Digitalization and integration solving the last mile problem – thoughts from my personal flu shot experience

I went to a local grocery for the flu shot last night. The pharmacist over there were very polite. He asked me to fill in the paper form. It took me about 4-5 minutes to fill in the form. Signed my name, I returned it to the pharmacist. I also gave him my insurance card.

Going through my form, the pharmacist tried to locate my insurance record in the system. Somehow, he found out the record in their system didn’t match with the information from my insurance card or the form I filled in. In fact, over the years, I rarely need to see the doctor, let alone go to the pharmacist. My record in the local grocery could be the record from last couple years. He tried to retrieve my eligibility record using my insurance card, somehow it didn’t work either.

He explained to me what happened, and asked me to wait while calling the customer service reps from my insurance company. He made the first call, and could not get my eligibility record verified. He was told to make a second call, still can’t resolve the issue. I told him I just used my insurance card last Friday for another visit. He explained to me that he was going to make the third call, and asked me to wait a little longer. 40 minutes passed with 3 different phone calls, he finally got my record verified and my eligibility checked. It then took 3-4 minutes for the nurse to give me the flu shot.

During the entire visit, the pharmacist was very professional and courteous. I can sense those customer services reps from my insurance company were very patient and persistent too. I must admit it is the best customer service I ever received. I have been in healthcare IT so many years. As a chief architect for large health insurance program, I felt extremely embarrassed and guilty. We took every effort liberate the health data, with an intention to make it available at the customer service reps’ or patient’s fingertip. We came up with tons of innovative initiatives to directly engagement the members, educate the members and help the member make the right health decisions for the right cost they can bear. 

Then where are the problems? What could be wrong? What makes the best customer services inefficient? It is the last mile of any industry. It is the last mile we keep forgeting or ignoring. The cumbersome paper process, outdated system integration, staled data silos and aging customer service interactions (phone calls) make it impossible to have the patient’s data real time accessible. It creates barriers for efficient services at the corner of the street, at the remote rural area, or at the smaller doctor offices. If we don’t solve this kind of last mile problem, a 5-minute pharmacy visit could turn out to be 50 minutes, and a $20 medical service could cost as much as $200, considering the 45 minutes waste of the human cost the payer, pharmacist, and myself spent.

Imagine you can initiate your flu shot with one simple click on your mobile device before you walk in to the local grocery. By the time you walk in, they scan your digital insurance card and validate your eligibility right away. The entire process will take just 5 minutes, instead of 50 minutes.

This brings another personal experience of mine. Last summer when I visited my family in the remote countryside in China, I went to the local farmer’s market with my nephew. He picked a few local produces, took them to the farmer. The farmer calculated the cost with the smart phone, showed him a QR code to pay. My nephew scanned QR code, instantly paid the farmer with the phone. There is no paper involved, no cash exchanged either. If you have a smart phone, any customer can buy and pay, and any merchant can sell and get paid.

That is the digital transformation we need. It is the digitalization and digital disruption we needed to re-image the entire health industry, including the last mile. It requires the mindset changes to totally transform the health system. We have a long way to go.