Jeff Gourdji, co-Author of the book "Making the Healthcare Shift, The Transformation to Consumer-Centricity" joins me to discuss the five shifts that healthcare organizations need to make to adapt to this movement sweeping across healthcare. Hope you enjoy.
Bill Russell: 00:00 welcome to influence a production of this week in health it where we discussed the influence of technology on health with people who are making it happen. My name is Bill Russel. Recovering healthcare CIO and creator of this week in health it. A set of podcasts and videos dedicated to training the next generation of healt it leaders, this podcast is brought to you by health lyrics helping you to build agile, efficient and effective health It. Let's talk visit health lyrics.com to schedule your free consultation. Today we explore the transformation of healthcare to consumer centricity. This was a huge topic at himss and it continues to be a wave that's crashing over healthcare. We're going to have this conversation with Jeff Gourdji a partner with Prophet. I hope I get this right and global agency that helps companies with brand digital transformation and growth acceleration. Good Morning Jeff and welcome to the show.
Jeff Gourdji: 00:55 Good Morning Bill. Thank you for having me.
Bill Russell: 00:57 Is that pretty close to what Prophet does?
Jeff Gourdji: 00:59 Yeah, absolutely. We consider ourselves a management consultancy that helps our companies grow better through the things you mentioned through marketing and sales transformation, a brand strategy development experience innovation, um, and organization and culture changes. And, uh, we do it through across a lot of industries. I lead our healthcare practice and spend most of my time in health care, which includes everything from payers, providers, pharmaceutical companies, and a whole bunch of other folks that live in the healthcare ecosystem.
Bill Russell: 01:28 Yeah. So you guys have been busy. So you and Scott Davis recently released the book making the healthcare shifts, the transformation to consumer centricity. I'll start with congratulations, but tell us about the process of writing the book.
Jeff Gourdji: 01:41 Yes. Well, it's a thank you. It's, it's been a two year journey and uh, I think of it a little bit like running a marathon. If, if I ever run one, which will be once I run a marathon, I will be a marathoner and there'd never be a reason ever run another one. Um, Scott tells me I'll feel differently. Uh, it was 10 years since his last book though. And at the moment I'm feeling like this a, I'm an author and once this, no matter how many books I write, I'll still be an author. So I may say I need to stop while I'm here. But it's been a fun process. I've learned a ton doing it. I've been very lucky to have access to a lot of people who shared their insights and stories and I'm looking forward to sharing some of that with you, bill and with uh, and this conversation here today.
Bill Russell: 02:23 That's great. So I'll tell you what, I was a, I'm impressed with how logical is laid out, but just to give people a little perspective. 60 organizations, 250 executives, uh, you, it's global in nature. So it's large hospital systems, payers, Pharma and medical device, a digital health companies, us, Asia and Europe. And uh, so you have literally talked to people around the world about this whole, uh, this whole change that's happening and I guess it's not just a US phenomenon. Digital is transforming people's expectations and changing the way they want to interact with health.
Jeff Gourdji: 03:01 Sure. Yeah, absolutely. I think there's both, you know, the case for or, or for consumer centricity is, there's a couple ways of thinking about it. One is that people's expectations are changing, right? For all the reasons you articulated through the expectations of other categories and other ways of interacting. And the benchmark for a good experience is no longer in that other one. How did this health system treat me versus, the other different health system. It's how they do everything else. It's in their lives, Amazon, Uber, et Cetera, et cetera. So there's certainly the expectations change, right? At the same time, there's also the economic pressure, and this is not just a US phenomenon. This is true around the globe to get a handle on just skyrocketing healthcare costs. You can make the case, it's more acute here in the u s and look at our percentage of GNP, etc.
Jeff Gourdji: 03:48 But healthcare budgets are on a budget, global budgets are on the world are being strained by healthcare costs. So you've put that together with the consumer expectation, changing the cost pressure. And, uh, in a lot of markets, certainly in the US, all of a sudden consumers, the high deductible plans, et Cetera, uh, have the financial incentive to, to seek out and to engage in their healthcare little differently. So there's actually an important clarification that we make. You know, you've had to make it, for some people they say, oh, consumerism is all around, uh, winning with consumers who increasingly have choice. And that's true in a lot of times on a context. A lot of cases, consumers do have greater choice for, for the reasons we've talked about. However, as you know, particularly here in the u s there's also restricted formularies, restricted networks, restricted plan choices.
Jeff Gourdji: 04:38 So in some ways, in some markets, people, consumers have less choice, but that doesn't lessen the need for this transformation that we write about. Because the transformation is both how to engage consumers when they're quote unquote, you know, shopping or for healthcare. But it's also about engaging consumers as they behave in their own life and their own health and helping systems like inner mountain healthcare, which arguably have less competition. A lot of other places, um, are the forefront of helping consumers change their behavior so they act healthier, behave healthier and have healthier lives. And then lower costs.
Bill Russell: 05:15 You lay out the book, the case for change in healthcare, which you just jumped into. And then there's five shifts and we're going to go into the five shifts, but the case, so let's go to the case a little bit more. As a CIO, I had to make this case and I think a lot of health it professionals are trying to make this case, which is we have, uh, informed consumers. We have a motivated consumer. So when you now have consumers that can get some pricing online, technically, I mean, there's some transparency that starting to happen. So they're informed, they're, they're motivated. And even if they're in a walled garden, if you will, uh, in sort of tied to a provider or provider network, they may change jobs and ended up not being to that provider or they may be on a high deductible plan.
Bill Russell: 06:00 And those kinds of things are changing as well. So you have informed and motivated consumers. You have new entrance as you said. You have the care anywhere kind of a telehealth players. You have a Oscar and the, uh, insurance. So you have a bunch of new entrance. Um, you have government pressure, which you talked about a little bit in terms of just the, the, I mean, if you watch all the stuff that's coming out from Seema Verma at CMS and, um, and whatnot, you're seeing an awful lot of, uh, push towards opening up the market to, to opening up healthcare to market pressure. And then I think there's a societal pressure that maybe you didn't touch on, which is just, you know, if you're in healthcare and you go to a party in variably you hear horror stories, you hear this, Oh God, I got seven bills. I, I, you know, and there's a societal pressure that hey, you know what, my life's changed in so many different areas. When is healthcare going to catch up? I had to, does that capture sort of the, the case for it?
Jeff Gourdji: 07:05 Yeah, I think absolutely. I mean one of the things that we, I've, I've surmised is that making the intellectual case for change that consumers are increasingly in charge and should be in charge is pretty easy. Right? You know, at every health system I've walked into, and probably you as well says something like patients first patients on, right? So, so the intellectual case for, for the need to empower consumers as we prefer to call them or, or patients is, is pretty clear. The, the emotional understanding of the need to transform organizations is the intellectual cases for need for transformer organizations is relatively clear, I think where it gets harder. And you probably know this from your past experiences when it comes to a both financial investments, right? And be the cultural change required to make the transformation. So it's a little bit of moving organizations from knowing to knowing which is an intellectual to believing and feeling and, and that that's harder, right? That we always get the question, okay, you tell about these shifts, how do we get started? How do we do this? And we can certainly touch upon that. Oh, we have slash no news Flashes. There's no easy 30 second answer.
Bill Russell: 08:29 No, no. And we are, cause I mean one of the reasons I was drawn to your, to your book, which originated with some research that you guys have done as you say a couple of years ago. And, uh, I was drawn to it because you actually do get into the, okay, we make the case and a lot of consulting sort of ends there and you get into some very pragmatic ways that, uh, these health systems have gotten in here. So what I'm going to do is I want to march through the five shifts. Okay. Read a little excerpt from your, your material and then just jump into some questions. So the first shift from tactical fixes to an experience strategy, and I'll just do it in your words. So while healthcare organizations often start enhancing consumer experiences in one off initiatives, and that is so true, uh, they should move towards optimizing entire healthcare journey as a strategic priority. Doing so requires establishing a vision for the organization, hiring the right leaders to take charge and creating an experiential plan to change. And win the consumer, win with the consumers, so gave us, and I mean that there's an awful lot there. Give us an idea of what this, this first ship looks like from tactical to, to a holistic experience strategy.
Jeff Gourdji: 09:42 Yeah. So I can't help but thinking in three. So let me give you three thoughts in your, in your question. I am a, I am a management consultant after all the, the first one is CX and you, you reference it is going from a to do item to something to business organizes around, right? So if the idea that the definition of customer experience or patient experiences, let's have friendly people that greet people as they enter the hospital and help them find their way, that's a good thing to have on a to do item. But that's not, that doesn't fundamentally change the experience. Right. I'd say the same thing about initiative to reduce um, night noise in the Med surge unit or an initiative to reduce wait time. When people call the call center with a billing question, all those are good things to do.
Jeff Gourdji: 10:26 But in and of themselves do not galvanize transformation when it becomes truly around like the Oregon, not something on the to do list, but the overall strategy for it. Let's just take health systems as, as the most you know, were present. Present example is, um, it becomes the organizing idea for everything we're trying to do. So one of the stories we can talk more about, you know, Piedmont healthcare and, and how they did that. That's kind of 0.1 though, going from a to do item to some business organizers around. The second thing, and this is related, is going from a touchpoint orientation to a relationship orientation. When I measure h caps, that speaks to a single night stay in the hospital and did I have a good experience now that's more than one touch point. That's several touch points but versus an nps type of measure of how do I, what's the relationship we a health system has with people in our communities?
Jeff Gourdji: 11:21 That's a very different way of thinking about just as from a metric standpoint, how to think about patient experience holistically and a patient experience strategy holistically. And it takes you to doing different things. And then the third idea is what I call going from fixing what's broken to a brand experience, right? Fixing what's broken mentality is where are we pissing people off and how do we stop pissing them off? And again, that's a good thing. Versus saying, what's the unique way that we, our organization want to live and be perceived in the marketplace and be, and let's synchronize what we're telling people, what we're telling them about why they should come here versus what we're actually delivering. And let's make the promise that we make through our marketing communications match the promise that we deliver. Right? And make sure it's unique and differentiating and relevant. So those are, those are the three ways that we think about making this shift from tactical to more holistic.
Bill Russell: 12:18 That's really interesting. Um, I liked the training. I like the distinction between, you know, fixing the problems and touch points because we, in conversations, we talked to an awful lot about touch points, you know, here's, here's where people experience us, but they, they experienced us more. Uh, if you're going to change the culture, it's more than just about fixing all these little things. I mean, you can fix up all the things that are wrong with the house, but still the foundation's broken and you don't, you just don't galvanize or, or mobilize the organization to change the way they act. And I guess that's what you're, that's what you're after here is really changing the entire health care system to be thinking about experience holistically versus just fixing the things that are broken. Is that, does that capture it?
Jeff Gourdji: 13:01 Yeah. Yeah. No, exactly right. And to your point, one of the things we write about is this need to jumpstart change, right? In order to galvanize, and there's a few examples we use. I mean, for me the most classic and it's, you know, now a few years old, like what, what Geisinger did a few years ago with their proven experience moneyback guarantee. Right? And what we hear from our interviews with, with some of the leaders there is that, you know, when, when, when Dr Feinberg first put this out there, there was a lot of grumbling about the new guy and is this crazy and how are we really gonna do this? How would this work? Um, but in a few years and only 500,000 were put air quotes, only 500,000 in payments made in in refunds will $500,000 could have easily been justified by the quality of the PR they got. The publicity alone would have made it a good investment, but far more important than the PR was how it changed because all of a sudden they could track service line by service line, location by location, who's giving refunds. And it signaled as much internally that they were serious about this and serious about putting the consumer at the center and really being consumer centric and winning with them. And that, you know, that that tactical program, that experience strategy became a galvanizing force for change.
Bill Russell: 14:17 Yeah. Are there, are there other Health systems? I mean you, you share a lot of stories. Yeah. Inner Mountain Navon, Piedmont, others, but are there other stories around that, around this, this movement?
Jeff Gourdji: 14:30 Yeah, I think that, you know, those are, those are my favorites and my go tos, but almost every client we've worked with, transformational change usually starts with I, it sometimes starts bottoms up, sometimes it starts tops down. But even when it starts top down with our vision is got to have a series of quick wins and, and, and small moves to start to prove and prove it's not flavor of the month. Um, we've seen it with Pharma client recently is, is done it, we've seen it with payers as well. It's really a pretty consistent pattern. The question is within, in any, in any company, there's always a million initiatives going on. How do you create something so compelling that it actually starts to get people to act and think differently? Um, and, and that's why I go with that example.
Bill Russell: 15:14 Yeah. At our health system, we actually know, we did the journey mapping around a specific around orthopedics and then we did, um, we identified, and I think you had some of this in the, in the articles. Uh, know me care for me, ease my way. And to be honest with you, we had two others, I don't even remember what they are now, but the uh, but essentially what it was was a, an attempt to get the organization to start thinking about, um, you know, how do we get to know the patient more? How do we, uh, make sure that we're not asking the same question over and over again? How do we do our core competency and do it well in terms of caring for them? But then how do we do it at a price point that is a palatable to give them a bill that is understandable and the ease my way thing is where we ended up spending a lot of time because there's an awful lot of friction within healthcare and that that was really our starting point. Would you recommend a different starting point or how, where, where would we start?
Jeff Gourdji: 16:19 It's a good question. So I think it depends on who's driving the transformation, right? When, when it's CEO led, it very often starts with this, this shift one, right? Setting this vision for what does consumer centricity look like for us and how is it fit with our overall business strategy? And then it cascades to some more tactical fixes when, and we'll talk about the shift late later, three and five. If it's marketing, it led by a marketing function or an experience function, it can start with, you know, a new base of insights and understanding of consumers. It could start with a approach to innovation. It can start in different places when it starts more grassroots. And for grassroots leaders that aren't leading big functions that aren't necessarily tangentially part of this part of the c suite or, or, or close to the c suite, it almost always starts with some of these smaller types of pieces. Um, and, and sometimes it starts with, you know, stop pissing them off as I, as, I mean to dismiss that at all. But it starts with some of those things aren't just, you know, getting to know folks a little bit better and start to find, make sure that everyone else around you knows more about what they're dealing with.
Bill Russell: 17:26 All right, well let's move to the second shift. You have a from fragmented care to connect with ecosystems. And again, I'll just introduce it with this snippet here. So although payers, providers and Pharma companies are finding new ways to work together, the healthcare journey is still fragmented for most patients causing frustration inefficiencies and high levels of dissatisfaction operating in a healthcare ecosystem rather than in a standalone entity is the only way those in the healthcare value chain will survive and thrive in the future. So, so this is about orchestration. Give us, you know, what, what, what is this shift about?
Jeff Gourdji: 18:03 Yeah, so again, a few ideas, you know, but the story we sometimes like to tell, and it's, you know, it's getting older and older, but some folks still remember it. Well, you know, when apple launched the iPhone, they didn't just say we're a manufacturer or manufacturing it in shipping and good luck. They actually picked a single carrier and at&t and formed a close partnership with them. Now, I'm sure there's all kinds of financial reasons they did that were also allowed them to work very, very closely with the at&t team to make sure those people were signing up and getting on board and learning how to use this. And back in the year of what is an APP, right? They took charge of the whole journey, right? And they integrate themselves in the whole journey rather than saying we manufacture the phone, call somebody else,
Bill Russell: 18:53 right? And we're going to go, we're going to go live with 20 manufacturers. Now all of a sudden you have all sorts of sign up problems and issues across the board
Jeff Gourdji: 19:00 or that's right. So, so hopefully the analogy, it starts to become, you know, reasonably obvious to, uh, to, you know, to healthcare where we're very often, you know, consumers all the time. I called the insurance company, they said one thing I called the hospital, they say call the medical group. I called the medical group, they said call the hospitalist group. And when I, and there's, and there's that that leads to that fragmentation. That's just from a billing standpoint, right? Then of course there's the specialist telling you one thing and this other specialists telling you something else. So the opportunity in this shift is, is around owning and connecting that entire journey, even if it hasn't historically been in the purview of payment for example, of, of a particular provider or you know, making, you know, there's smooth transfer information between specialists.
Jeff Gourdji: 19:48 So in the case of where value based care create, create the financial incentive, it's in theory easy, right? It's never easy, but it's easier because all of a sudden the financial incentives start to get aligned. But even where that hasn't happened, if an era where consumers have choice and are looking for that and winning and competing for them is making sure the experience is not frustrating. There's opportunity for, for all systems, regardless of their reimbursement strategies to to think differently about this. So this is around a couple things, you know, one, instead of owning your piece, owning the entire journey, right? This is around thinking about everything's done, we invent things here and that's what we do. And we're exclusively in house to external collaboration and partnership and really empowering teams to think about, oh, instead of just owning discrete responsibilities, having the metrics in place to create empowered problem solvers within organizations so they're not passing, you know, patients or consumers off.
Bill Russell: 20:42 Yeah. And this is, this is challenging. We just recently had somebody on the show when we were talking about, uh, uh, social determinants of health and the partnerships that are now the new, whole new set of partnerships for healthcare systems that have to sort of pop up in terms of, uh, being able to coordinate care and responses to those kinds of things. So this is really a, I'm going to put on my it hat. This is really challenging because now you're trying to orchestrate things, uh, across, uh, multiple systems, multiple data silos, multiple those kinds of things. Is there, is there a way of, of doing this that sort of smooth that out, that sort of says, hey, we're gonna, we're gonna orchestrate this and then we're going to deal with the complexity
Jeff Gourdji: 21:30 at a later time? It's a good question and I'm sure I could learn more from, from you bill then, then you can learn from me. But just a couple of thoughts. One is what we've dealt with this with clients where essentially the it stack and the system's inability to integrate and the investments required to make those things happen can kill things that are otherwise pretty light light types of investments. We worked with a pharmaceutical company recently that was um, uh, in the oncology space trying to create some of these, you know, to a non it person reasonably easy solutions. How do we create tracking apps and how do we make sure that we allow them data to be shared between the patient that enters it and the, and the in our company and the Pharma and the, and the oncologist. But of course as you know, that that's way easier to draw than it is to actually architect from assistance standpoint.
Jeff Gourdji: 22:15 The answer there, it was going to, there's a couple of answers, but in this case it was finding partnerships outside of, uh, finding digital health partnerships to white label some of these things and starting to create these things outside the ordinary staff going around the ordinary stack and systems to do that. Now that may be a, that may be, uh, uh, I may be stepping on a third rail with, with your listeners and with the CIO is out there. I don't know. Um, but I think, you know, in the end, I think it comes down to finding creative ways around some of those challenges because if it, if it takes three years to put that in place, it will be out of date.
Bill Russell: 22:49 No, and that's what you're saying is what we're seeing more and more within the, uh, CIO ranks, which is, uh, uh, or you know, pulling different things together and sort of making sure that they can communicate on a standard set of Apis and those kinds of things so that we're, we're, we're building more platforms and a lot less application silos so that we can be responsive. Um, this is a fascinating conversation for me anyway. Um, the, uh, the third shift, uh, from population centric, the person centric. So this is, this is really, this is where it really gets interesting for me. So healthy organizations must move away from creating product services and experiences for groups of similar consumers. So that's, there's those who have the same condition or those who fall into the same demographic. Health organizations must begin to create product services and experiences for consumers based on their individual needs. Now, this, I mean, the technology left, it gets really interesting, but, uh, but I want to talk about what this means. So you want to move, you want to move from populations all the way down to individuals. So there's, there's gotta be a couple steps there to get from there to there. I mean,
Jeff Gourdji: 23:58 yeah, yeah, yeah, for sure. I don't know of any scenario or any manufacturer and in almost any business that can truly create personalized products, right? There's a lot of places that create the, you know, with, with common platforms, you know, create the appearance of customization. I don't know that that's necessary here. It's not necessarily what we're talking about. We are talking about is a couple of things. One, you know our payers who talk about, oh we have segments, we have large group, we have a large group commercial, we have national accounts, we have, you know, local groups. We have Medicare, we have the exchange, all organizing consumers by essentially the products or the funding mechanisms. And that case, right in a health system, it's typically by disease states, right? Or or occasionally by insurance source is the way they think about different groups of different people.
Jeff Gourdji: 24:45 Now add a product service. And so this is your point. I think about this two steps this way. The first step is how do you start to create products and services and experiences that are not lowest common denominator. And that usually requires identifying a group of segments or personas is sometimes a more invoke your term these days. And was that five, six, seven personas picking the two or three to, to customize around and maybe create a couple of different flavors and varieties. Um, you know, this idea sometimes people say, well wait a minute. We have to serve everybody. We're a community hospital. How can we just pick two of our seven personas and and focus for them? And it's a fair question. Right now, none of this is to suggest we're firing or not firing. Our patients are not treating anybody that comes in. But I would contend to this when Gatorade is going to sound like a far fetched analogy here.
Jeff Gourdji: 25:37 When Gatorade set their design target for designing their products and their services or experiences as competitive athletes, they built a strong business. When they watered it down to become a lifestyle brand, their business went down dramatically. When they went back to focusing on a competitive athlete or three to 5% of their volume, all of a sudden it became relevant and interesting and appealing for whole lot of other people, right? So again, rather than picking lowest common denominator of what works for everybody and creating generic experiences, how do we pick two or three personas as as bull's eyes and maybe there's two different bulls eyes. So we're not trying to do just one, but pick two or three focus, create something for them. When we make the big scale investments in product service experiences, that's the first bit. The second bit, which is obviously you know, what's getting all the y'all airspace and media today is how do you then really, really, you know, using Ai Algorithms, personalize.
Jeff Gourdji: 26:31 But then in the end is probably using those products, services, solutions, platforms and, and in groupings that have been created using segments and personas to customize the delivery, customize the communication, customize the content. So it's a little bit of a two step first, get from big populations to personas and pick the right ones. And then from there, that's where you make the big scale investments in products and services. But then when you get to actual delivery of content, et Cetera, that's where it can help create a really more of a, of a, of an illusion of customization. But it's certainly a true customization when it comes to us and the specific things, messaging, frequency, content, et cetera.
Bill Russell: 27:13 So let's, let's break this down. So, um, yeah, so a lot of health systems have created personas. I know banner has a, that Providence, uh, uh, one of the things Aaron Martin did when he first came in was, uh, created this persona, whether it was a couple of personas created, but the one he really honed in on was, uh, expectant mothers because they make so many of the decisions around healthcare. And the thought process was if we can meet their needs throughout that entire process that we can build out from there because they're going to give birth the birth of the child, and then you can start to figure out how you're going to care for that child, a child potentially born with a chronic condition, that child that's born healthy, um, eh, you could sort of move, I guess, move along that path if you will. Uh, the creation of personas is this know, is this, I mean, what does that process look like for a health system?
Jeff Gourdji: 28:05 Yeah, there's, there's different flavors. I mean, it can be as easy as picking a group and saying, you know, let's design everything around expectant mothers. Your example. And it doesn't need a lot of rigor. It doesn't need a lot of uh, uh, you know, custom research. It just, it just takes some good strategic sense and agreement to focus on, on, on, on particular group rather than trying to be all things to all people where we've done more rigorous, formal quantitative segmentations with, with clients. Uh, it has a lot. It can have additional benefit. One, you can go beyond what I call demographic characteristics expectant mothers, right? Cause one thing we know is that expectant mothers engage with health care differently. They have different attitudes about their own health, their own wellness, what they can afford, their, their belief that that either they're, they're all going to die and therefore there's no point versus a belief that they can change their future by, by acting and engaging.
Jeff Gourdji: 28:56 There's all kinds of different ways to thinking about expectant mothers differently. So you know, when the resources are available and the wherewithal is, is they're moving to more formal quantitative segments that are multidimensional in nature that take into account not only life stage. For example, you know, expectant mother, which often has a, has a narrower demographic component to it, but, but multidimensionally thinking about people's attitudes, their needs, their psychographics, their orientation toward their own ability to take care of themselves, their families, et cetera. Um, and then you can do then the, so the next more so my first base we're talking about kind of pick one, right? Then there's, you know, let's use a survey to understand consumers in our marketplace and break them into groups. And then I think that third mode, most robust is, let's actually you end the payers I've seen do this more than providers so far is let's actually use our database and let's type personas onto our database. So we actually can say of our members, we know 17% or in this persona with 80% accuracy, you know, 22% are in this persona based on that accuracy. So we not only can use it as a construct to say, how do we design products and spirits is based on their attitudes and needs, we actually can use to understand our own quote unquote book of business.
Bill Russell: 30:10 Yeah, that's fascinating. You've, you've talked a lot about data here. And so data collection becomes one of the, um, becoming a data organization and organization that knows how to collect the right information that has the right guardrails around privacy and obviously, but also a mechanism for, uh, creating value from that, from that data it becomes, uh, becomes really, really important. Um, it's, so again, what does, what does that look like? How do you create that sort of data ecosystem, if you will?
Jeff Gourdji: 30:44 Yeah, and again, something that you and your listeners, we'll have plenty of experiences that are relevant as well, but, but there's an idea that we put forth, we think, and we're starting to work more and more clients on, it's around eight a data strategy and, and, and the core of that is a customer data value, what we call customer data value exchange. Right. So I'm wondering, it's easy to collect lots of data and then figure out what to do with it later. Right. A more strategic approach is to understand based on the customer journey, based on your holistic experience strategy and the things you're trying to impact over time. What is the most clear critical data that you can use in the next 12 months? And what's the critical data you can see yourself beginning to use and call it the next three years, right? That's to uncover the data needs.
Jeff Gourdji: 31:27 Then from there, what is it gonna take to get the consumer to share that with us? Right? What does that data value exchange that says, I know you're a little concerned about privacy. I know you're a little skeptical of any organization that goes, you know, gets bigger and bigger and bigger and you're no longer local hospital, you're not a big health system. So I'm more and more skeptical. And how do you create the proposition? So classic example that doesn't work for everybody, but I think it illustrates the point. There's a, an online platform. Many of your listeners may know called patients like me based in Cambridge that has a, the most transparent customer data values exchange strategy I've seen. They essentially say, I'm paraphrasing, give us your data. We will sell it to life science companies. But in doing so we will help create the next generation of cures.
Jeff Gourdji: 32:12 So your next of kin won't have to live with the horrible diseases. You will, if we can help to Pharma companies, create cures, your next of kin won't have this, right? There's, there's summary headline of it is data for good, right? And it's literally at least last I checked literally right on their website, give us your data, here's how we'll use it and here's what you get for it, right? So that doesn't work. That doesn't work for everybody. Right? Um, but what, what is the proposition? What is the proposition based on those data needs that you want? How do you make clear to consumers why, if, if sharing the data will make their life easier, it's not just the ability for you to use it to manipulate them, but you're gonna use it to help make their lives better. And that's really the, the, the consumer centered view of thinking about data strategy. And then of course, all the hard work behind the scenes that, you know, the it community has to do.
Bill Russell: 33:01 Yeah. But I mean culturally if you can, well first of all they have to set up the mechanisms for collecting the data in the proper ways. But um, but one of the things that I think creates a cynicism amongst the users is when I give you my data and it's not used, that's where you talk about ecosystem as opposed to just sort of a, and we have a data department over here and that does analytics and whatnot. You're talking about something where the data sort of mashes around and starts to inform future decisions and future experiences and, and customized experiences and personal experience.
Jeff Gourdji: 33:35 Yeah, no, no, exactly. And just as an example, I mean we just did focus groups very recently for a, for a payer client. And we hear it from the same people in the same, not focus groups, actually just a qualitative interviews with, with folks one on one. Uh, and we hear from the same people. There'll be saying, I don't trust you. I don't want to give you my data in the same one side of their mouth. You just have, their mouth will say, you already have my data. You know me, why can't you show me that? You know me? If you know who I am. And I called the call center three times, why would I call next time? You pretend like we've never talked to me. Yeah. So there's still those, those privacy concerns are still there. I've seen, I've sensed over 10 years of doing this type of research, there's more and more willingness to share data. Um, but there's also the same time that comes with an expectation for your point that it's going to be used to, to, to personalize things even as simple as answering the phone and saying, you know, Hello Mrs. Jones. I see you called us before.
Bill Russell: 34:28 Yeah. Which, which was actually from a technology standpoint and pretty, pretty easy lift. Uh, so they're your fourth shift from incremental improvements to pervasive innovation. And, uh, I, I guess at this point we're really starting to hit on all cylinders. It's a, here's what you have to say. So instead of settling for small and time consuming improvements to already established systems and processes, organizations should reimagine innovation. They need to be consistent. They need to consistently adopt both an innovative and a minimally viable product mindset and using the portfolio of innovative approaches and spark changes. And, but one of the, one of the sentences that section the healthcare industry continues to struggle with innovation because it's, it has a crippling aversion to risk, which is understandable. I mean we manage risks that is very acute. Um, the difficulties of proving a return on investment for long term projects and a lack of structure for rewarding successful innovation. So just those three things. Yeah. So we have to, this is a, this is a big cultural move. Uh, where have you seen this? How have people been able to sort of break out some, some are starting
Jeff Gourdji: 35:38 to really break out in this area. Yeah. Yeah. So three ways. But let me just give you an example just to really illustrate the point I think a little bit before I share the three ways with you. We have a client that is a, I mean this case is a pharmaceutical company. I think this is most acute in, in, in Pharma, but, but, but also elsewhere. But where people have been giving permission to text message them, they've literally been saying, yes, here's my number, please text message me for two years and I can't get alignment between regulatory affairs, legal affairs, medical affairs, it, and all the other pieces of how they're going to do that. Right. And of course it's born out of the right reasons, right? Adverse events are important. They want to make sure if they, if they hear about them, they can treat them responsibility for their own, for the good of the patient, for their own kind of shareholders, et Cetera, for all those reasons.
Jeff Gourdji: 36:29 But these are people that have said, yes, it's okay, please text me. Right. So the diagnosis I, I, I think I'd offer here is that the historic culture of clinical innovation. Well, let me just, again, use Pharma as an example. I think it certainly is relevant with, with the health systems as well. The, the, the orientation is we're going to test something in a very small scale and then we're going to test it again and then we'll test it with animal. Then we'll test it with small numbers of humans and bigger numbers and bigger numbers are humans. And then we'll make sure legal affairs and regulatory affairs, legal, they're all through this process to make sure that when we bring a product to market, it's safe. You can get through the regulatory structure, et Cetera. So that culture of, of, of, of making sure things are safe that is there for all the right reasons when it comes to clinical innovation, unfortunately that culture often bleeds over, we'll call experience innovation, right?
Jeff Gourdji: 37:23 So we can't do anything. We can't put out a app or a, an online set of tools until we've tested it and tested again and run it seven ways to Sunday. And uh, that, that becomes a real barrier to innovation because then by the time you come up with it, right, it's no longer state of the art because you've tested it for five years. Right. Versus the Silicon Valley approach of let's put the most minimally viable product out there at the MVP approach, the one dot. Oh, and you know what, we'll roll out a new version in four weeks and another version after that. And Facebook every two weeks. It's a bad example of these days, but any kind of online app, they every two weeks there has send you an update and your download the newest app in the APP store and right. It'll improve and get fixed, et cetera.
Jeff Gourdji: 38:06 So that's hard to do. But we came across, you know, here in Chicago at what's now Advocate Aurora health with their example of uh, you know, the mammography program where one dot o version, it was calling be seen today, right. Which should on a major pain point around, you know, the anxiety that comes with, you know, needing to get a mammogram. It evolved. The two out o version became call seem to get results today, but it took an extra six months to align up all of the operations behind the ability to go from call and be seen today, which took some doing, right? But call seeing get results today was another version. So they didn't wait and get the result. They start with call and be today and I think, you know, six months or so later call and be seen and get results today.
Jeff Gourdji: 38:46 And then the 3.0 version is to continue to scale that to other procedures, et cetera. Versus saying, we think same day appointments are a good idea, but let's take three years to make sure we can do it across all of our points of care, all of our service lines, all of our geographies and um, versus let's start small scale enrolling out from there. So, so this MVP approach is I think one of those, and it's a little bit just a different mindset. It just says what's the minimally viable thing you need to put out there? All the important caveats that again, we're talking, if we're talking about an APP, you know, we're not, we don't need to test it through three phases of clinical trials, right? We can, we can go a little faster. So it kind of ones is MVP approach. Second, we see companies using internal incubators and trying to set aside and treat the new culture and to change that culture and bring in different talents and skill sets and give them a pot of money and let them go to work.
Jeff Gourdji: 39:40 And then in third, there's just knew the accelerator organizations that are not necessarily tied or loosely tie, right? So the Texas Medical Center Innovation Institute is a great example. They, they provide a safe space and some coaching and support and they have a very competitive process for promising startups to get into the program. They come in for six months, they give them access to, uh, you know, their, their member hospitals so they can accelerate their innovation. Right. You know, they're the, the former innovation director told me, you know, look neat. These, these startups, digital startups, it can take them 12 months to get an agreement to even run a test with the health system. They don't have the cash and the burn rate to survive that long. Right? So, so the hospital systems are stifling innovation by some way, by being so conservative in making it so hard for startups. For a lot of the innovation is coming from to partner with them. Sometimes those accelerator programs can be a way to, to shortcut that.
Bill Russell: 40:34 Yeah. Yeah. We had Darren Dorkin was talking about his accelerator a couple of weeks ago and uh, yeah and I think there's more and more of those creates a different set of challenges. But um, you know, I wouldn't put on my it hat here for a second cause this is one of the areas where the it staff is going to say, you know, here's, here's the challenge. Um, you know, yeah. You could stand things up pretty quickly. Like we did telahealth for, we did telestroke program and people were getting all bogged down and what we ended up doing was just doing, uh, you know, essentially a video link between, uh, the place with the specialists and the remote location. And they were able to share a medical record because we already had shareable medical records. And then it was just a matter of getting the telemetry data. Well, you know, we just use off the shelf kind of stuff.
Bill Russell: 41:22 We stood something up very quickly before we tried to, and that, that happens in it all the time. But when you're talking about the consumer and the consumer experiences, yeah, there's an expectation of, oh well we'll just use face time. Oh well we'll just use, we'll just text back and forth that the challenge becomes the regulatory environment, which we live in. We have to capture all that stuff. And so when a doctor and a patient are texting each other, that's an apples walled garden and we don't have access to that data. But then when the lawsuit comes that says, Hey, we told you about this, we have no record of it. So there, there are some challenging little challenging things there that, that we, uh, that does actually causes, causes us to, I dunno, uh, slow down a little bit and think about it just because our environment's not quite silicon valleyesque in that. Yeah.
Jeff Gourdji: 42:13 Um, it is highly regulated, no doubt challenges exsist.
Bill Russell: 42:20 Um, I liked the MVP approach. Have you seen it? So we need to talk about, uh, creating an internal startup. You, uh, you reference the accelerators, but, um, have you ever seen anybody, have they taken groups of people and just said, you know, they're part of the, the organization, but they push them over and they say act like skunkworks, act like a startup and start innovating, but they're actually employees of the health system. Have you seen that model
Jeff Gourdji: 42:52 One that comes to mind is in his farm of Boehringer Ingelheim, you know created Vix, right. And I don't know what their legal employment status was, but essentially it was a funded group. I think it might've even been a separate entity. I'm not sure what the employment status changed, but it was, it was the best. It was trying to create the best of both worlds. It was a startup in terms of culture and expectations and motivations. Um, but they brought in both and some of the legacy members of, of Bi went over to bring the expertise and the, and the, and the knowhow, um, together with new employees. And again, I don't know whether they became legally new employees or, or just kind of parked in a separate business unit. But it certainly created the employee experience of, of being separate and, and you know, into the side.
Bill Russell: 43:32 So we're talking a lot about consumer and patient experiences. Um, but uh, there there's also the providers aren't happy. Are you looking at that side or are you just mostly focused on the creating experiences around this consumer? Cause I mean that's the, that's the really the core hypothesis here is that healthcare is changing around the consumer. What do you tell organizations that get caught up in the, but we have to create these experiences for our providers as well.
Jeff Gourdji: 44:00 Yeah, so it's, it's a great question. The, the, the focus of our research was primarily on how organizations are transforming because of, you know, the empowerment of the consumer. And, and part of that answer is always, you know, and, and the most influential groups are very often the physician groups and bringing them on board is critical to make the consumer happy, but also to, to make them happy and achieve the success they need. You know, Carl Armato, who's the CEO of Novant health said, and I'm paraphrasing essentially, you know, we used to get caught up and provider experience versus patient experience. Now we just call it the human experience and we need to stop thinking about them separately. We need to think about them collectively as a group of Dennis Murphy at Itu Health didn't quite put it in those words, but as we did the work with, with him, some of the strategy work around their transformation.
Jeff Gourdji: 44:45 He also wanted to think of those almost equal and critical audiences because I think they've got, I don't know, 20,000 employees around the state of Indiana and making them happy with certainly crucial. There's research and it's hard to say what's, what's important and what's causation, what's correlation. But there is some anecdotal evidence I've seen is that there's a correlation between staff satisfaction and patient satisfaction. Right. Well, which is it? Is it that happier patients leads, makes the staff's job easier? Or is it a happier staff? Makes, makes for more engaged, friendly in delivery of care. So that makes the patient happier. Don't know, but it's pretty intuitive to me that you can tackle them together and holistically.
Bill Russell: 45:27 Yeah, we are, we are, we're in the home drive here. I'm sorry, I'm smiling because I just, I'm, I'm one class away from finishing my MBA. I just finished my statistics class. So listening to you talk is just washing all that stuff over me again. So, um, shift shift number five from insights has a function to, to an insights operating system and a establishing insights as a function is critical to gathering intelligence on the consumer. But it's not enough interesting statement in and of itself. Healthcare organizations need to create a culture of consumer obsession where everyone in the organization keeps the consumer front and center at all times. Organizations can build this by creating an insights operating system. So tell us what an insights operating system is and how we get there.
Jeff Gourdji: 46:12 Yeah, so my colleague Christine Brand Jones, who leads our insight practice, gave me this analogy. So I'm going, not going to take credit for it, but she said in insights operating system is when you have the quarterback and the receiver working seamlessly together. And then a passing game. Right? So what short of that is, you know, you, you had said, you know, it's not enough just to have insights and intelligence. It's not enough to have a great quarterback. Someone's got to catch the ball, right. So the organization needs to be able to, oh, also to generate insight and information, useful information about how to meet consumer needs when they make business decisions and they need an organization that knows how to use the information and integrate it into business decision making. One large payer that we spent a lot of time with has an enormous, probably has a 25 person staff just in market research, not marketing, just in market research.
Jeff Gourdji: 47:01 And this is several years ago. So it might be different number by now, generating all kinds of reports and doing all kinds of research. But yet when we interviewed their internal customers, they said they're always issuing these reports. I don't know how to find them, what they mean, and even what it means for me. So the insights operating system is around is the seamless integration. You know, I, I would venture a guess, and again, I spend most of my time in healthcare, but inside some of the large technology companies that are so good at being consumer centric. Now you Amazon for example, I don't know, do they have a formal market research department maybe or, or is it just that, you know, does Nordstrom probably maybe right? Maybe somewhere in corporate, but it's really everyone's job to understand kind of consumer needs and how to meet them.
Jeff Gourdji: 47:43 So that's, that's the principle that we talk about. So the question is how do you do that? How do you take that philosophical construct and how do you make it happen inside a company? So we've seen a few things. Um, one is we've seen, you know, Aetna, Dave Edelman talks about creating an account management structure. We took his market research team that was organized by functional expertise, you know, statistics versus survey design versus that type of thing and reorganize it around business units. So each business unit has a partner from that team that's assigned to get to know the business, understand the needs and bring back information. And then can the context, it's useful to a business unit. So that's kind of 0.1, reorganized it on an account management structure on internal customers. Number two, uh, uh, Eli Lilly and company has a made the decision rather than hiring deep, deep, deep experts in the methods of market research, they're going to make that role in insights a rotational program and have seasoned executives from not only for marketing but from sales and other leadership functions rotates through what's a traditional market research function. Spend a year and a half there because A, they bring business insight and perspective into the role and two when they leave it and go back out to their other roles, they also have an understanding of how to think about it. So again, trying to create that seamless flow of information beyond just doing additional studies are a couple of the ways we've come across how organizations are starting to think a little bit differently and create that insights operating system.
Bill Russell: 49:13 So really, I mean, it's, by the way, that last example is really fascinating to me and I'm going to, I'm going to think about that for a while, but the, um, we, we get caught up a lot of times in this conversation of who owns it and who runs it. And, uh, and I would say it just because you're talking about a cultural change that has to permeate almost every part of the organization. It needs to come from the CEO and they need to own it. But with that being said, you can't have it over here doing their thing and marketing over here doing their thing and strategy, doing their thing and operations doing their thing. I mean, those four need to be so knitted so closely together that the, it almost operates as one person's brain. You know, they, they know what each other's doing and there they're integrating data collection methods.
Bill Russell: 49:58 They're integrating a insights and they're delivering them back. Uh, but they're also educating people on how to, how to use it. And they're empowering people to create new solutions around. I mean it, I mean, what you're saying is like, this is the, the final exam. This is the capstone for an organization becoming a consumer organization. And it's where all parts of the organization are sort of intertwined and it, it just continues to build upon itself. It creates these insights for the organization as well. Said. No, no question there. I'm leading the witness. Sorry about that. Uh, no, I mean, that's a, that's exciting. This is exciting stuff. So, uh, hey, I, you know, I actually, we're at the, we're at the end of year, so I really appreciate this. This is a, this is a great book. I will, uh, you know, I'll, I'll throw up a picture of it on the, uh, on the, uh, video when I put it out there, but the book is making the healthcare shifts the transformation to consumer centricity. Scott Davis, Jeff Gourdji, and I really appreciate you coming on here and a, and sharing these insights. This has been great. I appreciate the opportunity and enjoy the dialogue very much. Well, thanks. Well, this show is a production of this week in health it for more great content you could check out the website @www.thisweekandhealthit.com or the youtube channel. At thisweekinhealthit.com/video is easiest way to get there Again, thanks for listening. That's all for now.