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March 28, 2017

What Healthcare Can Learn From The Retail Industry

Five years ago, the predictive analytics industry reached a new milestone. Target, the 6th largest retailer in the U.S., developed an algorithm to accurately identify pregnant women based on their purchases— and, in some cases, did so a bit too early.

An angry dad complained that a Target in Minnesota was encouraging teenage pregnancy after his teen daughter began receiving coupons for cribs, diapers, and baby clothes.  As it turns out, the major retail chain wasn’t prodding his daughter toward pregnancy—it just knew she already was.

If Target, five years ago, could spot a pregnant teen before her own dad could, why has healthcare failed to get past “meaningful use”?

When patients visit a hospital today, it is surprising how little is known about them. Retailers, by contrast, can predict what, when, where, why, and how their customers will purchase goods and services. Not only that, they use technology to upsell and enhance the customer experience.

Likely due to their experiences with retail and other consumer sectors, patient expectations for digital health outpace the reality for most health organizations’ capabilities. According to a survey from Humana’s population health arm, the majority of patients believe healthcare organizations, regardless of type or location, should have access to important information about their medical history. In fact, they expect that organizations across the spectrum can easily share and receive patient data.

Unfortunately, this expectation is far from reality. Due to poorly designed financial incentives and interoperability challenges, health data has historically been fragmented. The result is that care teams are often left in the dark regarding patients’ past medical encounters. And this has negatively impacted care and costs. A 2015 study in the American Journal of Managed Care found that patients whose primary care providers delivered highly-fragmented care were more likely to have high rates of preventable hospitalizations and, on average, incurred $4,500 in additional healthcare costs.

As the healthcare industry undergoes a transformation to improve care coordination, data can no longer live in siloes. Increasingly, health plans, ACOs, medical practices and health systems are being tasked with accepting greater responsibility and financial risk for their patients as a means of driving more efficient, higher quality care. To be successful, these organizations need timely, accurate patient data.

The first step forward for healthcare providers is implementing a system that notifies them when a patient receives care at any facility and for any healthcare need. Just as retailers know when consumers seek their products, all members of a patient’s care team should know when they seek care.

While the healthcare and retail industries are dramatically different, success in both demands a consumer-centric approach. As health organizations aim to improve quality, decrease costs, and enable safe care transitions, the retail industry’s deep analytical and tracking approach can be a guide. 

Tagged: Interoperability, Care Coordination, healthcare data

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