scaling people

Scaling Humans and Healthcare

A key project I’m involved in at work is an online program that helps people with diabetes and prediabetes make sustainable changes to their habits for better health. Our health coaches, in particular dietitians, are an essential component that contributes to the efficacy of the program.

An oft-asked question I get is that health coaching is a high-touch human service – how do you scale that up? Or the famous ‘million’ question – Suppose you have 1 million participants, you can’t possible have enough dietitians or coaches to handle them all, right?

Here’s my take on scalability:

The potential to scale is what makes us innovative and different, and is what will eventually drive the business and revenue. It is all about the efficiency we can deliver while maintaining good clinical outcomes and engagement.

Technology has a vital role to play in this – we use it to make the manual, repetitive parts as simple and efficient as possible, so that our coaches can focus on doing what they do best. It allows us to move up from the < 1:10 coach-to-patient ratio in current face-to-face interventions, to a ratio closer to 1:200, while still being effective. That’s already 20X. But that comes with its own unique challenges, something we constantly think about in our product design and development –  what data do we need to present to our health coaches so that they have enough context to be just as effective, even though they spend less time with each individual?

Online platforms, which are accessible 24/7 and anywhere with an internet connection, allow us to tap on excess, unutilized capacity in the system to create additional value. For example, there may be excess capacity/expertise in a particular geographical location, which can be brought in to cater to areas which are lacking. It brings into the system health coaches who want to work with a certain level of flexibility or beyond their typical day jobs.

As we scale up, an issue that we need to monitor closely is ensuring the quality of our health coaches on the platform. When hiring health coaches, I look not only at whether he/she has the expertise to meaningfully work with people with diabetes, but also whether he/she is comfortable delivering care in the modality we live in, which is mostly through text messaging. Data also gives us an open window – allowing the tracking of individual coaches’ engagement metrics.

It’s not an easy route. But we have chosen this path because we firmly believe that human connection and empathy is the heart of healthcare – we just need to get everything else out of the way, with technology.

 

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