Mass customization is the future of care. Here’s how to achieve it.
That Netflix has something to teach the healthcare industry may not be immediately obvious. But the streaming giant has mastered a skill that America’s hospitals must urgently integrate into their work. That skill is mass customization.
Consider Netflix’s user experience. Netflix has about 150 million subscribers around the world. They all turn to Netflix for the same service. Yet when they boot up their apps, no two subscribers are going to see the same home screen.
Instead, each viewer is treated to a set of tiles reflecting their viewing histories, coupled with individualized recommendations for future viewing. Even the poster art changes to reflect viewers’ unique aesthetics. Everyone, in short, gets an experience all their own.
This is the ideal that health systems should strive for.
Healthcare leaders can be forgiven a little skepticism at this idea. It’s one thing to serve up customized versions of a software product; it’s quite another to distribute customized care experiences, across dozens of service lines, to tens of thousands of patients.
The fundamentals of mass customization, however, are well within hospitals’ capacities—and, so long as they observe some basic principles, a Netflix-like tailoring of healthcare services is closer to hand than many healthcare leaders might suppose.
It starts with segmentation
Though the idea has its roots in consumer products, mass customization has already entered the lexicon of health-system management. A recent article from NEJM Catalyst defined it as “the ability to create different experiences, at the customer or patient level, in scalable ways.”
As the definition suggests, scalability is the central challenge of applying customization in healthcare. Creating a unique experience for one patient is simple enough; creating unique experiences for every patient will strain hospital resources to a breaking point.
This is where patient segmentation comes in.
Segmentation is a cornerstone of any mass customization practice. Netflix, for example, does not laboriously create new home screens for each of its customers. It divides its subscriber base into segments (called “taste communities”), and serves each of these segments a customized version of its product. Crucially, these segments are meaningful enough to make each viewer’s Netflix experience feel both personal and satisfying.
This approach is exactly what researcher Joanne Lynn, in an article in Milbank Quarterly, advocates for healthcare organizations: “to stratify the customer population into groups that are sufficiently homogenous to enable arranging a set of commonly needed supports and services to meet their expected needs.”
Effective segmentation divides patients into meaningful cohorts. Hospitals can then direct their resources to meet the needs of specific groups of patients. In this way, segmentation furnishes the scalability that mass customization needs in order to function.
What’s missing from patient segmentation
Healthcare already practices such segmentation, albeit in a limited way. Triage splits patients by their health status. Population health divides patients according to their demographic data. These modes of segmentation help hospitals allocate care and produce high-quality outcomes.
To create care experiences that resonate on a personal level, however, organizations will have to reach further—they’ll have to pursue segmentation that includes patients’ identity, not just their clinical presentation. For this, hospitals will need psychographic models to complete their understanding.
The Institute for Healthcare Improvement has developed five psychographic categories that reliably predict what patients want from their care.
Knowledgeable care-seekers are patients who are proactive about monitoring their health, have few barriers to navigating healthcare systems, and enjoy a high degree of social support.
Casual and cost-conscious consumers are those who prioritize avoiding unnecessary care, and may delay needed care if it’s too expensive.
Constrained and chronic patients have health problems, feel overwhelmed by their care burdens, and need extra support in their care journeys.
Traditional and reliable consumers are those who vest a great deal of trust in their providers, and will almost always follow their advice.
Independent and naturalist patients, finally, are those who prefer to seek non-traditional treatment modalities like supplements, home-remedies, or TCM.
Putting the models together
In combination with behavioral, demographic, and clinical data, these psychographic profiles are enormously useful to health systems. They enable organizations to more fully understand what patients want from their providers.
But because they denote the invisible aspects of patients’ personalities, these measures are also difficult to uncover, and still harder to analyze. As a result, even if they do manage to successfully segment their populations, many organizations may struggle to create services that suit these personalities.
Fortunately, though, hospitals don’t need to draw from the near-infinite options that a service like Netflix must work with. IHI’s analysis shows, in fact, that healthcare organizations have only five variables to consider:
1) Patient needs—The domain of clinical expertise a given patient’s condition calls for.
2) Provider type—The kind of provider a patient prefers to see.
3) Location—Where the patient prefers to go, including factors like geographic distance from the patient and qualities of the setting itself (e.g., a hospital vs. a clinic).
4) Communication style—How patients prefer to be notified about their care, and in what way they want to interact with healthcare professionals.
5) Supplementary services—Whether or not a patient desires ancillary care, such as a dietitian or a coach.
By adjusting care experiences along these axes, hospitals can tailor their experiences to best fit the appropriate segments of the patient population.
As an example of how such adjustments work, take the case of a pregnant independent naturalist. Such a patient (1) needs maternal care, and will prefer to see a (2) doula or midwife, (3) at home. She also likely (4) wants frequent, personalized communications from her practitioner, and (5) is interested in alternative therapies like acupressure massage or water-birthing.
The closer a hospital can come to aligning on all five of these points, the more satisfied this hypothetical patient will be.
A foundation of understanding
No doubt, facilitating such highly specific care experiences is both demanding and complex. It takes considerable investment in technological infrastructure, analytic capabilities, and service-line development to reach Netflix-like customization.
But the good news is that mass customization is not an all-or-nothing proposition. Any step, however small, that hospitals can take toward individualizing their care is one that patients will be grateful for.
The crucial point to remember is this: These efforts all begin with a genuine, human understanding of patients. It requires coming to grips with who patients are, not just how they’re ailing. And patients are willing, even eager, to tell health systems who they are—so long as organizations are prepared to listen.
To learn more about NRC Health’s partnership with IHI on this topic and research, please check out the On Demand webinar.