Whether you are a Provider, Payer, Employers, Pharmaceutical/Pharmacy Benefit Management (PBM) or a Medical Devices company, you need to make sure you have an established Digital Center of Excellence that caters to all the consumers you typically interact with on a daily basis in the healthcare ecosystem. You might not give the same weightage to all the components of the Digital COE depending on what role you play in the overall healthcare ecosystem. However, you need to have an established best practice that is well accepted and adhered to within the organization. This will ensure you are able to measure and achieve the appropriate healthcare outcome you desire.
Please note that we will be using the term ‘consumer’ instead of ‘customer’ thru out this article as we will interact with different constituents who will use our services and our solution will vary depending on whether they are a Customer or a Provider or an Employer. The Digital COE should take all of them into account and come up with a strategy that does not ignore any one of them. These are the key components of a well-established Digital Center of Excellence.
A robust KPI measurement framework – This is key and probably the #1 item to focus on. While one might keep track of usual indicators like Net Promoter Score (NPS), Total Cost of Care (TCC), there must be robust framework that is well adopted and accepted. Most importantly we should have our projects and initiatives be adjusted based on progress, or lack thereof, in our KPI targets. So, what are the most recommended KPIs we should look to track? Here is a good list of them with their definition.
Activation Rate – % of consumers with valid contact information (phone # and email) so that can reach them on a timely manner and stay engaged with them all the times
Net Promoter Score (NPS) – NPS for various categories including call interaction, digital interaction, overall brand and are we meeting their needs
Self Service Registration – % of consumers who are registered for self-service and are actively using self-service channels
Cost of Goods Sold (COGS) – COGS measured in PEPM (Per Eligible Per Month) to monitor efficiency of operation and how the overall healthcare cost is kept in check and within desirable limits
Total Cost of Care (TCC) – Total Cost of Care measured in terms of estimated savings in the overall health care cost for the consumers thru various initiative that target healthcare waste and focus on ‘pay for value’ instead of ‘pay for performance’.
Growth – Measure in terms of increase in membership which is a direct indicator of how well you are accepted by your consumers and how valuable the outcomes have been of your policies and initiatives
Customer Relationship Management (CRM) strategy – A holistic CRM strategy is crucial to engage with the consumer, keep a pulse on competitive intelligence and improve the penetration with their consumers. This should typically involve the following key capabilities
Master Data Management (MDM) – This is the foundation of any CRM Strategy where we make sure we have a golden copy of our stakeholder identity, preference, and their Digital Profile
Campaign Management – We need to create and distribute timely engagement campaigns to the consumers thru multiple Direct to Consumer (D2C) batch and real-time campaigns.
Insights & Opportunities – Another component that enables the CRM strategy is leveraging various data sources and create timely and useful insights that can be used to generate next best actions for our consumers. These insights and opportunities should leverage a holistic interaction repository that captures interaction across all consumers and makes all the necessary connections between them to draw the appropriate insights.
Integrated and Consistent Digital Experience across all consumers – While it might be hard to have a single digital experience across every single interaction with our consumers, any fragmentation in the experience should be more of an exception than rule. I know it is hard to achieve it when we are in constant cycle of Mergers & Acquisitions (M&A) and always partnering with new innovative product and capabilities being introduced in the healthcare industry. However, we need to be sensitive to not diluting our brand, purpose, and value proposition to our consumers. Some of the best practices that will enable an integrated Digital experience include
Digital User Experience and branding guidelines that is followed for all digital experiences no matter what entry point is being considered
Advanced Client-side programming frameworks like Nx Monorepo (www.nrwl.io) that enables shared front-end programming components and widgets across applications
Omni-Channel Enablement – While digital self-service engagement is crucial for a Digital Strategy, we cannot ignore the other channels and we need to make sure there is a holistic outlook on how each channel can enable other. Most importantly, our Digital Best Practices needs to take these channels into account when strategizing and implementing any initiatives. This will ensure these channels are not competing for the same consumers and create engagement overload and turn off the consumers due to untimely and insensitive reach outs. The channels that needs to be actively managed includes
Agent Desktop servicing the customer service agents who need a robust application with access to real time data on any domain or function that a stakeholder might call about.
Click to Chat/Chat-Bot with the agents who service the consumers who prefer the C2C channel over other traditional channels. Additionally, the C2C capability needs to be augmented by a BOT strategy to ensure we can sense the purpose of the chat and provide the most relevant information to the consumer.
Interactive Voice Response (IVR) used to track, record and route calls from the consumers and ensure that there is a smooth, reliable, and expedited transition to other channels.
Virtual Hold/Callback is the ability to have a consumer, who is on the phone or a digital channel, be able to have someone call them back.
Outbound Dialer used to engage with our consumers for specific D2C batch and real-time campaigns.
SMS is a crucial channel that enables outbound and inbound communication thru text message based on their acceptance to Opt-in for txt-based communication.
Social is a fast-growing channel that we need to pay attention to, especially as more consumers spend a lot of time on the popular social channels.
Digital Foundational and Innovation Roadmap – While we pursue all the best practices referred above, we need to ensure that we have solid technical foundation and innovation roadmap that is future looking and enables new business capabilities at a faster speed to market. The key challenge will be to keep up with the fast-changing technologies and trends that innovate in the healthcare industry and make sure we are not left behind when compared to the competitors. Some of the key advanced capabilities that are currently trending include
Cloud enablement
Open Source Web Development
Robotics Process Automation (RPA)/ Artificial Intelligence (AI)
