There is a longstanding beliefe about how patients chose their healthcare providers and services. "[P]atients [are] passive health care consumers of physician services..." We go to a doctor a friend or someone at work tells us about, and if we need a specialist or study, we go where that doctor suggests. Is that the case because people want to be passive? Or is it because the "system" is structured in a way which makes consumer choice too difficult to contemplate?

Sometimes the universe gives you subtle hints, and sometimes it smacks you upside the head. Within the last four weeks, I've been inundated with references to Kim and Mauborgne's Blue Ocean. Blue Ocean is book and way of thinking about strategy.

When I first read Blue Ocean a few years ago, I didn't have a context for it and consequently didn't fully appreciate it.

Among other hints, we've been studying Blue Ocean in our graduate program which has given me a renewed interest. So, I'm re-reading it. Or rather, re-listening to the audio book on runs. Same difference.

The biggest lesson for me, to boil it down, is the need for any business to understand its market and its customers.

Understanding customers and markets isn't the same as asking them what they want. It's more about designing strategies, products, processess and services which addresses needs, even if they are unspoken, or even unknown.

Patients (and we're all patients aren't we?) would gladly chose their healthcare in a consumer directed world.

We've built a system around monolithic hospitals with radial arms touching pockets of outpatient care. Imagine if we reversed today's design. What if, instead of one huge epicenter, we had storefronts everywhere? Family medicine, internests, and other primary care practitioners, operating as a unified, front-line brand under consistant quality expectations which could be deployed around the service area as the face of the brand.

What if:

  • Care and experience were top priorities for providers (I'd be willing to be compassion is the biggest unmet, unspoken need)
  • Going to the doctor was as easy as going to Starbucks
  • Patients could schedule their own appointments, on mobile devices.
  • We could use FaceTime rather than waiting in waiting rooms.
  • Healthcare data belonged to patients, and providers would access it, with our permission, as they need it.
  • There would be navigators who's job would include making sure meds were picked up and appointments scheduled.
  • Docs would follow up about tests and treatment directly. And, they'd be accessible (within reason) by email or phone or twitter or text...

I know what you are thinking, many of these things are happening now. But not as a cohesive strategy for provider organizations. Providers are not thinking about designing strategies around emerging consumer wants. Why? The perception is the money is in the old school way of operating.

Remember when coffee used to come in a can from the grocery store? Did we think we wanted a coffee store on every corner? Starbucks tapped into that consumer desire and it seems to have worked out for them.

From the Blue Ocean site:

If the value and profit propositions are strong but the people proposition does not motivate the organization to move forward with focus and commitment, it will result in execution failure. Alternatively, if the people proposition is powerful but the value and profit propositions are weak, the company’s performance will be lackluster due to formulation failure.

via Blue Ocean Strategy.