Digital health services affect patients' choice of provider

Digital health services are having a greater impact on patients' choice of provider compared to 2016, according to a new survey by the consultancy Accenture PLC.

The "Accenture 2019 Digital Health Consumer Survey" identified the top three factors that influence a patient's choice of provider as electronic prescription refills, email or text reminders for preventative or follow-up care, and secure communication with the provider via email. Among U.S. healthcare consumers ages 18 and older, all three factors saw an uptick between 2016 and 2019, with secure communication via email seeing the biggest leap -- from 57% three years ago to 70% in 2019.

The shift toward nontraditional healthcare, which the survey defines as emerging types of service delivery, such as virtual health, digital therapeutics and on-demand services, requires healthcare organizations to transition from being purely physical institutions, said Kaveh Safavi, M.D., J.D., senior managing director and head of Accenture's global healthcare practice.

Providers must also recognize and adapt to a patient's need for immediacy by offering digital health services.

Editor's note: This interview has been lightly edited for brevity and clarity.

Every company wants to be a healthcare company -- or so it seems. How is that impacting the industry?

Kaveh Safavi

Kaveh Safavi: If you actually look at the strategy of companies that are not in healthcare that want to get in healthcare, whether they're technology companies or financial services or consumer product companies, they're all trying to fill in that need, mostly around the parts of healthcare that can be effectively executed on either an all-digital or mixed digital and physical platform. And they're putting pressure on the traditional healthcare participants -- providers and payers -- to move their businesses or risk losing a small but profitable part of their business.

Do tech companies that are entering healthcare have to overcome issues of trust before consumers feel comfortable using them?

Safavi: Everyone will have to have to deal with that. It's not unique to just the tech companies. Anybody who wants to take information is going to have to demonstrate that they're using it for a good purpose.

The tech companies are building technology capabilities and they will go to market either through partners or through these companies directly. But they're perfectly happy to have providers build on top of their base. It's not clear that they want to be healthcare companies, but they want to participate in the healthcare marketplace as it becomes more able to meet patients on their own terms.

People want healthcare on their own terms, where and when they want it.

This is the way I think about it: There's a strong demand -- research studies continue to support -- that people want healthcare on their own terms, where and when they want it. So, effectively, by creating markets of one -- that's a term that's often used -- you cannot solve or meet that market in a traditional or physical care delivery model. You need to have a physical-plus-digital platform in order to meet people on their own terms -- where and when they want it.

Who creates the mixed model could be traditional healthcare providers, or it could be new companies we've never heard of, or it could be coming from the tech companies themselves.

What should be top of mind for healthcare providers who are beginning to offer digital health services?

Safavi: There are a couple of mindset issues that are critical. The first mindset issue, the model that you're going to start to see more and more of, is a model of, 'We have to meet you on your terms. We go to you, you don't come to us.' Some version of that, [and] it gets expressed a lot of different ways. But it's really a shift in the basic concept that we create an institution and you come to our institution. So I think that's the first one.

The second is that we're starting to see organizations increasingly recognize that it's not just about having a digital alternative; you actually have to reimagine the physical and digital together in a concerted fashion. If you have your traditional, physical [presence] and then you stand up the digital alternative, you almost never get the results you're looking for compared to people who build a physical and digital [presence] combined.

The best example of that is if you compress time around retailing. We had physical and then we had digital and they sat in parallel. But what's happened to all retailers is that they now have an intermixed physical and digital [presence]. You can shop online but fulfill physically, or you can shop typically but fulfill online. You can have it sent to you or you can go pick it up. It's seamless because everybody has a different context for any given purchase and you don't have to pick all of one or the other. Healthcare will have to go through the exact same experience.

How does a nontraditional healthcare setting affect the patient-provider relationship?

Safavi: I do think that we're seeing, in general, that a nontraditional setting is becoming important to everyone. People can hold down two relationships: one with whoever they view at their personal or usual place of care and then a set of services that they would like to seek based on immediacy. And they'll put immediacy ahead of the [usual care] relationship if they think that it's safe and reasonable to do it.

Some people characterize it as the loss of status for the usual care setting. I would describe it as more of a realization that you can have both of them, and that, ideally, to stay competitive, if you're the trusted primary source of care, you need to figure out how to provide your patients with alternatives when immediacy is the most important issue.

It's going to be up to the providers to make themselves accessible. But if the view is that the providers are going to stay the same and the patients are going to just have to give up that desire, we know that's never going to happen.

We have some data that we presented when we presented the full research at HIMSS [the Healthcare Information and Management Systems Society conference], but not in this study, that if you look at millennials, while they don't have PCPs [primary care physicians], they want PCPs. And, at the same time, they want digital alternatives. So they don't see these as being conflicting ideas; they're looking for both.