Consumerism as we know it has been slow to take hold in healthcare. Design and construction can play a role in better connecting providers with the changing needs and demands of their consumers.

We often think of healthcare consumerism as a new concept, but since the 1930s, there have been frequent references to “consumerism” in healthcare. Today, consumerism broadly refers to people proactively using trustworthy, relevant information and technology to make better-informed decisions about their healthcare options.

A Kaufman Hall survey found that 66% of providers consider consumer-centric initiatives a high priority. However, the most successful tools employed in retail, travel, and banking—business-to-customer (B2C) strategies, consumer segmentation, price comparison shopping, and so on—have fallen flat in healthcare. While the business-to-consumer strategies have not been as successful, we are inundated with more tools and access to data and measures than ever. The Internet is full of information on various merits of medical treatments, provider quality measures, patient satisfaction scores, and more. The problem becomes making sense of available data and whether the information that is accessible is the information that consumers will use to drive their personal buying journey.

“The pursuit of customer-centric care has wide-reaching effects,” said Supina Mapon, one of DPR Construction’s healthcare strategists. “Understanding what works and what does not inform where and how care is administered impacting the overall experience—as well as how healthcare facilities are designed and constructed.”

“Fundamentally, healthcare patients don't behave like retail consumers. Healthcare is a service (some would argue, a fundamental right), not a commodity so factors like convenience, ease, and choice only trump face-to-face connections and the quality of care you receive to a point,” Mapon said.

For example, contrary to what we’ve come to expect of Generation Z as digital natives, recent surveys of this youngest consumer group note that human interaction is as important as ever.

“It’s the equivalent of an uncanny valley effect for healthcare,” Mapon said. “We like the lower cost, convenience, and access that retail and automated solutions bring, but begin to question their value when they begin displacing authentic, meaningful engagement with our providers.”

Another significant challenge is the information asymmetry that exists between consumers and providers. Networking platforms like PatientsLikeMe, Curatio, and Wisdo Healthhave attempted to address this imbalance by letting people share information about their health, symptoms, and treatments. At the same time, other companies from Castlight to MD Insider, are focused on providing comparable pricing data. However, we are still a long way from enabling true information parity. Until consumers have relevant information about their condition, treatment options, and the cost-quality trade-offs for each alternative, they will continue to fall into the role of the passive patient rather than the active owner of their own health.

Lastly, consumer segmentation in healthcare is simply more complex than it is in other industries.

“Healthcare programming has traditionally been based on patient segmentation as defined by their condition or diagnosis, functional status, and needed care support,” Mapon said. “And while dividing patient populations into groups based on similar needs for services continues to make sense, other industries segment consumers by looking at lifestyle attributes, psychographic factors, and technology usage patterns. A new approach to programming that incorporates both the disease state and consumer behavior triggers is needed.”

To Mapon, none of this means a consumer-centric approach to healthcare should be shelved. Doing so would have far-reaching costs to providers, ranging from lower patient satisfaction scores and associated incentives/penalties from the Centers for Medicare & Medicaid Services (CMS), deferral of care, and even losing patients to competitors or talent to other sectors.

“It’s more about adapting the consumerism approach to the realities of the healthcare industry and emerging pressures,” Mapon said. “Those paint a picture of what consumers truly value and provide a pathway for construction and design planning aligned to it all.”

Rising consumer sophistication and the need to address the total cost-of-ownership (TCO) pressures are chief among healthcare leadership challenges.

“Consumers and providers are increasingly sophisticated, and the industry has seen an influx of capital from more savvy customers,” Mapon said. “Consumer demands are also evolving regarding sustainability. Smart buildings, energy and operational efficiency, and the flexibility and adaptability of structures will become higher priorities for them, so they will also be for the providers they turn to. Compounding this are the heightened expectations to address health equity and social determinants of health (SDOH).”

Moreover, advances in other industries, products, services, and environment are driving consumer expectations for healthcare. Companies like Disney, Amazon, and the Ritz-Carlton have set the bar for a seamless experience, personalization, and meeting consumers where they are at. These expectations will eventually stir up a storm of new, unanticipated competitors that are particularly good at blurring the lines between the physical and virtual to create an end-to-end experience. The speed of innovation is also shaping expectations.

“Consider how manufacturers once focused on features and functions of smartphones as selling points,” Mapon said. “Those selling points are now table stakes. Today, the emphasis is on style, lifestyle, and simplicity of use.”

Since construction is at least two degrees removed from these pressures, it is easy to think builders and the way projects are planned are not affected. Mapon sees that as a fallacy.

“Care itself means the right care,” Mapon said. “And the right care encompasses the right time, right place, right cost—and now, the right experience. The ways to adapt and integrate this convergent approach in healthcare into the physical places of care is instrumental for everyone involved in the right care.”

There are several ways Mapon recommended for construction to keep up with changing consumer preferences. Most critical among them is an acceleration imperative for speed-to-market.

“Having facilities online sooner is more critical than ever before,” Mapon said. “Organizations must satisfy the ‘right now consumer. ’In many ways, the long lead times of construction are antithetical to being nimble, flexible, and adaptable to consumer needs. So, contractors must find creative ways to deliver facilities or platforms more quickly.” Among the ways she sees as key to this aim are:

• Early partnering and procurement using more collaborative delivery models such as IPD or design-build. This minimizes supply chain and lead-time challenges.
• Digitalization of products and processes to be nimbler. Virtual design and construction (VDC) tools can be applied to create “digital twins” or to layer schedule and cost information into early project planning.
• Automated parametric design and object libraries that use digital channels to better inform buying and selling goods across the value chain.
• Adopting prefabrication or product-based approach to increasing the share of structures and surrounding services that can be delivered in a standardized method.
• Adapting supply chains to reflect what works well in a post-pandemic economy.

All that must be built upon a clear understanding of owners’ objectives for consumer-centered care.

“Builders can support owners’ consumer experience objectives by understanding their unique patient demographics and experience plans,” Mapon said. “That unlocks collaboration with owners and key partners in the early stages of planning to create facilities that offer a more seamless experience.”

This is especially important when working in active healthcare environments.

“Being sensitive to the hospital environment and provider and consumer satisfaction during construction or renovation phases seems like table stakes, but it needs more attention,” Mapon said. “Wayfinding, maintaining access on an occupied site, an understanding of different end-user flows, types, and intersections that occur on the campus... there’s much to account for.”

Solutions range from temporary wall systems to mitigate infection control risk and protect occupied sensitive areas to actions that preserve access and egress for all facility stakeholders. Builders should also not underestimate the importance of frequent, consistent, effective, and most importantly, pre-emptive communications to support consumers and providers through change. Much like the travel industry has focused on delivering real-time communications to let consumers know what to expect before the day of their travel, builders can adopt similar strategies to manage expectations.

“Being able to truly demonstrate inclusivity, including a keen understanding of the local community, is also vital,” Mapon said. “Values and preferences vary dramatically from region to region, and contractors who strive to work with local designers, planners, architects, and other professionals on each project are better able to understand and incorporate local trends and preferences.”

Ultimately, healthcare real estate must account for consumers who want a consistent experience with providers no matter where they interact with them, from physical locations to digital portals.

“Having a holistic approach—with the right partners in the discussion early on—enables project teams to bring more creative cost, schedule, and logistical scenarios to the table,” Mapon said. “That can help a healthcare provider achieve its overarching organizational goals, not just a single-building experience.”

This means staying at the forefront of technological advancements and changing IT costs, as well as incorporating flexibility in physical spaces and planning for advancements in medical equipment. Cyber security and digital and electronic infrastructure are also increasingly affected by natural disasters, which, in turn, should inform design and construction approaches.

“You cannot create a unified experience across a healthcare system without also adequately supporting and planning for changing equipment, technology, or care models during the design and construction phases,” Mapon said. “Additionally, a seamless patient and staff experience means being able to identify and procure the best technology to support customers.

“Healthcare can’t use the consumerism playbook other industries have been using,” Mapon said.“Rather, it’s up to the most innovative providers to pave the path towards a new type of consumerism tailored to the unique demands of the healthcare market.”

Photos: Ground Picture, fizkes/shutterstock.com, Prefabrication by Joanne Castner