Understanding Key Influencers in Health (7/8) on the modelH Canvas
As we close out our 7th post of eight, we round out our Customer Segment understanding by looking at Key Influencers and how they affect our healthcare business models. Key Influencers affect the User’s understanding and ability to complete their JTBD. Influencers are not the same as Intermediaries (which we discussed in detail) because the latter acts as a value-add (or blocker), whereas the formers are enablers. Why do we need this block called out for our healthcare business model canvas — let us see.
By the way, this will be a long post. We have a few objectives today:
- Defining the questions to ask for the Key Influencers Block
- How to identify and activate healthcare Key Influencers
Who are Key Influencers (and why are they different than Intermediaries)?
In healthcare, at least, the successful resolution of a JTBD by a Customer Segment and the full realization of the corresponding Value Proposition usually require some form of activity, activity set, and behavior change by the User. In modelH, this activity is called Key Behaviors, which we discussed in detail in the last post. Specific individuals connected to the User can stimulate key behaviors positively and negatively — in modelH, these people are called Key Influencers.
This block is separate from Intermediaries, which are present in a business model between the Value Proposition and the Customer Segment. Key Influencers affect the User’s understanding and completion of their JTBD. In contrast, Intermediaries affect how the Value Proposition is seen and paid for by the Buyer (which may or may not be your User).
Everyone needs a little help! Plenty of science shows that people make behavior decisions easier and have better completion rates when they learn and act in unison with others. It is natural for the human condition to be influenced by our peers, and healthcare is no different.
This block looks at how we can best use Key Influencers in our business model. Doctors, family, friends, and co-workers can all be informal or formal influencers. They are all sometimes called the “extended care team.” Companies and organizations should account for and take advantage of this network of influencers to help ensure their Customer Segments realize the fullness of their Value Proposition.
Given their significant influence on Key Behaviors, it is strategic for a company to elicit those Key Behaviors to formalize its relationship with Key Influencers, making them a Key Partner. Surprisingly, very few companies have effectively implemented this approach, raising questions about the efficacy of many existing healthcare business models.
Questions for the Key Influencers Block?
As we know, people can be influenced by others. For our purposes, influence means the ability to change behavior in others to form a desired set of actions better. An influencer creates motivation in others to change. An influencer can motivate others to replace harmful behaviors with better ones, but they can also promote or reinforce them. In short, an influencer can make things happen. This building block is about helping Users in their JTBD through Key Influencers.
The journey from influencer to partner begins with identifying the Key Behaviors that can and should be influenced. A company can then systematically utilize Key Influencers to drive behaviors, paving the way for a more effective healthcare business model.
The modelH canvas should help practitioners both:
- Design business models where Key Influencers can add value to a JTBD.
- Design business models that transform crucial Key Influencers into Key Partners.
Here are the questions you should ask for the Key Influencers Block in our modelH business model canvas for healthcare.
- What Key Influencers are required for the Buyer & User to realize the Value Proposition?
- What parts of the JTBD do the Key Influencers affect?
- How do the Key Influencers communicate with the Buyer & User?
- What is required for your Key Influencers to understand your business model?
- How can you activate Key Influencers without adding Cost?
- How do you turn Key Influencers into Key Partners without adding Cost or Complexity?
How do you identify your Key Influencers?
Key Influencers' ability to apply the behavior change theory sets them apart. We discuss properly activating the Key Influencers you identify in the next section. The first step is finding them.
Modern behavior science reveals that not all influencers are created equal. Therefore, it is of utmost importance to find the ‘right’ influencer and harness their potential to drive profound, rapid, and sustainable behavior change in your Users.
In modelH, we define a person who influences our customers as a Key Influencer. This individual directly impacts our Customer Segment’s (Buyers & Users) Key Behaviors, which drive their ability to fulfill their JTBD and thereby realize the total value of our business model’s Value Proposition. In essence, we aim to leverage influence through others to ensure our customers can use our products to achieve the optimal result of our business model. To achieve this, we must first identify the Key Influencers and then activate them within our Value Proposition.
Like the method we applied for Intermediaries, we suggest you try to first isolate (identify) the Key Influencers by defining a canvas specific to their business model concerning your Customer Segment and then re-insert them back into yours based on their Key Activities, Value Proposition, and Customer Relationship. We believe this is a valid approach and can lead legacy businesses to rethink how they approach their intermediaries — and possibly even seek to disrupt them. Once you identify your Key Activities, you can use the methods described here to activate them.
Furthermore, business models that seek individual health consumers as the Customer Segment will do well to craft their Customer Relationships and Experience systematically. It is essential to consider the needs of caregivers who influence health-care decisions and the actual patients (Users). Therefore, creating Key Activities for the User and (again, depending on the business model) the Key Influencers, Key Partners, and Intermediaries is critical. Each may/will differ in context and subtext for the Buyer/User and others in their circle of influence.
Note: more on Customer Relationships and Experience in a future post.
How do you activate your Key Influencers?
Persuasion is the art of using deliberate communication to change how people think, feel, or behave. In the context of healthcare business models, ‘Key Influencers’ are individuals who have a significant impact on the decisions and actions of others. Persuasion in the short term can lead to long-term, permanent, and positive effects. To activate your Key Influencers, understand how people adopt behaviors so you can use influencers to align Users/Buyers with your Value Proposition. Remember, health is fundamentally about each of us as individual humans. We all need help.
In most business models, providing a high-touch, one-to-one service is unrealistic unless you can extract revenue through a premium price point that Buyers are willing to pay for. However, in healthcare business models, the direct activation of the User is far better than through the Key Influencers or Intermediaries. This strategy is more than just a suggestion; most healthcare business models must find a means to affect high touch with a much less expensive set of Cost Drivers.
Why does this matter for healthcare business models? People tend to have friends who are similar to them. They “hang out” with people who share their interests, beliefs, and demeanors. In behavioral science, this is known as homophily. Social network research supports this concept in interesting (and sometimes harmful) ways. Scientists have shown that humans are more likely to adopt new health behaviors when engaged in close networks of people they already know well. Research shows that getting people to change ingrained habits requires reinforcement from redundancies within a close contact network. Humans must hear and see a new idea within their circle of friends multiple times before adopting that behavior.
I strongly advocate using a framework (like the Influencer Model, which you can read here: Influencer: The New Science of Leading Change) to persuade your Key Influencers to impact your Users. This concept is not just theoretical; it’s a practical tool that can activate Key Influencers by identifying the “high-leverage” behaviors that lead to rapid and profound change. Using a model like the Six Sources of Influence will not just aid, but significantly enhance the design of the Key Activities you want to elicit from Users and Key Influencers in your business model.
The Influencer Model organizes influencing strategies into six sources that motivate and enable people to change through personal, social, and structural forces. These are the reasons why humans behave a certain way: personal motivation, personal ability, social motivation, social ability, structural motivation, and structural ability.
Here is how we suggest activating your business model’s Key Influencers to help your Users.
- Personal Motivation. Help your influencers build personal motivation in your Users by giving them a platform to relay relevant personal experiences about desired behaviors. Key Influencers can help Users learn to love what they currently avoid (or hate) by introducing choices, creating direct experiences, telling meaningful stories, and gamification.
- Personal Ability. Help your influencers build personal ability in your Users by giving them the deliberate, hands-on practice of applying wanted behaviors in real-life situations. Key Influencers can help Users master the Key Behaviors needed to realize your business model’s Value Proposition through coaching and rapid positive feedback that builds their confidence.
- Social Motivation. Help your influencers build social motivation in your Users by creating directed informal influence through the network of people they already know well. Key Influencers, like Key Opinion Leaders (KOLs) in pharma, inspire physicians to adopt novel drugs as part of their regimens.
- Social Ability. Help your influencers build social ability in your users by giving them the individual support required to enact new behaviors through network interactions. Key Influencers can work together using a team-based approach to move behaviors in the right direction.
- Structural Motivation. Help your influencers build structural motivation in your users by propagating incentives and rewards through new behaviors. Key Influencers can participate in the incentives, rewards, and feedback mechanisms (warnings and punishments) you design into your Value Proposition to ensure outcomes.
- Structural Ability. Help your influencers build structural ability in your Users by using technology to create cues, reminders, and reports that keep their new behaviors real and present. Key Influencers can include digital health features you design into your Value Proposition, making it easier for Users to make and sustain behavioral changes.
Our concept of identifying the Key Activities of our Users to be affected by the Key Influencers can be applied to both good and bad behaviors. For instance, a Key Activity in Healthcare could be regular exercise or adherence to a medication regimen. Remember, in modelH, we seek to drive the Key Behaviors of our Users so they can complete their JTBD. We now know that Key Behaviors are more easily driven when a User is connected to a body of influencers, and you, in turn, can leverage that structure for a positive outcome. The same can be said for stopping the negative behaviors that pull a User away from their JTBD. Change how the Key Influencers reinforce those negative behaviors or convince your User to change their contact patterns. Likewise, while the research shows that immediate social bonds are stronger regarding affecting behaviors, getting someone and their network of Key Influencers to engage in structured and healthy Key Activities is difficult.
Let’s take an example from Life Sciences — the development and oversight of a clinical research program. In this instance, the BioPharma company (the “Sponsor”) is motivated to ensure the research bears fruit. The contract research organization (CRO) the sponsor pays to run the trial is also motivated to ensure the research proceeds compliantly. Failure here has ripple effects on the CRO’s core business model. The research site (a research hospital, for example) needs funding to complete successful research, receive accolades, increase the number of research scientists, and grow. Failure here could shatter the research site’s reputation and erode trust with participants and sponsors. The participant, a human eligible for medical research, wants cutting-edge treatment to help heal their condition. There is ample opportunity for any one of these connecting settings to fail.
This reason is why key opinion leaders (KOLs) are widely used in pharma. They are trusted experts who significantly influence other healthcare professionals and patients. They are typically physicians, researchers, or academics with extensive experience and knowledge in a specific therapeutic area. They provide credibility, as their stamp of approval validates new drugs. They also bridge the gap as they translate complex research for everyday use. They also influence the development of better medications from the start through early guidance.
What is also interesting is the use of digital therapeutics, which are evidence-based therapeutic interventions driven by high-quality software programs, as part of these trials. This technology helps motivate participants to provide the necessary data capture to support the program. I am bullish on the business model of Evidation Health. Their digital health platform uses machine learning and data science to turn insights into tools, treatments, and guidance. The platform measures the health of individuals with their consent by using patient-generated health data (PGHD) from wearable technologies and apps, such as activity trackers, smartphones, and smartwatches. The ‘influence’ part comes into play when Evidation members earn points by tracking actions like walking, sleeping, logging food, taking surveys, and participating in health programs and research. They can redeem their points for cash, gift cards, prepaid Visa cards, charity donations, or bank deposits.
Let’s take an example from Healthcare — team-based approaches, which involve multiple healthcare professionals working together to provide comprehensive care for home health. We can draw from successful home health agencies that co-opt family members into the support structure of their patients. In this scenario, John, an 82-year-old senior, lives alone and uses a home health agency’s services. The agency installs various smart devices in John’s home, including motion sensors to track John’s daily activity levels, and can detect unusual inactivity, potentially signaling a fall or illness. They can also include smart medication dispensers that automatically remind John to take his medications and dispense the correct dosage. They even include smart refrigerators and pantry sensors to monitor John’s food stock and can alert the agency or family members if John isn’t maintaining proper nutrition. The health agency can also use a secure mobile app that John’s daughter, Sarah, can access. Sarah is not paid to do this work but is motivated to influence her father’s behavior. She can and will undoubtedly affect his behaviors and impact his health outcomes. The app provides Sarah with real-time data to see John’s daily activity levels and medication adherence. The app can notify Sarah if John experiences unusual inactivity or forgets his medication. Sarah can use the app to video chat with John, send messages, and even schedule virtual appointments with healthcare providers. The agency can incentivize and reward John (and his daughter) along the way for completing tasks and maintaining good behavior. Everybody wins!
How do you use Technology with Key Influencers?
Activating Key Influencers in your business model can be expensive and time-consuming. Technology can help. Though we will discuss technology in detail during our section on the Platform building block, it is worth mentioning here in the context of enabling Key Influencers in your business model.
As in all business models, technology lowers the cost of performing Key Activities and can be a competitive differentiator. As such, there has been a rush to extend “digital health.” A 2023 Pew Research Center survey found that 90% of US adults now own smartphones. This number represents a significant increase from just a few years back, with ownership at 81% in 2015 and 85% in 2021. The trend leans towards younger generations, with smartphone ownership reaching 97% among 18–49-year-olds, compared to 76% for those 65 and over. Interestingly, the survey also suggests a slight gender gap, with 80% of men owning smartphones compared to 75% of women.
Technology has always served to reduce the cost of touch. What used to require a person-to-person connection can now be automated through AI. Nurse lines and patient calls can be automated as reminders through a smartphone.
Technology also reduces the cost of compliance with Externalities. Consider how it has been applied to claims processing (see Forbes The AI Revolution In Medical Claims Processing), prior authorizations at Cohere Health, and electronic medical record chart chasing at Rhapsody, moving the healthcare industry toward paper-free.
Technology can also reduce the prices of high-demand items. For example, prices for cosmetic surgery have remained flat or dropped while producing higher outcomes, mainly due to the demand for these procedures (sixfold since the early 1990s), which has driven demand for continued technological advances.
Depending on the business model, technology can enable the Key Influencers, Key Partners, and Intermediaries to drive behavioral change as it helps move healthcare from out of hospitals and doctors’ offices to wherever patients are. Technology has become a significant Channel in healthcare. However, it is only as good as the Key Influencers, Key Partners, and Intermediaries they use to spread information and help health consumers with their JTBD.
While giving health business models a better sense of how to influence influencers successfully, technology is far from the only answer to activating key influencers. However, given the constraints and costs of using other methods, it is among the best. The trick is to find out what combination of cadence (Customer Relationship), process (Experience), and means (Channel) makes the highest impact on the Key Influencers you have identified for your business model.
As stated earlier, we will discuss this topic in detail when we get to the Platform block of the modelH canvas.
In Conclusion
In conclusion, incorporate these concepts into the Key Influencers block in your business model canvas and activate them using the six sources of influence. Whether your business model is aimed at Patients, Providers, Payers, or Purveyors, defining understanding and using Key Influencers will ensure your Customer Segment can complete their JTBD and realize your Value Proposition to the fullest.
What is Next?
We have examined all of the Customer Segment (the “Who”) blocks for the modelH canvas. To wrap up this mini-series, we will use one more post.
Interested in what I am doing and want to learn more? You can read all about modelH business model innovation for healthcare on Medium.
to your health,
- Kevin
