Mass Customization

Mass customization is a process that offers a variety of products or services designed to meet on demand a wide range of consumer needs without losing the economies associated with the limited choices inherent in the methods of mass production. The term was introduced by Stanley M. Davis in his book Future Perfect (1987) and is receiving increased attention in the health services management literature.

Mass customization is the logical consequence of the ongoing industrialization of products and services. Health care organizations are presently evolving through that process. Historically, providing individualized and customized care within the context of the traditional doctor–patient relationship, the realities of cost, and the emergence of managed care has moved the industry into the mass production phase of the industrialization process. However, patient and provider variability and the expectation that treatment must adapt to individual differences have forced health care organizations to meet on demand a wide range of consumer needs without losing the economies inherent in a mass production system.

Advancing scientific knowledge of the underlying mechanisms of health and disease increase has reduced acceptable levels of clinical ambiguity and thus has reduced variation in practice patterns and their attendant costs. The revolution in genetics, for example, is increasing, and will continue to increase, the proportion of health care activities supported by science, reducing the proportion of patient care processes subject to artistry and craft. Highly reliable processes supported by information technology and modularization can provide the potential for mass customization. This development promises individualized treatment at reasonable cost.

Figure 1 shows a diagram of the four states of industrialization identified by Victor and Boynton (1998) with two possible paths. Path A shows the traditional path of industrialization in the production of goods and services. Once the dominant design of a product or service emerges in the marketplace, the process is rationalized and mass production takes place with low product and process variability. Modern quality improvement techniques are then used to continuously modify (and improve) the process, leading to opportunities for mass customization.

Path B shows the route being taken in many health care organizations where the mass production stage has been bypassed or at least minimized. The provision of health care has moved from a craft to process enhancement, in[Page 355] which the focus has been on quality-enhancing efforts such as continuous quality improvement, evidence-based medicine, best practices consortia, treatment protocols, and case management. These efforts have provided standardization sufficient to enable providers and insurers to consider mass customization opportunities. Examples of the latter include case management of catastrophic illness cases and the provision of deep Internet portals and customized feedback for insurance enrollees with chronic illnesses.

Mass customization does not imply an infinite variety of products and services, nor does it imply the end of invention and adaptation in medicine. It refers to a conscious effort to introduce ever-increasing levels of personalization and variety of outcomes. Configuring and delivering modules of service in response to patient needs and preferences accomplish it. For example, a child born with spina bifida may need a wide range of medical and social services, depending on the severity of the case, the stage of treatment, the resources of the family, the resources of the community, the policies of payers, and the child' rate of development. The professional individual or team assigned to configure that child' care would pick and choose among available providers and services to best meet the needs of that child and family. That would require access to and use of efficient and effective patient records, methods of communication, databases, and service contracts and relationships.

Figure 1 Stages of Industrialization

Adapted from Victor & Boynton (1998).

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