In late summer of 2016, Sacramento, the city I call home, opened a new arena to keep the NBA’s Sacramento Kings from leaving the city. The investment in the arena included cutting edge technology, with the backbone to support emerging technologies, and had the Golden One Arena named the ‘highest tech stadium in sports’.
An evening at the arena includes the ability to purchase basketball tickets and parking passes online, a notification as you approach the arena directing you to the lot that has the most open spaces, mobile display of your ticket on your phone or smart watch for entry, digital guidance to your seat, and once there, the ability to order food and drinks which will be delivered to you within a few minutes. For someone who hates to miss even one moment of the game (or concert) this is magical. The stadium owners looked at the wants and needs of their customers and optimized every point towards ease of use and convenience. It is the experience I have come to expect and find myself disappointed when visiting other venues.
The argument in healthcare over whether we are patients, consumers, customers, or some combination of all three has been ongoing for several decades but is vitally important at this time due to the rise and adoption of technology and the fiscal limitation of dollars to be invested. Today’s population in the United States is connected to technology, utilize it in every waking moment of their lives, and expect the same improvements in their interactions with healthcare as they have experienced with the ability to purchase basketball tickets online.
Improved patient care is always named as the primary driver for investment in healthcare dollars, whether it is in the purchase or upgrade of technology to streamline care, expanding service offerings, developing new treatments, changing the payor system, or expansion/renovation to a facility. Assessing and anticipating the needs of patients has always been a challenge for healthcare providers, and with the exponential growth of technology and the digitization of everything, it could be easy to lose sight of the changing expectation from the biggest asset any care provider has, your customers.
We have seen great improvements from hospital systems and care providers using technology to improve the patient experience, from patient portals to home monitoring, to posted wait times at the physician’s offices and hospital emergency departments (EDs). This focus on patient experience – inviting them to take a more active role in their healthcare – is moving in the right direction. While the big buzzword at the moment is Artificial Intelligence (AI), and building and developing technology infrastructure with an eye to the future improved by AI is vital, providers would be remiss focus on unproven technology when the simplest route to retaining your most valued asset is to invest in technology that invites participation and improves experience and outcomes.
A big mistake I see happening as I sit in meetings with clients is the assumption that the ‘elderly’ will not adopt technology, and do not expect these amenities. As I am writing this article, my 83-year-old mother is texting me from her iPhone, and the coming wave of those considered ‘elderly’ have been adopting technology for the last twenty years. Aging baby boomers and Generation X’ers are your new patient base. Here is what they are expecting from you.
Seven areas for patient experience improvements.
1. Efficient patient “workflow”
When implementing technology, much attention is paid to the workflow of the physicians and clinicians. Every attempt is made to improve upon outdated and cumbersome workflows, and to maximize efficiencies for those providing healthcare. This is important, and efficiencies ultimately benefit the patient with increased productivity and accuracy from providers. This is also a logical place to start in improving consumer interaction with your facility by truly understanding your patients’ workflow. What steps do they have to take to get an appointment, travel to your facility, find the department or wing they need to be in, register, depart, pay their bill and receive results? Any one of these areas can be points of frustration or barriers to access. A thorough understanding and the will to make improvements are vital to the success of your organization or practice.
2. Ease in scheduling
Scheduling any appointment over the phone is an exercise in frustration for both the patient and the scheduler. The back and forth over dates and times becomes so time consuming that many will take ‘next available’ and then worry about how to fit the appointment into their life. Having a true patient scheduling portal for routine care and appointments frees your scheduling staff to take the time with patients who need guidance for more complicated procedures or simply have more questions. The technology is available to have a real-time calendar with appointment slots to choose from, and a large amount of the data required for registration can be collected at this time as well.
3. Ease of access - transportation, parking and electronic access
Without reliable transportation, patients are more likely to miss preventative primary care appointments, which can lead to more costly services at a later time. The rise and adoption of rideshare services can be a boon for providers with high appointment cancellation rates. For patients who drive to your facility, parking can be confusing and distances to services can be a challenge for those who are not in optimal health. By having an app or using email, providers can deliver clear and concise directions and maps to their patients, customized to where in the institution they are being served.
Another way to ease access to healthcare is to adapt technology that allows patients to be ‘screened’ before coming to your office. Many minor conditions could be mitigated by allowing patients to securely send images from their smart phone, (what is this rash?), or via video conferencing. Keep the flu season healthier by letting those suffering stay home and out of your waiting room.
4. Patient experience- Wait times and other annoyances
The last time I visited my primary care provider (PCP), there was a sign in the lobby notifying me of a thirty-minute delay in appointment times, with the offer of waiting, rescheduling, or of leaving my phone number to be texted five minutes before the physician would be available. I happily chose the latter and went to an adjacent coffee shop and got some work done while waiting. This simple gesture showed that my time was as respected as the physician’s, and probably garnered them a patient for life. I was also able to fill out all forms digitally prior to arrival, which made checking in and avoiding the dreaded clipboard all the easier.
5. Transparency in pricing
None of us would drop our car off at the shop without an agreement for a service estimate prior to any work taking place, and this same rationale is emerging in the healthcare market. With the rising cost of insurance premiums, deductibles and co-pays individuals seeking care are price shopping. Being able to provide an accurate cost for an office visit, a lab test, or a procedure and being willing to negotiate cash payments are becoming a necessity for every provider. Healthcare consumers are no longer handing over their bills to insurance companies with the assurance that most of the cost will be covered, and the perceived ‘gamesmanship’ of healthcare entities to be vague about pricing will no longer be tolerated. Walking patients through pre-certification when required is necessary and supporting your patients in the case of insurance denials is of the utmost importance to consumer satisfaction.
6. Quality metrics
I cannot remember the last time I went to a restaurant without checking either Google or Yelp reviews. I want to know ahead of time what to expect- how was the food, the service, has anyone gotten food poisoning, etc. I like to know the dress code, peruse the menu, and see pictures as well as hearing first hand from happy and unhappy customers alike. A bad review will not necessarily put me off as I can rate and rank responses myself. Providing outcome metrics to patients can help them in their decision to utilize your facility, whether it is low post-operative infection rates, the speed of lab results, overall patient satisfaction scores, or low average wait times, just to name a few. Encourage patient feedback and do not be afraid of a negative review- that is your chance to make things better.
7. Free the report
Last, but not least, is primary to imaging and testing services. I had a mammogram in early December last year and did not receive results until mid-January. Being a former mammography technologist, I know that the reason we delayed delivering results was usually because there was something wrong and we either needed priors to verify the abnormality or needed to contact the PCP prior to contacting the patient for further imaging or biopsy. I was fairly certain they were waiting until after the Christmas holidays to tell me I had less than three days to live. Fortunately, it was ‘just a technology glitch’ in getting my report from the facility to the provider. Your patients are adults. Let the imaging facility send results as soon as they are ready. I understand the argument for patients getting bad results out of context, but we all get bad news we are not prepared for. Having the results before the follow-up appointment gives one time to digest and process the information and come up with a list of coherent questions that do not come to mind in the face of a diagnosis.
The next generation of healthcare consumers is here
Healthcare entities that realize the next generation of consumers is already here will be far ahead of the curve in tailoring the patient experience. The seven areas above are merely the groundwork for all that lays ahead. The adoption of wearables, the expected connectivity of everything, the implementation of home monitoring devices, the speed of transmitting information, the involvement of the patient in cost, efficiency, treatment and outcomes create new demands for delivery of service, and expanded opportunities for those ready to implement them.
About the author:
Barbara Smith is a partner at Paragon Consulting Partners, providing subject matter expertise and project management for radiology, mammography, and enterprise imaging projects of all shapes and sizes. Having worked in radiology for more than 20 years and IT consulting for almost 10 years, she brings relevant clinical and operational experience to health IT initiatives.