The digital era has birthed the new ‘connected’ world of empowered consumers and changing expectations. This new world affects all industries, including healthcare. Dr Ali Hamdulay from Metropolitan Health explores what this changing world means for medical schemes and South African healthcare.
Raising the bar
Consumers usually don’t make distinctions between industries, expecting all industries to match or improve on their best customer experiences, or even great customer experiences they may have heard about in the connected ecosystem.
The information or digital age, in particular, has had some interesting knock-on effects. Interconnectivity, immediate gratification and a highly-personalised and relevant user experience across all channels are now not only welcomed – they are demanded. This will impact on members’ expectations with regards to how they engage with their scheme, the value their scheme delivers and service delivery across the health value chain.
In the consumer-empowered age of digital communication, we see a shift from mass solutions for the ‘herd’ to highly-personalised solutions for the individual.
As this trend becomes more embedded, individuals become more;
- self-directed (seeking the ability to look for whatever they want – anytime, anywhere),
- experiential (demanding ‘unique experiences’ tailored to their personalities and preferences),
- social (relying on the wisdom of the crowds), connected (to multiple channels and devices) and
- informed (demanding personalised, relevant content, when required).
In terms of healthcare delivery and the medical scheme environment, this will require a fundamental reorientation away from an aggregated view of the patient or scheme population towards a far sharper focus on each individual health consumer or beneficiary. However, such a focus requires a far more in-depth understanding of an individual member’s personal health profile and needs.
Big data means big insights
Medical schemes, their administrators and managed care companies manage huge quantities of data about the health and lifestyles of scheme beneficiaries on a daily basis. However, ‘big data’ is useless unless these vast data sets are mined to develop an in-depth understanding of members’ needs, generate new insights, drive product innovation and enable personalised engagement that supports individuals in their personal health management journey.
The changing environment requires that medical schemes and their service providers develop new competencies, including extensive data mining and analytics – which will be essential enablers for ‘listening’ to scheme beneficiaries and delivering personalised, relevant engagement to support healthy lifestyles and behaviour change.
Mobile health (mHealth) apps, wearable medical technology, patient-accessible electronic health records (EHR), tailor-made health portals and social media platforms are just some of the many technological developments that can be used to support healthy behaviour change.
The rise of restricted schemes
Restricted schemes may offer greater flexibility in the development of more personalised health solutions and service experiences than open schemes. Unlike an open scheme, which is required to meet the diverse needs of a far broader population, restricted schemes are able to tailor delivery and products to the specific needs of the employees and employers they serve.
Many see healthier lifestyles as the new cure. Here in South Africa and globally, there is growing recognition of the urgent need to help citizens to lead healthier lifestyles. However, the challenge is sustaining healthy behaviour change, given the individual’s need for instant gratification in the form of immediate improvements in health and wellbeing.
We should not fear this new era. Rather, the new connected ecosystem and digital platforms should be fully leveraged in the development of innovative, personalised health solutions that support sustained behaviour change through a tightly managed and systematic process of prediction, prevention, early detection and treatment for those individuals for which healthy lifestyle alone is insufficient to prevent the onset of one or more chronic conditions.