Inmar Inc. | August 15, 2014

Is that an absurd notion? Actually, in the right context, there's a lot of truth to it. What grocers and all major retailers know is how to reach people, engage them and influence their actions.

Healthcare needs to be better at that. Episodic engagement relegated to appointments and the occasional community health fair won't cut the mustard anymore in increasingly competitive environments where the pressure is on to grow and reduce cost.

Retailers have mastered tools that, once adopted in healthcare, could represent a monumental transformation to the industry: The ability to reach out to people to meet them where they are, know their needs and challenges, and be a full-time partner in solutions to their needs.

Retailers don't just tell you about their stores, products and service when you're in the store. They make extraordinary efforts to make themselves as much of a full-time piece of your life as possible. They do that through deep-dive information gathering about more than just the things you need.

They look at what you buy, how you decide to buy, why you choose it, how you go about making the choice, what else you buy when you buy it, and so on. They look at where and how you seek information about products and what kind of information leads you to buy. And they work hard to put themselves in a position to influence that choice.

Healthcare organizations can leverage these tools to transform their industry and change lives. So how can you do that?

We're exploring that now, and the results are promising. Inmar recently partnered with Novant Health, a regional health system based in \Winston-Salem, NC, to apply the power of retail behavior analytics to data regarding the needs, challenges and behaviors of diabetic patients. The results present great opportunities for how health enterprises can gain from the analytical tools retailers have known about for years. But I'll get to that later.

There's great debate over the idea of treating patients as customers. What's far more important is the critical need to find new ways to engage them more deeply in the management of their care.

Healthcare has plenty of room to make great gains toward solving one of its biggest challenges: Driving better health outcomes by engaging people to participate with more commitment and discipline. In other words, getting them to do what the doctor says. Unfortunately, a great many people don't, and they suffer for it.

The National Community Pharmacists Association gives the United States a C+ grade for taking their medications correctly and consistently for chronic conditions. The report estimates that this low level of medication adherence adds as much as $290 billion in costs to the healthcare system each year.

Providers are understandably befuddled that patients don't follow their care regimens — even when they directly tell a patient that not following the doctor's orders could result in their death. So if death doesn't motivate them, what will? Good question.

Doctors can't be there every day to help people cook and remember to check their blood sugar and take their meds. That's where healthcare can learn from retailers. Healthcare operates in an episodic mode, mostly only handling people's needs when they present themselves for checkups or treatment. Between appointments or hospitalizations, they are left to their own devices. The result is that people's care is in reactive mode rather than the proactive mode that could prevent episodes from happening.

How do you get out of episodic mode? Reach out to patients
the way retailers do, creating opportunities to have an influence on day-to-day choices. Become people's resource — their day-to-day partner in their care.

Retailers devote focused effort to gathering behavioral data to understand and leverage people's behaviors. Do you know that for any given discount offer, there may be hundreds of different versions? You probably didn't know that — you only see the offers targeted for you.

Retailers understand how people make decisions and what motivates them to do certain things. They use that to predict future behavior and seize the opportunity to influence that future behavior.

In healthcare, that translates to creating ways to positively influence medication adherence, diet and lifestyle choices, as well as incentives to participate more fully in managing their health. Do you need to have a sale? Maybe. The point is that whatever the incentive, when you offer them, people respond.

From our study with Novant Health Innovation, we have learned three truths about the fully engaged patient:

  • They are hungry for information.
  • They WANT to do the right thing.
  • They are willing to share personal data to get better outcomes and service.

People are already learning the value of data sharing from other industries, and they see the value in sharing some information to get something in return: They have loyalty cards at the grocery store; online sellers track their searches and purchases and offer suggestions, and so on.

Are people that engaged with you on their care? No — but the answer may be simply because you're not giving them the opportunity.

The Novant Health study with Inmar reveals that diabetics will gladly share information in return for incentives or rewards related to actions they can take to better manage their disease. A whopping 78 percent of those surveyed said they would be interested in coupons for food items that are diabetic-friendly. Could healthcare partner with retailers to make that happen?

Here are some thoughts about how to get the ball rolling:

Shift from episodic care to collaborative wellness
If you only influence patients during clinic visits, all you can do is react to the choices they make and hope they follow. Patient-engagement initiatives give more frequent opportunities to be a whole-picture partner in managing patients' health.

Ask people to share their data
If you give them value for sharing information discreetly, they will. They prove that every day with in-store shopper cards, social media profiles and online shopping. This quote from one survey respondent tells the tale: If sharing with you what I buy at my local grocery store can help me change my recipes into diabetes-friendly recipes and I don't have to do the work, count me in.

Implement scaled listening techniques as a function of customer service
Scaled surveys with a range of choices offer the chance to gauge responses more specifically and get a better picture of what is important to respondents. It's the difference between asking someone "is it difficult finding diabetic-friendly recipes?" versus "how difficult is it to find foods that help you manage your blood sugar?" That's where insight begins to take shape.

Target different messages (and incentives!) for different audiences
Different patients have different needs and are motivated by different rewards. Once you have good, scaled informational insight, you have the ability to reach people where they are and meet their specific needs. Yes, the face-to-face conversation in the clinic gives you that. But when the diet-challenged diabetic gets an offer that subscribes them to an awesome diabetic recipe website, they feel more like you're really providing a service.

When you also know the cooking-challenged person already has a gym membership, you don't send them the partnered offer with the local gym for two free months. That offer goes to the person who needs the incentive to exercise and manage their weight. That means your enterprise gets more bang for the marketing buck; targeted service to each of those patients equates to improved loyalty ratings.

Rethink points of patient entry
How do patients come to you? Outside of the clinic visit, they do have other influences/choices/partners in their health choices (friends, grocers, pharmacists, restaurants, support groups, community organizations, etc.). And don't forget the Internet — a 2012 Pew research study found that 72 percent of Internet users had sought health information online. Are you their online resource? How can you partner with these other resources to insert your organization even more deeply into their world?

Explore new opportunities for data from mobile and wearable technology
Can you reach people on their mobile device? Every health enterprise in the country has to adopt electronic medical record systems with patient portals. If it's only being used as a passive means for patients to check their labs, appointments, etc., you might be missing an opportunity. Can you engage people to receive push notifications containing information they tell you they want? What if you send reminders that their prescription will need renewal soon so they don't end up in an event because they ran out of meds? The answer is yes, mobile holds great promise.

Matthew Gymer, Corporate Director of Innovation for Novant Health stated that in "a recent pilot program, Novant Health Innovation validated in a clinical setting the use of mobile generated data as an accurate predictor and treatment facilitator for better health-related outcomes…validations we are seeing across a number of different patient populations."

Imagine the possibilities of robust, active engagement with the people you serve, in cost reduction, reduced episodes, improved outcomes — simply because you asked them for the opportunity to help. Isn't that what healthcare is all about?

What do you think about how healthcare can better engage people? Please share your comments or questions in the comments section below.


  • Health Care