Welcome to the age of omnichannel healthcare
Telehealth and digital care delivery aren’t new concepts. But, over the past 18 months, the COVID-19 pandemic has pushed them into the mainstream, forcing healthcare providers to accelerate their adoption and rollout of both to accommodate huge shifts in how care can be accessed.
With hospitals and clinics under increased pressure, local lockdowns and social distancing rules limiting people’s ability to physically access care, telehealth quickly transformed from a niche option used rarely, to a primary care delivery method for millions of patients.
In January 2019, telehealth engagements accounted for just 0.17% of total healthcare claims. By August 2021, that figure had increased to 4.3% — a 25-fold increase in just over two years. And according to McKinsey, the adoption of telemedicine, digital patient engagement technology, remote monitoring capabilities, replacement therapies, and E-triage are all set to increase significantly over the next 5-10 years — with most more than doubling in adoption.
But now, as the impacts of the pandemic begin to ease around the world, those technologies and care delivery methods aren’t going anywhere. They’ve emerged to fill a short-term need, but in doing so have proven their long-term value and found an all-important killer app — improving the accessibility and quality of mental health care.
In January 2020, 30% of telehealth-based claims were related to a mental health diagnosis. By June 2021, that figure had more than doubled to 61%. For those kinds of engagements, telehealth has gone far beyond just being a suitable stop-gap solution while physical appointments have been harder to conduct. It’s emerged as a preferable way of delivering that kind of care — and it isn’t going away.
The message is clear: digital healthcare channels and technologies are here to stay. They’re not completely replacing physical care delivery, of course. Instead, they’re co-existing alongside physical channels, creating a new omnichannel healthcare landscape that thousands of care payers and providers will need to master.
New standards. New environments. New demands.
With this new omnichannel world of healthcare comes a whole host of new rules, expectations, and demands that organizations need to meet:
The personalization and convenience delivered by digital consumer experiences have become basic patient expectations across both physical and digital healthcare delivery touchpoints.
Remote working has become a common part of many healthcare working patterns, and requires new tooling and technology to support it and ensure that it’s aligned with other workflows.
New technology is enabling patients to drive more aspects of their own healthcare journeys — from scheduling appointments, to collecting and sharing their own healthcare data using personal wearable devices.
Many aspects of healthcare are now delivered in dynamic and personalized contexts, beyond hospitals and clinics. There are more parties involved in the average patient’s complete healthcare journey.
Each of those shifts presents different challenges for healthcare organizations. But, tackling them one by one might not be a strong path forward. Instead, healthcare payers and providers should look to their peers in the retail industry, who have recently gone through a very similar transformation.
Testing your readiness with extreme-case hypotheses
The ongoing shifts that have come together to create today’s omnichannel healthcare world aren’t showing any signs of slowing. So, it’s important for organizations to not just think about how they facilitate those changes as they are today, but rather, how they’ll adapt to them if they continue to the extreme.
Providers and payers must start by preparing answers to four extreme-case hypotheses:
- What if over 80% of your patient engagements happen digitally?
- What if over 80% of your use cases happen in a place where you have zero control or design impact?
- What if over 80% of your clinical staff spend over 50% of their working time at home?
- What if over 80% of the technology you use to engage with your customers is not owned by you?
Applying lessons from retail in healthcare
When omnichannel was first being discussed as a new concept in retail, it was commonly confused with multichannel — where organizations simply operate through and support multiple channels simultaneously. Omnichannel, however, demands that those channels are woven together seamlessly, enabling journeys to flow freely between them.
As many retailers learned the hard way, that isn’t something that can be facilitated by point solutions alone. You can’t just add new digital elements to physical experiences (or vice versa) and expect that to deliver omnichannel experiences. Instead, it requires holistic change and an end-to-end redesign of patient journeys.
By redesigning and reimagining patient journeys and experiences from the ground up, organizations can find innovative and engaging ways of weaving channels and experiences together to create something far greater than the sum of its parts.
Their work might be very different to the likes of Amazon or Walmart, but the principles today’s retail leaders followed in their own omnichannel transformations hold true across industries. The best way to create winning journeys and facilitate strong omnichannel experiences is to zoom out, challenge what’s possible with new technology capabilities, and redesign journeys in line with what both customers and employees demand today.
Why today’s healthcare organizations need to be thinking about service design
Service design is the concept of designing your organization’s service offerings in a way that maximizes the efficiency, productivity, and quality of customer journeys and how a consumer experiences your offering.
It isn’t a new concept. But, what is new are all of the innovative digital touchpoints and interactions that have emerged to create today’s omnichannel healthcare journeys. Teams need to go through service design processes with all of the aforementioned technology, consumer, regulatory, and demand shifts in mind, carefully considering how they should influence decisions regarding:
Processes and practices
Technology and tools
Training and knowledge management
Communication and touchpoints
Metrics and accountability
Value-drivers and outcomes
It’s a new landscape that calls for new technology, new approaches, new journey considerations, and crucially, new principles of both design and execution.
The five core principles of service design for omnichannel healthcare
Based on our experience helping organizations conquer the evolving omnichannel healthcare space, Thoughtworks has identified five principles of effective omnichannel healthcare design.
Principle #1: Design journeys and ecosystems around key patient moments
In the world of omnichannel healthcare, there are a huge number of digital and physical touchpoints that come together to create connected patient journeys and experiences. Naturally, some hand-offs and connecting points between those touchpoints are tougher to facilitate than others.
In the omnichannel age, designers need to carefully consider how they’ll support and enable key touchpoints and channels, including:
Virtual care (telehealth) experiences at scale, and journeys that are entirely virtual from first contact to resolution.
Hand-offs between virtual care and testing (MRI, lab, etc), when no physical appointment is held before referral.
Hand-offs between virtual care providers and specialist virtual care providers, with no physical interaction or referral in between.
How patients consume test results or other potentially difficult news digitally, without specialist physical support.
The integration of data from patient-owned wearable technology with Electronic Medical Records (EMRs).
Service designers need to find a way of prioritizing the moments that matter most to modern patients and employees, and create a value framework around them that supports and enables continuous improvement. To do that effectively, they’ll need to:
Clearly define the ecosystem surrounding those customer moments, defining all of the parties involved, creating governance rules, and building relevant APIs to support data interoperability across every organization.
Establish KPIs, tracking mechanisms, and monitoring approaches to measure success, ensure accountability, and enable continuous improvement.
Create customer-driven feedback loops to find out what’s really working for the people that matter most, and keep up with evolving patient and employee needs.
Designing hardware and software in tandem at MySense
MySense is a healthcare technology provider that offers IoT-enabled hardware, designed to track patient health trends over time, and deliver real-time insights into decline, so action can be taken before a patient needs acute care.
Thoughtworks recently partnered with the company to create a simple-to-use health analytics platform that would help patients, families, and practitioners easily understand and act on the insights generated by MySense devices.
A critical success factor across the project was how we worked together to co-develop hardware and software, carefully considering how the two would need to support one another to meet patient and user needs in the strongest ways possible. Instead of starting with one and engineering the other around it, we looked at the two in parallel, considered the ecosystem they needed to create and support, and let the needs and experiences of patients guide the rest of the development journey.
Principle #2: Good EX drives successful CX
With more parties involved in the delivery of modern omnichannel healthcare journeys, it isn’t enough to be patient-centric. Instead, service designers need to expand their view to better understand how everyone across the omnichannel ecosystem wants to work, how care needs to be delivered from an organizational and regulatory perspective, and what everyone needs to perform at their best.
As part of the service design process, designers should consider:
How technology could better support new and evolving workflows.
How training and development can be conveniently built into the omnichannel healthcare ecosystem.
Which processes will be most affected by new technologies, data sources, and parties entering the healthcare delivery ecosystem.
How recognition of employee effort can be delivered virtually, and what you’ll need to do to maintain motivation across digital and physical workflows.
By carefully considering those factors and elements as part of the service design process, designers can create strong employee experiences (EX) that in turn help drive successful customer experiences (CX) for patients.
Designing for clinicians at the US Department of Veteran Affairs (VA)
The United States Department of Veterans Affairs (VA) is a department of the federal government charged with integrating lifelong healthcare services to eligible military veterans at the 1,700 VA medical centers and outpatient clinics located throughout the country.
When the COVID-19 pandemic struck, it represented big changes and new challenges for the VA’s physicians, and demanded consistent treatment and decision-making across them all. So, the VA engaged Thoughtworks to help it build and deploy data-driven diagnostic tools and resources to assist in the assessment of, communication about, and treatment for COVID-19.
By working closely alongside frontline clinicians, the Thoughtworks team learned how they worked, and how they needed to be supported. Those experiences fuelled the service design process, and helped us create a clinician-friendly Clinical Decision Support experience in just weeks, helping the VA get ahead and stay ahead as the pandemic evolved.
Principle #3: Prioritize ecosystem resilience and adaptability
When designing healthcare services, teams can’t just focus on the conditions, channels, and technology seen today. One of the few things that we can confidently say about the future of healthcare is that the pace of change is only going to continue — and very likely accelerate — moving forward.
As a result, resilience and adaptability should be key areas of focus in system design today. As they design, teams need to think critically about what would happen to the services or journeys they’re designing if:
New regulations were introduced that impacted how medical data was handled across digital and physical touchpoints.
Another pandemic happened, and processes were forced to adapt to it again.
Supply chain issues or labor shortages impacted your ability to deliver care within your current model.
New payment models emerged, transforming how patients access and pay for your services.
To do that effectively, designers need to think beyond the current status quo and embrace the art of the possible. Instead of just facilitating what organizations and patients need today, they should think carefully about ways that they may be able to proactively create future and long-term value.
For example, using APIs and open standards to create open systems could be a huge differentiator that helps make services highly adaptable. As integration and coopetition become more prevalent across healthcare, it could be exactly what a system needs to stand out and deliver immense long-term value.
Building a foundation for future success
NYU Langone’s DataCore initiative is a perfect example of how healthcare organizations can prioritize adaptability to deliver long-term service value and ensure resilience. It’s a resource that integrates expertise and resources from multiple departments, divisions, and centers at NYU Langone, helping everyone access best practices, expertise, processes, and compliant software.
It’s a different kind of transformational service — one that’s focused on helping teams use data in the best ways, and keep up with new technology and data standards as they shift. It’s entirely focused on keeping the organization at the edge of what’s possible, supporting strong outcomes rather than delivering those outcomes directly.
Principle #4: Envision a platform strategy and design for reusability
The services designed by healthcare organizations can — if successful — become important parts of a patient’s daily life for years, or even decades. They need to be resilient and fit for purpose, but most importantly, they need to directly support the organization’s strategy, and support patients however they want to be supported.
By following the principles of effective Digital Platform Strategy, designers can prioritize the capabilities patients and users really want, and translate that into a technology strategy that supports the wider organizational strategy.
To do that, designers must:
Carefully assess patient, employee, and user needs, mapping out which needs are greatest and which could most easily be met.
Look at the third-party tools already in use across the healthcare ecosystem to identify capabilities that should be brought in-house.
Prioritize capabilities that need to be created first in line with user and customer needs.
Build a technology strategy around those capabilities — mapping out clear ways to create them, and weave them together in ways that deliver unique value for all players across the omnichannel healthcare ecosystem.
Building on a history of platform success at Canadian’s Top EMR Provider
The Canada-based health tech provider offers a wide range of powerful digital healthcare tools that can help practitioners and clinicians transform care delivery for their patients. Institutions look to the company to gain innovative capabilities that help increase the efficiency, speed, and quality of their healthcare services.
For the company, that doesn’t just mean constantly working to create new solutions and build its portfolio — it also means regularly reviewing how its existing offerings can be extended or enhanced.
The company’s HBM (Health Benefits Management) platform has been a cornerstone of its revenue-generating services for many years. So, when the team was thinking about potentially modernizing it, they turned to Thoughtworks to help.
Working closely with the team, we conducted a comprehensive assessment of the potential future state of the platform, created a HBM modernization playbook and execution strategy, and helped build a tangible ROI-based business case for modernization — securing a high-value future for the platform, and the company.
Principle #5: Test, learn, and iterate
The world of omnichannel healthcare is still new, and from a technical perspective, there are a lot of unknowns. Specific best practice is limited, so organizations that want to lead in this space will need to jump in, gather feedback, learn from real user journeys, and be ready to iterate on the services they create.
During development — and critically, also after deployment — service design teams need to carefully assess and reassess their service’s:
Viability: is it fit for purpose? Are all of the players in the ecosystem able to utilize it? Does it meet their needs equally and effectively?
Usability: Where are the key points of friction in service user journeys? Is there anything preventing users from utilizing specific capabilities or elements of the service?
Value: Is the service delivering value for everyone and every organization it needs to? Who is losing across the omnichannel journeys you’re trying to support?
Feasibility: Are your plans for the service practical and achievable? Are your aims and intended results realistic?
Practically, that means not only looking at how people utilize a service, and how players across the omnichannel healthcare ecosystem interact with it — it also means carefully looking for antipatterns that may be leading to unintended results or negative journeys and experiences.
Choosing the ideal departure point for a cruise line’s transformation journey
When one of the largest cruise operators in the world embarked on a transformation journey to become a modern digital business, the company hired Thoughtworks to help it visualize current and future customer journeys, and where transformation was needed most.
We started by mapping out end-to-end customer journeys, from pre to post-cruise. From there, we identified key points of friction today where experiences could be improved, areas where journeys were likely to evolve in the near future, and points where technology could be better utilized to transform current capabilities.
By connecting the dots between experience expectations, business needs, and technological capabilities, we were able to find the best place to start — enabling immediate, effective service design, and kickstarting the cruise line’s transformation journey.
The COVID pandemic has transformed how care is delivered, managed, and even paid for forever. By bringing virtual care into the mainstream, and enabling healthcare players to see its full value across key use cases like mental health delivery, it has accelerated the shift towards omnichannel healthcare.
In the omnichannel healthcare world, healthcare providers, payers, and providers need to carefully consider how they can optimize patient journeys across digital and physical touchpoints, and harness new technology to deliver exceptionally convenient, satisfying, and productive experiences for all.
Service design thinking is key to achieving that. In order to start creating highly-connected, highly-valuable, and highly-adaptive experiences, journeys, and ecosystems, organizations simply need to follow our five key principles of healthcare service design:
Learn how Thoughtworks can support your organization through this transformation, and master both service design and digital platform thinking to build exceptional omnichannel healthcare journeys.