Ask 4 Questions When Creating Healthcare Decision Support Tools

Consumer decision support tools were going to transform healthcare. They promised automated enrollment and deeper consumer education leading to consumer empowerment weighing value over price – it didn’t happen. What happened to Americans taking a more active role in their healthcare?


Are you thinking of deploying a customer decision support tool? Has your company already started the process of creating one? Creating Healthcare decision support tools can be tricky. To help your quest, we’ll beef up your knowledge to make informed decisions. First we’ll cover the theory, then we’ll cover the practice by carving out practical questions that lead to clear business outcomes.


The Theory

In the MIT Sloan Management Review, fall 2015 edition, there is a great article by Sheryl Kimes and Joel Collier called, “How customers View Self-Service Technologies.” Kimes and Collier address the real issue around consumer technologies: they often don’t deliver the expected benefits. While, normally I might brush this off as older data or even a bit academic, but we need to acknowledge and directly tackle the lessons learned here and dance with behavior theory before we introduce new technologies into our customer facing environments/


Kimes and Collier used the example of a kiosk in a restaurant, with a light sampling population of 254 customers. While I agree the sampling population is low, when you observe the results they clearly will scale. The result of the survey proved statistically that were was a gap between the manager’s perceptions of what customers wanted and what customers actually wanted. The article identifies three key findings: 1. Customers’ need for employee interaction 2. Convenience of the self-service technology and 3. Desire for speed in the transaction. Empowered with this information we can draw clear lessons learned and adjust our consumer decision support tool roll out accordingly.


Approach Adjustments:
1. Employees want a safety net, in case a failure occurs
2. Public location self-services, needs on-site employee support
3. Have employees lead by example by using the technology, proving the value of service extension through application of use


The Practice

Questions to Ask

Consumer decision support tool utopia starts by first understanding what we actually need and want. We have to define done. Sit your leadership team down and ask these four simple questions:

1. Is the decision tool for care and treatment options or selecting a health plan?

  • Common consumer decision support tools include:
  • Selecting a health plan
  • Choosing a type of health coverage (e.g. HMO vs. PPO)
  • Choosing between difference medical treatment options
  • Comparing difference prescription medications
  • Selecting a primary care physician
  • Choosing between prescription options (e.g. grand vs. generic)
  • Selecting a provider (e.g. hospital or physician for a given service)


It’s important to understand the ‘what’ you’re trying to accomplishing as you push forward working to empower your customers.

2. Who are you trying to target?

Tools fall into two primary categories selection or care. The first type of tool is selection.  This occurs before a consumer is aware of their care needs, and it’s used essentially to anticipate future costs. Typical examples of selection tools include:

  • Out-of-pocket cost estimators
  • HSA savings calculators
  • Side-by-side plan comparisons
  • Health benefits/needs questionnaires
  • Open enrollment presentations


Each of these tools has value anticipating future out of pocket costs in one form or another.


The second type of tool is care support.  This occurs after the consumer knows they have a condition, may have treatment, or have become the patient. Typical care support tools include:

  • Symptom checkers
  • Knowledge databases
  • Health-related videos
  • Online customer service
  • Personal health records storage
  • Provider databases


All these tools provide support after out of pocket costs are a given once the consumer has become the patient. They don’t help anticipating costs, they help mitigate excessive costs. Where are we in the patient lifecycle? At this point the consumer has already enrolled in a health plan and is exploring options based on existing coverage.

3. What is the desired outcome of the decision support tool e.g. education, better plan selection, better care or decrease cost of care?


To create a desired end-state, we must understand key barriers to effective use. Each of these barriers should be considered as you roll out the consumer decision support tool. Classic barriers to effective use include:

  • Lack of consumer awareness
  • Lack of relevant and standardized content
  • Poor design and presentation
  • Missing features in web-based tools (poor UX)
  • Lack of trust in the source of the support
  • Low levels of health literacy
  • Lack of online access to web-based tools


4. Tell me about best case a year from now? What can patience or members to today, they couldn’t do before and why are they so happy?


You have defined the ideal future consumer state. Has buy-in been established to move forward. Where do we start? There are five important strategies for promoting more effective use, which your leadership team should be aware of including:

  • Understanding the decision context and audience
  • Crafting appropriate content
  • Strategies for presenting complex information
  • Selecting an appropriate medium
  • Maximizing awareness and use of the tool

Selecting a consumer decision support tool starts by understanding where in the patient lifecycle, the tool will be assistive. Then define the ‘what.’ What are we trying to accomplish e.g. out-of-pocket cost savings or education? Lastly we need to clarify the ‘why.’ Fast forwarding a year, why has the consumer’s experience changed? ‘Why’ are they happy?


Look outside your industry, open the curtain. What other industries have similar consumer decision support tools?  U.S. News and World Report have for year published America’s best colleges. What are they trying to accomplish and why will the consumer experience change for the better? Several other industries show us similar examples.  The food and beverage industry has Nutrition Facts Panels and the automotive industry has Consumer Reports: Car Buying Guide. When creating or evaluating consumer decision support tools take a wide view. Consider these ten areas to ensure the tool you’re buying will truly drive informed consumer decisions:

  1. Audience
  2. Readership/customer base
  3. Context of decision
  4. Context of tool
  5. Sponsoring Organization
  6. Business plan (is there a future plan)
  7. Tool design (UX)
  8. Tool context
  9. Marketing and promotion
  10. Objective of tool
  11. Source and legitimacy of data used


Once your team has answered these hard questions, you’ll be ready to transform the consumer experience. God Speed!



Strategy Analytics. (2015). Consumer Telemetry (online image). Retrieved October 25, 2015, from


Peter Nichol, empowers organizations to think different for different results. You can follow Peter on Twitter or on his blog. Peter can be reached at pnichol [dot]

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Peter is a technology executive with 19 years of experience, dedicated to driving innovation, digital transformation, leadership, and data in business. He helps organizations connect strategy to execution to maximize company performance. He has been recognized for Digital Innovation by CIO 100, MIT Sloan, Computerworld, and the Project Management Institute. As Managing Director at OROCA Innovations, Peter leads the CXO advisory services practice, driving digital strategies. Peter was honored as an MIT Sloan CIO Leadership Award Finalist in 2015 and is a regular contributor to on innovation. Peter has led businesses through complex changes, including the adoption of data-first approaches for portfolio management, lean six sigma for operational excellence, departmental transformations, process improvements, maximizing team performance, designing new IT operating models, digitizing platforms, leading large-scale mission-critical technology deployments, product management, agile methodologies, and building high-performance teams. As Chief Information Officer, Peter was responsible for Connecticut’s Health Insurance Exchange’s (HIX) industry-leading digital platform transforming consumerism and retail oriented services for the health insurance industry. Peter championed the Connecticut marketplace digital implementation with a transformational cloud-based SaaS platform and mobile application recognized as a 2014 PMI Project of the Year Award finalist, CIO 100, and awards for best digital services, API, and platform. He also received a lifetime achievement award for leadership and digital transformation, honored as a 2016 Computerworld Premier 100 IT Leader. Peter is the author of Learning Intelligence: Expand Thinking. Absorb Alternative. Unlock Possibilities (2017), which Marshall Goldsmith, author of the New York Times No. 1 bestseller Triggers, calls "a must-read for any leader wanting to compete in the innovation-powered landscape of today." Peter also authored The Power of Blockchain for Healthcare: How Blockchain Will Ignite The Future of Healthcare (2017), the first book to explore the vast opportunities for blockchain to transform the patient experience. Peter has a B.S. in C.I.S from Bentley University and an MBA from Quinnipiac University, where he graduated Summa Cum Laude. He earned his PMP® in 2001 and is a certified Six Sigma Master Black Belt, Masters in Business Relationship Management (MBRM) and Certified Scrum Master. As a Commercial Rated Aviation Pilot and Master Scuba Diver, Peter understands first hand, how to anticipate change and lead boldly.