“The consumer is a powerful person in healthcare”
Episode 84
: [00:00:01] Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez
Saul Marquez: [00:00:19] Outcomes Rocket listeners welcome back once again to the outcomes rocket podcast where we chat with today’s most inspiring and successful health care leaders. Really want to thank you for tuning in again and I invite you to go to outcomesrocket.health/reviews. Leave us a rating and review. We’d love to hear from our listeners. Let us know what your thoughts are on today’s episode or anything that you listen to comes rock at dot com slash reviews. Without further ado I want to introduce our outstanding guest today. His name’s Brian DeVore. He’s a health innovator strategist entrepreneur and user design leader. His focus is the consumer, the patient and he is here to discuss that today. And so he’s co-founder and CEO at Swift. Well he’s been a member at the Oregon Health Policy Board, Director of Strategy eco systems at Intel and has his experience has been in healthcare for quite some time. So really excited to introduce this amazing guess. Brian welcome to the podcast.
Brian DeVore: [00:01:22] Great, thanks for having me.
Saul Marquez: [00:01:23] It’s my pleasure. And so today Brian we’re going to dive into this topic of health care consumerism. But I did want to ask you what made you decide to get into the medical sector to begin with.
Brian DeVore: [00:01:34] I came into the medical sector sort of when we were way back in the 90s when we all moved to the consumer directed health plans I would make them by turning to Wall Street for years of making was really where I was trained and in the 90s as you remember the consumer directed health plans kind of took off and enjoying it helped start a company in a that was focused on getting these things up call the help of candidates which ended up being held Etting accounts. Were actually money back then because it was owned by the company but it was giving consumers some money to have them in the game. And when I made the switch back in the late 90s who’s going to set up the account went out and talked a lot of the banks the Wells Fargo the world and they were like What are these thing. Never heard of what they are why what we want to be in health care of course now you’ve got the folks a lot of the large physicians that are involved with health care so that’s how I got into healthcare. It had bolthole role. And again most have always been on behalf of cuber when you use your healthcare to drive you know better value at a lower cost engagement multiple ways. Whether personal health record or buying Intel on behalf of our members or employees and you really trying to insert innovation into a market that’s ripe for innovation on the diagnostic and treatment side a pretty archaic. When you go and get to the blocking and tackling every other vertical and working in whether it’s retail travel you name it banking have all gone and realize the consumer is a pretty powerful person in healthcare hasn’t quite figured that out yet.
Saul Marquez: [00:03:04] Hey you know as leaders begin to think about the health care consumer there’s obviously and we had a chat before this. You know there’s there’s the consumer which is who is the consumer it’s the person receiving services. Is it the payer is it you know who is it. As leaders look and tackle this issue of health care consumerism what insights would you give them on this, Brian.
Brian DeVore: [00:03:28] Well again I think it’s been a big focus on the patients and you have to realize the patient is not the or not yet the consumer either is somebody who’s thinking about losing healthcare or housing needs healthcare or both the consumer and the patient. But there’s a lot of folks in this country that don’t really a lot of care and they don’t engage in very often. And yet we are designing the sort of systems for people that we to be overjoyed with the fact that they actually have to engage with their doctor with the hospital or with an emergency room or with an ambulance. And the truth is it’s sort of a weird market. You have a sort of a non willing consumer in healthcare. I can’t recall when the other day if you were to bump into an 85 year old man and ask him Have you ever been to who a doctor and he said no would you say to him absolutely disappointing sure that you haven’t had a chance to engage our wonderful health care system. And you know you say that’s fantastic you can’t believe you’re healthy and well and so you ask people what do you think about your health. How often do you really enjoy going to the doctor from you two. No. So I think we’ve got sort of this model here a model of engagement around the patients already in the system. The company like really was built around engaging them well before that. So I mean with so the expectations are what makes them tick is six inches between the space of their ears. And that’s for a lot of health care and something is driven in certain by mindset opinions beliefs values expectations and we don’t know that no one’s really uncovering that it’s sort of a hidden hidden gem. And if you can begin to call that out by engaging them before they ever begin to get care there’s a lot of doubts in saving you can drive this point knowing how people are sort of wire and what they do what they don’t want what they believe and what they don’t believe in. So another might that the vertical have done this and the reasons why you get post are BMW or postcards from Toyota. There’s reasons why you check into a hotel they know that you have the third floor with foam pillows and the king size bed. They’ve uncovered those sort of beliefs and desires ahead of time. So you don’t want an early wakeup call you don’t know it’s because they ask you and a lot of them because they’ve actually observed or bought the notion the company. So who are they. So again I think we just need to clearly understand that Consumer Healthcare typically unwilling consumer and we need to do things to engage them in a way. Other industries have done without drawing community. The morass of healthcare. Honestly I don’t think folks really want to think about their health. They can get about 50 other things that are more important to them.
Saul Marquez: [00:06:02] I think that’s a great call out Brian and for us to get specific. Maybe you could dive into a company or a client or somebody that you’ve worked with that doing things differently and creating outcomes because of it.
Brian DeVore: [00:06:16] Well I mean I’ve about Intel I can’t speak for Intel with the currently doing what I did there. I think what we did take time to do which took time and delayed the project a little bit which is important is we actually went out or hired a lawgivers. Those are people that study human behavior and not just to the tool of observation and that was really telling to me because a lot of the beliefs I had on how people do things that what they really want is based upon what surveys told us or what people would vocalize. Sometimes the vocalization of concerns troubles desires or they often offer proxies but they don’t really know how to solve the problem themselves and so they’ll ask for a proxy because that’s really all they can think of is how to solve that problem. They can be in a variety way over the health care or the work life balance. It could be. Elder care could be how you get paid. Are a lot of things that people say they want because it only know how to verbalize what it will be worth and Intel actually went out and hired a firm because you obviously couldn’t do it on employees. We hired a firm to actually and observe how our population interacted with the healthcare system. Though they may say they used an online service within the to get the health information the truth is that they probably don’t know they probably up next or neighbor where to get their health information. And they probably don’t use the doctor tools or tools that are out there they probably walk again next door to their neighbor and ask about the knee surgery that he had and the surgeon he had a day like him with it. He’ll okay with the treatment. Good. That’s how people make these health care decisions. Relationship based despite the fact that we’d like people to pick the 5star if at all they just do not conceive that way and so by observing that you end up building up relations with people you do what they really want not what they actually say they want. And again you can only really gather that through observation with something that has gone into not just the two of them my own company but a lot of that kept popping up a other large employers making sure they understand their population. Your observation is not just your surveys that you’ll be missing some nugget though that handling them when it points you.
Saul Marquez: [00:08:19] That’s an interesting point and how many of us put higher ethnographers to figure out what consumers are actually doing versus just telling us. And yeah I mean I think that’s a really interesting way of approaching the situation. It’s definitely one way to just dive deeper and even validate the things that you’ve heard. Are you seeing the things that you heard or the responses that patients and consumers are actually giving to you. I mean that’s great. I mean it’s a really good call out and based off of these particular steps here Brian. Have you seen any type of improvements in outcomes for any of the people you’ve worked with.
Brian DeVore: [00:08:57] Well we could the data to show that people will get better and typically have better personal health if they are engaging as either a trusted provider or a trusted system one that they believe is has their best interests in mind and that the body is out there and not have to go with that out there. You can sort of put up a Web site built on trust and so anything you can do to enhance trust in heightened trust get obviously we can drive better behavior I think it drives trust drives lower downstream utilization because folks still believe that the system is somehow designed or rigged against them and they really do believe that they believe the healthcare system is somehow impaired or are not listening providers. They’re defensive and they believe that the insurance company is somehow in it for the money and the doctors are doing it just to drive more income and so that’s why you know with US opinion of the system is so poor. So again if we can enhance trust by uncovering those sort of beliefs and expectations and values I think we the data show that once you engage with your doctor in a more mutually rewarding relationship you will do better. You will take your medication because the doctor actually said that ahead of time you don’t like me. You don’t like certain medications that make you feel guilty or whatever. Sometimes those questions are never out. A lot of assumptions happen in healthcare. So the two we built it worked really well it’s not designed to be the end all be all true but it doesn’t cover some of those beliefs and passing that information on to the care team whether it’s an HBO which is responsible for that. Or you want a fee for service model. Once you understand what’s making people tick you don’t try to push people in directions they don’t want to go in again. Getting somebody aligned to a primary care doctor mental health whatever it might be. It’s got an online mindset allied expectations aligned values that it is pretty strong at their care.
Saul Marquez: [00:10:54] Now that’s pretty cool. And so with the two that you and your team built Brian over at Sifft that’s S I F F T you guys helped put together this information so that when the patient actually gets to where they’re going to get care they have the provider has a more complete picture of the patient. Is that correct.
Brian DeVore: [00:11:16] Yes. Critical though. I cover those critical things through observation through history of physical those kind of things you testing we’re uncovering again those soft science the psychographic questions which are really gathering that I get every other industry wants to uncover. Why do you drive fast you drive slow. I mean those are things that once they figure it out they’re going to market what kind of cars. Uber the difficulty are we don’t do that in healthcare and this is about you know anywhere from 25 to 30 percent thrash every year people going to doctors that kind of art aligned and they don’t like this don’t agree with that ethics experience a lot of it’s just we just didn’t seem to gel. You know it just feels like you’re on a different wavelength. And so this was designed to uncover some of those questions about your opinion of healthcare specifically what you’re looking for example that I you know pediatrics biblical future with your kids. Great question. As we talk a pediatrician does he believe in vaccinations. Know the same I do not with vaccinations. Why on earth would I send you to somebody who’s pro vaccination that is going to get frustrated and have arguments the get go. And that’s not a trusting relationship that’s going to cause friction using only natto with that question around the antibiotics. Are you scared to just what antibiotics your kid right off the bat are you one of the lucky the wait. The question is when we try to uncover in this tool those questions that drive me or somebody further away from a certain provider or order to provide it and ideally we get the genesis of the whole case. When I was at Intel we were asked to assist them do a much better job in taking our members and tools really are pretty poor sort of like you know you trusted the directory. How do you find a doctor when you sort of choose your insurance if we trusted them to get a date. The tool became dating engines like match.com. You’d never find anybody where you’re looking at right you did give you 7000 men or women in your zip code that you go to. It doesn’t help overwhelm people when you overwhelm people. They shut down and they could do anything. So we tried to use teachable moments when people are choosing something even to pick an insurance plan or they have to go find care as sick. The teachable moment tool you can design to uncover those things. So it’s really sort of those weird questions that people often don’t even think about asking the addict ahead of time but once they get in the process. Most doctors do interogative the question you know a year a year and a half and then in the meantime the patients are unhappy and they’re frustrated because the mission and following their protocol. They’ve asked for they can’t figure out why a person will not take their drugs and never actually do it without their permission. Do you even want drugs. Like are you are you a drug person or not a drug person that is not a drug person. That’s me. Why would I go to somebody who’s like here just take drugs or take a prescription. We’re just going to have this really weird relationship where I don’t live i trust him because he’s just giving me stuff I never really wanted the first thing. So often patients not verbalize that they’re they’re afraid of challenging Doctor, challenging provider and so we ask that question Who are you willing to judge a provider state status sort of what you believe in. But how is with the diagnosis and treatment is in some doctors. We appreciate that and some really don’t like that. So again and again interesting or aline with somebody you could ever trust with a truly the goal.
Saul Marquez: [00:14:31] It’s a really good idea. So can you give an example to the listeners of how this has helped you know some of your users improve outcomes.
Brian DeVore: [00:14:39] Well we will definitely lead to a Harat adult benefit Internal Medicine. We know that older patients especially the poor lady looking for her mother who did not want to take medication that made her dizzy and she was very much in the natural benefit of vitamins and is frustrated with the hurt locker and he kept handing her packets of different prescriptions. And so what is happening was she just not going to the doctor if she didn’t feel like he was really listening to her. So they used that tool again some tool designed for health plan. The point when the current testing we did on the open market for the consumer that the patient actually go back and get my mom found somebody that she really liked the stock was totally divided and totally into alternative medicine. And they really feel like she’s you know she’s out of the she’s listening really listening said the patient and we have somebody that we have engaged patient instead of somebody who’s not engaged. So the challenge is is there any sort for the weird application of this is not rocket science. These are questions that most care providers of care teams should be asking to think any way some do. Most don’t. Too cumbersome and yet once you sort of in the system they ask you about your blood pressure see everything about your physical health. It’s mental health. It’s not often about what you really want to carry you doing. We are seeing some of the stuff happen in the last year. So folks are starting to ask those questions is really weird odd questions about you want to be sustained if you are not or or you know not alive or sort of yes door and those similar questions. So what are you what are your expectations. And it’s a new science is new to the world with healthcare. So good example where we know we help the consumer get better care if they were much more aligned to who treating it.
Saul Marquez: [00:16:24] That’s a great example. Brian let’s pretend you and I are going to build a leadership course in medicine and what it takes to be successful. Today it’s the 101 course or the ABC of Brian DeVore. And so we’ve got four questions here. Lightning round style and then we’re going to finish with a book that you recommend to the listeners you ready.
Brian DeVore: [00:16:45] Yeah I think of the book really quickly because you have to be health care book and.
Saul Marquez: [00:16:50] It doesn’t have to be. It could be any book you want and this syllabus. OK. All right so here’s a question what’s the best way to improve health care outcomes.
Brian DeVore: [00:16:59] Measure what really matters.
Saul Marquez: [00:17:01] What is the biggest mistake or pitfall to avoid.
Brian DeVore: [00:17:04] Measuring what doesn’t matter too easy to measure what doesn’t matter.
Saul Marquez: [00:17:09] Indeed indeed. How do you stay relevant as an organization.
Brian DeVore: [00:17:13] Despite constant change understand the market constantly look for ways of innovating internally.
Saul Marquez: [00:17:20] What is one area of focus that should drive everything else in your organization.
Brian DeVore: [00:17:24] Reduction of errors and the consumer again and eliminating waste. So be Liem wherever you are and look to improve whatever processor charges.
Saul Marquez: [00:17:35] And finally Brian what book would you recommend to the listeners.
Brian DeVore: [00:17:39] Well I just finished reading I saw a record of that what was it really like there was shoe dog which is so like biography and how we started like he was something that makes a little point. I thought I knew the story like he pretty well and I didn’t really know how long it actually took it. How closely were you going belly up a number of occasions. A great great example of perseverance understanding the market taking risk being willing to pull yourself up go out of business actually for the benefit of the consumer.
Saul Marquez: [00:18:07] Love it. Listeners take that book down. And if you don’t have a pen or you’re driving just go to outcomesrocket.health/briand that’s B R I A N and D is in Devor and you’ll be able to find all of the show notes in the things that we discussed today as well as the syllabus that we constructed for you along with a link to that book. He just shared. Brian. Time flies when you’re having fun. But before we conclude I’d love for you to just share a closing thought with the listeners and the best place where they can get in touch with you.
Brian DeVore: [00:18:38] Closing thoughts your listeners getting involved. Health care is more complicated than cell. Be careful those who believe in a silver bullet. Because I haven’t seen one yet. It’s pretty complicated and I think that society need to come to a conclusion have a larger discussion as to what exactly do we want to do. Now it’s pretty polarized. Other countries have done the same thing. You can e-mail me at brian@gosifft.com and I’ll get back to you.
Saul Marquez: [00:19:12] Awesome Brian really appreciate you sharing your thoughts today. It’s definitely an environment that we want to spend some more time thinking about is just how we take care of this healthcare consumer and I’m sure your insights will definitely help the listeners reframe things in a new way. So just want to say a big thanks to you and looking forward to stand in touch.
Brian DeVore: [00:19:30] Sure you bet.
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