Digital Front Doors Pt. 2 — Where do They Lead?


The quest to respond to heightened consumer expectations in healthcare continues, compounded by value-based care models, and the need to deliver care and experiences in the most personalized way possible. While some organizations are deploying science – i.e. precision medicine – most payers and providers are looking to get past their initial attempts at Digital Front Doors and into more sophisticated consumer engagement platforms.

According to Gartner, the Healthcare Consumer Engagement Hub (HCEH) is a “technology and process concept that ties multiple systems together to optimally engage the healthcare consumer.” The engagement hub model promises to combine partnerships and technology to deliver a personalized, contextual and omni-channel engagement. It allows these organizations to meet consumers wherever they are in their healthcare journey and preemptively address their needs even before they realize it.

HCEH – Why The Concept Matters

While Payers and Providers have worked through a variety of home-grown, co-development, and licensing approaches to engagement technology, it hasn’t stopped the growth of new technologies and benefits from continuously being introduced to the market. This has created a situation where organizations find themselves “always catching up to the next thing”.

It is therefore important to find a technology and process concept that supports evolution as the market, and the marketplace, evolves. Engagement Hubs are designed to change the way companies approach consumer engagement, writ large.


Fig: DFDs vs HCEHs

Only by making the shift in mindset above will digital transformation efforts start to truly pay off.

Payers are leading the charge, again

The shift, fortunately, is already happening, as demonstrated by the lead Payers are once again taking. A recent report by McKinsey & Company points out how “winning payers” are making the shift above:

  • Longitudinal healthcare consumer journey: Payers are pursuing vertical integration through partnerships to retain members by supporting them throughout their journey, minimize medical costs, and enable opportunities to cross-sell products.

  • Digital-First payers are gaining market share: Digital-first payers are attractive to tech-savvy consumers whose needs can be served by “narrow networks” and “pay-what-you-need” coverage. Examples are Oscar Health, Bright Health, and Bind – all of whom have raised significant investment.

  • Member experience and next wave digital innovation: The next wave of digital innovation includes Machine Learning and Deep Learning Analytics that will drive proactive member engagement, predict needs, and communicate gaps and interventions preemptively.

  • New revenue streams are emerging: Market dynamics are making Payers natural “Digital Health Hubs” that will scale digital-only product distribution, high-deductible product personalization, and big data monetization. Front runners include Cigna-ESI and Aetna-CVS who have both recently announced such “marketplaces”.

Getting to personalized, contextualized consumer journey support

There are two parts to supporting personalized journeys for healthcare consumers: an optimal experience design and using a target architecture can deliver such an experience.

Optimal experience design requires going beyond the usual simple interaction design models of today. Sure, a simple interface is neither easy to accomplish nor a bad thing. However, before a simple interface design can make the complex simple, it needs to build on good Service Design and Behavioral Design. The illustration below demonstrates how optimal design is a convergence of all three design approaches.




Fig: Designing for personalized journey support

  • Service design: A consumer should have the same level of experience across online, offline and in-person settings as they interact with service providers.

  • Interaction design: The consumer digital user experience should be personalized and respond to any form factor (desktop, mobile, voice, etc.) to address their needs no matter where they are.

  • Behavioral design: The services and interactions should be designed with empathy towards a consumer’s motivation, habits and literacy. Through behavioral design, healthcare organizations can solve needs of consumers treating them as population of N=1.

Good design needs good technology

The HCEH is a “living digital ecosystem”. It is a suite of products, not just one tool. To accomplish this, it is best to think of it as technology convergence into a target architecture that supports evolution of partnerships and capabilities, while always maintaining a brand relationship with the consumer. This target architecture model is illustrated below:



Fig: Leveraging evolving technologies

  • Content Tech: Web and mobile apps are not going anywhere and the use of these are expected to grow in the coming years. A new set of visual and voice enabled technologies have been added to the mix to deliver content to consumers. Significant innovations are taking place in the field of augmented and virtual reality and voice-enabled solutions.

  • Decision tech: Data analytics, artificial intelligence and machine learning allow healthcare organizations to perform predictive analysis on consumer needs and conditions; use cutting-edge decision support systems to create a self-service menu, which in turn minimizes healthcare costs and improves health outcomes.

  • Connected Tech: Connected devices such as wearables, ingestible and biosensors allow for the collection and sharing of critical data, with the consumer’s consent. Clinicians and other healthcare providers can use this data to get a complete understanding of a consumer’s health, unforeseen factors impacting exacerbations and influencers of preventative care.

The HCEH platform space is still emerging. Medullan’s own VARA platform is such an example, supported by existing web, mobile, CRM, and other conventional enterprise technologies.

Providers have a steeper hill to climb

Only one-third of the providers are making headway in digital health transformation. Delivering care is even more complex than managing benefits – especially given evolving legislation and threats from retail giants and digital disruption.

Inevitably, providers are evolving into digital / physical organizations that have to carefully adopt technologies that are clinically sound, and do not overstretch their clinical staff. The HCEH for providers will emerge a “virtual hospital” or a “learning health system”. The goal of a virtual hospital or learning health system is personalized journeys where the patient population is as close to N=1 as possible. This is made possible by a convergence of population health, digital health, and precision health, as illustrated below:




Fig: Evolving care delivery to a Virtual Hospital model

  • Population Health: brings together clinical information, demographics, lifestyle and Social Determinants of Health (SDoH).

  • Precision Health: utilizes genomics, biomarkers, and imaging to get an in-depth analysis into factors impacting patients’ current and future health.

  • Digital Health: offers the promise of Digital diagnosis (DDx), digital therapeutics (DTx), remote patient monitoring (RPM) and digital biomarkers as “next generation medicine” for the virtual hospital.

In Summary:

DFDs were a simple, reasonable start. The HCEH construct is far more complex. But it is necessary.

The industry is being reshaped by traditional and non-traditional players. Consumer expectations continue to evolve. For Payers and Providers to sustain business innovation and economic health, they must adopt a model that similarly evolves: from consumer mindset to design approach to target technology architecture.

Looking for a trusted digital partner? At Medullan, we are driven to solve the toughest problems in healthcare. Contact us today to learn more.

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