Leaders in healthcare are problem solvers. Our goal is to continually revolutionize healthcare by designing innovative products to address complex challenges and deliver better healthcare outcomes for our members and customers.
Today’s healthcare solutions landscape is flooded with new products, making it easy to feel overwhelmed by the numerous point solutions in pharmaceuticals, medical devices, healthcare services, and digital health.
As a healthcare product leader within Carelon, I am keenly aware of the wide variety of solutions available in the marketplace. At Carelon, we adhere to three guiding principles in product development to foster impactful innovation – moving beyond point solutions – which leads to a better consumer experience and, ultimately, higher quality outcomes. It starts with a disciplined practice of knowing the problem to solve, empathizing with the customer, and continually refining solutions to improve the outcome. Innovation begins here:
1. Identify the gap. We often ask the question, “What problem exists that needs an integrated experience to deliver a solution?” We use predictive analytics and data to help identify potential gaps in experiences and care that need a solution.
Data show that 80% of suicide victims interact with primary care providers, but only 25% consult psychiatric professionals during that time. Additionally, the systems in place to care for these individuals are fragmented and siloed. This creates an experience marked by duplication and information blind spots, resulting in longer times for care and associated outcomes. What if we could create an experience to address those gaps for both patients and caregivers?
We recently launched our Crisis Safety Platform to do just that. Partnering with several states, this solution powers the recently established “988 Suicide & Crisis Lifeline” with an integrated experience across diverse systems, vendors, and data sources to bridge the information gap at the point of the encounter; it also empowers caregivers with the necessary information to identify and assist members in the moment of crisis and then rapidly get them access to appropriate, ongoing care. By identifying and “filling the gap,” we can better serve callers in their most vulnerable moments, and enhance the care delivery system.
2. Focus on patient-centered design. “Patient-Centered” or “User-Centered” are words that all product leaders use, but we take that personally by asking ourselves if the solution we create would be the one we want our friends and family to have. We focus on creating solutions that are simple, affordable, and comprehensive – addressing multiple, related needs to drive outcomes. By taking this approach, we help ensure our solutions make life easier for patients, providers, and employers.
Weight loss is an experience that necessitates multiple interventions over time to guide individuals toward successful outcomes. According to the Centers for Disease Control and Prevention, more than 49% of adults in the U.S. attempted to lose weight last year, but research shows 80% regained it within a year. Acknowledging the need for a solution that addresses immediate need and supports members throughout their weight loss journeys, we developed and launched our weight management product. Recognizing that digital engagement alone was not enough, we integrated live human support, behavioral health, social health factors, and medication management support for those who utilize GLP-1 medications, all coordinated through a person’s prescriber to ensure continuity of care.
By putting the patient at the center of the experience, we created a product that drives real outcomes by setting the member up for long term success.
3. Build, test, launch, optimize. The launch of a new product marks a beginning, not an end. It’s crucial to keep learning, evolving, and developing a new solution over time, considering the product’s performance, market needs, and insights about user experience. While this may seem straightforward, it represents one of the most significant challenges in product management: balancing the creation of “the next big thing” with enhancing existing products in the market. This focus on innovation through iteration enables us to provide ongoing and consistent value, improving performance and experience over time.
When we launched our data mining product around payment integrity, we did so with this mindset: we built a minimum viable product designed with the essential features needed by the market and included the foundational capabilities necessary for future development as we monitored performance and listened to customer feedback. During our testing phase, we collaborated closely with customers to validate the solution using real data, applying initial feedback to enhance the product before launch. As we iterated in the market, we leveraged this mindset by driving rapid updates, improving knowledge, appropriately expanding automation, and broadening the outcomes delivered.
There’s no room for complacency in product strategy and innovation. We must maintain an unwavering entrepreneurial spirit to navigate the complex healthcare ecosystem. It’s a privilege to focus on creating better solutions and delivering value in everything we do. We owe it to the people we serve and our communities to create a higher quality whole health experience.
Gautam M. Shah, MBA, FACHDM, is chief product officer at Carelon, part of Elevance Health.
