What healthcare innovators can learn from academic coaches in higher ed


Jan 9, 2018

Patient-centered care initiatives often aim to increase patients’ health literacy, encourage them to participate more actively in treatment decisions, and create a less stressful care delivery environment for them. Increasingly, though, healthcare innovators are aspiring to do much more for, and with, patients than that.

Many are helping patients tackle the social and environmental barriers that prevent them from effectively engaging with traditional care processes. The most ambitious are actually changing care processes to fully incorporate the patient, giving them unprecedented influence over the goals of care, as well as where, when, how and by whom it is delivered. This often entails development of a trusting, longer-term relationship with patients, and promoting patients’ increasing proficiency in self-management.

One way innovators are pursuing these broader, patient-centered objectives—particularly in caring for high-cost, high-need patients—is by pairing patients with a dedicated contact with whom they can interact throughout a particular care process, or patients’ tenure with a system. These roles have titles like patient advocate, case manager, care navigator, or health coach; and their roles vary depending on the health system and patient population.

They’re being leveraged by well-established players like Mayo Clinic and the Alaska Native-owned Southcentral Foundation, as well as new market entrants like Oak Street Health and Cityblock Health. But such roles are not yet commonplace, and there remains much to learn, both about how they can be crafted for optimal impact, and how business models need to be designed to enable them. For healthcare innovators grappling with these questions, the education sector may provide fresh inspiration.

Much like our healthcare system, today’s education system—from K–12 to college—consumes an enormous amount of taxpayers’ money, and largely delivers a standardardized service to its users, though each is an individual with unique needs. So it fails many of them in terms of both the quality and utility of educational experience, as evidenced by some sobering surveys.

The 2016 Gallup Student Poll, which surveys public school students in grades five through 12, found that fewer than half of all students felt engaged with school. This echoes a 2009 report by Public Agenda for the Bill and Melinda Gates Foundation, which found that boredom played a major or minor role in 45% of recent college dropouts’ decisions to leave school. Equally concerning, a 2016 report by PayScale, a compensation data and software provider, revealed that a whopping 50% of surveyed managers feel that recent college graduates are inadequately prepared for full-time work.

The good news is that education innovators are on the path toward new and better solutions. They’ve discovered that the most fruitful learning (like effective health management), doesn’t emerge from standard solutions, but tailored guidance, support and empowerment. And it requires students’ collaboration in the form of inquisitive interaction, productive independent study and practice, and much more.

Initiatives to create these conditions in the classroom often fall under the banner of student-centered learning innovation, which is in many ways analogous to patient-centered care innovation in the healthcare world. Southern New Hampshire University’s College for America (CfA) exemplifies a particularly successful one.

An outgrowth of Southern New Hampshire University’s original online program, CfA’s entire business model is designed to meet the needs of its target population: non-degreed, working adults who require new skills to advance in the workplace. Such students face very different barriers to obtaining a degree relative to typical, younger undergraduate students. Limited academic preparedness, demanding and/or unpredictable work schedules, parenting and elder-care responsibilities and stretched finances number among the most common, and the traditional brick-and-mortar universities just aren’t set up to help.

But CfA is. Partnerships with employers, who benefit from their employees’ continued learning, keep fees affordable. The program’s unique, online model enables students to tailor learning goals, activities and pace not only to their professional needs, but also to their personal competencies, preferences and real-life circumstances. One of the core mechanisms by which it does so is of particular relevance to healthcare: the use of coaches to help students successfully navigate through their learning experience.

Dedicated to individual students from matriculation to graduation, CfA coaches initially help students assess their needs and construct their goals. Then, periodically checking in by email or phone, they encourage students, and help them identify and solve problems in or out of school that impede their progress. In essence, coaches are the means by which CfA delivers efficient, student-centered learning at scale. They ensure each student engages effectively with the most personally relevant aspects of CfA’s offering, and thereby reduce waste of valuable CfA and student resources.

The power of CfA’s coach-facilitated model is evidenced by Southern New Hampshire University’s remarkable transformation from a small, traditional liberal arts college with just 2,500 students in 2003, to one of the U.S.’ biggest, most innovative providers of online education today, with over 80,000 students and $500 million in income in 2015 (the last year for which data has been published).

In healthcare, patients can be a tremendous resource in managing their own health, as well as in reducing ineffective or unnecessary care, if only given the right, personalized support. Health coaches and similar professionals could play an important role in providing such support to a large population, but there’s still much to learn. Healthcare innovators who seek lessons on that subject not just within, but also outside the industry—such as from Southern New Hampshire University’s College for America—might just end up at the head of their class.

For more on patient-centered care innovation, see Health for hire: Unleashing patient potential to reduce chronic disease costs.

As Senior Research Fellow for the Christensen Institute, Rebecca’s research focuses on business model innovation in healthcare delivery, including new approaches to population health management and person-centered care.