Pioneering a Personalized Healthcare Experience: In Conversation with NRC Health

With almost 40 years under their belt, NRC Health are helping change the healthcare game by enabling practitioners to deliver a unique and personal service to their patients. How? With data.

And it’s clear from talking to Jon Tanner and Echo Alexander from the company that they take great pride in the work they do. And for a good reason.

“Our kind of tagline is human understanding” says Jon, a Product Director with almost 10-years under his belt at the company. “[our mission is] to help health systems and care providers understand their prospective customers, patients, families, those that they serve. It's to understand them in a way that they can feel known, understood and cared for.”

But how does that translate into actually helping people?

Gathering data to help

“If you understand what's important to your patients, your consumers, then ultimately you should be attracting more patients and helping keep them loyal to your health system through that journey.”

“If you're loyal to a care provider along your health journey, you're also having better outcomes in addition to kind of the better business outcome for the hospital and the health system here.”

It’s an intriguing, bold, and exciting mission so I was keen to find out how they felt such a holistic approach could deliver such a great outcome for NRC Health's customers and their customers’ patients.

“We actually operationalize that vision is through a lot of different types of datasets” says John.  “[It’s] largely survey and feedback based, although it's enhanced with information already gathered about the patient.”

Jon goes onto explain the products they offer to their customers.

“One [product] is just like a very large syndicated survey where we're just going out and buying panels of prospective customers across the country and paying them to complete like a 300 question survey around How do you select your healthcare provider? What type of chronic conditions are you worried about?” Jon explains.

Like any industry it must adapt to new times, so they also tend to dig a little deeper on how the consumer feels about new trends in the healthcare industry.

Are you someone who's likely to adopt telemedicine? Are you someone who prefers ads through Facebook or through AM radio? It's a very common brand tracking type approach, but just specific to healthcare.”

The other product they offer is a more focused on aftercare when they’ve already received the treatment.

“The other major component of what we do is more focused on once you've had that experience. Let us quickly know How are you doing? So now that you've gotten home, do you understand your medications? Do you understand how to schedule your follow-up appointment?

“Then let us know how we did. So net promoter type stuff, How likely would you be to recommend us? Did doctors communicate to you in a way that you could understand?

Putting the data together

Gathering data is all well and good, but unless you know what you need from it it’s pretty useless. Luckily the team are pretty experienced when it comes to making the data useful.

“That data will show that ‘Jo’ has a certain insurance type, fits certain demographics, might come with certain diagnosis. Then we can help them start to understand the data of amongst patients who have diabetes, who are between 18 and 24 and don't speak English as their second language.” Jon explains. “Here are a lot of opportunities you have to serve that population in a more meaningful way than you're doing today.”

It’s a customer focus at a granular level. Using gathered data to know things about their customers and patients instead of making some kinda guess based loosely on assumption-based personas.

“It should be ideally all the way at an N equals one individual level.” says Jon.

“If we know that after Jo's most recent visit that he doesn't understand his medications, that he doesn't know how to schedule his follow-up appointment, and that he's very unlikely to recommend you, you'll get an alert from our software saying, ‘Hey you've got a patient that needs follow up, please have a nurse manager follow up with Jo so that you can answer any questions he has about medications. See if there's anything you can do to apologize for the last experience that he had. Let them know how you're going to improve that in the future.’” says John.

“There's core kind of service and clinical recovery opportunities from it as well. Then if you take a thousand ‘Jos’ you can start to find themes and process improvement opportunities as well.”

The Full Experience

It’s clear NRC Health put a lot of effort into helping their customers deliver the best possible customer experience.

Customer-centricity is at the heart of everything the company does. It’s a rarity for what could easily be written off as yet another big data company particularly one as established as they are.

With such a long history you could assume things have stayed the same at NRC Health, but recently they’ve started refocusing their efforts and changing the way they collect their data.

“We started almost exclusively in healthcare within a year of launching. So our entire history has been focused on healthcare. The type of research has really evolved as technology and capabilities have allowed us to evolve our focus.” says Jon. “So up until really five years ago it was much more focused on large syndicated surveys that Gallup would do, or like Nielsen. Those types of things, but focusing on healthcare.”

As technology changed over the years, NRC Health realized they must adapt.

“Over the last five years as we've been able to take advantage of—not the most advanced technology in the world but—technological advances like text message and email. Embedded web surveys and things like that. It's allowed us to evolve our mission to much more of a ‘every individual matters’ alerting service recovery.” explains Jon.

“Because there's huge differences if you leave the hospital today and we can ask Do you understand your next care steps? versus sending you a paper survey three weeks from now and asking you that question. The type of response a hospital can have is very different in those two scenarios.” says Jon.

Technology hasn’t just changed the company’s approach to collecting data—it has actively made it much better. “Our ability to do that for everyone with great immediacy and urgency has really narrowed over the last five years as technology's matured.”

Changing technology, updating support

Jon and Echo have seen that change first hand having joined the company 10 and 6 years ago respectively.

“We're both on the product development team. I'm a product director and Echo's a product analyst.” explains Jon.“That product that I just described, the post-service How are you doing? How did we do? service recovery type. That's the platform that we manage. And also where we've put HelpDocs”

So how did a 38 year old company manage their support without a knowledge base? A lot of PDFs it turns out.

“Before HelpDocs we had an 80 page PDF that was our user guide and if you needed help or learning, or understanding, you could consult our 80-page user guide and that was your option.”

“Or documents on several different pages and websites, and folders” adds Echo.

“Yeah. Or call your customer success manager. The number of hours we've saved out of it has been great too."

“Effectively I support the product in the same ways that Jon does, just not as strategically.” says Echo. “Making sure that we're, listening to our customers and doing work within the product that is going to meet their needs.”

“I think of myself honestly as like a mini Jon. He's the strategic side and I do more of the operational side. Which I think that kind of simplifies it a little bit.”

Jon disagrees 🙈

“I would say it's substantially more valuable than being a mini Jon” urges Jon. “So our team in general is responsible for listening to the market and understanding what our customers want and need. Then translating that into requirements in a way that our engineering team can fulfil those asks.”

But that’s not where the product development stops. “We go back out to our stakeholders, as well as our customers and help evangelize. Here are the problems we've heard. Here's what we've built. Here's how we think those are addressing those problems and are going to solve asks that you've got in the market.” says Jon.

Getting feedback on a product you offer can be tricky business, but the team also have a strategy for that too.

“Echo's focus is on a lot of the operationalizing of Here's the ask we've heard, how can I translate this into a way that our engineers can effectively build and understand the problem in a way that they can design solutions for?” explains Jon.

“As a part of our evangelism duties, Echo has launched our entire knowledge base strategy. Not just for the solution. But for all of them.”

It’s quite a feat. And one that speaks to the company’s focus on empowering their users and building the best possible experience as an individual.

“I think in healthcare there's a fundamental problem that as a patient you don't feel known. When you walk into a hospital here you are filling out the same paperwork over and over again.”

NRC Health know they can help healthcare providers be better than that.

“They're just like fundamental things that people don't know about you. And so, we're not specifically solving the problem of You have to fill out the same paperwork every time. But trying to address the problem that when I'm seen by a doctor, when I'm seen by a nurse, what I'm seeing by our caregiver, the people who should be understanding and empathizing with me the most.” explains Jon. “And the people who want to empathize with me. They just fundamentally don't have the information about me to be able to do so.”

The team hopes that by giving healthcare providers the data to understand their patients better, the patients will get far superior, individual care.

“For any given patient—and then for your populations at large—how can they feel like known individuals. Which is only going to improve the way that you can care for them when they can see that empathy and feel that empathy.” says Jon.

Unlike the NHS in the UK or in other European countries, the US doesn’t have a universal health record. That makes things a little more complicated for healthcare providers.

“You don't have a patient chart that follows you everywhere you go within a general health system, which tends to be fairly regional.” explains Jon. “There is no interoperability between them and the health system next door in terms of all that information that followed you. So that is a much larger problem in US healthcare that we're particularly equipped to solve.”

The problem comes when there are simple healthcare problems that need to be flagged or are important to the patient. There isn’t a place to do that in the current healthcare system.

“Is Jo very annoyed by waiting?Is Jo very annoyed by not being able to get an appointment on time? We need to have kind of a different type of conversation with Jo or we need to make sure that Jo's spouse is always available to help document follow up things.” explains Jon.

“That's the problem that I think we're most aimed at. There's a problem that the clinical information doesn't really move from one place nicely to the next.”

The Practitioner Concierge Service

The crux of it is NRC Health are enabling practitioners to actually deliver a better standard of service using real data from the people themselves. The kind of personal data you might pick up in conversation with friends. And that kinda data can help build out a concierge-type service.

When talking with Jon and Echo, it turns out concierge-type services are becoming an added extra on top of health insurance premiums.

“You always have to be dangerous comparing healthcare to other industries because people want healthcare to be special, and it is.” says Jon. “But if you go to something as simple as getting a haircut—which is a terrible example for me, but other people I hear when they get their haircut—you walk into the barber, they remember the cut you got last time. They know if you like a magazine. They know if you like to talk a lot, or if you just want it quiet while you're getting your hair cut.”

Turns out it’s much more uncommon for healthcare to be personalized, despite it being far more important than a blow and dry.

“They don't know if you're afraid of getting an MRI. Or if they should offer you music while you're getting the MRI taken.” says Jon. “There's just all these crucial small personal things. Almost any other service industry has figured out how to capture and empower their frontline with that information. And in healthcare we're just lightyears away from that.

The concept is rooted in good business sense. Wanting to deliver an exceptional customer experience to delight and inspire return customers.

“A big difference of why it's important here in the US is with socialized care you don't really get to pick where you’re treated.” says Echo. “But here, you do. And so, it's very important to get those little things right to build that relationship and rapport so that you can retain those customers.”

“Yeah,” adds Jon “because it is truly a business. If I walk away and decide I don't like one provider anymore my insurance will likely cover three or four other providers that I can go and choose and use instead.”

But it seems like things are getting better in the US healthcare industry.

“A key buzzword in the US right now is consumerism in healthcare.” says Jon. “You are truly a consumer and you get to vote with your dollars to a large extent about where you want to receive care and who you trust with care. So if my provider messes up those details, someone else will get them right."

The Satisfaction of Great Experiences

As we draw the conversation to a close I can’t help but be enthralled by Jon’s and Echo’s love for the work they do. It’s clear they get a lot of satisfaction and I think it’s down to connecting the dots. Drawing a line from their desks straight to direct improvements in the end-user's experience.

“Last year we heard from more than 24 million patients, and we heard open-ended comments for more than six million of them.” says Jon. “And so even just when we start to look at our capabilities like natural language processing and stuff, we're able to train an algorithm across six million patient comments. And we're hearing from 24 million people in a year.”

The impact of the data collection is profound. “We've had some sort of impact on 24 million patients.” announces Jon.

Jon tells me how the pair aren’t alone either. This interest in healthcare and improving the patient experience is a core value of NRC Health.

“The people that NRC attracts are interested in a few different things. You're either passionate about healthcare—we have a number of former nurses, former front office health care workers who are passionate about healthcare and just kind of haven't found the right way for them to contribute to that mission yet. We get quite a few associates who are really passionate about that.”

But it isn’t only former healthcare workers who are attracted at the thought of contributing their expertise. It’s data scientists too.

“I think that's personally where I'm a little bit more interested” says Jon. “I like healthcare but I like the data side of it as well. Just knowing that in any given year we're hearing from millions and millions of data points. And what should be able to be learned and uncovered, and utilized in that way. I think that is really exciting.”

Jon explains that healthcare is a huge part of the US GDP. In fact, it is up to 17.8% of the US GDP this year. Compare that to 1960 when it was only 5% (source). “It's by far the largest, industry and most important industry we have in the US” remarks Jon.

Of course when any conversation turns to collecting data on the scale NRC Health are able to there’s the potential for concerns around privacy.

“We've got 19% of our GDP and there's always two sides.” says Jon.

“When you do the type of research and information gathering that we do, there's always two ways to view it. You can view it as kind of like evil big brother. Facebook knows all this stuff about you. And that's true. But it can also be used for great things. If you get the right ads. If you get the right information. That's really useful.

“I think it's really exciting to be in a company that can make sure as we're gathering all this information about people in healthcare, we get to control that that's being used for the right things, to improve services, to personalize care, to help you find the right resources.”

Being on the brink of technology and healthcare really excites the both of them.

“It's really rewarding and exciting to be in a company that gets to be on the leading edge within healthcare of what we can learn and understand about a person through their interactions, but then help make sure that that information is utilized in the right way.”

Echo shares Jon’s sentiment.

“If you just replay back what you've said over the last couple of minutes. At the core of it is that I know that the work that I do on a daily basis—although it seems very tangible and it's focused on engineering and things like that—the downstream effect of that and the impact that that has on individuals that are receiving care is monumental.” says Echo.

“It's honestly just that sense of personally knowing that what I do does make a difference. And it can make a difference for so many people in so many different ways. Jon said that a bit more eloquently I think, but I've got experience here in a couple of other divisions outside of the product team, and our focus right now is really heavy on that kind of human understanding piece of it.

“But I've also got a little bit of marketing experience in a couple of other teams. And it's always been that I know what I'm doing and whether it has a direct impact on a patient.

“I know that I don't see a patient but I'm providing those that do interact with that patient information to give them the best possible experience that they can. Which will have downstream effects on their day and their lives."

And so it seems like the blend of healthcare and data can make a real difference to patients.

With new technology coupled with the fantastic work Jon, Echo, and the NRC Health team are doing patients are getting more personalized unique service to help them lead healthier and happier lives.