5 Important Considerations for Designing Effective Omnichannel Member Experiences within Legacy Systems

Omnichannel Experiences Hero

An omnichannel approach — in any industry — looks at how to integrate every channel and touchpoint your customers/members have with your product or service and ensures that the experience is consistent, seamless, and frictionless. It doesn’t look at those channels as separate entities with separate experiences. Instead, it finds a way to merge them into a holistic experience that is seemingly effortless from the perspective of your members/customers. 

When done right, an omnichannel approach focuses on integrating data and technology, content, and communication while coordinating the needs and desires of your members/customers by meeting them where they are. And this is an important distinction to make. Meeting your members/customers where they are is the single most important thing in an omnichannel approach, as opposed to pushing information to them from where you are.  This is particularly challenging in health insurance with its legacy systems and corporate structures typically oriented around business operations instead of member [needs]. 

 So, what does taking a holistic approach mean? It would be easy if you were starting from scratch and creating an ideal scenario where everything works perfectly. But how do you develop an effective member-/customer-centric omnichannel solution when you must depend largely on existing systems that may not have been designed with the end-user first?  

 Here are some key considerations:

 First and foremost, assess your landscape. Be clear on what your members/customers want and how well you can respond to their needs. Conduct an audit of the current member/customer experience to better understand where the gaps and blind spots are — both from a member/customer perspective and an internal organizational and operational perspective. How well you can respond to your member/customer needs directly reflects what you value most as an organization. Are you really putting your members/customers first, or are you oriented around a business structure that prioritizes your perspective over your member’s perspective?

Acknowledge the constraints of the system and structures you’re operating in. That means surveying your internal and external landscape. In healthcare, you not only have to meet members where they are, but you also have to make up for the existing deficits of the systems currently in place (e.g., Legacy infrastructure, siloed data and organizational units, regulations, policy restrictions, HIPAA compliance).  Many of these hurdles can’t be overcome overnight, but that doesn’t mean it’s impossible to circumvent or minimize the friction points for members. Nor does it mean settling for status quo. Rather, it means starting with where your organization can influence change. Acknowledging systemic constraints and structural hurdles allows your organization to see where those opportunities are — what to focus on first while planning for longer-term changes. 

Don’t put all your eggs in one (digital) basket. Many organizations consider digital to be the singular way forward to an omnichannel approach because it allows them to cut costs elsewhere. (e.g., reduce customer service calls by improving digital experiences that can offer the same info). However, pushing a digital agenda by not understanding your members’/customers’ preferences will not get you the engagement you’re looking for. Taking a holistic approach will. You have to meet your members where they are first before you can motivate them to act on the benefits of doing something else. And you have to accept that some people will always pick up the phone and call no matter how much you’d like them to use a different channel.

Consider the importance of context. Don’t rely on data alone. Research to find out why your members do what they do. Data alone doesn’t give us context. Knowing that 20% of your members reach out to your call center is good, but do you know why? Are they calling because they are traveling and need healthcare abroad and thought it was easier to call the customer service number on the back of the card? That person may likely be a digital power user but, in this context, found that calling was the right choice. Could they be calling because they’re looking for basic information but can’t locate it on your website? Or, is it possible they don’t have broadband access which makes using your services challenging? 

Make sure your organization’s business objectives aren’t self-serving. Earlier, we talked about being able to assess your internal landscape as objectively as possible. In doing so, you better understand how your organizational perspective skews when it comes to your customers/members. Understanding this allows your organization to pivot and adjust to keep members centered. It’s important to consistently check yourself on this as you go through this process. Often, member needs are deprioritized because organizations focus on business objectives that don’t favor their perspective. However, what is the cost of leaving some of your members behind? 

The COVID-19 pandemic showed us how digital has the capacity to connect us in many ways, making healthcare easier for some. Still, it further revealed the inequities and fractures that exist in our society. In healthcare specifically, even in this “digital age,” it exposed how lack of broadband limits people’s access to care and how this can have compounding negative effects on their quality of life over time. To that point, the FCC (Federal Communications Commission) has an established task force that’s been researching the lack of broadband access as a social determinant of health. According to the Pew Research Center, despite growth post-COVID, there are still digital divides between rural, urban and suburban America. These aren’t edge cases to be ignored. 

Co-create a workable plan through cross-functional collaboration. While overcoming technology infrastructure challenges is expensive and time-consuming, cross-functional collaboration can be done rapidly to help overcome arbitrary organizational structures oriented around business needs. Even without changing organizational structures that may silo work, pulling together a cross-functional team to view the member/customer journey independent of corporate structure can provide a strong starting point for collaborative solutions. Through workshops that enable teams to co-create solutions oriented around the member/customer, you can find innovative ways to bridge the silos and work with what you have to meet their needs.

If you don’t yet have the technology infrastructure in place to seamlessly support your members you have to be aware of what the gaps are and how you can make up for them in other ways — whether through influence or minimizing friction points in existing processes until you can create a new process altogether. Sometimes, good old-fashioned communication and teamwork can go a long way in creating more fluid experiences. 

 Now what? How do you begin to get there? 

As design practitioners at Mad*Pow, focusing on a holistic approach is inherent in how we approach our work. From a Service Design perspective, we take a broad look at the landscape to assess where the gaps are and what the opportunities might be and help you figure out how to work with what you have while you work towards future improvements. Fundamentally, Service Design looks at all stakeholders, both those that are direct recipients of the product or service and those that are necessary to operationalize the product or service you’re creating. It inherently takes a human-centered approach, helping your organization hone in on what members need to help you drive business objectives versus driving business objectives at the member's expense.

If you are looking for innovative ways to create a more member-centric experience within the constraints of your legacy systems, let’s talk!

Contributed by
Eleni Stathoulis
Job Title
Principal, Service Design