewards programs generate loyalty and word of mouth – the best experience you have anywhere is the experience you want everywhere – and that includes in healthcare.

Ken Chaplin, Chief Marketing Officer, City of Hope 

There’s no doubt this is hard work. There are several reasons why healthcare leaders say it’s been an uphill battle – from a lack of integrated technology systems to concerns around patient data privacy – these are valid reasons to be concerned. However, other highly regulated industries have shown how to connect and protect consumers data. We spoke with several leading healthcare innovators to understand why this work is daunting and what they are doing to overcome the challenges:

1. Non-Proprietary Platforms Are Not Designed for Optimal User Experience 

Health systems often started with their EMR as the main platform, and what was the EMR developed to do? Billing, coding or quality documentation. They certainly weren’t designed for the user experience of a clinical physician or clinical nurse user – let alone a patient.

Jodi Rosen, Vice President Innovation & Digital Strategy, City of Hope 

2. Barriers to Risk-Taking 

We can have zero failure when lives are at stake, zero failure. That doesn’t apply to the business-oriented things we can do. We need to ask to experiment and fail and then fail forward, to learn and get better. But it’s just culturally very tough for people nowadays.

Jeremy Rogers, Executive Director, Digital Marketing & Experience, Indiana University Health 

3. Internal Resistance to Change

How do you have large scale change when you are changing the way people work? Number one, we cannot innovate and bring customer centricity to life without the operators – we can’t move forward until everyone comes to the table.

Sara Saldoff, Head of Product Management & User Experience, OhioHealth 

4. Overcoming Data Concerns With the Right Data Value-Exchange  

I don’t think it’s truly a challenge to get consumers to believe their data is safe. I think it’s about translating, what’s the benefit to them? We must help patients and health consumers understand the value of sharing their data. How do we tell the story in the right way to facilitate their willingness to share private health information or behaviors?

Jodi Rosen, Vice President Innovation & Digital Strategy, City of Hope 

5. Competing Priorities, Competing Investments, and Tremendous Pressure 

You have to invest in building an appropriate infrastructure. You need talent that doesn’t necessarily exist in the system already. You’ve got to build a lot of capabilities. But these strategies, in the long term, will alleviate some of the pressures we’re all facing.

Nick Stefanizzi, Chief Executive Officer, Northwell Direct 

Challenges aside, shifting to a platform-based model is the solution to achieving the transformation C-suite executives have been collectively working towards to achieve better business and health outcomes for patients. 

There’s a massive amount of data that health systems today have access to. If we can get this right and gain more consumer trust, we can harness that data in a way that can help with precision medicine, drug discovery, disease prevention – it’s so incredibly powerful.

Jodi Rosen, Vice President Innovation & Digital Strategy, City of Hope 

Inherent in this shift to platform thinking is a value proposition for consumers: I share information about myself so that a company can provide me with more value via content, loyalty programs and tools. Equally as important is the value generated for the organization. Today, many consumer engagements with health systems are transactional, leading to drop off, and overall brand neutrality. This is exacerbated by behaviors of younger generations (Gen Z and Millennials) who often don’t have a PCP. For health systems, the opportunity to develop meaningful relationships with consumers, whether they need care today or in the future, is essential for driving loyalty and patient volume in any market. 

Beyond the acquisition and retention of patients, there is a halo of benefits for building strong consumer relationships including increased adherence, proactive preventative care, lower costs for the system (both administrative, e.g., faster bill pay, and clinical, e.g., getting preventative screening) and better negotiating power with payers. Properly collected, synthesized and actionable data could ultimately shape future innovations in disease prevention or treatments. Platforms help C-suite leaders optimize and personalize the patient experience with critical knowledge and data-driven insights.  

Platforms are the way to: 

1. Make Holistic Care Real 

This has been an ongoing topic in healthcare. Health systems struggle to deliver holistic care, particularly for marginalized groups. Collecting data and applying insights to deliver better care, based on what patients really need, would drastically upend engagement and loyalty in healthcare. Consider how Amazon uses its data – from grocery shopping to prescription drugs to baby care essentials, to deliver better experiences.  

 Patients are doing all these things in the wellness space that are tangentially attached to their health, but that health systems don’t know about. We don’t know where it’s happening, and we don’t necessarily provide all the tangential services that customers want or need. The question is how much of that experience can we stitch together in partnership with the customer so we can treat the whole person?

Sara Saldoff, Head of Product Management & User Experience, OhioHealth 

We’re creating communities that connect cancer fighters with prospective patients – it’s incredibly powerful and allows us to drive deeper, meaningful relationships with patients.

Ken Chaplin, Chief Marketing Officer, City of Hope 

2. Empower Ongoing Engagement With Health 

It’s no surprise that consumers are willing to pay to engage with their health (i.e., Fitbit; Apple Watch; fitness, sleep, wellness tracking apps, etc.) Connecting the healthcare experience to meet consumer needs and their desire to be “always on” has the power to turn engagements from transitional to longitudinal. Facebook enjoys regular engagement from users drawn in by sharing features, community connections, and a focus on life’s moments (“on this day,” birthdays, etc.). 

So much of the journey happens outside of the clinical experience. What are we doing to engage patients in between those appointments, those procedures? Modern consumers demand autonomy- agency in their healthcare journey. If we can give them agency, they’ll take advantage of it.

Jeremy Rogers, Executive Director, Digital Marketing & Experience, Indiana University Health 

We envision a world where care support is everywhere – a doctor prescribes a curriculum where the patient can access tools and educational content about their prescription regimen, diet, broader wellness – and not have to go digging and find it on their own.

Ken Chaplin, Chief Marketing Officer, City of Hope 

3. Create and Drive New Revenue Streams 

Platforms have the power to optimize white space opportunities to create new revenue streams. They also have the potential to shift health systems’ focus from “sick care” to “well care”. Northwell Direct saw an opportunity to disrupt the traditional payer model and better serve employers by strengthening the connection between health coverage and care. They implemented a plan to reduce the hurdles for providers and patients, to drive to more comprehensive wellness for the employees they serve.  

We have an opportunity to serve our communities through a different pathway. We took this idea and said, how do we create a business around this? Yes, to meet employer needs through services…but also to disrupt the payer space because it’s our belief that a more direct relationship between those who provide the care and those who pay for the care is beneficial to delivering higher quality care and to better managing and improving outcomes.

Nick Stefanizzi, Chief Executive Officer, Northwell Direct 

4. Make Personalized Care Scalable 

The balance between the hyper personal and the need to scale across a health system is daunting. There are myriad nuances that impact or shift an individual’s health journey. Value-generating data collection through platforms can help to bridge this gap. Consider Nike’s app family – from workout classes and SNKRS drops to monitoring runs and alerts when footwear needs replacing based on the integrated mileage tracking, they can serve consumers what they need before they know they need it. 

The dream of our Smart Rooms is to give us real time feedback so we can solve problems with a patient in moment – but down the road, we could use the increased data use and AI to help us anticipate when something could go wrong and recommend solutions so we can get ahead of an individual’s care needs.

Sara Saldoff, Head of Product Management & User Experience, OhioHealth 

If we can hyper personalize, for example, for a person whose family was touched by asthma or coronary heart disease or cancer or diabetes, and determine how to engage that individual over a lifetime with preventative behaviors and interactions, it can cut across things like health, education, literacy, economic status and be inclusive of race, religion, gender, etc. It’s going to be hard – but it’s also going to be a big game changer.

Jodi Rosen, Vice President Innovation & Digital Strategy, City of Hope 

We see exciting signs of progress. It is still early days for health systems, though clear signs of progress are emerging. From OhioHealth’s “smart rooms” to City of Hope’s connected patient communities, there are signs on where health systems are heading. Others, like Advocate Health, are already leading with their LiveWell Platform, which helps consumers manage both their health and their wellness. Jamey Shiels, SVP Consumer & Digital Experience at Advocate Health emphasized that driving organizational alignment required connecting the vision with pre-determined patient needs with business requirements.  For example, easier check-in process means less stress on front-line staff, on-line scheduling means reduced volume in the call centers and more  

We are constantly improving LiveWell, listening to what our consumers are telling us about the experience to create a feedback loop we can engineer back into the experience. We mapped the consumer needs to the business metrics and showed how lifting those needs could improve the business metrics; connecting what matters most to the consumer to what matters most to the business is our biggest challenge but where I think platforms play a large role. We believe platforms are the business model of the future. Healthcare is behind, but we want to get into the game and lead the way.

Jamey Shiels, Senior Vice President Consumer & Digital Experience, Advocate Health 

If platforms are the answer, how do we get started? To begin building a Platform Connection, start by thinking about how to align your platform’s needs with your organizational ambition. Winning Through Platforms lays out a path to success, and it starts with cultural shifts to gain three key advantages: Strategic, In-Market, and Alignment. 

Strategic Advantage: Bring Something Structural to the Market That the Competition Doesn’t Have  

  • How might the organization’s portfolio of solutions (i.e. care, coverage, ancillary services) better connect to demonstrate the value of the care network it offers? 
  • How can teams better share assets to reduce efforts and increase flexibility? 
  • How can the organization align on the customer personas (patients? payers? referring physicians?) and journeys to align strategic intention? 

In-Market Advantage: Grow at Higher-Than-Market Rates Through Better-Than-Competitor Practices, Spanning Go-to-Market and Innovation 

  • What technology is required to capture patient information and organize it for action that results in customer and system benefit? 
  • How can content across the journey be personalized by life stage, condition type, and relevant social determinants?  
  • What role might community and patient-generated content play in enriching the overall engagement experience – and keeping patients engaged beyond the transactional? 

Alignment Advantage: Translate Better Internal Alignment and Teaming Into Stronger Customer Engagement and Superior Organizational Performance 

  • How might the traditional functional silos be restructured into a full journey, collaborative, go-to-market model? 
  • How will internal teams align on and ensure a consistent set of customer interaction standards? 
  • What will define best practices when it comes to an elevated patient experience? 

There’s too much at stake to not figure out the right way to partner for better outcomes for patients.

Jodi Rosen, Vice President Innovation & Digital Strategy, City of Hope 

FINAL THOUGHTS

Transformation in healthcare is not a new topic but rethinking how a health system organizes itself to better observe, engage with and deliver value to consumers is. Health systems that are infusing platform thinking into their organizations are starting to see the immediate return on those efforts – as well as the path ahead to greater impact across the communities they serve. Now is the time to activate and advance platforms in health systems, reimagine how an organization is set up to deliver a full continuum of engagement, differentiate against competitors and elevate the value delivered to consumers.

REPORT

Impossible Math

Why the healthcare labor crisis is more than just a people problem – and how to solve it.

The healthcare industry is facing a massive labor and operating model problem – one that involves a predicted workforce shortage of up to 3.2 million people. With more than a quarter of the industry workforce planning to leave in the next two years and $9 billion in annual burnout-related turnover costs the healthcare industry is at a crossroads. So, where do we start?  

Prophet suggests that the solution starts with our nurses. In this report, we clarify the magnitude of the crisis, identify tangible issues to tackle and introduce viable solutions that will begin to drive impact against this behemoth of a challenge.  

Key Takeaways:  

  • Addressing the workforce shortage starts with a focus on nurses. By starting with the largest population of clinical workers, we can begin to make a more meaningful impact on the collective workforce challenge.
  • Sustainable solutions to this crisis are not just about workforce retention. They will require us to revisit hiring and talent development practices, redesign care delivery models and the roles required, and rethink the infrastructure needed to support innovation and scale care.
  • Ultimately, to drive meaningful impact for nurses, we need to hear from nurses. Once nurses have a say in the tools and solutions we develop for them, real change can happen.
  • Before jumping to the most ground-breaking innovations, we must bring ourselves back to the day-to-day needs of our nurses. Simplifying their routines with technology can help them feel heard and improve employee and patient satisfaction.
  • Prophet’s Human-Centered Transformation Model can help you understand where your organization can begin to tackle organizational and cultural dynamics that contribute to the labor crisis.

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Impossible Math

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Five Rules for Optimizing Omni-channel Clinical Care Models 

Building a human-centric healthcare organization that delivers on patients’ needs. 

With the pandemic increasingly in the rearview mirror, many healthcare organizations are coming to terms with the big and small changes that have become permanent parts of the healthcare landscape. Ushered in during the pandemic, omnichannel care delivery is now a fixture and will play an influential role for many years to come; that’s a good thing, as patients prefer having options and are often enthusiastic about new channels, technologies and treatments. More caregivers now see the value of omnichannel care, especially telehealth and in-home care, because they work so well for patients.    

In our recent work with clients, we’ve seen how different types of healthcare organizations can capitalize on leading practices for change and transformation as they seek to refine, optimize and expand their omnichannel clinical care models.  

The common denominator with healthcare leaders is human centricity. Organizations that successfully drive change design their care models around what patients want and need. Similarly, organizations that adopt a human-centered approach to transformation are more likely to succeed in winning hearts and minds, instilling new behaviors and changing the culture in sustainable ways.  

1. When transforming the clinical care model, start small and iterate fast. 

There are ample transformation opportunities across healthcare but organizations that take on too much change too fast are bound to struggle. The key is to focus on the achievable while understanding the distinct needs of underserved populations and addressing drivers of high cost. 

Organizing around a condition or a use case, rather than a service line, can be useful both for making progress and setting up for broader change over the long term. Breaking down big changes into manageable steps is the only way to go. For example, to redesign diabetes care, leaders will need first to address issues typically treated by primary care, endocrinologists and cardiologists, as well as supporting clinicians in nutrition and other related aspects of care.  

Our work with one national player confirmed how many patients with kidney failure “crash” into dialysis in an unplanned fashion when longitudinal care models can address the holistic needs of such patients. When Geisinger launched a home care program, it realized impressive results, including reduced ER visits and lower costs, largely due to its careful patient selection, a focus on chronic conditions and proactive outreach by care teams.   

Within value-based care models, better patient communication can increase HCAHPS scores, which directly impacts reimbursement. That’s a relatively small-bore change that can yield potentially big results. 

2. Recognize that every healthcare organization is also a software company. And an AI and data science firm, too.  

Whether or not they want to be, all types of healthcare companies are in the technology business – and we’re not referring exclusively to electronic medical records (EMRs). Software now underpins every step of the care delivery process and is essential to making the “anytime care from anywhere” vision a workable operational reality. And yet, there’s no denying that tech has contributed to significant burnout among healthcare workers, including physicians.  

Healthcare organizations would benefit from several tech innovations, including agile sprints and experience design principles, to continuously enhance features. Had EMRs been designed in this manner, they would more seamlessly fit into the clinical workflow and not contribute to provider burnout as they are today. Healthcare organizations can take a similar approach as they design omnichannel care delivery models and deploy new technology.  

Thinking like a service designer will help orchestrate the linkages between backstage systems and data sources and, ultimately, create a seamless experience for all types of users. Accommodating the needs of users with different levels of technology access and literacy – including both patients and caregivers – is the key to developing high-impact solutions. When designing a patient app for patients receiving home dialysis, we went through multiple rounds of design and user testing to ensure that the experience met patient needs in an intuitive way and delivered the right information at the right time. That’s how to empower – rather than overwhelm – users.  

Organizations must also change the perception, common after initial rollouts of EMR systems, that technology is the enemy. One way to overcome that persistent bias is to co-create solutions with patients, caregivers and providers. That’s what we did with a national player seeking to shift the site of care from clinics and inpatient settings to the home. Service designers worked directly with nurses and nurse practitioners who could speak empathetically to the day-to-day needs and challenges faced by home healthcare teams and provide feedback on initial design sketches. These foundational insights, as well as those from patient groups, guided the design of new tools.  

AI Goes Everywhere

There’s no talking about tech without talking about artificial intelligence (AI). AI seems to be taking over healthcare. Payers are using it to digitize claims, conduct audits and monitor payments. Clinically, AI is helping physicians scan X-rays and get ahead of emerging risks and adverse outcomes. Providers use AI to design care paths, personalize care coordination and model the financial impacts of different treatment plans. AI promises to revolutionize clinical trials in the pharmaceutical sector.  

Embedding AI-enabled technology deeply into care delivery processes can make routine tasks simpler, faster and safer. And it’s the most effective way to use technology as a “force multiplier” in delivering care, which is the primary motivation for many healthcare organizations that acquire technology companies. Technology that enables caregivers to do their jobs more effectively and operate at the top of their licenses is invaluable in a time of provider shortages. Equipping end-users (including physicians) with training, skills and knowledge to use the right tech at the right time is how tech can directly support better outcomes.  

That sort of human-centered approach is necessary to change minds, create advocates and smooth the transition as the organization evolves from being healthcare-centric to thinking and acting like tech, AI and data science companies.  

3. Transformation takes an ecosystem.  

Achieving ambitious change objectives will almost certainly require collaboration with others – including payers, specialty care providers, technology companies or other third parties. So finding the right partners is critical, even when focusing on a manageable, well-defined issue or opportunity.  

The massive complexity of healthcare – both as a business and in terms of delivering care – makes broad organizational buy-in an absolute imperative for effective transformation. Overlooking a key constituency can make the difference between success and failure.  

We define stakeholders as anyone playing a role in care or invested in its outcomes. Thus, the universe of stakeholders includes everyone from institutions (e.g., payers and large employers) to back-stage actors (e.g., hospital management, pharmacies) to front-line care providers (e.g., PCPs, specialists, therapists, care coordinators, social workers) and, of course, patients who must remain at the center. These stakeholders have wildly different incentives, hold different values and operate with different information and authority. 

The broadest ecosystems require teams to think like systems designers in working outward from the patient to the entire stakeholder ecosystem, including front-stage actors (e.g., caregivers, PCPs and specialists) and back-stage actors (e.g., care managers, pharmacists, hospitals, payers, regulators).  

Ecosystem design requires incorporating the needs and perspectives of many different stakeholders.  

All of these players have widely different incentives, hold different values and operate with different information and authority. Misalignment among ecosystem partners can manifest in systemic problems that reach deeper than any single touchpoint. When we design healthcare ecosystems, we apply such principles to understand current systems and envision those that will be necessary tomorrow. Design tools such as ecosystem and value exchange mapping are a critical part of incorporating the entire innovation ecosystem into specific solutions. 

Leveraging Internal Ecosystems

The most successful transformation programs also involve many different internal constituencies. One Fortune 500 healthcare organization seeking to disrupt renal care with increased use of in-home dialysis built a diverse, cross-functional team, including digital strategists, product teams, client nurses, nephrologists and other specialists, in its ideation process. It gathered ongoing input via iterative design and feedback sessions. The testing process of initial solutions involved 40+ external users, including patients, nurses and other caregivers and social workers.  

Organizations enacting large-scale strategic change often convene a leadership council for regular reviews and feedback. Typically, such groups include chief medical officers, clinical business unit leaders, medical specialists and senior operational and administrative leaders.  

4. Embrace regulation and payer mandates as inspiration for innovation.  

The expanding adoption of value-based care shows how regulatory requirements can prompt necessary change for organizations with creative leadership and high degrees of operational agility. By default, many leaders resist new rules and love to complain about old ones, which can lead to regulatory oversight being used as an excuse not to change.  

Federal regulators are certainly looking to foster innovation and prompt greater use of in-home dialysis via reimbursement changes in kidney care and other areas. The acute shortage of clinicians is another area where regulators are likely to be flexible in allowing healthcare organizations to experiment with new care delivery options. Consider how pandemic-era stop-gap measures to allow providers to practice telemedicine across state lines have remained in place. We believe the clinician shortage is an existential threat that must be at the forefront of the design of omnichannel care delivery models. Certainly, it will force provider organizations to automate more low-value tasks as they seek to expand their reach.  

Social determinants of health (SDoH) are also being incorporated into regulatory frameworks as their importance to health becomes clearer. Medicaid changes are more likely in the short term, with Medicare following suit in the long term. Organizations that are proactive in developing solutions – ideally in collaboration with regulators and other partners – will be positioned for future success.  

Working with a national provider organization to address the needs of diabetes patients, we focused on SDoH in determining how to shift the site of care to the home. Patients with mobility issues, those that lived in food deserts, or lacked reliable WiFi for remote diagnostics each required different design decisions. As innovation strategies more frequently intersect with regulatory requirements, we help clients think through the implications and find opportunities to streamline compliance processes as an outgrowth of experience design and technology development.  

5. You can’t change your clinical care model without changing your business model.     

This might be the hardest challenge in healthcare, because of the frequent tension between what’s good for patients and what’s good for the bottom line. In theory, clinical care organizations can find the financial backing to move to a more consumer-centric clinical care model in one of two ways:    

  • Improving patient loyalty and outcomes to become a recognized market leader or provider of choice, with the net effect of boosting both patient volumes and financial returns. 
  • Maximizing reimbursement for all kinds of clinical care services including those delivered outside the traditional clinic.    

We’ve found the first is a harder recipe for success and following it can lead to internal disbelief at best and barriers at worst. Financial incentives need to align with care incentives. Organizations that invest in transforming their care model should expect to realize financial rewards or at least figure out how to get paid for providing services that benefit patients.  

To make it happen, we have helped strong leaders think outside of existing markets to create new categories of care based on patient needs. To model the potential for a new home health business that a diversified healthcare giant was launching, we created a consensus view of existing service lines that could be brought together to meet patient needs in the home, from infusions, to telehealth, to diagnostics and monitoring. Here again, the key was getting stakeholders to collaborate and communicate in new ways.  


FINAL THOUGHTS

Is there a more human-centric industry than healthcare? With technology becoming ubiquitous in all forms of care delivery, it may seem an odd time to ask the question. But in our experience, healthcare organizations that master the human touch in both care delivery and designing and implementing their own transformation initiatives realize the best clinical and business outcomes.  

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Your M&A is Likely Hurting Your M&S (Martech & Salestech)

Avoid falling victim to cost-focused consolidation efforts that potentially limit growth. 

Historically, corporate mergers and acquisitions (M&A) were undertaken to help companies scale, find cost efficiencies, gain access to distribution and block competitors. In the past decade, we’ve seen a digitally driven shift in M&A activity, with the focus moving away from barriers and efficiencies, and towards true growth: leveraging digital technology and business models to offer better products, more engaging experiences and more effective ways of working

Beware of Antiquated Approaches to Integrated Management Offices 

The most important role in a successful M&A event is the Integration Management Office, or “IMO”.  With the digital-centric M&A model, IMOs need to change their approach from an operational focus of pruning off duplicate assets, consolidating teams and looking for organizational synergy, to a strategic rethinking of the firm’s approach to growth

One critical foundation of growth that IMOs typically mismanage during M&A activity is the MarTech & SalesTech infrastructure. IMOs often focus on identifying and eliminating duplication of systems and subsequent cost reduction but don’t proactively explore improvements such as tighter cross-system integrations, cleaner data or more thoughtful process automation. While these sound like minor operational factors, they can become the underpinnings of more effective customer engagement strategies, compelling user experiences and powerful upsell/cross-sell/retention initiatives. 

If organizations aren’t careful, MarTech and SalesTech can fall victim to cost-focused consolidation efforts and might come out of an M&A deal tied to systems that will suffocate growth. Here’s how to spot these dangers and avoid them. 

Do Not Assume Your Options are Binary 

We have yet to see a sales or marketing team 100% satisfied with their existing tech stacks and workflows. After a deal, you will have to invest time and money into consolidating and migrating systems. You will also have a large pool of vendors -many of which you have great interpersonal relationships with- feeling the pressure to hold onto their accounts. 

Fight the urge to pick from a subset of existing vendors. You may find yourself with a system that is only designed for half of the company, or unable to scale into the new larger enterprise. Take the time to step back and make a holistic and strategic set of choices before diving into a large migration effort. It’s better to be at the bottom of the right ladder than halfway up the wrong one. As Amber Sundell, head of demand generation at Merative, a data and technology healthcare company, puts it, “We might have fewer marketing and sales systems these days, but everyone in this space continues to feel those budget and data standardization cuts/missteps.” 

Clarify Your Desired Future State and Look Backwards  

Your CEO and the deal team likely won’t stop talking about this future utopia of the new combined organization. That utopia two, five, or ten years from now probably doesn’t have tech stacks designed when the two companies were operating with different intentions.  

For example, lead handling systems typically put potential customers into different categories or types. What if those categories are different between the two merging companies? And what if those categories are hard-coded into all sales flows and reporting systems — how will you operate? 

Or what if your organization uses Platform X for email campaign management, and the acquired firm uses Platform Y, but they both use different sets of templates and other source data to trigger the message? Is it possible to send a demand generation campaign or order confirmation message without a manual workaround? 

These sorts of “differences” are assumed and understood when framing an M&A event, but rarely is there budgeting for the hard work of standardizing data taxonomies, refactoring (reducing) templates, or re-integrating systems outside of core billing. What starts as potential synergy quickly becomes invisible technical debt. Often, that debt becomes a long-term liability for the resulting Marketing or Sales Operations Teams, and it persists for years beyond the merger event. 

You are Building Pipes and Plumbing, not a Funnel  

If you’re not already operating in a multi-business unit enterprise, the latest acquisition might spur it, or will in the near future.  There is already an invisible wall between marketing and sales on a variety of dimensions, incentives, cultures, skills, styles, etc. And as you move towards –or deeper into – a multi-BU enterprise, you’ll likely have fragmented sales teams and centralized and decentralized marketing teams. From a demand gen perspective, you need to stop thinking of lead flows as a funnel, and more like pipes and plumbing. And don’t underestimate the people risks associated with M&A activities. Sundell states, “The employees who are redistributed or leave the organization after an integration, take legacy knowledge with them. You also find yourself missing reasons why things were or were not done in a certain way.” 

How do you move forward with this approach? Examine each joint and pipe and look for leaks. Measure the pressure and flow rate at each valve and faucet.  

And check the temperature frequently. 

Translation: Standardize data formats and integration points to make sure systems are talking and information flows correctly from one step to the next. Use reporting to capture meaningful operational metrics and KPIs for each overall process and important sub-step. And use ROI analyses with clear and simple dashboards to know when the process is working and the effort was successful. 


FINAL THOUGHTS

It is said that most mergers and acquisitions fail. Many believe that it is because deals are normally predicated on growth, but the integration process is dominated by cost-related decisions.  The answer is both, and most importantly, your Salestech and Martech are your biggest demand gen investments. There will be opportunities to combine stacks to lower ongoing operating expenses.  But don’t lose the opportunity to step back and fully re-evaluate your platforms to maximize your demand gen efforts to support the growth of the newly combined enterprise. 

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3 Ways to Transform Customer Engagement for the Future of Medtech  

Customer engagement models are essential to maintain a thriving business, learn how Medtech firms can get theirs fit for purpose.

For a long time, the customer relationship between MedTech companies and healthcare professionals (HCPs), as well as healthcare providers (HPs), has been changing. The Medtech industry, like many others in the past couple of years, has been faced with an acceleration of nascent changes such as digital transformation and an increase in customer expectations – causing trends to solidify and become the new normal. Now, with basic assumptions around interactions and relationship building fundamentally altered, traditional customer engagement models can no longer deliver against their ambition for the future. We have witnessed different approaches by Medtech companies, some learning from inside and others from outside the healthcare space, to rethink their approach to customer engagement and how to make it more future fit.  

Based on our experience, we have identified three crucial ways to transform customer engagement strategies so businesses can succeed in this new world of Medtech. 

Hybrid Engagement with a Purpose 

COVID-19 has permanently changed how the healthcare system works, forcing Medtech to quickly shift to remote engagements and digitize offline processes. Now, that the pandemic is more under control, it is apparent that there is no way back. Today’s customer engagement preferences have changed.  

So, what does this mean for Medtech moving forward?  

Medtech needs to engage with customers in a blended way – balancing the online and offline worlds – making permanent use of remote channels while at the same time recognizing the points at which a more human interaction makes a difference. In-person interactions remain a valid and irreplaceable tool at various points in the customer journey, but Medtech companies need to be targeted and purposeful in which types of interactions they favor for this and leveraging virtual interactions and multi-channel where relevant and feasible. 

How to achieve a more hybrid engagement model? 

  • Shift your mindset from sales to customer: One crucial element in our work in this space is about the organizational mindset shift – from a sales funnel mindset that focuses on closing the “deal”, to more of a customer journey mindset, where building longer-term relationships is of higher priority. The closing of a sale no longer marks the end of the journey, it is only one additional step in the MedTech-HCP/HP relationship.
  • Adapt engagement approach to customer type and journey stage: Different customer groups have different needs and preferences at different stages of the customer journey – understanding the journey both from a funnel perspective (awareness to conversion to loyalty/recommendation), but also from a touch point perspective (I.e. which touchpoints does a customer use across their journey). For instance, a hospital’s procurement lead will have different engagement needs than a physician who owns a single practice. Vivantes, the biggest hospital system in Germany, has different needs than a rural doctor. Understanding these needs and preferences is key to identifying which type of interaction adds the most value at each point along the customer journey.  
  • Capture individual customer preferences: Medtech should focus on customer preferences and align with them where possible. Accurate tagging in CRM systems helps paint a stronger picture of customer understanding and personalization. It is important that this knowledge is shared within the Medtech organization so that all stakeholders act upon it accordingly (sales reps from different divisions, marketing, etc). 
  • Ensure engagement and experiences align seamlessly: Individual high-quality interactions are relevant but diminished if a customer feels that follow-on connections are disjointed. A set of well-orchestrated interactions across the journey can improve the overall customer experience. MedTech organizations should work towards ensuring sales and marketing have a holistic view of the customer and follow through on the captured learnings. 

Optimized Interactions in the Virtual Space 

The pandemic has forced many to embrace tools they weren’t previously comfortable with, and these changes are permanent. The use of online tools has grown – and HCPs are using online information sources more than ever. The key benefits of more digital interactions are around convenience – research shows aspects such as flexibility of timing, less travel, less impact on workload and a more extensive selection of webinars instead of conferences. But purely digital interactions also have their shortcomings: loss of personal relationships with the sales reps, inability to network and overall, less engagement between reps and their customers. The focus should be on optimizing virtual interactions and reducing these drawbacks.  

With so many competing demands on attention, nurturing and managing leads with targeted engagement is even more relevant in categories where the typical product lifespan is longer, given fewer windows of opportunity to sell the product. And digital channels allow for much more customized and recurrent interactions that permit Medtech to stay within the relevant consideration set. 

Excellence in virtual events is driven by recognizing where efforts should be refocused when designing the experience. The key is to ensure virtual interactions are optimized to take advantage of the technologies used to engage customers, rather than be seen as a lesser alternative to in-person interaction. How can that be done? 

  • Update and optimize content online: While online sessions are usually seen as more convenient, it is also harder to keep the participants engaged and focused. Digitizing content used in offline interactions was the first step many Medtechs took – and quickly found that this was not sufficient. The content needs to be fully adapted to fit different channels and delivery mechanisms, in terms of level of detail, structure etc. 
  • Use data and insights to underpin decisions: One benefit of digital is its measurability. Data and insights need to be used to ‘test and learn’ when selecting and enhancing channels, content and delivery methods. Establishing the right KPIs and monitoring them is key. Virtual interactions provide an excellent opportunity to collect further customer insights, which can help inform both future remote and in-person interactions.
  • Reimagine interactions to facilitate discussion: Oftentimes, virtual interactions don’t provide the same opportunities for participants to connect with peers and share experiences. Duplicating offline approaches into an online channel does not work, and MedTechs need to refocus their activities accordingly. Optimized virtual events prioritize connection and community elements while reducing the relevance of purely communicational elements.  

Content is King (even more than before) 

Customers are looking for convenient ways to educate themselves on specific topics. An individual Medtech’s authority in specific fields can make them a trusted source to provide education or even build connections in a non-commercial way. But they are not alone in this endeavor, and companies are feeling the pressure to deliver high-quality, relevant digital content like never before. While not all companies can keep up with the accelerated pace of content creation, Prophet’s Altimeter colleagues found that those that are successful in meeting this demand have implemented an “Agile Content System.” For many Medtechs in particular, and healthcare companies in general, internal compliance processes  are a key obstacle to timely content creation, but there are simple ways to improve this:  

  • Ensure technology and workflows are working to streamline approval processes: Approval and compliance processes need to be structured in a way that allows for speedy, efficient publishing. In healthcare specifically, reviews by multiple stakeholder groups such as the ethics boards, legal teams and subject matter experts can slow down the approval process significantly. A modular content creation approach can help, as well as clearer content ownership and roles. 
  • Restructure content teams for greater agility: A centralized content team does not necessarily work for all Medtech firms. Depending on the key objective and business need (i.e. brand awareness building vs demand/revenue generation), the ideal structure should be set up but it’s essential they work together on a shared agenda. Our research shows that the most effective organizations balance both brand and demand.
  • Set bolder, clearer goals that go beyond brand: Oftentimes, Medtech organizations are focused on content to drive brand awareness. With the changing preferences of their customers, there is a need to revise this approach. This shift in thought leadership (i.e. Siemens Healthineers Insights series or their Healthcare Challenges podcast), also requires a review of the KPIs to ensure the correct content metrics are being tracked and reported on. 

FINAL THOUGHTS

Customer engagement is a critical aspect of any business, and this is no exception in the Medtech industry. The complex ecosystem and the diversity of customers do not make this an easy task for Medtech organizations, but there are strategies that can help to transform and succeed in this new world of customer engagement, enabling Medtechs to become the customer’s first choice of engagement. 

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Five Healthcare Trends To Watch in 2023

Healthcare leaders can drive change in 2023 by thinking boldly and targeting investments in the following trending healthcare spaces.

Looking ahead to 2023 in healthcare, the big macroeconomic clouds on the horizon make for a less than cheery outlook. The combination of an economic downturn and higher costs will be a dominant theme for the entire healthcare industry and a huge challenge for organizations across hospitals, health systems and device makers, pharmaceuticals, and life sciences companies, as well as players in technology. 

Still, taking the glass-half-full view, we see many opportunities for leaders across the business to drive operational discipline and innovation by focusing on investments that matter most in driving better outcomes for all stakeholders. As we point out in our transformation playbook, changemakers that push beyond the many common barriers to innovation can achieve a great deal. Yes, the economic pressures will be greater. But 2023 will see plenty more disruption – and thus plenty of growth opportunities – as our annual list of healthcare trends below makes clear.  

1. Holistic Wellness Solutions Continue to Influence the Market  

Successful one-off wellness apps and small niche solutions are adopted by large employers and payers to enhance benefits programs and give people more options to live healthier lives. As consumers adopt wearable data trackers in support of that goal, they will increasingly choose to work with healthcare organizations that are committed to holistic wellness.  

 It’s not about the gadgetry, but rather driving good outcomes, particularly relative to social determinants of health (SDoH) and patients’ lived experiences. The start-ups and tech firms with the most attractive and powerful solutions will achieve rapid scale by going the B2B2C route. We think the biggest winners will emerge in in-home diagnostics, preventative health opportunities (e.g., perimenopausal women and metabolism and nutrition) and mental health, which will be of interest to large employers, as well as individuals. Apps and widgets that empower individuals with their own data, plus timely prompts and attractive incentives, will crack the code on growth.  

2. Venture Capital Focuses on the Best and Brightest  

While we expect to see a few big winners among tech players, most firms will face a tighter funding landscape and more intense due diligence. Venture capital, which has been flowing freely and voluminously for years, will become less available as investors scrutinize business models more closely and back only the best and brightest.  

 We suspect the firms that attract funding will be those that focus on narrowly defined patient cohorts already engaged in self-monitoring behaviors and where innovation can move the needle on cost control or value delivery. Those that can collect real-world data from outside the four corners of traditional clinical environments, and integrate seamlessly into core systems, will be specially well positioned to attract funding and potential partners. Chronic disease management, patient engagement and population health solutions will also be priorities because there is clear clinical and financial upside in all these areas.  

3. The Workforce Shortage Worsens as a Full-Blown Crisis  

With continuing burnout among healthcare workers, large provider organizations face issues with care quality and deteriorating patient experiences. The supply-demand fundamentals are inescapable: There are simply not enough doctors, nurses and paraprofessionals – not to mention data scientists, business analysts and experience designers – to fill all the vacancies. 

However, there are multiple potential solutions to resolving talent shortfalls. Workforce optimization and workflow efficiency are necessary, so too automation and more advanced technology in everything from reading x-rays to identifying payment fraud. More support for patient self-monitoring, continued expansion of telehealth and in-home care will also help alleviate chronic talent shortages. There’s also a large cohort of tech-savvy talent looking for jobs with a higher mission after layoffs from Silicon Valley giants.  

4. Value-Based Care Models Become Innovation Labs  

The inevitable momentum toward value-based continues. More than 40% of U.S. healthcare reimbursement now has some value-based component, a proportion that will only rise in 2023 and beyond. Though pockets of resistance remain, more provider organizations will advance and mature their Value-Based Care capabilities. And they’ll do so on several fronts. More sustained preventative outreach efforts to underserved, high-risk and high-cost populations for routine screenings will continue producing strong results. Shared-incentive contracting will be more attractive for capital-intensive equipment, such as MRI machines and CT scanners.  

Sophisticated technology usage will be a hallmark of VBC winners. Consider how the burden on the workforce could be reduced with digital apps and AI-enabled patient engagements leveraging HIPAA-compliant natural language processing on existing voice platforms (e.g., Alexa). Such applications also free clinicians to operate at the top of their licenses. The next year will see many pilots of creative concepts in the space.  

The tightening economic backdrop, alongside rising consumer expectations, more powerful technology and the prevalence of chronic conditions, will fuel further adoption of VBC models. Large employers wanting to know what they are getting from higher rates will be yet another prompt for innovation.  

5. Consolidation Increases as Non-Traditional Players Press on  

Challenging macroeconomic conditions will drive more consolidation and spark aggressive plays from tech platforms and large retailers. In this sense, 2023 will look a lot like recent years. Retailers and other non-traditional players are cracking the code on healthcare, faster than healthcare players are cracking the code on consumerism.  Amazon, Walmart and other large players will continue experimenting on their own, buying up promising ventures and looking for partners that can further their huge ambitions.  

And their ambitions won’t shrink just because the economy does. If you already thought these companies were relentless competitors when the economy was good, then you can expect them to press their advantages even more forcefully in pursuit of ever greater market share as cost and capital pressures rise for others.  


FINAL THOUGHTS

The healthcare industry has seen plenty of change during the last few years. The next year will continue that trend. And as challenging as the economic conditions will be, healthcare leaders can drive change for the better by thinking boldly and targeting investments in the most promising areas of opportunity.  

Contact our healthcare team today. We’d love to talk about the transformation opportunities at your organization. 

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The Keys to Improving Patient Engagement in Pharma  

The notion of patient engagement has been taking shape for over 30 years. Here are 10 tips to accelerate and embed patient engagement systematically in your organization.

The notion of patient engagement has been taking shape for over 30 years. Going beyond patient advocacy, patient engagement is the active involvement of patients in processes and decision-making in their care experience, across the entirety of the development lifecycle and beyond.

Patient engagement works to address health disparities and inequity more systematically by including and elevating diverse patient voices across the key touchpoints of drug development, ultimately raising the standard of care all patients receive and the outcomes they experience. It’s about going beyond clinical outcomes and driving a more holistic understanding of patients and the treatment effect across their preferences, social phenotypes and circumstances – socioeconomic or otherwise. Ultimately, the goal is to create medicines, treatments and experiences with (not for) patients. 

And we’ve seen the business and clinical results at key points across the development cycle.  

So Why Haven’t Pharmaceutical Companies Cracked It? 

Pharma is the only industry that has not fully embraced the end user in its product development. The practice of understanding patients and applying that understanding systematically to treatment development is complex and difficult.  

There are several barriers to successfully engaging patients in pharma:

  • Historic Disregard of the Patient – The industry has historically been wired to disregard the perspectives and needs of patients outside of the clinical outcomes related to therapies of interest. Practitioners can often be resistant to centering on patients, with a typically paternalistic relationship with patients, coupled with a lack of time and capacity to actively involve patients in their care.
  • Regulations and Resources – The regulatory requirements, time and investment required to engage with patients mean it often doesn’t happen. Or at best, it happens sporadically.
  • Corporate Culture – Fragmented and siloed corporate structures and cultures result in ad hoc and unsustainable attempts at patient engagement. Not to mention, they are often not built into the drug development lifecycle.
  • Limited Pharma-Patient Interactions – Patients have limited capacity and agency to engage with pharma, leading to difficulties in diverse and representative patient groups.
  • Lack of Faith as a Strategic Priority – Due to the delayed ROI associated with patient engagement, pharma struggles with prioritizing patient engagement as a sustained and systematic business imperative.

The only way to initiate and scale patient engagement sustainably is to take a systematic approach across the entire organization and at key moments throughout the drug development lifecycle.   

External Pressures for Patient Engagement are Mounting 

All of that said, the lack of impetus is changing. Patient engagement is no longer a nice to have, with a range of forces driving an increased focus on patient engagement. Industry leader, Roche, is in the process of training 10,000+ employees in patient engagement. The most important medicines regulators in the world, the FDA (Food and Drug Administration) and EMA (European Medicines Agency) are strongly invested in expanding Patient-Focussed Drug Development (PFDD). In 2016, the FDA codified patient engagement as a key pillar of its mission, formally requiring records of Patient Perspectives in drug review under PDUFA VI. It will become increasingly difficult and slow to get new indications approved and paid for without showing patient engagement throughout the development process and treatment regime design. The global COVID-19 pandemic has also seen familiarity, scrutiny and pressure on pharma corporate brands as their reputations increased hugely, presenting a timely and important opportunity to build trust and understanding between pharma and patients.  

The Solution? Systematically Embed Patient Engagement into Your Culture and Operating Model 

Through the learnings shared by different businesses and patient engagement leaders, it has become evident that no existing business function can fully own patient engagement. An overarching function, or center of excellence, must focus on shifting mindsets of each therapeutic area and motivating change while permeating tools, training, new ways of working, processes and systems through all cross-functional aspects of the organization to deliver impact for patients and ensure patient engagement practices are adopted cohesively.  

Leaders must be bought into the need for patient engagement and must be willing to drive home the message within their teams and prioritize it as a focus across the organization. For a patient engagement function to be able to identify and navigate the appropriate channels within the organization, the correct process, governance and stakeholders must be in place. This requires organizational, operating model and cultural adaptations to bring an enterprise-wide and systematic approach to patient engagement. Getting it right brings not only better results but renewed purpose and inspiration to teams across the business. 

10 Tips to Embed Patient Engagement (PE) Systematically in Your Organization  

From our experience globally we have distilled the key areas of focus that will help you build and embed a systematic approach to Patient Engagement across your organization 

Set Up Strategically 

  1. Embed patient engagement holistically, X-FN and enterprise-wide approach
  2. Clearly articulate the value of patient engagement – and link it to the corporate and therapeutic strategies 
  3. Ensure the patient engagement function sits strategically in the organization and is clearly distinguishable from other patient-facing functions, acting as a key enabler for other functions 

Initiate Meaningful Work 

  1. Create a comprehensive patient experience blueprint that drives equitable access to care and an improved experience
  2. Start by piloting patient engagement initiatives and tactics in the “moments that matter” across the lifecycle 
  3. Develop a patient insights function to understand patient experiences and improve outcomes  

Disseminate and Scale Rapidly 

  1. Build patient engagement infrastructure quickly by codifying best practices into repeatable processes
  2. Fill gaps in understanding with bespoke learning and development programs 
  3. Maintain momentum by creating visible platforms to articulate the importance of patient engagement 
  4. Focus on the value of patient engagement to society – the “S” in ESG (Environmental, Social, Governance)   

Making Patient Engagement Happen

To become systematic in your organization, patient engagement needs to be driven by enterprise-wide momentum while being bolstered simultaneously with enterprise-wide infrastructure. Why? Proving the ROI of patient engagement is still challenging for most organizations. As a result, the patient engagement function needs to develop a strong and robust proof of concept across drug development and commercial processes. This means partnering and collaborating across the business to make sure everyone is clear on what ‘including the patient’ looks like in their role. This will reconnect employees with the organizational purpose, which in turn attracts top talent, galvanizing them to build enterprise momentum around the value of patient engagement.  

At the same time, for this to be sustainable, we need to ensure a systematic approach so pharma can realize the full ROI of patient engagement – building the right infrastructure to make this happen. You need momentum to be able to build the infrastructure. These two things can’t be done sequentially, they need to be done in tandem.  


FINAL THOUGHTS

The good news is that it’s easy to get started. Patient engagement is inherently motivating to your people and every pharma organization has teams with an immediate need for support.   

To figure out how to accelerate the momentum of your patient engagement strategy and embed it across your organization, Prophet conducts a 2-hour workshop that helps clients define and articulate their challenges and where they need to focus efforts based on our top 10 insights outlined above. Get in touch with our Organization & Culture experts at Prophet to learn more.  

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5 Common Mistakes in Managing Healthcare Data Products

How healthcare organizations can avoid and navigate data pitfalls while building data products.

As we embark on another chapter of technology adoption, moving from the Internet of Things (IoT) to web3 and the metaverse, and as a greater degree of interoperability takes hold, data in all things healthcare is no longer a differentiator but a table stake.  As we cover in our research, “Transforming Healthcare: The Changemaker Playbook,” the ongoing healthcare data revolution opens the opportunity to deliver better clinical decisions, faster and more appropriate care delivery and ultimately more equity and context to patient treatment. Everyone by now knows that by using data and managing it the right way, organizations will see costs go down and both clinical and business processes get smarter and more efficient. However, where does data specific to your needs come from?  Who’s generating it, curating it and selling it?   

There is a massive gap emerging in organizations as it relates to managing and extracting value from their data, namely the productization of it. Yes, there are seasoned players in the healthcare data space such as Optum, Merative and IQVIA that have a high degree of maturity as it relates to data-as-a-product.  But there are also new entrants, such as growing physician groups, amassing unique and compelling data sets, as well as device and equipment manufacturers, whose smart products are also accumulating data.   

We are finding that these fringe players in healthcare data are extremely eclectic as it relates to their product management capabilities with data. These organizations are oftentimes shining examples in product development with their core products (e.g. specialty practices, vital signs monitors, claims clearing houses, etc.), but when it comes to data-as-a-product, they are often overlooking a variety of fundamentals. These mistakes are having a dramatic impact on their ability to create value with data. Generally, we are seeing three categories of data products that exist in healthcare:  

3 Categories of Healthcare Data Products

  1. DaaS: Data as a Service – When you take raw or transformed data that can be sold or licensed to additional parties
  2. Data Resulting From a Feature – By utilizing features of an existing product or service to generate data that may be productized
  3. Algorithmic and Logic Based – Where you take data, apply logic and algorithms to it to give outputs or aid in decision making 

The following highlights a set of frequent mistakes to avoid when entering the healthcare data space.  
   

1. Prioritizing “More” Data Instead of Necessary Data 

Date range or depth are often things companies will tote as a major selling point. As you peel this back, we found that customers look for the quality and completeness of the essential data that they need to solve problems they’re working on.  

Focusing on who wants or needs this data, and why, is a critical question to answer when defining the data product. Adding lots of nice-to-have data sets to your product may not create customer value. Sophisticated customers who take the time to examine your data will often try to poke holes or find gaps that will impact their decision to purchase and adopt your product.   

2. Lack of Data Accessibility  

Whether your product is a database, web platform, App or API, thinking through the end-to-end customer journey is often a gap. Data is usually part of a broader workflow that combines multiple systems, tech stacks, integrations and processes.  

As you build your product, it’s crucial to envision the data’s entire journey. Make sure your customers can pull and access the data! Rarely does a customer only use a single data source, so being able to integrate and distribute with their other solutions is essential. Often data may need to be mapped to your customers’ existing data models. A helpful tip is understanding your customer’s personas, and their level of understanding and skills, as they will be the day-to-day people interacting with the data.   

3. Loose Data Governance Practices 

As your product’s data is generated or compiled, it is critical to creating a formal taxonomy (hierarchical grouping which gives structure and standardizes terminology). This allows you to keep track of the attribution (source, rights, ownership) of where the data comes from.  some of the things included in data taxonomy are clear definitions of what data means, whether those terms are generally accepted in your industry and knowledge of how to explain the data. Another critical element to data governance is understanding your meta-data. For example, it is essential to document things like time stamping, user, source, security, segmentation and IP rights. Data in healthcare can be sensitive with regulations and policies affiliated with it so understanding what is classified as HIPAA when data can remain identified or needs to be de-identified needs to be considered.  

There will be a number of team members working around your data (engineers, data scientists, database managers, statisticians, researchers, product managers, etc.), so creating a taxonomy and decision for access rights ensures the integrity of your data is preserved. Continuously auditing change logs and benchmarking data is essential and good hygiene. Furthermore, you need to ensure that this data is protected and that your business model for monetization is secure with accessibility. Whether it be in your technology or contract terms, protect your data’s IP. From the business and legal side of governance, your MSA, EULA and contract language (whatever is applicable to your product) need to clearly spell out ownership, give the right to anonymize, create derivate or redistribute data. Knowing where you are or what you can’t do must be relayed back to the product and technology development process.   

4. Data Analytics and Tools as an Afterthought 

Along with #2, we have found that customers want to generate more insights out of their data. This is often why clients ask for periodic data dumps or direct lines of access to the data. It is an important product decision to determine if and how much you want to invest in analytics and tools that enable your customers to generate more insights on their data.  

The more you understand their needs and what they are doing with the data outside of your product, the more you should consider what would make your product stickier if you built those capabilities in. These can be simple things like filtering, searching, scheduled reports or extracts or dashboards. We often see customers still taking data and using excel or tableau to generate basic insights that can be offered inside your product.   

5. Overly Technical Products Can Deter Adoption 

Knowing your user, their technical abilities and their thresholds should be accounted for in your product development process. User retention will suffer if it takes too long to develop skills and understanding to use your product. This will manifest itself with low user activity, as well as unsatisfied business stakeholders who made an investment in selecting and implementing your product. If you are building products that are technical in nature, be sure to engage that user type/ persona early-on and understand how big that sellable market is. Don’t expect a large population of non-technical people to easily embrace your product. You will get early and stronger usage with intuitive products, short-term implementation cycles and onboarding processes, FAQ/help documents and quality customer support offerings.   


FINAL THOUGHTS

As data, product and strategy experts, we have built and worked with numerous healthcare organizations that are challenged with building products that thrive in this rapidly evolving environment. Many companies that are in the early stages of building data product(s) are working through the prioritization of a backlog through current experiences – face a set of common obstacles.  

As a growth and transformation firm, we focus on partnering with our clients to enable the building of the highest quality products possible. Our specialization in healthcare, data and product management practices is a great resource to support you on your data product journey. We cover this subject more in our new report, but please reach out if you’d like to learn more. 

REPORT

Transforming Healthcare: The Changemaker Playbook

Tackling the top four areas ripe for innovation and transformation in healthcare, this report inspires action and impact with big-picture strategic ideas and tactical tips for driving change.

Change is hard, especially in healthcare. But in the sometimes lagging, but always vital industry, transformative change enables real people with real needs to live better lives. Not to mention, change strengthens bottom lines, improves investor returns and supports a more productive and sustainable society. That’s a powerful and synergistic business case to inspire all people that work in healthcare to take on the challenge of driving innovation.  

At face value, becoming a “changemaker,” can be daunting. It requires bravery and a clear sense of direction. This new report, from Prophet’s Healthcare team, was written to empower and guide healthcare’s future changemakers so they can ignite change in the industry and realize their transformation goals.  

Based on interviews with 29 senior leaders in healthcare, extensive market research and decades of experience helping healthcare organizations transform, “Transforming Healthcare: The Changemaker’s Playbook,” provides insights and recommendations to drive necessary change in healthcare.  

Download the report for: 

  • Deep dives into four areas ripe for innovation and transformation in healthcare:
    • The rise of connected and empowered consumers
    • The expansion of care outside the hospital
    • The ascendancy of Value-Based Care
    • The decentralization and democratization of data
  • Highly relevant commentary and insights from industry leaders across the ecosystem 
  • Digestible and achievable “next steps” for leaders seeking to become changemakers

Download
Transforming Healthcare: The Changemaker Playbook

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