First Republic is proud to support medical professionals and their practices by sharing insights to help build their business. This is Part 1 of a six-part series on health care in the age of personalization.
Several months back I published an in-depth series asserting that inclusion should be embraced as a growth strategy for enterprises across all industries. I went so far as to say that inclusion is a skill, one that needs to be learned, practiced and mastered by every leader starting with the CEO on down.
Inclusion is the most essential leadership skill today. Why? Because we have shifted from an age of standardization to an age of personalization. Those who master the skill of inclusion will be able to shift their ingrained methods of standardization – many of which no longer apply and slow progress down – to methods of leadership in line with our new reality.
Today I’m kicking off a new series on health care in the age of personalization.
What do I mean by the age of personalization?
As a society, we are more diverse than ever, we are more informed than ever, we are aware of and proud of our individuality.
One person might be a Latina, an introvert, a millennial, a morning person, a trained economist, a city-dweller, a high-potential employee. She might specialize in seeing the big picture and anticipating roadblocks, while someone else with the same credentials and title specializes in meticulously plotting the day-to-day path to a project’s success.
Every single one of your employees and patients/consumers is a unique mix of strengths and expertise, and we are more aware than ever of our unique capacity to have influence and impact as individuals. We are no longer inclined to hide our identity or feel pressured to fit into the standardized version of mainstream. We are aware of and proud of our individuality. We want to influence our workplace and the marketplace in our own way.
But for the most part, the way leaders lead has not caught up to this new reality. I will be so bold as to say that more than 80% of leaders across industries have not.
In standardization, the business defines the individual. We’re told what to do inside the box we’re given. Progress toward the company mission is what matters and is measured. We protect our functions and work within our silos.
In the age of personalization, the individual defines the business. Our individual capacities should be elevated and activated, so we can influence the business. Progress toward individual impact and legacy should be what matters and is measured. We must value and seek interdependence across the enterprise.
What does this have to do with health care?
As an industry, health care has a head start in this era of personalization. Leaders have had to consider how to combine the efficiencies and quality of standardization (we all get the same flu shot) with the understanding that every person is different and health is affected by many factors:
- On the clinical side – advancements in genomics and precision medicine make personalized treatment and prevention possible, while the move toward value-based care shifts incentives toward finding a standardized way to provide personalized care.
- On the non-clinical side – for years healthcare leaders have been considering how people are affected by social determinants of health, things like access to housing, food and transportation. Within their own organizations, leaders grapple with how to create a diverse talent pipeline for both clinical and non-clinical roles.
As our population gets more and more diverse, keeping people healthy will increasingly depend on how well healthcare systems understand and address diverse populations. Yet, as noted above, diverse populations are not homogeneous – we are all individuals.
I’ve been researching how health care addresses this challenge for a few reasons. First, the stakes couldn’t be higher for this industry – they deal in life and death and everything in between. Also, other industries can learn a lot from healthcare leaders who have been thinking about personalization more than the rest of us.
In a conversation with Mark Laret, president and CEO of UCSF Health, I shared my thoughts on the importance of inclusion as a strategy for organizational growth, considering this new age of personalization. He responded by taking it even further: “Yes, I’ll stipulate it [inclusion] as a growth strategy. Maybe this is going too far, but I’ll say it’s a survival strategy.”
I don’t think that’s going too far at all. In fact, I agree completely.
For this series I interviewed 13 CEOs or other C-level executives from leading cancer centers around the country. I also interviewed eight chief HR officers from healthcare organizations. From these conversations I will publish a series of articles that dive into the following themes:
- Personalization and population health – how do they fit together?
- Health equity and social determinants of health
- Finance structures, payers, insurance – how does personalization impact the business model, and vice versa?
- Personalization in both treatment and prevention, and overcoming mistrust of the system
- HR, ensuring a talent pipeline, and creating an organizational culture of inclusion
- Methods and systems that organizations have put into place to move toward personalization, and what metrics we should be using to measure progress
Everyone I spoke with was enthusiastic about this topic and agreed that inclusion is crucial in this age of personalization.
Here’s just one reason why, shared with me by Nancy Davidson, MD, executive director and president of Seattle Cancer Care Alliance:
“We know in cancer that outcomes are affected in part by differences. That different populations have different outcomes, and in some cases disparities can contribute to poor outcomes. And so we understand from the get-go that if we want to make an impact on the burden of cancer, we have to be able to do this across all populations. In health care, I think we’ve also come to realize that the best way to do that is with a diverse workforce, a workforce that matches our patient population – because that’s going to be the strategy that we can use to have the best possible connection with our patients. And I hope that’s going to translate into the best possible outcomes for our patients.”
You’ll hear more from Nancy Davidson and Mark Laret throughout the series.
For me, even though this series will focus on the industry, this topic is bigger than just what these leading institutions can do. We also need to find a way to get individuals themselves to take ownership and become their own self-advocates for care. We all must become more self-directed if we are going to make the healthcare system work for us and our communities. In our conversations, several leaders acknowledged the challenge of earning trust within communities of people who historically have not felt welcomed into the healthcare system – often for valid reasons (such is the legacy of the horrible and unethical Tuskegee syphilis experiment, among other examples).
Individuals are already forcing changes.
But here’s why we can’t just ignore these trends toward personalization or the tendency of some individuals to avoid seeking treatment or prevention. People’s lives and health are at stake. And, of course, health care is a business. Organizations risk becoming irrelevant if they’re not paying attention.
A recent survey from Accenture shows how personal preferences and health-related behaviors are changing.
Unsatisfied with health care’s status quo, millennial and Gen Z consumers in the United States are paving the way for non-traditional care models, such as retail clinics, virtual and digital services, according to results of an Accenture survey released at HIMSS19 in February.
Some of the changes (taken from the press release):
- Slightly more than half of Gen Zers and two-thirds of millennials said they have a primary care physician, compared with 84% of baby boomers.
- Without a primary care physician, some millennials are seeking some types of routine medical services from retail clinics (41%) and virtual care (39%).
- Nearly one-third of all respondents have used some form of virtual care — up from 21% in 2017 — and almost half have used a walk-in/retail clinic.
- Half of all respondents said they use a wearable or mobile app to manage their lifestyle and healthcare conditions.
- More than half use virtual nurses to monitor health conditions, medications and vital signs.
- Younger generations are more likely to choose medical providers with strong digital capabilities, such as those who provide mobile or online access to test results (44% of millennials vs. 29% of baby boomers), electronic prescription refills (42% vs. 30%), and booking, changing or canceling appointments online (40% vs. 19%).
So how do you lead in this age of personalization?
If you have 18,000 employees and 30,000 patients, does that mean we need to have 18,000 and 30,000 different ways of treating them? Or maybe it’s just 10 because we’ve actually taken the time to discover the like-mindedness within people.
We continue to classify and categorize people – in other words, we try to standardize them. It’s easier that way. It can be more efficient. I say “can be” because at a certain point that efficient standardization works against us – someone won’t fit into the category we’ve defined. That outcome is more and more likely today because of personalization.
What does leadership in the age of personalization look like? How does the healthcare industry prepare for it? And what can the rest of us learn from health care along the way? This is what we will explore throughout this series. But we can make one claim that is certain. The future of health care and its ability to deliver value-based care, in a digitally transformed world, where operational and clinical care excellence is at a premium – demands leadership in the age of personalization.
Next, I’ll take on the question of what we measure in order to track our progress toward more inclusive health care.