Medical Practice

Time Really Can Be Money

By KIM BELLARD

If you are not an IKEA fan, or haven’t been spending any time in Dubai, you may have missed the chain’s marketing campaign to help promote its second store in the area.  Titled “Buy With Your Time,” customers got store credits for how long they spent getting to the store. 

Gosh, that’s something that should make any self-respecting critic of the U.S. healthcare system perk up.  Count me as intrigued.

The campaign involved checking the customer’s Google Maps’ Trip tab to determine how long it took them to get to the store.  IKEA benchmarked the average hourly wage in Dubai, and converted the travel time into how much credit they’d generated.  It works out to about $29/hour, or $0.48 per minute.  Spend long enough getting there and you could get a free coffee table or even a bookcase.  Prices in the store include the equivalent time currency.

An IKEA spokesperson explained:

“Before the birth of this campaign, we realized two things: time is precious today, and many loyal IKEA customers spend a significant chunk of it visiting our locations, which are sometimes away from the city center.  We think it’s only right to reward our customers’ efforts by repaying them for the time spent reaching us. It’s our way of helping the Dubai community make the most of every minute.”

It is believed to be the first time a retailer is letting customers use their time as a means of payment. 

The campaign depends, of course, on Google Maps’ ability to track users’ movements, and for customers to allow IKEA to use that data.  On the other hand,  Google is tracking those movements anyway, so the least we should get for that tracking are some free meatballs.  

Jason Aten, writing in Inc., was impressed: 

“I think the promotion is brilliant–even if it is just a marketing campaign to promote a new store. Any time you can turn one of your biggest challenges into a win for your customer, that’s still a win. And it’s also a very creative use of technology.”

Simon Chandler was more skeptical, warning in Forbes: “the promotion is another step towards normalizing the idea that it’s okay to be watched wherever we go so long as we receive ‘free stuff’ in exchange.”  Still, he concedes: “this promotion opens the door to a significant and profound change in  how consumers purchase goods, and in how they relate to brands.”  

The program seems to have been a success:

I love this campaign for a couple reasons.  One is the concept that it recognizes that, yes, our time is valuable, and not just in a lip service sort of way.  The second is that “money” is a broader, more elusive, concept than the formal forms of currency that we usually use.  

Healthcare should be thinking about both of those.  

Travel is often not a prime consideration in healthcare, with medical tourism and centers of excellence still not achieving mainstream status.  We like our healthcare local, failing to recognize that, for most of us, local is far from the best care we could get.  But what if, taking a page from IKEA’s campaign, the time we spend traveling to — and taking off work for — sources of higher quality care translated into credits that we could use to pay for that care?

More important than travel time is the waiting.  I have railed before about how the healthcare system often treats our time almost contemptuously.  As I put it previously, we wait to get appointments, we wait at appointments, we wait during appointments, we wait for results after appointments, and, if we’re in a hospital or nursing home, we spend most of our time waiting.  Plus, of course, we spend inordinate amounts of time enrolling in our health insurance plan, waiting for claims payments, and, should you ever need it, on hold in customer service queues.   

Healthcare should be valuing the time we spend in the system waiting for something to happen.  Some parts of the healthcare system seem to track and report waiting time — e.g., urgent care centers or emergency departments come to mind — but they don’t seem to do much with that information.  E.g., a three hour wait at an emergency room doesn’t give you any credit off the big bill you’ll get for that experience.  

The healthcare system values the time of the people and things in it, not the people using it.  Imagine how the incentives would be different if our time cost them money.   Note, for example, Nicos Savva and Tolga Tezcan propose in HBR that payments for emergency room visits be tied directly to wait times.

We shouldn’t just be looking at giving wait times monetary value, but also explicitly valuing the kinds of behavior that keep us out of the healthcare system.  This has been the goal of “wellness programs” for several decades, despite near-universal evaluations from objective observers (e.g., Rand or Song and Baicker) that they are not really effective.  

It boils down to the fact that we have an illness system, not a system of health, and so all the monetary rewards revolve around dealing with how we treat those illnesses.  In the ideal health-oriented system of the future, payment should be oriented to activities and people who keep us healthy, or return us to the best health most effectively.  

Imagine instead of paying health insurance premiums we accrue credits for our good health behaviors, which can be redeemed when we need some sort of intervention to maintain or improve our health.  IKEA couldn’t have done its campaign without Google Maps, and we’re getting close to the kind of 24/7 tracking options that would allow for us to determine and manage such credits.  

The problem will be that no existing entities in the healthcare system are really equipped (or incentivized) to administer such an approach, opening the door to new types of market entrants.  Maybe we should ask the people at IKEA…

IKEA’s effort may just have been a clever gimmick to promote a new store in an isolated location, but there are lessons to be learned from it nonetheless.  As Mr. Aten suggested, turning pain points for the customer into a win for the customer is, in fact, a win.  If there is something that we can all agree on, it is that healthcare has too many pain points for its customers.  The question is: how can we turn them into wins for those customers?  

Kim Bellard is editor of Tincture and thoughtfully challenges the status quo, with a constant focus on what would be best for people’s health.

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Hans Duvefelt, MD Recent comment authors
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Hans Duvefelt, MD
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A proud Swede, I just finished my meatballs, eying the large pine kitchen table and chairs I bought at IKEA around 1981 and shipped over when I emigrated. I heard on NPR that H & M is taking a baby step away from disposable fast fashion by renting clothes out. What these two Swedish companies are doing is admirable, IKEA crediting the customers time and H&M listening to more environmentally conscious customers. Healthcare is a pretty stodgy business when it comes down to the patient experience and I think more people designing clinic workflows should follow the business news and… Read more »