Patient experience: Where your hospital needs to be five years from now
Healthcare C-suites are very concerned with how patients experience their organizations and the care delivered within. The patient experience is a factor that has grown in importance over the years. And forward-looking provider organizations are branching out by doing such things as signing agreements with Uber and Lyft to transport patients to appointments.
A big question today is what should the patient experience look like tomorrow? And in five years? But to understand where the patient experience should go, healthcare C-suites need to know where the patient experience is right now, and how health IT can help. CIOs and similar executives have a lot to say on the subject.
Looking for new methods
Children’s Hospital of Alabama has systems in place for doing things like measuring patient satisfaction and reporting patient satisfaction and things that show follow-through, according to CIO Bob Sarnecki. From an IT perspective, the organization is trying to find ways besides just logging satisfaction.
“How can we engage the patients through the technology that we have to put in place anyway for a normal hospital to function?” Sarnecki asked. “We are experimenting with things like having a help desk also support calls from patients and families, providing technical support with issues like connectivity for both our patients and their families when they are here, we are trying to figure how to best take the IT systems we have in place to support our providers and colleagues and bring that down to the patient level.”
One of Children’s Hospital of Alabama’s measures is to get a rotating help desk in place out on the floor and regularly meeting with the nurses and care providers to find issues but also to be a resource for the patient.
At the Advanced Urology Institute, which serves southwest Florida, health IT is strongly integrated with the patient experience because of the mandatory integration of the EHR, said Tricia Miller, IT manager, who uses health IT from vendor CareCloud to assist with patient experience efforts.
“It all starts with the initial data that comes in through our practice management system,” she said. “Staff will send the patient a portal invite, giving the patient an opportunity to fill out paperwork and manage their account before and after they enter the office. That data then interfaces with our EHR.”
This part of the patient experience proceeds from there. Once the patient enters the office, the provider organization onboards that person and interfaces with the EHR to notify staff where the patient is in the process.
Then the caregiver creates a visit in the EHR and the charge data interfaces back into the practice management system. Once the claim is in the practice management system, a rules engine verifies and cleans the claim before being sent out electronically. The remittance is returned electronically and posted with payment going to a dropbox.
“Our patients have an opportunity to register at many different entry points on our campus,” said Brian Sterud, vice president of IT, CIO and CISO at Faith Regional Health Services in Norfolk, Nebraska. “We have staff that escorts them to their destination to help ensure they arrive in the correct place. IT helps their experience by providing an improved guest Internet experience. We are currently investigating digital wayfinding as another avenue to help the consumer experience in our facility.”
So if these CIOs were in a C-suite meeting and the CEO asked them where should the organization’s patient experience be five years from today, what would they say?
“My CEO has asked that very question,” said Sarnecki of Children’s Hospital of Alabama. “The thing that we are working on heavily is taking the patient experience to the phone. The vast majority of our decisions are made by millennial mothers, and their world is tied to the phone.”
As an example, Sarnecki said he has a daughter who is 30 years old who has never been in a bank. She has a checking account but the idea of a bank has never existed for her physically.
“We’re starting to push out the patient experience down to the phone to make it easy for our decision makers to do things like registration by phone, check-in, patient portal, doing all those things back to the phone and making the phone experience second to none,” he said. “That has become our really big focus. Some of our work this year has been to start on wayfinding, and then moving to the patient portal, as well as registration.”
The days of the kiosk are probably numbered because people are past the point where doing things at a kiosk is where they want to be, he added. Most patient experience solutions should be available by phone, he said.
A virtual experience
Miller of Advanced Urology Institute would like to see more of a virtual patient experience.
“We are already seeing the beginnings with telemedicine,” she said. “However, I am aware of the limitations with what can be done over a camera. The implementation of any time-saving step is always desirable as society becomes more expectant of instant gratification and acknowledgement. I feel this can only be accomplished by IT processes and the additional transparency they can offer.”
Sterud of Faith Regional Health Services said the future needs to be something similar to an airline check-in process or self-checkout at a grocery store.
“While many patients and family members will prefer to meet with a person, there are many that would like a streamlined check-in process,” he said. “In the future, the patient would approach the facility and be greeted with an alert on their smartphone. They could check-in and be provided directions to their destination.”
Further, the patient experience doesn’t end when they leave your campus, he added.
“We need to provide an accurate bill that is easy to understand and an easy method of payment – app, portal, etc.,” he said. “This billing process needs to begin when the patient enters the facility and the charges need to be accurately estimated so there are no surprises at the end when they receive the bill.”
Uber and Lyft
Sarnecki at Children’s Hospital of Alabama is keeping an eye on what hospitals are doing with ride apps like Uber and Lyft.
“I come from Phoenix most recently, and in Phoenix there was a lot of experimentation around things like Uber and Lyft and taking the patient right to the hospital doorstep,” he said. “Medicaid was up to speed on paying for that and realizing the cost/benefit as opposed to doing bus transit and other things. Here we are watching where things go from a Medicaid perspective in Alabama. But there is a trend toward that.”
In this coming year, the hospital might be doing a proof of concept, he added.
The patient experience becomes even more important in the age of consumerism in healthcare.
Miller of the Advanced Urology Institute said that as government regulations change to try to value the quality of care, she believes the consumerism trend will increase to ensure the patient experience is an efficient and pleasant experience.
“We need to offer our patients a multitude of options for service to increase their experience through technology such as emails, portals, texts and telemedicine,” she said.
Healthcare is becoming more consumer-oriented and, in many ways, needs to be treated similar to the retail experience, said Sterud of Faith Regional Health Services.
“Patients will have more options and will select based on price, quality and experience,” he said. “C-suites need to be thinking about the ways they can impact these facets of the patient experience. Even in rural areas where there isn’t as much competition, executives need to be thinking about the experience in terms of reputation. A good or bad experience can travel very quickly and have an impact on the community.”
Branding and marketing the patient experience
What is becoming much more important is that the way a hospital brands itself is changing and the way things are marketed needs to change as well, said Sarnecki of Children’s Hospital of Alabama.
“The technology provides a number of new ways for connecting with the patient that we did not have in the past,” he said. “We’re no longer in the days of passive marketing where you put up a good brand and people come to it. Now in some cases you have to solicit and in other cases nab opportunity when it knocks.”
From an IT standpoint, the provider organization is looking to marketing in a different way.
“This marketing in terms of products, adapting an agile methodology, iterative building of a project as opposed to a multi-phase project, we are running that to the point of delivery of that something that is consumable,” he explained. “And what you probably see in a consumerism-based approach is a lot of proof of concept.”
Sarnecki said he may not know exactly what patients will buy, but he will target something and move on.
“We can alter quickly to go back and do what is needed,” he said. “We do a lot more proof of concepts and look to the proof of concepts to provide feedback for the next step to evolve the product. You will always need a marketing department; IT people are not marketers by nature, but there is an awful lot to be learned from people who know how to deliver a completed product to the consumer.”
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