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Improving Healthcare Compliance by Understanding Generational Patient Expectations

Michael C. Howe, for HealthLeaders Media, February 25, 2010

We have all heard the latest success advice for healthcare providers—make care more patient-centric care and consumer-driven, and improve the service experience quality. We have also heard the usual justification: These concepts are needed to effectively compete in the "new" healthcare marketplace.

While it's clear that healthcare organizations have a great deal to learn from other service-focused businesses, the most pressing reason isn't to outshine competitors. Rather, it's to ensure our healthcare delivery system accomplishes its primary goal—the effective treatment of acute and chronic conditions.

Research shows that the quality of healthcare outcomes is almost always directly tied to the level of patient compliance. What many healthcare organizations fail to realize is that understanding consumer decision-making and patients' expectations regarding communication, engagement, and education can lead to greater patient compliance and therefore better patient outcomes.

Lessons from Marketers
So how do healthcare leaders leverage knowledge about consumer decision-making and expectations to change patient behavior? They do what product and service marketers do every day—engage consumers through effective communication in an effort to educate them on the benefits of the marketer's product or service and influence their buying decisions (i.e., change behavior).

To reach consumers most effectively, marketers look for common traits or values within their target audiences. They then segment consumers along these common traits and build their communication or marketing strategies to appeal to the targeted consumers in ways that have the best chance of changing behavior.

The Generation Gap
If healthcare were to use these strategies to enhance the engagement and education of the targeted segments of patients, thereby improving compliance and patient outcomes, what would it look like?

As an example, consider how four generations interact with the current healthcare system. Typically classified by birth years—Greatest Generation (1925-1945), Baby Boomers (1946-1965), Gen X'ers (1966-1985) and Millennials (1986-2005)—each generation's expectations are defined by common experiences such as societal changes (wars, economic boom or bust, cultural shifts), institutional responses (government's handling of societal changes), technological advances, and accepted workplace attitudes.

How the generations view healthcare is no exception

Greatest Generation: Direct Me
The Greatest Generation grew up believing in the value and effectiveness of large institutions and the credentials of the individuals leading these institutions. This generation weathered the Great Depression and saw the government's economic intervention carry the country through this tragic period. World War II was viewed as an honor to serve and protect the country that had worked so hard to right itself economically. This generation looks to the healthcare system to provide specific direction and support.

Baby Boomers: Engage Me
Baby Boomers were raised in a period of incredible economic prosperity. Social norms shifted enormously: racial riots over equal rights, the sexual revolution, and campus protests led by focused individuals all combined to forge a generation that believed the world could be changed if you worked hard enough. Thus, the generation of workaholics was born. Institutions were not to be blindly trusted. The administration lied about its handling of the Vietnam War; people were beaten and jailed for being different racially or philosophically, prompting the credo, "Don't trust anyone over 30." Boomers expect the healthcare system to be a two-way interaction. They want to be involved in the decision making and will bring their own perspectives to any discussion.

Generation X: Educate Me
Members of Generation X were the "latchkey kids" of the workaholic Baby Boomer parents. They learned to prize independence and self-sufficiency, although they place a high value on peer-to-peer interaction. They reject the workaholic approach of their parents. Gen Xers seek balance in their lives between work and family, and they often view large institutions and formal organizations with disdain. This generation considers healthcare a personal responsibility; they are looking for the healthcare system to support their drive for independence through education regarding their family's health.

Millennials: Connect Me
Technology has become an extension of their very being. Texting is the preferred mode of communication (even when they are sitting next to each other), and Facebook and Twitter capture every detail of their lives, allowing continuous connection with their cyber community. They expect the healthcare system to replicate this level of ubiquitous access.

The Value Proposition
Much of the current healthcare system is structured to meet the expectations of the Greatest Generation, designed to establish provider authority and drive patient compliance through direction and one way communication. Historically, this approach worked because it is consistent with the values of the generation it was designed to serve. However, this structure is out-of-date for the majority of patients providers are now facing.

Baby Boomers are looking for a system that provides two-way communication and shared decision-making. They want a provider to engage in a discussion of the treatment regimen and they are looking for options or alternatives. Be ready to engage in a dialogue with these patients. Listen to their input and validate that these patients agree with the treatment regimen, not just understand it. Adjusting to this expectation becomes especially relevant because Boomers are not only accessing the healthcare system more frequently due to their advancing age but are also serving as the decision-maker for their parents' healthcare needs.

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