Intuit’s success with personal and small business financial software provides valuable lessons for healthcare organizations regarding health data.
As health care’s traditional business model evolves, there is no shortage of new players in the market, all eager to share their disruptive innovations aimed at wellness and population health management. These innovators seem to have willing allies in consumers, millions of whom are purchasing personal fitness trackers and home health devices, and small business owners who are working to reduce insurance costs by keeping employees healthy.
Meanwhile, traditional healthcare players remain mired in a model in which providers retain control as they store patient data within their own disparate systems, which are hampered with access restrictions and do not provide a holistic view of each patient. Patients participate in a system that affords them neither easy access nor the ability to interact meaningfully with their own medical records.
Responding to these challenges will be a difficult but critical task for healthcare organizations. If patients were to be given greater control over their health and healthcare spending, and access to technologies that would allow them to take more meaningful control of their lives, they would be empowered to fully understand their condition and care options and to follow through on their treatment plans. For the nation’s healthcare system, the result would be better patient outcomes and population health. To achieve these goals, however, healthcare organizations must develop new business models that will appeal to all stakeholders.
A Lesson From Outside the Industry
Not so long ago, the financial services industry was facing many of the same challenges. Consumers and small business owners did not have a clear view of their financial condition because their data were held in silos by individual financial services companies. When it came time to work with their accounts for tax preparation or with financial advisers to make personal or business decisions, gathering data was a monumental task, and the consumer’s ultimate tax liability or financing rejection often came as a surprise. One significant story of success in this area comes from Intuit, the developers of Quicken software.
In 1983, Intuit launched its Quicken personal financial software for use on DOS-based PCs and the Apple II computer. Since then, the software has been upgraded regularly, but its premise remains unchanged: Provide consumers with control of their personal budgets by tracking account balances, transactions, and more.
The software was embraced quickly, and Intuit founders Scott Cook and Tom Proulx parlayed that success to create QuickBooks, a full-featured financial management application for businesses. Both programs were designed for users who have little if any experience with accounting or financial management.
Intuit’s focus on small businesses and individuals was a strategic decision, and it paid off. By March 2008, Intuit claimed that 94.2 percent of business accounting software purchasers chose QuickBooks, and by 2015, the company still controlled 80 percent of its market, including 29 million small businesses on the system. a More than 50,000 independent business consultants, certified public accountants, and accountants are members of the QuickBooks ProAdvisor program, which gives users exclusive benefits above what is offered by QuickBooks alone. That success enabled Intuit to approach banks and credit-card companies with the objective of unlocking customers’ financial data. Intuit offered financial institutions and accounting firms steep discounts on the software, allowing them to share the profits when introducing it to their clients. The company reported revenue of $4.7 billion in its fiscal year 2016.
Intuit’s success was based on a series of strategic moves aimed at putting financial data in consumers’ hands. The healthcare industry can learn from Intuit’s example and apply the same strategy to healthcare data. The isolation of consumer data has become the norm for the healthcare industry has siloed consumer healthcare data, with healthcare providers unsuccessfully attempting to manage silos of data from within their organizations. For those considering new avenues for making consumer data more available, Intuit’s story offers insights into the attributes consumers are seeking, summarized by the following guidelines.
Make it user-friendly. As the leading small business accounting tool on the market today, QuickBooks is successful largely because it makes an essential task for small business owners easy and understandable. The software has been written to automate tasks and make accounting manageable for the small business owner. It takes the pressure off the owner for sending out recurring invoices, paying recurring bills, and syncing data across accounts. Likewise, Quicken (the software meant for personal use) makes use of simple budgeting tools and enables the customer to easily download bank information.
When a tool allows the consumer to accomplish a goal easily, the consumer will embrace it. In the healthcare industry, where numerous stakeholders are eager to get consumers to embrace healthy habits, the opportunities for developers of easy-to-use tools are significant. Portable fitness devices and trackers are a perfect example. These new technologies have overcome the traditional challenges of interoperability, making diagnosis and ongoing care more convenient for patients. Today’s health monitoring devices provide data that enable physicians to guide patients toward healthier lifestyles. For example, by connecting a home medical device to a mobile app capable of tracking the users’ vitals, such as blood pressure or heart rate, a healthcare provider can make more informed decisions about that patient’s treatment and how best to approach their care plan. Healthier patients are more responsive to treatment, resulting in reduced healthcare costs, which empowers healthcare providers to better manage chronic conditions and avoid unnecessary episodic care.
The challenge here is that the industry must find a way to eliminate unnecessary restrictions on patient data to optimize workflows and free up information for automation to make things easier for everyone.
Allow for connectivity. Quicken encountered some early resistance as it began to move its software to the cloud. Consumers had concerns about the safety of their financial data, and consumer-facing data security safeguards were new almost too new to provide a strong level of confidence. But over time, consumers embraced the idea, and today, QuickBooks Online is a top seller for the company. Today, QuickBooks integrates electronically with more than 150 third-party apps—most of which are cloud-based—that accomplish everything from marketing tasks to customer relationship management to payment processing. The data are controlled centrally, but the consumer has the power to apply analytics and other third-party tools as desired.
Health care can accomplish the same thing by centralizing, standardizing, and tracking patient data in a single, cloud-based healthcare ecosystem. The resistance to such technology is less of an issue today; indeed, consumers have moved away from tools that are unable to easily connect for their convenience. But this concept must extend beyond the tools we give consumers to use on their own health data, and move toward a closer connection between the patient and the provider. The healthcare industry is increasingly decentralized, making engagement through health monitoring among patients and providers a difficult proposition. Greater connectivity can lead to higher patient engagement if providers actively pursue initiatives that connect them. Healthcare providers must be ready to take on the important role of closing that feedback loop by responding on priority, as demanded by the patient condition at hand.
It is important to recognize that data protection is critical in financial, healthcare and personal situations. Technology-based industries are constantly trying to stay ahead of the curve in terms of security, and with this in mind, special care must be taken in the healthcare industry to ensure the security of private systems and data. For example, IV pumps and dialysis machines play a key role in managing patient vitals and are critical to patient care, while a glucose meter, does not pose as much of a threat to the patient’s immediate health. Regardless, healthcare IT companies must emphasize the importance of not only keeping patient data secure, but the patient’s entire health ecosystem as well.
Engage trusted professionals to drive adoption. One of the smartest things Intuit did was to approach local accountants to form partnerships and revenue-sharing opportunities that provided incentives for these trusted advisers to recommend QuickBooks for their small business clients. Today, thousands of financial advisers are promoting the software through this huge network. Creating joint sales targets out of consumers and their trusted advisers is something the pharmaceutical industry has understood for many years. By providing information to providers and then prompting consumers to ask the right questions, drug companies have been able to increase sales. Although this process has met with criticism, consumers do have a high degree of trust in their healthcare practitioners.
It is the responsibility of healthcare professionals—who bear more accountability than ever—to make a concerted effort to educate patients on the importance of managing life-long health and wellness.
Understand how infrastructure will affect future expenses. It would be naive to think that any company could achieve the connectivity that Intuit did on its own. It would have been prohibitively expensive for QuickBooks to access consumer bank account information if it were not an automated process built on industry standards. Likewise, new entrants seeking to offer access are likely to encounter high fees to access important consumer data if the industry fails to work collaboratively to develop the right infrastructure. Some of this work already has been accomplished by other industries, and more is being accomplished through the Office of National Coordinator Health Data Aggregator Challenge to make new technological solutions available to the market.
Reinforce the consumer-centric model. Intuit chose to focus its efforts on the consumer first, and then on the small businesses those consumers were operating. That strategy was critical to the company’s success.
Putting the consumer at the center of the transaction works even when change is the direct result of a regulatory mandate. The mortgage industry provides an example of this type of change. The industry’s new federal regulator, the Consumer Financial Protection Bureau, has required the industry to change the way it treats consumers by making the customer’s experience a metric for judging regulatory compliance. Among the first to embrace this new focus with great success has been Quicken Mortgage with its Rocket Mortgage brand. Since launching the brand in 2016 with a promise of a simple mortgage loan qualification process, Quicken Mortgage has increased its share of the online lending market significantly.
Time to Consider the Patient’s Perspective
For too long, the healthcare industry has treated the patient as a work input and considered the real transaction to be between the provider and the health plan or government payer. That mentality is changing as patients continue to assume a greater portion of their healthcare costs and become more careful consumers. Of course, there is much work to be done if healthcare providers hope to follow this path. Consumers will have to be reassured that when a platform is provided by their employer, their data will not be used against them. And providers must have protection against lawsuits based only on the availability of data or delivery of remote services.
Increasing the availability of consumer healthcare data will be challenging, and the implementation of future legislation could affect industry efforts to accomplish this objective. As healthcare consumers continue to become more involved in the decision-making process for their own health care, however, healthcare organizations would be wise to take lessons from consumer-focused industries.
Dinesh Sheth is founder and CEO of Green Circle Health, Pensacola, Fla. (Twitter: @GreenCircleH)
a. Tucker, S., “How Many QuickBooks Users Are There?” QuickbooksUsers.com, March 18, 2011.