First Republic is proud to support medical professionals and their practices by sharing insights to help build their business. This is Part 2 of a six-part series on health care in the age of personalization.
Measuring diversity takes us further away from inclusion.
Unless we proactively interrupt that process.
That’s why we need new metrics.
In the first article in this current series (Health Care in the Age of Personalization), I introduced the age of personalization, how it’s connected to inclusion, why it is significant for health care and why health care, in particular, can help point the way for all industries to lead in the age of personalization.
This piece is the second half of the introduction to the series. In the articles that follow, I will share excerpts from my interviews with CEOs and other C-level executives at some of the most prestigious healthcare institutions in this country. They get it. They have big ideas about how to take on this wide-ranging challenge of meeting the needs of so many individuals. They also readily acknowledge the difficulties.
Health care understands the challenges of the age of personalization better than any industry.
Two massive shifts are happening in health care simultaneously: a shift from volume to value – making the industry more accountable for individual health outcomes; and a shift in demographics – a shift in the very populations of individuals whose health they’re accountable for.
In the midst of those shifts, the industry has to improve patient experience and quality of care, reduce costs and re-admissions while keeping efficiency on individualized care and precision medicine, and move from a fee-for-service system to one based on the value that rewards health outcomes rather than services rendered.
Whether or not the industry can accomplish these ambitious goals comes down to how well the industry serves individuals.
But first health care has to overcome the foundation that was laid throughout the age of standardization:
- Delivery of care was built around services, not the unique needs of the individual.
- An existing lack of diverse leadership, physicians and inclusive cultures, which continues to place the industry in a silo.
- Health systems that are unprepared to lead and serve populations as those populations become more diverse and their needs change.
Current investments in industry transformation are at risk if inclusion and individuality are ignored.
When I say health care can point the way in this age of personalization, I am not saying that the industry has figured out diversity – far from it. Modern Healthcare covered the industry’s lack of diversity in the C-suite in this article a year ago: “Racism Still a Problem in Health Care’s C-Suite.”
“Only 14% of hospital board members and 9% of CEOs are minorities, according to the most recent study by the American Hospital Association’s Institute for Diversity and Health Equity — the same percentages as in 2013. Minorities represent 11% of executive leadership positions at hospitals, compared with 12% in 2013.”
But here’s the thing: if we focus on diversity we’ll never reach inclusion.
Today, we are all feeling the tension and turmoil between the age of standardization and the age of personalization. Our workplaces, consumers and communities are multi-cultural, multi-generational, multi-gender, multi-skilled – we each have different needs, personalities, strengths, experiences and temperaments. Focusing on diversity and numbers makes people run away from the conversation because the people of diverse populations never really feel that they are influencing change, and people who are non-diverse feel like they are left out. Silos begin to perpetuate more than ever.
Diversity does not automatically lead to inclusion. Diversity gets more attention because there’s a formula – numbers to meet. Inclusion is not as easy to define, let alone measure and track.
Inclusion is active: It’s a system for making sure the organization is welcoming at every level to every individual. An environment that is inclusive can be safe for people to be and celebrate their individuality. An environment that enables and celebrates individuality can lead to inclusion.
But neither guarantees the other.
In non-healthcare industries, the discussions around diversity and inclusion have created this whirlwind of hires for diverse people. This creates a feeling for the diverse hires that they represent the “diversity tax.” I’m just here to fill a quota so the company can say it’s diverse. And that’s how people will feel in health care if we try to duplicate the efforts that have taken place in the non-healthcare industries.
That will backfire. Diverse job candidates won’t trust that the industry really wants them, at a time when the industry desperately needs them. And diverse patients won’t believe that health system outreach toward them is authentic.
Be careful to choose the right metrics to measure – it matters
Above, I referenced a Modern Healthcare article about the lack of diversity in the C-suite. What were your thoughts when you read that headline? Did you think about your own C-suite? Did the word “racism” trigger a reaction in you? Did you question the value of C-suite diversity as a metric with meaning?
I am not saying there’s a right answer to any of those questions. But I want you to notice your own reactions – and to notice the power of putting forth a metric, and the risk of reacting to a metric for the sake of perception or reputation or compliance.
This happens in all industries. I had a conversation recently with the dean of a law school who told me that schools are at the mercy of U.S. News and World Report and their annual university rankings (which cover a range of subjects, not just diversity). She said the criteria used for ranking universities is so outdated it makes it almost impossible for a university to reinvent itself because the perception of their brand is being controlled by a metric that makes it difficult for them to evolve.
A university could challenge the criteria or ignore the rankings, but that would be a risk. Public perception is tied to the rankings, so the school’s reputation would take a hit, possibly affecting the school’s draw as a top institution for academics and research. The onus is on the school to defend and explain why the metrics of the ranking shouldn’t matter and why their own metrics do matter.
Solve for diversity and inclusion by creating standards for personalization
It’s not that we don’t need standards. Of course, we do. But if we’re not thoughtful about which standards get entrenched and why then we are bound to standards that are not accomplishing what we set out to accomplish in the first place. The standards themselves get in the way of progress.
Health care is in a prime position to adopt systems and methods that enable inclusion that honors our new age of personalization. The key is to create systems and methods that make inclusion the de facto reality throughout an enterprise. Ask yourself:
- Does our organization have performance metrics that help us measure how well we work together across functions and silos as an organization?
- When we’re hiring at any level, do we understand that experience and education are not the only indicators of potential – do we give at least equal weight to individual capability, and do we know how to identify individual capability?
- Do we have processes in place to get to know patients as individuals, and to make sure that knowledge is shared across the continuum of care (as appropriate, while maintaining patient confidentiality)?
- Do we have processes in place to get to know employees as individuals – so we can activate individual capacity to influence the business?
A personalization model is something that the healthcare industry understands
That doesn’t mean the industry has mastered it. But there’s already a narrative out there around patient-centricity and precision medicine. There is an understanding that there’s no one-size-fits-all about how we serve patient populations.
The stakes are high in health care. We can’t afford to let the industry get sidetracked by metrics and false competitions that don’t lead to real inclusion.
I don’t just mean that being inclusive helps healthcare organizations better serve their diverse populations of patients – though that is true and it is important. I mean the organizations themselves cannot thrive, grow or even survive as business entities without inclusion.
Our nation’s demographics are changing. By 2043, we will be a majority-minority nation. At its highest calling, the healthcare industry is responsible for the health of all people – population health, encompassing communities as a whole; and individual health, treating and preventing disease person by person. If any given health system is not ready to serve these changing populations, that institution loses its ability to meet its goals related to prevention, care, research, talent acquisition, digital transformation and innovation.
Personalization is the lens and inclusion is the strategy for all of that. Inclusion is a strategy for growth, it’s not a cost center. It doesn’t belong as an initiative buried within HR. It belongs in the office of corporate strategy.
Throughout this series I’ll explore all of this in more detail with the help of the CEOs I spoke with.
Don’t miss the opportunity. Don’t default to the old standards that will put the industry in jeopardy.
In my next article, I will examine business models of health care in the age of personalization.