Digital done wrong

For readers in the U.S., the following is an all-too-familiar—and painful—story I need to tell to make a point. Warning: reading this may raise your blood pressure or tie your stomach in knots.

Jeannie is a middle-aged woman who takes medication for two chronic conditions. She will likely take both for the rest of her life and is grateful for her employer-provided health plan.

Because of the long-term recurring nature of these medications, her health insurer insists they be purchased from its in-house mail-order pharmacy. One of the medications is generic and inexpensive—it has been around for years and is supplied by the normal pharmacy in 90-day intervals. The other is a brand-name, recently launched drug that costs almost $3,000 per month and is supplied by the insurer’s specialty pharmacy in 30-day intervals.

On any given day, Jeannie may receive a robo-call from the insurer stating one of her prescriptions is ready to be shipped, but they must speak to her to confirm her order. She thinks this is likely the more expensive, brand-name drug she takes, so she immediately presses the button to be connected to an agent. The Interactive Voice Response (IVR) system takes her information, including her birthday and ID number, and she is quickly connected to an agent. The agent immediately asks for the exact same information, and then asks her what she is calling about.

Jeannie says, “Actually, you called me! But I suspect it’s about shipping my regular prescription X.” The agent responds that her request is handled by the specialty division and needs to transfer her call. This happens quickly, but the new agent again asks for the exact same identifying information before processing the order. Jeannie wonders why the smartphone app she was asked to download by her insurer doesn’t make this any easier. Days later, Jeannie receives an email from her insurer asking her to call in. Thinking it might be about the second medication, she calls and repeats the process of providing the same information three times to a machine and two people. At this point, she discovers it is about the same drug she already addressed in her first call! A few days later, she gets the same email, judges it to be yet another repeat, and ignores it.

A few days after that, she gets a letter in the mail saying the company has been unable to reach her and is unable to fill a prescription unless she calls immediately. She does call, goes through only the two-step process (the specialty pharmacy isn’t needed in this transaction), and her other prescription is filled.

She again wonders why she can’t handle all this on the app, which uses fingerprint recognition for extra security. She investigates on the website and it turns out she can refill her generic directly on the website, but not on the app. The specialty drug requires a phone conversation and cannot be filled by website or app—so she is stuck with two processes.

Jeannie goes through this tedious exercise at least once a month. Almost always, within a few days, there is a follow-up call to survey her on her experience. A heavily accented voice reads a script. When she is able and willing to answer, she gives the call center rep detailed feedback on how to streamline the process for her: “Tell me which drug we are talking about, verify my information only once. Better yet, let me do everything on my smartphone and save us both some time!” Nothing changes.

Here comes the point: The irony is the insurer has all the tools at its disposal to provide a successful omnichannel digital experience. It is hindered by what are obviously some legacy processes and organizational silos that just don’t make sense.

As with so many digital stories, the technology to make this a great experience is all there—the barriers are human and organizational! Why hasn’t anybody noticed that fingerprint verification is easier (and more secure) for both the customer and the company? Why hasn’t anybody written code to alert the agent that the person on the other end is responding to a call from the company? Why have two completely different divisions deal with the same customer’s medication?

CIOs that want to stay relevant must understand that digital experiences have to start with the customer and work backwards into the enterprise. The enabling technology is, in most cases, already there. Is your company willing to make the hard changes required to go digital successfully?