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Transform Care April 28, 2016

The Consumer’s Journey: Quantum Health CEO Kara Trott Applies Retail Lessons to Healthcare (1/2)

Founder & CEO, Quantum Health
Key Takeaway
Our research shows even if the #healthcare issue isn’t complex, the experience is - @QuantumHealth1 CEO Kara Trott

Kara Trott is the Founder and Chief Executive Officer of Quantum Health, a consumer navigation and care coordination company. Throughout her career, Trott has had success designing and executing research-based consumer intercept strategies for major consumer brands like Citibank, Ford, Walmart, and Coca-Cola. She brought this same expertise to healthcare. In 1999, Trott founded Quantum Health, the first company in the healthcare industry to apply consumer behavior mapping strategies. Using proprietary research, Quantum Health established a model for consumer care coordination and navigation based on how people experience their healthcare journey, what they need, and how best to connect with them. In Part 1 of a series on “The Consumer’s Journey,” she contributes her perspective on recent industry shifts and their impact on experience in healthcare:

When consulting in the 1990s, I observed parallels between the challenges people faced getting through the healthcare journey and those in other industries. There wasn’t a clear pathway for consumers to navigate the unchosen healthcare journey. They had to make a lot of stressful decisions in a short period of time and were being bounced around the system like a pinball, not knowing who to turn to or trust. The experience leaves those navigating the complex healthcare system feeling lost, stuck, alone, and possibly misguided, leading them to wrong solutions that pile on even more confusion and costs.

Lessons from retail

It struck me that the experience could be improved by first understanding the consumer pathway – where they enter the system, how they make decisions, and their frame of mind when in the journey. I had earlier worked with large retail companies on consumer research and strategy projects analyzing how shoppers moved through a decision process. Those efforts led to restructuring store layouts or product distribution to match the consumer’s normal behavioral patterns and intercept them in their normal process.

It struck me that the experience could be improved by first understanding the consumer pathway.

To find out how these lessons could apply in healthcare, I embarked on a two-year consumer behavioral research study that tracked the healthcare journey of 3,200 consumers with 290 physicians participating. The focus of the study was to map out each journey.

As expected, we observed how no one gets through the healthcare journey without getting stuck somewhere. We saw the emotional and physical state of the consumer at the moment they realized they were a healthcare consumer. We saw how the consumer feels as they experienced the journey (fragmentation, confusion, and bewilderment), points at which they had to make decisions, where they got stuck, and where all the disconnects happened.

We observed how no one gets through the healthcare journey without getting stuck somewhere.

Unexpectedly, we found there was no segmentation based on sociodemographic factors or the reason they were on the journey; all people experienced the healthcare journey the same. Our essential conclusion: even if the healthcare issue isn’t complex, the experience is. Another unexpected finding was how critical the starting point of the journey was to success: 41% of consumers’ self-referred to a physician and 61% of the referrals were to the wrong physician, resulting in a delay of receiving the treatment needed.  

Mapping the healthcare journey

With the results of this research forming its foundation, we launched Quantum Health in 1999. From there, we incubated and tested the model to ensure that results were replicable over multiple years in a variety of demographics, plan designs, geographies, and industries. In 2013, we updated the original research with narratology. This research involved panels of patients, consultants, and human resources professionals and enabled us to have an even deeper understanding of the entirety of the consumer healthcare journey, yielding insights and a clear understanding of their emotional state, the kinds of decisions they make, and the issues they face.

We gained an understanding of the consumer’s needs that helped us create a guided experience that connects them to the right tools and resources they need throughout their journey. We have been able to affect the way healthcare is delivered and experienced for both the consumer and the employer, by building trust, simplifying the experience, engaging earlier, and eliminating 20%+ of cost that didn’t need to be there in the first place.

Few solutions connect with the consumer at just the right time, when it is most relevant and appropriate for them.

As we have built out our business over the past 17 years, several industry shifts have had an impact on the consumer experience in healthcare. Assumptions on how to drive consumerism have evolved. Plan design has been used to incentivize engagement. By giving employees more information and encouraging them to use solutions and programs focused on wellness, the hope was that the consumers would make a change with the additional resources.

But now there’s a growing recognition that if you want to make an impact or get results, you have to have a more targeted approach and connect with the consumer at the right points along their healthcare journey, in the way they need to be connected with. There are a lot of solutions out in the marketplace that address certain issue at a certain point in the journey, but few solutions out there actually connect with the consumer at just the right time, when it is most relevant and appropriate for them. And at the very moment they realize they are on a healthcare journey, consumers have multiple decisions and questions they are being inundated with. They are confused, don’t know who to trust, scared, and unsure what is available to them and what to do next.

"Health Seeking" v "On the Journey"

What is missing right now in the evolving healthcare marketplace is the appreciation for the two types of healthcare consumer:

  • “Health Seeking Consumer” (chosen)
  • “On the Journey Consumer” (unchosen)

The next level of understanding will happen when the marketplace appreciates the differences between the chosen and the unchosen healthcare consumer. We have observed a lot of challenges with people understanding the “On the Journey” experience: They tend to translate the “Health Seeking” consumer’s behaviors to the “On the Journey” when in fact they are completely different and need to be treated differently to make an impact.

In part 2 of “The Consumer’s Journey,” Trott will explore more in-depth the approaches required to meeting the “Health Seeking” and the “On the Journey” consumers where they are.

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