We speak a lot at Crossover about the “currency of trust” being one of our most valuable assets. In fact, we think that trust is not only strongest but most relevant at the point of care, in the trenches, and when working directly with a dedicated care team. While we focus on traditional health outcome measures as key performance indicators, there is an unwritten, ever-present imperative that we also track everyday. We teach all of our care teams—from the host who greets our members at the door, to the nurse who encourages and educates our patients, to the providers who literally touch their lives—that everything we do is about building trust.
In fact, we believe that Trust trumps Relationships.
Say what? I thought the whole point of your model is to build relationships? I thought the member/care team relationship is the be-all-end-all of what you are building? I would counter with, “Does a relationship require trust?” or “Is trust required for a relationship?” While you consider that puzzle, let me explain my view.
Let’s face it, most people aren’t always looking for relationships with their healthcare providers. They want caring professionals not bowling partners! They want to place confidence in diagnostic expertise, not exchange annual holiday cards. While clearly there are situations where that type of a relationship is desired, I would say it is not required. What we believe people want is their questions answered honestly, next steps explained clearly, and their personal health issues resolved competently. If these steps are done well, our care teams not only earn trust; eventually a deep, therapeutic relationship becomes a part of the virtuous trust cycle.
Trust is complex, and a foundational social construct. It is postulated that trust allows individuals to short circuit the need to assess every contingency, reduce the choice overload, and simply follow the recommendations and advice of those they trust (i.e. the Speed of Trust). It starts with family and then extends to the interactions they have with friends, co-workers, and others, including of course, their healthcare providers. Research notes that people in general don’t apply trust to devices themselves, instead applying the trust they have to the individual or entity behind the device—so while we’re moving to a digital first model, the trust is still attached to the people.
We have been fortunate that our physical care delivery to date has been able to rapidly inspire trust as well as quickly build relationships (65% of all patients who come to our centers want us to be their primary care provider). As we have pivoted our care model to a “Digital First, Strategically In-Person” approach, one of the ongoing questions has been whether we will be able to replicate the types of relationships we seem to build so quickly and consistently with our in-person care. I would actually reframe the question—can we replicate the same type of trust that we currently generate. Can our digital tools of care, from signup, onboarding, asynchronous question sets, individual interactions, related followups, etc., all be delivered in a way that creates the same level of confidence? Will the collaboration, seamless interactions between care team members, new modes of followup, and other advantages of our digital approach inspire the same levels of confidence, and therefore trust?
I wrote previously about Kevin Slavin, his focus on System Design, and how the core “architecture” (purpose) of an organization determines how its operating processes are designed and as a result how they are experienced. As a result, we have (re)designed our Connected System of Health at every process, in every modality, and at all touch points to not only exceed expectations, but to delight with clarity, empathy, and effectiveness. We’re asking our members to believe—to trust that our online first care model is at least as effective as the in-person visit. We’re asking them to trust that the team on the other side of their Crossover app really does understand them and knows their concerns. We need them to trust that recommendations from anyone at Crossover (not just their primary care provider) are specifically suited to them. We need them to trust that the data we collect will be used to help them, and by extension, others, and not used for other organizational gains.
Our core purpose is not only to help people become and stay well, but also to earn their trust and ensure they believe that we will always do what is best for them. It is essential that our products, technology, and actions reinforce this, especially for all new services and all new channels. We believe as we grow the currency of trust with our members, they will give us the permission to continue to innovate with them, to disrupt old patterns and expectations, and create a healthcare model that truly changes the system.
We are banking on the future of trust, and look forward with “interest” at the possibilities! Now, let’s go bowling!
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