That escalated quickly: Non-traditional health care competition has already taken hold

Matthew Patrick Tobias: ©Bottle Rocket

Health care headlines were dominated in late 2022 and early 2023 by announcements of new competitors entering the health care delivery space. Amazon. CVS. Walgreens. Walmart. Best Buy. Dollar General. Dollar General? Yes, Dollar General – they have a rural reach that’s desperate for medical attention. They are all looking to provide primary care services and/or home health services.Much has been written about these new challengers, but for all the months of talking about the impending competition, few seem to have recognized: they aren’t impending anymore. They’re here and they’re expanding.

When I log onto Amazon, not only do I get a recommendation to re-order some Canadian All Dressed Ruffles (if you haven’t you should – it’s a sin they aren’t available in the United States), but I also get an offer to sign up for One Medical – 24/7 online appointments for $144 a year.Or I can click on “Clinic” and start an appointment in minutes. These non-traditional providers are offering what traditional providers consistently struggle with: easy to navigate experiences that can be individualized.Few industries are more entrenched than health care, but that’s exactly why these titans of other industries feel they can succeed. They’ve figured out how to attract customers by giving them exactly what they want. Traditional providers are largely still giving patients what they were willing to put up with in the 20th century. If you’re one of those providers read on.

In one survey – 63% of respondents said they would switch providers due to poor communication in their pre-care experience. Think about that – 63% percent of your business is willing to go elsewhere before you even get a chance to meet them. Now they have that ability to switch to a non-traditional provider (or some traditional providers ahead of the technology curve) without even looking up from their phones.

You can read lots of wailing and gnashing of teeth about this. Folks are happy to point out that non-traditional competitors don’t offer a full range of services or don’t give the opportunity to establish a long-term relationship with a particular MD, but all that is moot if the patient doesn’t care. When I have a sore throat on a Friday night I’m not thinking “I better go somewhere that can also offer me world class cancer care” or “I hope kind old Dr. T can diagnose this when he gets back from vacation.” Raging against this change in expectations will avail you nothing.

So what can you do about it?

The prevailing thought seems to be that you have one of two choices:

• Accept your new overlords and learn to work with them.
• Beat them at their own game.

We humans (at least in the U.S.) love to boil things down to a binary choice: left or right, good or bad, urban or rural, cats or dogs, smart or dumb, chocolate or vanilla – this list goes on and on. It makes thinking about the world around us easy, but it’s not reality. The real world has a soft serve machine at the end of the buffet with a middle lever that can put chocolate and vanilla flavored frozen product in a dish that will melt before you get back to your table.

You can pull the middle lever on the choices above: work with your competitor while working at beating them at their own game. Heck, you can even use your work with them to learn how to do what they do. Set up that pipeline so the patient that goes to a Minute Clinic can be referred to your surgeons or oncologists. When you welcome those new patients into your system, include them in your research. What drove them to use the Minute Clinic? How might you offer that same service or feature? Listen, learn, and adapt.

But in the meantime?

While you are waiting for the deluge of new clients coming to see your specialists how might you start down the road of beating the Walgreen’s of the world at their own game? Do you start selling a selection of overpriced grocery staples and janky off-brand toys? No, the same lesson applies here: don’t waste time railing against things you can’t control. Focus on where you can make an impact.

When it comes to digital experiences you will naturally look first to your EHR vendor. When you spend 75% of your IT budget with one vendor, it’s natural to want to extract as much value as possible. After all, places like Epic and Cerner convinced providers to spend millions by promising they were a one-stop shop for all their needs. Sure, they offer patient portals that do some things your patients want, but they are largely insufficient and kludgy. Patient interactions require personalization of the experience: both for the provider and for the patient.

If you want to do something unique, you’re free to submit an enhancement request to your EHR vendor. If enough other customers put in the same request, they may develop something in four to six releases. You don’t have time to gamble on that level of uncertainty. You aren’t constrained by EHR vendor timelines and whims. Shaking a fist at Verona won’t help – you need to get to work forging your own path. Engaging in custom development shouldn’t be seen as daunting. Partners can help while internal expertise is built.

But What should you build?

Like any consumer-facing experience, health care digital front doors, patient portals, or however they are branded, have a base set of expectations and the opportunity to differentiate. What are patients expecting as a baseline?

1. Searchable Provider and Location directories with Ratings and Reviews
2. Online Bill Pay
3. Online Scheduling
4. Appointment Reminders
5. Telehealth
6. Viewing Health Records
7. Messaging a Clinician

Those are the non-negotiables at this point. By the time you read this, more will be added to the list. Most of these features are available via EHR patient portals, but the experiences pale in comparison to similar seeming interactions with Hilton, DoorDash, Google, and other digital experience leaders.

You need to differentiate if you are to compete.On your own or with a strategic partner, you can develop products that provide what EHRs cannot – personalization and empathy. That’s what the non-traditional providers are banking billions (with a B) on. You don’t have to spend billions to keep up and differentiate.

What are some of those differentiators?

Ease of Navigation – More than anything else, patients want their experience to flow and make sense from their point of view. A thoughtful experience architect can work with clinicians and patient advisory councils to map out these journeys and uncover points of friction that can be alleviated with better experiences. Ongoing patient research can ensure that evolving needs are met. Pre-appointment paperwork and check-in processes are ripe for review and optimization.

Personalization – Know a patient’s preferences and communicate with them in that manner. A retiree may love text reminders and a teen may prefer a phone call. Don’t rely on demographic trends – ask each patient their preferences and engage in the way that builds rapport.

Quick, accurate answers from a trustworthy source – Patients remain skeptical of large businesses. Messaging with a trusted professional like an RN goes a long way to developing trust and loyalty.

Availability – Whether it is in person or video or even an online chat, patients want access to health care professionals on their schedule. Some things like common symptom checkers can be automated to provide answers 24/7. RNs can chat with multiple patients asynchronously to provide answers faster than having everyone wait in a phone queue or fill up your waiting rooms.

Traditional providers have a bright future ahead so long as you are willing to embrace the changes brought by patient expectations and not-so-new challengers. Cycles of evaluation and change may be coming much faster, but at its core, health care has always been about learning, growing, and adapting.

Matthew Patrick Tobias is Healthcare Program Manager at Bottle Rocket. Learn more about Bottle Rocket’s digital healthcare practice.