In the age of reform, healthcare settings are becoming more diverse. You’ve probably heard of consumer-driven healthcare. Well, how about the medical retail store?
Pellegrini delivered a keynote during the opening day of the 2014 Digital Healthcare Conference produced by WTN Media. The two-day conference, which is being held at the Fluno Center at UW-Madison, was organized around the theme “Preparing for Healthcare Business Model Disruption.”
One of those disruptions is occurring in retail settings. Healthcare is being delivered at a retail store near you because retailers, including pharmacies, have learned to leverage online and digital technologies. They have also been working to create a seamless consumer experience among the store, the Internet, wearable devices, and smartphones.
In the process, the Walgreens of the world are attempting to engage the consumer in ways that drive healthy behavior. Walgreens’ Healthcare Clinics offer prevention and wellness services, including vaccines and health testing, actual treatment for illnesses and minor injuries, and even monitoring of health conditions.
The most effective aspect of the Walgreens approach could be its work in customer engagement. There are challenges to consumer activation, which Pellegrini found out at previous career stops like Microsoft, where he worked on HealthVault, which at the time featured solid technology but offered no true incentives for patients to engage, and the American Cancer Society, where he learned that people didn’t wake up every morning thinking about health, so engagement is more about making it easy when the consumer actually wants to engage.
“I’ve been working in patient engagement for 15 years,” Pellegrini said, “and it has been tough.”
Until recently, that is, when the secret sauce of patient engagement was discovered. After joining Walgreens, he was asked to create a seamless and comparatively frictionless consumer experience with its online and mobile healthcare products. The concepts serve as the foundation for “connected health,” and they are offered via the Omni-Channel Digital Health program.
The company first established a healthy rewards program to incent consistently healthy behavior patterns and provide a way for consumers to share their experiences with others. Based on research Pellegrini had done with the University of Washington, he witnessed people getting excited about walking groups, even establishing incentives and rewards, but after leaving people to their own devices — “We basically said please keep doing what you are doing,” he said — they returned to previous sedentary behavior.
“It was a reminder that changes in behavior are not an episodic thing,” Pellegrini stated. “We need to get sustained behavioral change.”
With Walgreens, the rewards are ongoing with what Pellegrini called the right mix of incentive and rewards, frictionless engagement, and social interaction.
Walgreens has more than 8,000 stores, and experiences more than 8 million daily visitors to the stores and its online properties. Pellegrini, who is responsible for the customer’s digital health mobile experience, already knew Walgreens processes more than one prescription per second on its mobile app, so he also knew the company already experienced a lot of transactional experiences on that app.
Walgreens also has 81 million active Balance Rewards members, a program the company launched about 18 months ago. That number represents about one-fourth of the entire U.S. population, so management saw real potential in establishing a healthy choices solution through the Balance Rewards program, “so that it’s not just a loyalty program, but also a loyalty program based on health,” Pellegrini said.
The healthy choices campaign was part health and part stealth. One of programs is called Steps, and it was not marketed. “We thought it would be cool if we gave members points for walking, so they get $1 for every thousand steps,” he explained.
Even with no marketing campaign, the program exploded by word of mouth and social media. When Walgreens started adding components to it, those exploded as well. “We’ve given out 2 billion Balance Rewards points for health with no marketing, so that’s $2 million,” Pellegrini noted. “Most go toward the walking programs, and about 111 million miles were logged in the past 12 months.”
Also in that 12-month period, the company reports 1.3 million active users, which inspired the next question. What would happen if people were rewarded to monitor their blood pressure and glucose readings? In the first month and a half, 80,000 blood pressure and glucose readings were recorded, which inspired more questions. Who was doing this? Who were the people causing this to skyrocket? What else are they doing?
That led to the addition of a social network so that people could form groups and share stories, and the social support element also has started to groundswell.
While Walgreens does not promote this activity as a substitute for formal clinical tests, Pellegrini believes it demonstrates how lasting engagement can be established when incentives are aligned in a way that moves the needle at the population level. Nothing is completely devoid of friction, but Pellegrini says the open ecosystem is about making sure consumers have an experience they don’t really have to think about, and that keeps them routinely engaged instead of episodically engaged.
The Doc Fix
The concept of the retail health clinic is not without controversy, as physicians in particular have complained about retail clinics not being staffed by doctors. But as care delivery models change in response to shifting reimbursement models, consumers can expect to see more of these types of options.
Pellegrini’s DHC session was moderated by Dr. Barry P. Chaiken, DHC chairman, who believes Walgreens’ program offers proof that the era of healthcare consumerism has finally arrived. “The thing that makes that work is the fact that individuals — patients — are actually paying for things, whereas before they weren’t,” he noted. “Consumerism was about having patients involved with their care, and that is very important and critical, but today, they are actually paying for their care, so people are going to pay with their pocketbooks.”
The marketplace, including physicians, will have no choice but to respond to this trend. “Physicians are going to respond to the fact that they will have competition with these types of clinics, and I think that’s okay,” Chaiken stated. “The reality is that there are many illnesses like the common cold that easily can be treated by people who are not physicians.
“We need to expand the number of primary care providers, whether they are nurse practitioners or registered nurses or some other type of professional.”