In this episode, we are joined by Dr. Kip Webb, Managing Director of Clinical Innovation at Accenture, to discuss the results of their recent study about evolving consumer attitudes towards digital health and non-traditional care.
Highlights of this episode include:
- Background on Accenture’s survey of 2,400 U.S. consumers and their attitudes towards digital health and non-traditional care.
- Why there is a great discrepancy between baby boomers and generation Z consumers that have a primary care provider.
- Why affordability, convenience and reputation are important to consumers when making decisions on medical treatment.
- What consumers are looking for in healthcare digital capabilities.
- What do the findings of this study mean for the healthcare industry moving forward.
- And more…
Mike Passanante: Hi, this is Mike Passanante. And welcome back to the Hospital Finance Podcast.
Recently, Accenture released the results of its 2019 Digital Health Consumer Survey. To walk us through the results of the survey, I’m joined by Dr. Kip Webb who is Managing Director of Clinical Innovation at Accenture.
Dr. Webb has over 35 years of broad-based healthcare experience, including 10 years of clinical practice. Prior to coming to Accenture, Dr. Webb served on the faculties of Stanford University and Tufts University Medical Schools.
His academic work concentrated on clinical decision analysis, pharmacoeconomic, and medical outcomes research. He has worked with leading academic research institutions around the world and the Centers for Disease Control and Prevention. He’s the author of several peer-reviewed articles and has been a contributor to Nelson’s Textbook of Pediatrics.
Dr. Webb, welcome to the podcast!
Dr. Kip Webb: Thank you, Michael. It’s good to be here.
Mike: So first off, could you explain what the Digital Health Consumer Survey is and what you were looking at?
Dr. Webb: Sure! For about five or six years now, Accenture has sponsored an annual survey in several countries around the world in which we looked at evolving consumer attitudes towards digital health and non-traditional care.
This year’s survey included seven countries and almost 8000 consumers aged 18 or greater. And the data that I presented at HIMMS last week was the US data which included approximately 2400 consumers.
Mike: That’s a great set-up. So, let’s dive right into the findings of this survey. First, you started out by gauging perceptions of what we might refer to as traditional care. And as one might expect, you did find some differences from one generation to the next. Tell us what you found there.
Dr. Webb: Sure, let’s begin with some definitions.
Traditional healthcare in our study referred to typical care the way that we were used to receiving it in the old days—doctors and other professionals and hospitals and clinics and medical centers.
Non-traditional care, we define much more broadly than that. It would include walk-in or retail clinics, outpatient surgery, virtual health via the phone, video or on apps, on-demand services and/or digital therapeutics—so a much, much broader category.
With those definitions in mind, we actually looked at five different generations of American healthcare consumers beginning with the silent generation (defined as those born before 1945) all the way through to Gen Z (defined as those born in 1997). And what we found was pretty surprising.
What we found was that, first off, in terms of who had a primary care provider, there was a great discrepancy between older generations and younger generations. Specifically, silent generation and baby boomers, about 85% of those consumers had a primary care provider. Contrast that with Gen Z’s where only 55% of consumers have a primary care provider.
Now, one might quickly think, “Well, Gen Z’s are healthier and maybe don’t need a primary care provider or don’t want a primary care provider,” but that’s not what we found. What we found actually was that of those Gen Z patients, 20% of them would love to find a primary care provider if they could, but that provider has to meet their needs—on-time service, convenience, affordability, transparency, and digital offerings as well. So there was a huge difference between the generations. That was the first finding that we found.
The second thing that we found was that those Gen Z’s are very dissatisfied with traditional healthcare. When you look at their input on questions about things like effectiveness of care or transparency of care or responsiveness to follow-up questions, they were, statistically speaking, much more dissatisfied than were older generations.
Mike: And next, you asked about factors that influence when and where people seek treatment. What did you find there?
Dr. Webb: Yeah. Now, remember this is the US data. And so, it really in some ways is an artifact of our health insurance system which is different from other countries around the world. But perhaps not surprisingly, what we found is that American healthcare consumers make decisions on when and where to seek medical treatment based on affordability, convenience and reputation.
Specifically, 39% of those surveyed rated the #1 thing as that the provider accepts my insurance and 24% ranked at second by saying that “it’s low cost to me.”
What was interesting about this data was that recommendations either from a doctor or from a trusted friend or family member, were very low in being a factor on when and where and how actually a consumer in America receives care.
And I found this fascinating because as recently as say five or ten years ago, when somebody would move to my home town, I would invariably get asked the question, “Do you know a primary care provider that you like and think is good? Can you help me find an Ob-Gyn?” or something like that. I rarely get asked those questions anymore.
Instead, what consumers are doing is going to online things like HealthGrades.com or Vitals.com or even Yelp to make their choices about when and where and how they’re going to receive care.
Mike: Yeah, the landscape is changing. We see that all across the world. Particularly in my world in marketing, the same kind of thing, very, very non-personal communication and information gathering. So it’s very consistent with that I think.
The survey also looked at satisfaction, both the factors that determine satisfaction and also how satisfied people are with aspects of their care. Again, some differences across generations, isn’t that right?
Dr. Webb: Yeah, absolutely. One of the things we found across the board was that cost is equally important to the satisfaction of both younger and older consumers as one might expect.
But we did find that younger generations place a much greater emphasis on convenience of appointment times, efficient operations, and older consumers placing much greater importance on the transparency of the care that they’re having delivered—so very much differences that we saw across the generations.
Mike: The survey clearly showed as you kind of talked about at the beginning of the podcast that the demands for digital capabilities are on the rise. Can you break down specifically what patients are looking for when we talk about digital capabilities?
Dr. Webb: You bet! This question, we actually compared the answers from the 2019 survey to those that we did in 2016. And what we found across the board for all generations, that their choices for medical providers are increasingly reliant on those that are offering digital capabilities.
So, for example, in this year’s survey, 77% of patients said that they would chose a provider if they could request a prescription refill electronically; contrast that with 67% just three years ago.
Similarly, consumers were looking for the ability to receive reminders via email or text message, to communicate with their provider through secure email, book, change or cancel appointments online, and then finally, using a remote or telemonitoring devices to monitor and record their health.
What I find interesting about this is that most of the modern electronic medical records that are available offered this sort of functionality right out of the box. What’s missing with many provider organizations is a service layer behind that. For example, it’s one thing for a consumer to send a secure txt message or an email to their provider via a portal. But it’s the response time that ultimately is going to dictate satisfaction.
And I’ve seen some organizations where, by culture, that response time is within the next two to three hours. There are other organizations which culturally are not supporting that efficient response time. And it may be two or three days or maybe even weeks before that doctor or provider gets back to the patient.
And so, I think, increasingly, provider organizations are going to need to focus not so much on the technology, but the support layer behind the technology.
Mike: Technology is really just an enabler. It doesn’t substitute for the human touch and expertise that goes behind it.
Dr. Webb: Absolutely right.
Mike: And earlier, you talked about the differences between what we would term as traditional and non-traditional care. And you dug into the acceptance of what we would call a non-traditional care such as retail clinics and virtual care.
How do respondents perceive those options? And how have those perceptions changed over time?
Dr. Webb: Well, what we found across generations is that, increasingly, American healthcare consumers are using non-traditional healthcare services. In this year’s survey, we found that 57% of those surveyed have used an outpatient or day surgery center; 47% had used a walk-in or retail clinic; 29% had used some sort of virtual care telemedicine; and then, finally, 18% have used an on-demand healthcare service where you had no relationship with the provider but are calling in order to get some immediate satisfaction from that.
What’s interesting about that data is, across the board, those numbers are greater than they were just two or three years ago, especially virtual care. Where when we asked this question just two years ago, it was only 20% of consumers had used a virtual care appointment, now up 29% or almost a 50% increase in just two years.
I think there are several reasons for that. One of them is the more broad availability of virtual care. It’s supported in many states by funding. And it will be covered in folks’ insurance which is important. And then, finally, it offers the convenience that consumers are looking for.
One other thought with regard to virtual care which we found fascinating in this year’s survey was that virtual health, we always thought was the domain of the worried well, that someone said, “Hmmm… I’m a little under the weather, but do I really need to go into the doctor’s office. Maybe a virtual appointment is okay.”
We asked the question about “Do you have a self-described major illness or not?” And what we found across the board was that those within major illness where much more willing to use virtual appointments than those without.
In other words, it’s not the domain just of the worried well, but those of the sick as well.
Specifically, for example, when we said I have a major illness, or I don’t have a major illness, we found that 26% of consumers with complex needs seek out virtual care for a routine therapy or mental health versus only 20% of those who didn’t have the major illness.
Similarly, we found that for a physical injury, 24% of those with a major illness would seek virtual care versus only 11% of those without a major illness.
So you can see quite a broad discrepancy and quite large uptake among those with major illnesses.
Mike: And that is pretty surprising. I wouldn’t have thought that going into the survey. That is a surprising result.
Dr. Webb, my final question for you. Based on what you found in this survey, what do you think that the results mean for healthcare moving forward?
Dr. Webb: Oh, I think this is a very exciting time. What this survey shows first is that there is a new set of consumers out there in the marketplace and that healthcare consumers of all generations are much more open to non-traditional services than ever before.
We also found, remember, that younger consumers are the least satisfied with traditional healthcare models.
The second thing that we found is new demands. Patients of all ages expect transparent, convenient and high-quality care. But they also expect digital capabilities.
Third, we found increasing adoption and uptake of new models of healthcare delivery, whether it’s ambulatory surgery centers, retail health centers, virtual health or on-demand health services.
And finally, what we think is that this provides a great opportunity for traditional provider organizations because there’s more patients use and are satisfied with non-traditional care settings, payers and providers must adapt and consider the greater use of these digital capabilities’ more convenient self-service options and better locations.
You put that all altogether, and it says, “this is an amazing time of disruption for the provider industry where either traditional providers get onboard with consumer demands, or they face being displaced by upstarts and new entries into the provider market.”
Mike: Dr. Webb, it’s a fascinating survey. If our audience would like to look at a copy of that survey, where they can go?
Mike: Dr. Kip Webb, thank you very much for joining us today on the Hospital Finance Podcast.
Dr. Webb: Thanks very much. Have a great day!