I read a McKinsey report on Healthcare Consumerism.  A great study if you are interested in facts.  A less great study if you are interested in the application of those facts.

McKinsey concluded, correctly in my opinion, that what providers and payers provide, and more importantly, how they provide healthcare differs widely from what patients and consumers want.  And that difference is growing.

For example, around forty-percent of people prefer to get care, both urgent and primary from either urgent care, a pharmacy, or a retail store.  And the reason for this is a simple nuance.  It is not related to the quality of the care, it is related to the ease of obtaining care.

Providers and payers look at that nuance as a digital disruption to their way of doing business.  Patients and consumers view the nuance as ease of use, the same quality of care, the ease of access, and the level of engagement.

Healthcare views the difference as a set of nuances. Patients view the difference at a set of NUANCES.  Ease of access, engagement, and care management.  You can reserve a spot in line at the Minute Clinic versus you can schedule an appointment by phone for next Tuesday.

Eighty-percent of people want to interact as much as possible electronically.  Only twenty-percent are satisfied with healthcare’s current way of doing business. Healthcare executives still believe patients want a brick and mortar solution.  Clearly, they are not asking patients what they want, or if they are, they are ignoring what patients want.

Providers believe scheduling an appointment as a singular goal.  Patients believe the ease of scheduling an appointment as the goal. A phone call versus a digital experience. A nuance versus a NUANCE.

Amazon is a NUANCE company.  Bookstores believed that buying a book was the goal of its customers.  Amazon discovered that the ease of buying a book was the deciding factor.  Nuance versus NUANCE.

There was a time when ninety-percent of long distance phone calls were placed through large companies like AT&T and US West, and those firms charged on a call by call basis.  Sprint and T-Mobile changed that business model.  They delivered the same phone call.  Call someone from point A to point B.  The quality of the call was the same.  The person with whom the spoke was the same. The NUANCE was the fact that they discovered an easier way to charge for the same service that delivered the same product. They reinvented long distance calling.

Sprint and T-Mobile put mammoth firms out of business by simply adding a nuance to the business model.  Netflix delivered the same business model.  If you wanted to watch Top-Gun, you could make two trips to Blockbuster, or you could click on a link and have it delivered to your television or mobile device. You could pay-per-movie, or you could pay a monthly service charge and watch all the movies you want.

HBO, and movies on demand firms like FIOS and Comcast, offered a fixed number of movies for either a subscription fee or a pay-per-movie.  Watch a movie from a library of thousands of movies—Netflix—or watch a movie from a small library of on-demand movies.  Nuance versus NUANCE.

Ease of use matters.  It matters in television, banking, retail, and telecommunications.  The firms that failed believed that the product was the defining factor.  The firms that beat them, the firms that were created out of thin air—firms that did not focus on the product –put their would-be competitors out of business by simply rethinking the delivery model.  A nuance to the winners, an absurd idea to the losers.

Healthcare is in the throes of being out-nuanced by firms who understand their consumers.  Deliver a product that is on par with the product delivered by the incumbents, but do it in a way that meets or exceeds the expectations of their consumers.

By the time healthcare catches up to today’s nuanced delivery model, they will have already been surpassed by the firms which had already out-nuanced them.

For the bricks and mortar healthcare firm to succeed they need to reimagine how they do business.  How they deliver care. How they provide access to care. And how they engage patients.

Healthcare’s biggest advantage is that they have nicer lobbies.  Healthcare’s biggest disadvantage is that patients don’t care how nice the lobbies are.  When healthcare executives understand the difference between a nuance and a NUANCE they will compete, until then they will be fighting the battle between Borders and Amazon.