Patients are the solution – not the problem

Patients are the solution – not the problem

Healthcare sector needs long-term thinking and persistence to solve today’s issues.

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Businessman speaking in conference

Jeremy Hughes – CEO, Alzheimer's Society UK

There has been a tendency to view rising patient expectations as a problem that will stretch the resources of healthcare systems.

What other industries have long recognized – and what healthcare is at last waking up to – is that an active customer is actually a force for positive change. Their feedback can provide valuable ideas to help improve care, by making it more relevant to the needs of patients. Taking a leaf out of retailers’ books, these ideas can also drive research and development for new, relevant products. A more engaged patient is also able to play a bigger part in his or her own care, which can ultimately lead to significant cost savings.

Other industries are starting to tear down the barriers separating providers and consumers, by involving customers at more points in the value chain, notably in the area of self-service, which is replacing the roles of cashiers and shop assistants. The traditional paternalistic role of doctors as the possessors of all medical knowledge has proved a little harder to shift.

At heart, most clinicians realize that no one knows better about a patient’s needs than the patient themselves. They now need to seize this notion to meaningfully change their clinical interactions.

Customer engagement requires an upfront investment. Self-service in retail stores cannot work without the right equipment to select and scan items, while banks must provide the right interactive software to ensure safe, convenient online transactions. It is no different for healthcare, where patients need support from remote diagnostic equipment, powered by technology.

A number of healthcare organizations have turned to behavioral economics to better understand the way they interact with customers, and to shape their behavior. South African health insurer Discovery Health developed a product called Vitality, incentivizing policyholders to take better care of their health.

Health systems without private insurance need to look for alternative ways to encourage patients to get more involved in their own care. The need for active patients is even greater in emerging societies, where staff and resources are limited. However, in all cases, individuals require a supporting infrastructure, and cannot be expected to go it alone.

The Society for Family Health (SFH) is one of Nigeria’s largest nongovernmental organizations, whose mission is to empower citizens, particularly the poor and vulnerable, to lead healthier lives. SFH works with the private and public sectors, utilizing social marketing and other methods to improve access to essential health information, services and products to encourage healthy behavior. With appropriate support from communities, patients are urged to become the primary guardians of their own health.

Case study - Declaration of rights: Alzheimer’s Society UK

Patient representative group Alzheimer’s Society UK has created the National Dementia Declaration, comprised of three simple statements that, if answered, would transform the way that providers work with patients with dementia:

  1. I have personal choice and control or influence over decisions about me.
  2. I know that services are designed around me and my needs.
  3. I have support that helps me live my life.

Barbara’s Story, a video created by nurses at Guy’s and St. Thomas’ NHS Foundation Trust, lets staff understand the experience of those with dementia – a fifth of all hospital patients in the developed world – paving the way for better, more appropriate services.

View Barbara’s Story

Case study - The rewards of a healthy lifestyle: Discovery Vitality (South Africa)

In most societies, insurance and social security systems are coming under increasing pressure due to ageing populations, limitations in national budgets, and rising healthcare costs. While the underlying nature of risks are changing, traditional models of insurance have not evolved: the burden of disease across all societies has shifted from communicable diseases to non-communicable diseases. Inefficient healthcare, insurance and social security systems do not address the issue of poor human behavior – their business models are largely seen through a curative lens, rather than a preventative one.

  • assessed for their risk factors;
  • provided access to a network of wellness and health providers at a discount to remove price barriers;
  • incentivized to engage in prevention and wellness promotion activities, through which they are awarded Vitality Points and a Status from Bronze to Diamond; and
  • rewarded based on their Status, including retail, airline, travel discounts and more.

There is extensive evidence supporting the efficacy of this wellness-integrated insurance model, in terms of improved member engagement in health and wellness activities, improved clinical outcomes, reduced healthcare costs, increased productivity at work, and improved mortality rates. For example:

  • Targeted incentivized behavior includes:
    • the uptake of preventative health checks;
    • the purchasing of healthy food from partner chains, where over 14,000 HealthyFood items are up to 25 percent cheaper; and
    • regular exercise.
  • Between 2011 and 2013, there has been a 26 percent increase in screening activity, significant for both insurer and member, given, for example, the 9 percent reduction in the average cost per cancer case due to early detection. In addition, between 2013 and 2014, there was a 34 percent increase in the number of healthy food baskets purchased, a 9.3 percent increase in healthy food items purchased and a 7 percent decrease in unhealthy food items bought from partner stores. Finally, between 2013 and 2014, gym visits increased from between 24.1 million to 25.7 million.
  • From a clinical outcomes perspective, the results are significant: for those that are the most engaged with Vitality (Diamond Status), there is a 10 percent reduction in the hospital admission rate compared to the most inactive members, and a 14 percent lower cost per patient versus non-program participants. Furthermore, at age 65, there is an 8 year difference in life expectancy between those who are highly engaged (Diamond Status), on the program and non-program participants.

This wellness-based insurance model delivers unique benefits for members and the insurer, resulting in savings. These savings are in turn used to fund the discounts at the reward partners which are needed to drive the required behavioral change, creating a simple, powerful and reinforcing loop for Discovery Health and its Vitality members.

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