Digital health insurance - how user-centricity doesn’t become an innovation trap

Author: Jan Pilhar

Digital services shape our lives in almost all areas today. This also applies to health insurance companies. By shifting processes to self-service, digital health insurance companies offer insured persons easy and quick access to product and services and potential for greater efficiency and cost savings. In order to score big with a younger target group, digital offers also represent a strong differentiating feature on the market.

Berlin, 17.10.2022 – Today, digital services shape our lives in almost all areas, and the health sector is unimaginable without them. This also applies to health insurance companies, for which they are playing an increasingly important role. They provide insured persons with simple and quick access to products and services, which proved especially important during the pandemic. By shifting processes to self-service, health insurance companies offer great potential for greater efficiency and cost savings. In addition, the range of digital services is increasingly becoming an important differentiator for health insurance companies’ own brand, because without an attractive digital offering, it is no longer possible to score points, especially with the highly courted young target group.

Digital teams with a focus on user needs

Accordingly, large health insurance companies in particular have invested massively in the digitalisation of their customer interfaces in recent years, and have often set up dedicated teams for this area. These “digital teams” develop digital services for the insured and usually have a user experience (UX) focus. They usually work with the common methods of user-centred development, shaped by the principles of design thinking and service design. This innovative approach draws its inspiration primarily from the identification of (unfulfilled) user needs and current shortcomings in existing offerings and processes – so-called “pain points” – and derives ideas and starting points for improvement and further development.

Health insurance companies have made progress in customer experience

The introduction of this approach was a methodological quantum leap for most health insurance companies in their own digitisation efforts. Whereas in the past, most digital development topics were dominated by IT departments focused on features, stability, and long-term planned release cycles, the digital teams brought a breath of fresh air with a new agility and the consistent consideration of the user perspective. This innovation led to good results, so that today the digital customer experience of many health insurance companies – the much-vaunted customer experience – is impressive, and in many cases can keep up with the offerings of consumer goods manufacturers or eCommerce providers.

Digital health infrastructure offers new potential

Now, however, we are already entering a new phase of digital innovation in the health sector, in which the currently dominant approach of many digital teams falls short. In order for health insurance companies to be able to exploit the potential of the current digital development, they must again sharpen and expand their innovation methodology. Otherwise, the now established focus on user-centricity risks becoming an innovation trap.

The next digital innovation leaps in the health care system and especially in the area of health insurance funds will no longer come from the identification of further user needs and pain points. Rather, they will result from the possibilities of the digital health infrastructure that the health insurance funds are currently developing in cooperation with other actors in the health care system. This so-called telematics infrastructure (TI) is the infrastructural basis for current and future digital health services in Germany, and enables applications such as the electronic patient filing, electronic prescriptions, and improved communication between doctors, clinics, laboratories and health insurance funds. It is the result of a joint effort by these actors to finally make progress in the digitisation of the health care system. This TI offers new starting points for developing innovative digital services for insured persons on the basis of the insured person’s data, which goes far beyond simplified access channels and an improved customer experience.

Data analysis and machine learning as key

In order to make use of these new possibilities, it will be less important for health insurance funds in future to ensure that insured persons can fill out the right form online more quickly or that they can also download a certificate on their mobile device. These basic requirements have already been solved in the meantime – at least in the case of progressive health insurance funds. Now the insured must be offered services that make a real contribution to better health. The TI, in combination with modern approaches of data analysis and machine learning, enables completely new ways of health management. The innovation possibilities that arise from this, for example individual risk analyses and predictive recommendations for insured persons based on health data, can only be derived with difficulty from current unmet needs. This can be achieved with the help of cohort analyses, through which insured persons can learn to understand their relative health status. Side effects can also be avoided by automated checking of possible medication interactions. Steve Job’s famous bon mot applies to all these approaches: “People don’t know what they want until you show it to them.”

How health insurance funds are preparing for the future

For digital teams of the health insurance funds, this in turn means that they must supplement their focus on user-centricity and user needs with continuous monitoring of the newly emerging technological possibilities. In addition to user research, they should also take a closer look than before at the roadmaps of Gematik and its software and solution partners in order to be able to derive new approaches for the further design of their digital services. This also requires a deeper technological understanding than is currently available in many UX-oriented teams. Accordingly, the teams should seek even closer cooperation with the IT departments and see them not only as partners for the roll-out of new releases, hosting, and security, but as real innovation partners.

Customer needs and modern technology – the mix makes the difference

It is not a question of reversing the hard-won cultural progress towards user-centricity. On the contrary: user-centricity remains important, of course, because only services that are intuitive and easy to use are widely accepted. It is much more a matter of understanding that service ideas will no longer be generated primarily by the customer needs of the insured. More and more often, new technological possibilities for analysing and linking health care data will be the starting point for digital innovations with real added health value. This is precisely the development task for those who are responsible for the digital services in health insurance companies. Health insurance companies that succeed in this renewed change of mindset and innovation approach will create real added value for their policyholders. They will become digital pioneers of the coming years – with digital services that not only simplify life, but ideally also prolong it.

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