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What is consumerism amid COVID-19?

Consumerism is a perennial buzzword in healthcare. But it's a tricky and somewhat controversial trend to define, as some argue recasting patients as mere consumers of healthcare extracts some humanity from the equation of delivering medical care.

During the first day of HIMSS' annual healthcare conference, speakers at the executive summit attempted to put some context around the term, and delineate how hospitals can weave consumerism into their operations to try to provide better patient experience and care.

Even before COVID-19, the healthcare landscape had started evolving from a provider-oriented world, with decisions being made around the physician, to a consumer-centric one, based on the health needs of unique individuals. As such, it's important to approach consumerism from a clinical — not a clinician — perspective, panelists said.

That means keeping the entire patient experience top of mind, instead of just the experience the doctor is used to providing.

The biggest question hospitals should be asking themselves is, "How do we think about meeting the primary care needs of those patients as consumers?" Tom Kiesau, lead of Chartis Digital at the Chartis Group, said on a Monday panel.

For many physicians, it's a "battle" with management to define the difference between a patient and a consumer, but "they're two sides of the same coin," said Tarun Kapoor, SVP and chief digital transformation officer at Virtua Health, a nonprofit system in southern New Jersey.

One way to think of it is a person is a consumer if they're shopping between locations to get a flu shot, but they become a patient when they're forming a deeper, more longitudinal relationship with a physician or provider. The "key component for us, for all of us, is the integration of those journeys," Kapoor said. "Those folks who can figure out how to integrate it seamlessly will win the day."

Integrating this seamlessly is easier said than done, however.

As provider competition ramped up over the past decade or so, hospitals began to see consumer-focused amenities like same-day scheduling or concierge programs as a way to boost online ratings and cement patient loyalty, without sacrificing the bottom line. Consumerism was top of many executives' minds even before the COVID-19 pandemic caused demand for digital health products to soar.

But despite consumerism growing in importance, few hospitals have fully committed to the trend, according to a Kaufman Hall survey of health systems conducted last year.

The vast majority of systems that participated in the survey didn't meet the benchmark to be defined as best-in-class for delivery system redesign, pricing and digital infrastructure. Just 7% did, Kaufman Hall found.

That's despite consumerism being an important avenue to stay competitive, both with peers and with industry disruptors like big tech companies and payers interested in elbowing into direct care delivery, as consumers raise their expectations for their medical experience.

But there are strategies hospitals can pursue to reorient themselves around the consumer experience, including giving potential patients multiple access points into their organization, like chatbots, scheduling tools and telehealth visits, panelists said.

"I think the whole healthcare paradigm of the last few years is, patients come to us. We don't come to them," said Nick Patel, chief digital officer at South Carolina nonprofit Prisma Health. "That whole paradigm is shifting."

Management should try to identify the key components of the patient's journey, to zero in on the use cases that hospitals have to solve before targeting them with technology. That's key to avoid a clutter of point solutions, while ensuring doctors and medical workers feel confident a new digital health tool won't take up more of their time and contribute to 'click fatigue' or burnout, which is growing in severity as COVID-19 barrels into its third year, panelists noted.

Hospital executives also need to prioritize things like governance and interoperability, while focusing intensely on what they're trying to provide as an organization. Some problems are better solved by hiring additional staff members, instead of throwing a point solution at it, but the shift to consumerism for most organizations does necessitate adding adaptable and scalable technology at the end of the day.

However, speakers noted it's important not to exacerbate disparities by only increasing access for consumers with technological know-how and access.

Many barriers, including a lack of devices, tech literacy or reliable internet coverage, make it difficult for patients to access virtual care services — especially those living in low-income, minority and rural communities.

Roughly 19 million Americans, or 6% of the population, don't have access to fixed broadband service at threshold speeds, according to the Federal Communications Commission. In rural areas, almost a quarter of the population lack access to the service. That makes effort to reach these underserved populations with technology difficult, stymieing uptake of virtual care at a time when the deep medical inequities in the U.S. are particularly stark.

"The biggest thing I'm always sensitive to is, there's already a healthcare divide in America. You layer technology on top, you worsen that barrier," Patel said. "At the end of the day, we need to make sure that the patient's at the center."

Executives need to be sure they're retaining access for all facets of their patient mix, and that — despite being pushed by consumerism — they're not modernizing beyond the reach of every U.S. consumer. That means retaining services like call centers and capacity at walk-in clinics.

"Not everyone is going to be excited by a digital route. Some people just want to talk to someone," Nassar Nizami, chief information officer and chief digital officer at regional system Jefferson Health, said.

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