Patient Experience is a real thing, finally

The HITECH Act created an immense opportunity for healthcare providers with the appropriate tools and culture to thrive by engaging with patient. There are example after example where organizations are skating quickly towards who the payor is becoming, the patient. Couple the rise of mobile devices with the advent of organizations like The Leapfrog Group, Accountable Care Organizations (ACOs), and the creation of Health Savings Accounts (HSAs), and it’s now incumbent upon health systems to provide a quality patient experience before, during, and after care. It takes a village to do healthcare right. With the patient quickly becoming a larger payer of the reimbursement pie and Uncle Sam incenting for quality care, the organizations that enable patient satisfaction through quality patient-provider relationships and technology are ultimately the ones who will be rewarded with delivering care in the future.

A quick detour down memory lane. I mentioned the HITECH Act previously, and from that was born Meaningful Use (a.k.a. MU or, more recently, Promoting Interoperability) and a series of alternate payment models (APMs) which began to tie reimbursement payments to quality outcomes aggressively. Before MU, healthcare providers were not required to document patient visits electronically, at least to get reimbursed by CMS. So, engaging with patient’s electronically surrounding their care was far and few between dating back to Hippocrates. To expect healthcare organizations to instantaneously know how to drive patient NPS scores due to legislation is unrealistic.

The aforementioned payment and outcomes models have aggressively shifted the business dynamics of healthcare. Patients are becoming more financially responsible for their care through high-deductible health plans (HDHPs) and healthcare providers more financially responsible for reducing utilization. Unfortunately, the data show that financial incentives are a stop-gap measure to prompting engagement in healthcare. Engagement happens when patients and their support systems have consistent lines of communication with their provider, understand their care plan, and can easily access resources for help. The proverbial Nudge towards behavior change.

To be sure, healthcare is hard. Considering the true determinants of health and our health literacy, it’s not hard to understand where the most significant potential for impact rests. However, given the realities of collecting self-pay balances, healthcare organizations steadily realize that increasing patient-provider communication, verifying a patient’s understanding of their care plan, and efficiently exchanging medical histories across healthcare eco-systems leads to higher patient engagement. Consistent engagement around the costs and quality of work leads to better outcomes.

It’s more clear than ever that healthcare is not immune to consumerization, it just took longer to arrive. Technology adoption happens over longer time periods and information assimilation is more asymmetrical than any other industry. Efficacy is pretty important when your outcomes are another person’s life. So, how can healthcare organizations skate towards the rise of the new consumer and payer more effectively?

Providing care to patients is the highest of callings and one of the most challenging professions in the world. A patient’s relationship with their healthcare provider is the that a patient develops with their healthcare provider and is the single greatest driver of their overall experience. By that virtue, culture is the singular most important aspect of any organization’s success. Seth Godin outlines three pillars of being indispensable (Generous, Dignified, and Humane), all of which make up what anyone should ask for in a healthcare provider besides talent. Hiring individuals who embrace empathy inherently is critical to creating and sustaining culture. However, hiring for empathy is undoubtedly a very difficult thing to do. Really, how can you measure something like empathy?

The type of care you receive also tremendously impacts the patient experience. Different support systems will be in place for the varying degrees of care provided. I.E., going in for lip injections will not require the same follow-up as a co-morbid 65-year-old. Whereas, now that millennials are becoming parents, the requirements for pediatric facilities to take a multi-modal approach to engagement with parents is even more critical. Millennials are the first generation to grow up in the digital era. You can believe the right text message, at the right time, to the right person will continue to evolve and drive patient satisfaction. Quality organizations understand who their patient population is and play into those strengths.

So, culture is a linchpin for creating a quality brand. What is an effective technology adoption strategy for engaging with patient populations? As an up-and-coming consumer of healthcare, it’s unfortunate that HITECH created mismatched agendas and did not require a common programming framework for healthcare software programs from the jump. The nation’s healthcare communication channels (EMRs, HIEs, Patient Portals, etc.) are a patchwork quilt at best right now. However, as I alluded to earlier, text messaging seems to be the most preferred way of communicating with patients today. Much like our banking industry allows us to access our money from almost any terminal in the country, text messaging is ubiquitous across telecommunications carriers. The question then becomes, how can we take better advantage of the technology that virtually every patient has in their pocket today?

To be sure, numerous other quality communication tools built within the patchwork quilt are paramount to organizations communicating longitudinal patient histories, scheduling appointments, getting consent forms signed, etc. The patient portal is to patient engagement what the glove is to the hand in baseball. And, despite all the misgivings about data blocking, Epic is the only EHR vendor that creates a unified patient experience as long as you operate within their community of providers. Other organizations have realized the importance of communicating across multiple healthcare ecosystems and developed vendor-agnostic patient portal tools to satisfy that demand.

Building a care setting with healthcare providers that give a darn and are enabled to communicate with their patients efficiently through technology will be beautiful to the next generation of healthcare consumers. Consumers who will be armed with their own money (HSAs and HDHPs), the best mobile device in history (thanks to Moore’s Law), are beginning to make up the largest population of healthcare consumers in US history. So, who will create a technology-enabled environment with healthcare providers that give a Nudge?