Providers confront growing demand for instant access

Kim Dearnley couldn't call in sick after waking up recently with a sore throat.

As a computer trainer, she had limited sick days.

So she turned instead to the internet, where she found that the wait time was just 20 minutes at an Advocate Clinic at a Walgreens in her Chicago neighborhood.

She booked the appointment, made the five-minute walk, and was seen by a nurse within five minutes.

Dearnley, 30, lauded the convenience. "It's easy to get a same-day appointment at any time," she said. As for her primary-care physician, who was a half-hour bus ride away: "Good luck getting a same-day appointment unless you're there when they open and are put on the waitlist."

Dearnley's choice is increasingly the norm for a millennial generation that wants instant access to healthcare. They're also looking for a healthcare encounter that is frictionless, convenient and defined by good customer service. The younger generation—and many tech-savvy older Americans—are no longer willing to put up with the long wait times and inconvenient access points traditionally offered by large hospital systems and office-based physician networks.

And that is presenting a big challenge to major health providers such as Advocate, a Chicago-based healthcare system with a dozen hospitals and 1,500 employed physicians. It is among the many major players now looking to establish new access points for younger healthcare consumers, who give less weight to name brands or personal referrals than previous generations.

But many are late to the game. When it comes to meeting the new consumer expectation for speed and convenience, traditional players such as Advocate face mounting competition from stand-alone urgent-care centers, in-pharmacy health clinics and telehealth consultations. In some cities, there's even a return of on-demand home visits.

"As other players in the market begin to identify consumerism as an opportunity, they begin to accelerate their strategies," said Kelly Jo Golson, chief marketing officer for Advocate Health Care. "We don't want to be left behind."

The fear of falling behind is pushing the healthcare industry toward broader adoption of instant access, said Kathy Hempstead, senior adviser to the executive vice president at the Robert Wood Johnson Foundation. "There tends to be a sort of groupthink in healthcare, and I imagine that all the major systems are going to make these changes."

The new model requires healthcare consumers be treated well and have a good experience. But judging by the numbers, few systems are succeeding today.

Only 32% of millennial respondents in a 2016 Accenture survey said they were "treated very well" in the healthcare system, compared to 35% of Generation X, 51% of baby boomers, and 72% of the silent generation. Millennials were also the least likely to find getting care to be convenient.

"Their expectations around the end-to-end experience aren't being met," said Jean-Pierre Stephan, managing director of Accenture Health. In response, they're switching providers. Almost half of respondents to an Advisory Board Co. survey said they may switch providers in the next year.

"Health systems must find innovative ways to adapt," said Brian Flanigan, a value-based care consultant at Deloitte Consulting. "They will need to drive customer loyalty through a host of new programs and capabilities that improve the patient experience and therefore the 'stickiness' to providers."

Providers that don't adapt face "a threat to their growth, a threat to their ability to retain members and patients, and a threat to staying relevant, in addition to the bottom line impacts," Accenture's Stephan said.

Even urgent-care clinics, the exemplar of healthcare convenience, risk losing customers if they don't deliver as promised. When Brittany Hogendorn, 31, went to an urgent-care clinic in Boulder, Colo., with what she thought was a urinary tract infection, she left after being told there would be a four-hour wait. "I would probably say 'Never again!' if another location burned me like that," she said.

Hogendorn had visited one of the more than 7,300 urgent-care clinics in the country, a number that's gone up considerably over the last decade to offer consumers the clear pricing and expanded hours they want. "The fact that they have become so popular is a good indicator of the way people are looking for something that's a lot more intuitive and consumer-friendly," Hempstead of the Robert Wood Johnson Foundation said.

"Convenience and cost are obviously the biggest factors," Hogendorn said. "If I seek urgent care or ER treatment, the urgency places convenience above everything else."

Indeed, healthcare consumers today want immediate access to care—not in four hours and certainly not in four weeks. Healthcare systems will have to adapt to these expectations if they want to build loyalty among their patients.

Patients who can't get instant access will simply go elsewhere, said Fred Campobasso, managing director of Navigant's Global Construction practice. "The systems that are passive are going to see their market share erode," he said. "They'll find themselves in a precarious financial situation."

While today's healthcare consumers have grown more skeptical about big-name brands' ability to deliver instant access and convenience, they haven't given up on the idea of reputation entirely. They're just looking for it in a new place—the online reviews offered by fellow consumers.

When Aldo Blanco's son, Frankie, 6, started bleeding from his ear while they were on vacation in Mountain View, Calif., Blanco chose an urgent-care clinic based on proximity and because it was rated to be "great with children."

Social media is also playing a much larger role in driving online reputation, and with it consumer choices. "The millennials will drive these changes, and the older generations will adopt them," Stephan said.

Indeed, online reputation, driven by consumer reviews, may well determine who survives and thrives in the coming era of consumer-driven medicine. Companies such as Netflix and Uber have pioneered how to offer consumers personalized recommendations based on reviews, a person's previous choices and location as revealed by their web surfing history or smartphones.

"Customers want an expected and predictable consumer experience just like you might get going into Jiffy Lube or the Apple Store or Whole Foods," Hempstead said. "Over time, any successful system is going to need to adapt to that."