Leader Spotlight: Jamey Shiels, Senior Vice President Consumer & Digital Experience @ Advocate Health
Jamey Shiels is Senior Vice President of Consumer & Digital Experience at Advocate Health, where he leads digital transformation across one of the nation’s largest nonprofit health systems. He previously guided digital experience strategy at Advocate Aurora Health and Aurora Health Care and has taught social media and digital strategy at the University of Wisconsin Milwaukee.
In this conversation, Jamey talks about Advocate’s move into the product space and the challenges of building digital health and wellness solutions in a highly regulated industry. He also shares how the organization is differentiating itself from fast-moving consumer apps like Hims & Hers, and Ro, and outlines his vision for rolling out digital platforms that can scale across one of the largest nonprofit health systems in the country.
Building digital products in a merged health system
Advocate Health is considered to be the third-largest health system in the US, born from the merger of two large health systems. What are the biggest challenges of inventing digital products while integrating these two legacy systems?
As you mash two big systems together, there are different ways of doing things, different technologies, different approaches, and different cultures you have to navigate. So the idea of looking farther out into the future and asking, “If we were in 2030 and looking back, what would we regret not having started in 2025?”
That kind of framing helped anchor everybody around a different point of view, whereas everything was much more in the weeds about integration — how do we handle it in Epic, how do we handle it in Workday, how do we handle all these systems? It drew people out of the moment and set a different North Star for us.
One of the premises around the formation of Advocate Health is its scale and its ability to have a greater impact on healthcare — bringing new products to market, impacting both rural and urban health.
So you have to find a way to cut through the noise of the day-to-day work of bringing two large health systems together, set that North Star, and then rally the troops around, “This way may have been great, that way may have been great. Is there a better or different way to do it?” On the flip side, if one of those ways was super amazing and functional, we’d grab it and scale it.
Once we got the focus looking farther down the road, it opened up the aperture around how we would achieve things and how we’d look at it.
The second thing, from a cultural perspective, is that putting people on something hard and different can actually be fun considering the way healthcare usually rolls. Navigating two company cultures and two sets of assets is challenging, but people enjoy that hard work. It allowed people to roll up their sleeves and really dive into it.
Inside-out and outside-in models
You’re focused on building digital products in the health and wellness space. What research methods have you found most useful for uncovering insights into how people actually want to engage with wellness products?
From a health system perspective, we think there are two ways to look at products. The first is creating new clinical care models. Maybe not a consumer-centric product, but new ways of delivering care. That information is sourced from the clinicians, from the clinical encounters. It’s an inside-out model: is there something we can evolve or elevate?
It still follows product development methodologies, but with more guardrails and limitations because of how Epic works, how our workflows are built, how we handle A, B, C, and D. We use a stage gate process where ideas are assessed and either move forward, get shut down, or change direction.
The other approach, and the one my teams live in more aggressively, is consumer-driven. We’ll do consumer research: surveys, outreach, harvesting data from patient experience scores. We’ll do large-scale quant and qual, human-centered design, qualitative studies in homes, monitoring and exploring what health at home looks like.
Most recently we commissioned a big research project — both quant and qual — with over 6,000 survey participants across seven markets and 100 qualitative in-home or in-person visits, plus focus groups. It was big because as a newer health system covering multiple geographies, we wanted to go deep into the voice of the consumer around wellness and really understand what that looks like.
That resulted in archetypes and a series of product opportunities that represent a consumer lens versus a care model lens. Now we’re matching those up to see where a care model aligns with a consumer need, and where it doesn’t. That’s product thinking from two different ways: voice of the consumer versus a clinical care model.
Competing in a consumer-driven market
Speaking of the outside-in model, companies like Amazon, Hims & Hers, and Ro can operate without the same regulatory and clinical rigor as health systems. How do you turn Advocate’s requirements for evidence-based protocols into a differentiator instead of a disadvantage in the market?
This is an interesting challenge and an interesting opportunity. As part of the wellness research project, we focused on areas like weight management, sleep, cognition, and behavioral health. These are top of mind for consumers, and we’re seeing competitors — Hims & Hers, Amazon — hit those edges around GLP-1s or behavioral health.
One of the lenses we wanted to understand was: do people get their wellness information from a clinician or a Kardashian? It’s a long line, and our research found it’s all over the place. We think we need to understand the consumer, where we can differentiate, and where we can play.
Consumer wellness companies often bypass insurance and go straight to cash-pay. For a not-for-profit health system that must operate in an insurance-driven environment, how do you navigate the tradeoffs of what can and can’t be offered as a cash product?
Nontraditional competitors can scale quickly because they focus on one area and aren’t burdened by operational challenges. They can choose to make something a cash-pay business because it doesn’t impact other parts of their business.
We have to be careful. We have contracts with payers that provide certain levels of coverage. Some decisions around cash-pay could have implications on those contracts. Sometimes we’re not allowed to do cash-pay because of government reimbursements.
So direct-to-consumer cash-pay may be a difficult place for us to go. Our data also tells us we can’t differentiate from an experience standpoint there. Where we can differentiate is clinical expertise.
As we’ve done our research, again back to our spectrum — clinician on one end, Kardashian on the other — we’ve got a space right here. We can move farther up that spectrum instead of trying to compete all the way on the Kardashian side, because we’re not going to win there. For individuals who want an integrated experience with their providers, and for those who want more clinically based and proven evidence, that’s our lane. We’re not going to try to compete where we can’t win.
Competition is good. It challenges us to be more consumer-centric, to focus on personalization and seamless connected experiences.
Marketing and early pilots
Given Advocate’s limited marketing budget compared to DTC competitors, what creative strategies are you testing to build awareness and adoption?
We’re servicing 6.5 to 7 million patients annually. That’s a big difference compared to consumer startups. We already have somewhat of an established relationship.
In the wellness space, personas become important because not everybody responds to clinical engagement the same way. For example, 22% of our audience are rule followers who will act on a clinician’s recommendation. Another percentage are skeptics, and how we engage with them is very different.
So the first step is looking at our current patient base and identifying where the engagement opportunity exists. We have an audience that we need to engage and grow share of wallet with.
We also reap the benefit of consumer advertising in the market — virtual health, weight management, mail-order pharmacy. That message is already out there. Where we spend is on targeted, personalized marketing: “We have mail-order pharmacy too, and it’s integrated into your clinical experience.”
Our budgets are limited, so we have to be very targeted and data-driven. We’re shifting strategies around SEO to answer engine optimization, content, outbound messaging. Unlike consumer startups, we don’t start from zero. We start with an established population we can build relationships with.
Can you walk us through the early weight management pilot that you launched?
We looked at our data and identified patients who might be eligible for weight management programs. We said, even with a conservative conversion rate of 2, 4, or 5%, there’s a worthwhile population here.
So we got a small team together — human-centered design, experience design, user interface, clinical leaders, virtual health, and strategy — and started with quick consumer testing. We built an MVP that referred patients from their physician encounter into a virtual weight management program. It included access to GLP-1s if appropriate, plus coaching and other resources.
It’s been live for about four weeks, and we already have 500 people actively engaged, with another 300 in the pipeline. That’s more than we expected.
We treated it like a true product development plan: prototype, MVP, backlog grooming, new features. It started as a clinical care management product, but consumer data is now pushing a significant pivot in the roadmap. We’ll expand to sleep, cognition, and behavioral health next.
We call it “drunken sailor” project management — a mashup of agile and waterfall. Sometimes you just have to figure it out. First attempts don’t always work. But patients are giving us great feedback, and we’re grooming the backlog, building the pipeline, and rolling out new features.
Scaling and operationalization
You have six million existing patients. How do you leverage that base as an incubator for wellness products while still ensuring they can eventually scale DTC?
One unique challenge for us is that we don’t have one clinical record. We have two EHRs, one in Wisconsin/Illinois and one in North Carolina/Georgia. Consumers don’t care about that complexity — they want the same experience. Part of scaling is hiding our own complexity from the end user.
This is a virtual-only offering that augments primary care. That requires different staffing and training. We built a virtual-first clinical team, and that interaction is different than in-person care.
We piloted in one system, got learnings, and that will impact future hiring and builds. If the product grows quickly, can we continue to deliver? At some point it stops being an MVP and becomes a full product with service-level agreements. We’re preparing for that as we scale.
What have you learned about operationalizing digital products internally — for example educating clinicians, pharmacists, and virtual care teams?
We’re building an AI-based engine using persona research so clinicians can train against different scenarios. That’s one way to get data into their hands and help them practice.
Recruitment is also changing. Some clinicians nearing retirement don’t want the day-to-day burden of practice but still want to work. Virtual care gives them that opportunity, and it extends careers.
Change management is critical. In large organizations, if you build it, they won’t always come. You need deliberate onboarding and training.
The products we’re building have new and different reimbursement models, or none at all. That can make it hard to get resources and keep momentum. We still have to deliver everyday care to fund the mission. That tension means we have to be very purposeful in recruiting, training, and engaging stakeholders.
Future vision and platform strategy
If you could fast-forward three years, what would success look like for Advocate’s wellness product line?
Success would be moving from transactional healthcare to relational healthcare — building a platform that supports patients across wellness, care, and recovery. That means looking at opportunities presented by the market, by consumers, or by adjacent spaces, and applying product methodologies to bring solutions forward.
We want to build a platform that is personalized and relational, not just transactional. That will require partnerships with device companies like Apple and Samsung, who are in the wearables space. People are becoming the quantified self. We don’t need to own that space, but we want to partner in it.
Platform is a business model. Products are a way to identify opportunities and bring solutions to market. Partnerships create a more connected ecosystem. And at the end of the day, before you need us, when you’re well, we can support you. When you need care, it’s seamless. And when you’re back on your feet, we help facilitate recovery.
As Advocate is becoming a platform organization, what are you most optimistic about?
I love the challenge. I’m fortunate to be in an organization that embraces it. We believe we can reshape healthcare, redefine it, and reimagine it.
There are headwinds: changing financial models, lack of transparency, cost pressures. But scale helps us tackle those. We can be disrupted, or we can disrupt ourselves. Continuous improvement internally, with disruptive innovation through products.
I’ve been in healthcare a long time, and before that I built digital products for consumer packaged goods. Healthcare is a little late to the game, but momentum is in our favor. The economics and the climate are forcing change — and that’s good.
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