How design thinking can elevate the patient experience

Finding purpose in the mundane

What could be more boring than the traditional patient pamphlet?

Many times patient pamphlets are created without the most important ingredient, the patient. The traditional pamphlet is generally a collection of information that the health care marketer wants to impart to the patient. Little thought is put into what the patient wants to know. And even less thought is put into how the patient wants to physically interact with the pamphlet.

A little design thinking could change all that. One of the key principles of design thinking is purpose. Every element should have a customer-focused reason for existing. This requires a deeply rooted understanding of customers and how they interact with a particular object. It is this understanding that can transform the mundane into the marvelous.

One of the best examples I have ever seen is the in-room collateral for the Wanderlust Hotel in Singapore that I stumbled upon at an American Institute of Graphic Arts (AIGA) exhibit. The design team from Foreign Policy Design had a profound understanding of the prototypical Wanderlust guest. The type of guest who checks into the Wanderlust hotel is “curious and interested in discovering, engaging and immersing in new experiences.” They have a desire for personal growth through exploration.

Based on this understanding, the designers reinvented the “almost-useless conventional in-room directory” into a more useful travel tool. The in-room directory was morphed into an itinerary, full of useful local information including “area maps, train and bus maps, local shops and restaurants as well as thoughtful blank pages for notes and sketches.”

The reimagined in-room directory led to a redesigned check-in procedure. As the AIGA exhibit notes detailed, the itinerary “improved the check-in workflow, converting a laborious and dreaded check-in process into something fun, a talking point.”

This proves that one small design element can trigger a cascade of changes that lead to an improved overall brand experience. And the business results? The hotel has been featured in core travel publications including Travel & Leisure, has appeared on almost 500 blogs, and its room occupancy rates have risen.

And no wonder, “Creating a unique customer experience is one of the best ways to achieve sustainable growth, particularly in industries that are stagnating,” according to the consulting firm ATKearny. In industry after industry, higher customer satisfaction has been shown to drive sales and profits.

So back to the patient pamphlet. What is its core purpose? What is the problem that the pamphlet (or for that matter, the website, app or DTC ad) is trying to solve? What other problems does the patient have? Is there a role it can play there? How should it be redesigned?

What happens if the patient pamphlet is reimagined as an itinerary for better health, rather than merely a way to convey basic product information? Could infusing a higher-order purpose into a pamphlet set off a cascade of changes in all marketing activities?

The most overlooked marketing investment

Investing in your customers. That’s what companies, like YouTube, who have their pulse on the consumer do according to a recent article in Digiday. YouTube is helping their customers develop the content that will help them realize their dream of becoming digital stars. But the concept of customer investment goes beyond the digital world. Investing in customers is a business strategy well described in “Who Do You Want Your Customers to Become?” an e-book by Michael Schrage being offered by the Harvard Business Review.

Schrage says businesses can keep growing by asking, “Who do our customers want to become?” and helping them get there by strategically investing in customer capabilities. Invest in customers, because, as Schrage puts it, “your future depends on their future.”

Health care is no exception.

Think of the demands placed on physicians by the Accountable Care Act. To be successful in the future, physicians will need to become:

• Customer service experts since patient experience will drive reimbursement
• Data analysts as the practice collects patient satisfaction data
• Healthcare systems thinkers as practice ratings are dependent on the entire office visit experience, not just the physician interaction

The demands on patients have also increased. Take the experience of Peter Drier who practically become a forensic accountant to track down an unexpected $117,000 in charges associated with his neck surgery as recently reported in the New York Times. Or Matt Might who, according to an article in the New Yorker, had to supersize his social media skills to assemble a group of patients across the globe to give his son’s illness a name.
With the advent of the health care exchanges, Payers who once operated in the B-to-B mode have now found themselves having to develop the type of direct-to-consumer marketing skills pharmaceutical marketers acquired in the 1990’s.

There is no shortage of investment needs when it comes to pharmaceutical customers. Of course there is all sorts of regulation against practice building and incentivizing use. However, by applying a little creativity and keeping the end game in mind—improved outcomes and a better patient experience—the smart pharmaceutical “investor” will be able to eke out a competitive advantage with some well placed customer bets!

Bad Mom, Wonderful Woman: A Tale of One Health Plan

Improved patient experience. As a health care marketing professional, I see the topic everywhere. As a patient, though, it is often nowhere to be found. Here’s my Tale of One Health Plan. One day, one health system, two appointments, two dramatically different patient experiences. In one visit I was a “A Bad Mom,” in the other, “A Wonderful Woman.”

Bad Mom, Wonderful Woman

 

 

 

 

 

 

 

 

 

 

First the “Bad Mom.” At a Children’s Center” in an affluent hospital, my 15-year old daughter and I entered what looked like beige food court in a mall, little booths for each pediatric specialty ringing the room. Threatening signs dotted the walls cautioning against letting your children bounce on the furniture.

I approached a booth with a simple question. “What time was my appointment?” I had made the appointment for 3 pm but had received a confirmation call for 2:45. Asking one of the Booth Ladies, I was told, “I don’t know when your appointment is for, just sit and wait for the doctor.” This patient experience told me that the hospital’s time was more important than my own and that I could not be trusted to come to an appointment on time.

At 2:43, after eventually learning my appointment was for 3 pm, I decided to dash to the hospital coffee shop on the floor below. When I came back at 2:55, my teenage daughter was nowhere to be seen. Going back to the Booth to ask about my daugther’s whereabouts, the original Booth Lady didn’t even look at me, but told her companion Booth Lady, “I told the mother to wait for the doctor. This patient experience told me I wasn’t a person, but an individual filling a role, and doing it badly at that. Bad Mom, Bad!

Contrast this to my mammography later that day. Not only was I greeted by a friendly woman, I was given thorough instructions reinforced on a patient handout. I was then whisked away into a spa-like changing room, complete with honey colored wood lockers, thick terry robes and ethereal Spa music playing in the background. To top it all off, I got a bracelet commemorating breast health awareness month when I left. I was a “Wonderful Woman.”

Yes, this was the same health system. But no one had bothered to think through how an individual person might experience it’s different parts in her different roles: parent, patient and parental caregiver. I know a unified patient experience is possible.I increasingly use another health system in my area, the Summit Medical Group. The receptionists are uniformly friendly, even when you as the patient screw up. For example, one of the receptionists noticed I missed an appointment in another department and made a call to have them squeeze me in so I wouldn’t have to come back again. That patient experience told me I was an important individual whose time was valuable.

Now the medical care I receive in both systems is excellent. But if I needed a new doctor, I would go to Summit Medical Group. And I am not alone in judging a system by it’s support personnel. According to PwC Health Research Institute, 60% of consumers said staff attitudes are a key factor in evaluating their provider experience. The lesson here is to make sure the patient experience is understood and designed from the patient’s perspective. And that starts from the moment the patient picks up the phone to schedule an appointment.

“Orange is the new Black”: what prisoners and patients have in common

While binge watching the second season of Orange is the new Black I was reminded of an important parallel between patients and prisoners. Both are victims of a “3rd party decider economy” where “the person selecting a product or service is not the person who will actually use it.”

OITNB

In a New York Times article entitled, “Orange Is the New Green,” Adam Davidson, wrote about the plot line where poor Piper waits weeks to get her shower sandals from the prison commissary. In an economically rational world, prison commissaries would try to maximize sales to inmates and minimize out-of-stocks.

After extensive real life research, Davidson concluded that the prison system wasn’t focused on meeting the prisoner’s needs, but rather the prison’s needs. And it was this emphasis on the 3rd party rather than the end user that was thwarting rational economic behavior.

To a large extent, the US health care system has been designed to meet the needs of HCPs rather than patients. Pharmaceutical marketing perpetuates this 3rd party decider distortion by allocating the bulk of marketing budgets to HCPs rather than patients. According to the 2014 MM&M/Ogilvy Healthcare Marketers trend report, pharmaceutical marketers spend over 50% of their budget on physician marketing. This is on par with last years report. Despite all the patient centric talk, spending has not changed.

Like prison commissaries with out-of-stock situations, allocating more money to HCP marketing is not rational economic behavior. There is significant evidence that HCPs’ sway over prescribing decisions is waning. Patients and Payers are increasingly calling the shots. But old habits die hard. Most of pharmaceutical decision makers today have built successful careers on face-to-face selling to HCPs. It is hard to divert budget from a technique that has delivered so faithfully for so many years.

Perhaps the upcoming 2015 planning season will take on this HCP market distortion. The US health care system is slowly being reoriented around patient needs. For example, the government is driving more patient focus with the Affordable Care Act and the FDA has initiated hearings on patient focused drug development.

Pharmaceutical marketers could redesign the 2015 planning process around patient needs. For example, why not use the patient journey to guide investment across all customer groups, not just patients? What are the HCP initiatives that have the most impact on patients? Invest in those! Think of the 2015 planning process as a binge session on the needs of patients, a productive binge session you don’t even have to feel guilty about.

Thanks for letting us share!

Dorothy

Beyond the C-Suite: 3 ways to build customer focus

One of the most encouraging signs of progress in Pharma is the addition of C-suite level Customer or Patient Officers. While the impact of this new position remains to be seen, making a change at the top is a good start (see blog post, “Chief Customer Officers: Fancy New Title or Path to Meaningful Change”).

Customer

But it may take some time for C-Suite initiatives to trickle down. Meanwhile, what can be done at the brand level? Here are three ways to jumpstart customer focus on your brand:

1.  Create unified view of all customer feedback and interactions: Outside of Pharma, this practice is known as “capturing the voice of the customer.” Marketers go outside their functional silo and collect information from any department that has customer contact. In pharmaceuticals, this should include digging into Adverse Event Reports, long the providence of the Safety and Medical departments. A unified view of the customer is created by collecting the following information in one place:

  • Incoming customer contacts. For added texture, your call center can enable you to periodically listen in on calls
  • Survey information. Does anyone beyond the brand manager responsible for CRM see the CRM survey responses?
  • Social networks and community conversations.  Are your social listening exercises widely distributed and meaningfully communicated?

Once the information has been sourced, there are many companies that can help you automate the data collection for a real time view of your customer interactions.

2.  Interact with customers every chance you get: Vertex was particularly good at this. They did everything from regularly having patients visit their office for small group meetings to spending full-blown research weekends with patients. It is one thing to read that your patients have trouble with basic life-skills and another to get a panicked call from the patient at 7 am because she is worried about her hotel bill.

3.  Change your metrics to reward customer centricity. The time has come for the pharma industry to adopt the net promoter score, which measures the degree to which customers would recommend your brand to a friend or a colleague. Extensive research across industries demonstrates that as the net promoter score goes up, so do sales and margin growth. Changing metrics will change behavior. Marketers will be incentivized and rewarded for solving customer problems rather than producing pretty PowerPoint presentations. Right now, Marketers serving the needs of internal customers, like the Field Force, get more recognition than those meeting external customer needs.

Customer focus isn’t intuitive for pharmaceutical companies. Many brand managers aren’t even allowed to attend customer research in person any more. While all the rest of health care is focused on getting closer to the customer, it often seems that Pharma does everything they can to separate their marketers from their customers. That has to change at all levels from the C-Suite to the brand manager.

Thanks for letting us share,

Dorothy

3 ways to become radically patient focused

Learning from “Orange is the New Black.”

This is the fourth blog post in a twelve part series that transforms ideas from the marketing world at large into practical plans for pharmaceutical marketing in the time of health care reform. 

Who knew binge watching “Orange is the New Black” could illuminate a central issue distorting pharmaceutical marketing?

Let me back up a bit and connect a few dots.

Adam Davidson wrote an incredibly perceptive piece for the New York Times entitled, “Orange Is the New Green.” His recent binge watching of “Orange Is the New Black” sparked a key economic insight about the“3rd party decider economy” where “the person selecting a product or service is not the person who will actually use it.”  Sounds a lot like pharmaceutical marketing to me and a prime candidate for the 3 e’s of extro-analogs: exploring, extrapolating and exporting.

Davidson’s insight was inspired by a plot line where the protagonist, Piper Chapman, is frustrated by the inability of the prison commissary to provide the shower shoes she has ordered. In an economically rational world, prison commissaries would try to maximize sales to inmates. But the prison wasn’t taking what would be the rational economic path towards revenue maximization. No shower shoes for Piper!

After extensive research, Davidson concluded that the prison system wasn’t focused on meeting the prisoner’s needs, but rather the prison’s needs. And it was this focus on the 3rd party rather than the end user that was thwarting rational economic behavior. In fact, Aramark, a company trying to transform the prison commissary industry “by focusing on what the end-users, the prisoners, want,” was actually suffering in the marketplace.

Healthcare, particularly pharmaceutical marketing, has long suffered from this “3rd party decider economy.” However, there are movements afoot that put more focus on meeting patient, rather than practitioner or payer needs, including:

  • Affordable Care Act with its focus on linking patient experience and outcomes to reimbursement
  • Patient focused drug development initiative by the FDA that includes meetings with patients to help infuse patient reported outcomes (PRO) into the drug development and approval process

While there is certainly a strong rationale for the learned intermediary in pharmaceutical sales (both practical and legal), the 3rd party decider model does cause distortions. Consider the disproportionate investment in physician versus patient communication.

The key concept in the story for extrapolation is the need to maintain a strong focus on the end user, the patient. So what if you took a “radically patient focused” approach to your budget and communications? Here are some thought starters for getting there:

  1. Use the patient journey to guide investment decisions in HCP and payer marketing. The patient journey is the key tool patient marketers use to prioritize patient marketing investments. The tool could also guide physician and payer investments by asking questions such as, “what are the key things HCPs have to communicate about the disease and medication to inspire the patient to continue treatment? What are the barriers to treatment the HCP is uniquely suited to address?
  2. Examine your past HCP and payer initiatives for their potential to benefit the patient. How could your physician and payer programs improve patient experience, compliance and/or outcomes? What would you stop/start/continue if you took a radically patient focused approach?
  3. Determine your internal barriers to communicating with patients. Patients are increasingly using mobile devices and online video to learn about healthcare options. Is your brand adequately represented in these channels? If not, what is holding you back?

Certainly a lot of what pharmaceutical marketers invest in physician and payer marketing is critically important. But it bears examining whether what has been done in the past will still continue to move the needle in this increasingly patient focused healthcare world.

Check back on Thursday for the fifth post in the twelve part series, Three ways to supersize your patient KOL strategy Pepsi-style!” In this post I explore how using an “arts patronage approach” can build important relationships with key patient advocacy groups. 

Thanks for letting us share!

Dorothy