Healthcare lags other industries in this key consumer strategy, and it’s negatively impacting outcomes, cost and loyalty.
Industries outside of healthcare have studied and prioritized customer engagement relative to conversion and retention for years. Data-driven strategies such as “onboarding in the first 48 hours because churn is highest during that time” or “launch a customer success plan and outreach within an hour of after signup” are commonplace in tech, banking, hospitality and other industries. In healthcare, we are just starting to form committees, assign senior roles and research onboarding initiatives. As such, a pressing question we often field is: what is the experience of a “customer” when they schedule a visit with a provider?
Anecdotally and based on our secret shopping data, patients typically have to do the following to schedule an ambulatory visit with your system:
Step 1: Guessing what the right service line (physician, APC, urgent care, virtual visit) to use, assuming they understand all the service lines you offer.
Step 2: Searching website(s) to pick a provider with little guidance on which provider is best suited to their needs, often defaulting to selecting based on gender, location or university.
Step 3: Calling a central scheduler and spending 15 minutes on the phone reviewing insurance, etc. and getting (at least) “3rd next available” for the provider they requested with little to no guidance if this is the right provider or if another provider or service line can meet their needs sooner (based on need, insurance, risk, value based contract, risk of no show, risk of ER usage, etc.).
Step 4: Receiving a standardized, impersonal packet of papers in the mail outlining practice policies, no show fees, and several medical history forms.
Contrast that to your last experience purchasing a good or service from another industry – the customized experience, ease and speed of scheduling or completing the transaction, and time to follow up or orientation to other complementary or necessary goods and services available.
We recently conducted a patient survey inquiring about the onboarding experience across all types of ambulatory provider visits. The survey respondents represented 42 states and were 53% female; respondents ages 18-44 were more heavily represented (4:1) over those 45+, likely representing a higher percentage of commercial insured, although we didn’t ask that question specifically.
Here’s what we found:
• 62% of patients said they received nothing from the practice/ health system prior to their visit
• Not surprisingly, and in stark contrast to what patients currently experience, 95% of respondents indicated that personalized information sent pre-visit would be helpful.
• 50% of patients who received some type of communication got a phone call or snail mail; it’s hard to think that was impactful given that most research shows less than 20% of people listen to their voicemail anymore. An alarmingly low connection rate when the cost per call can be upwards of $7 each. And snail mail?! When was the last time you got excited to read something you received in the mail? Chances are it was when you were waiting to circle everything you desperately wanted in the toy section of the Montgomery Ward catalog. (Yes, you now know my age.)
• Now here is where it gets more troubling. If you oversee growing a service line, market growth or patient retention, you can just read this part:
o 80% of respondents feel like they know the different ambulatory service lines you offer [Advanced Practice Clinicians (APCs) versus physician visits, Urgent Care versus Emergency Room, Telehealth, etc.] and when/ how to use them appropriately. I know, my head just exploded, too. How can that be when all we see is the poor adoption of APCs and telehealth. Furthermore, 80% of patients believe they are using the ER appropriately over primary care and urgent care options? I was recently in the ER of a health system here in Chicago, and based on my observations of those waiting with me and the 6 hour wait I endured for a necessary CT scan, I can assure you that is not true. It’s not a coincidence that the data my company is analyzing from that system validates it. This is precisely why patients need a personalized onboarding experience and guidance. Patients think they know what to do when, but we can quite clearly see in the data, they do not.
• The patients you are looking to add and retain in your system are absolutely looking for a different experience. Less than 25% of patients ages 18-44 believe they are onboarded and welcomed to a physician practice like they are in every other industry where they consume services (retail, travel, personal care, etc.).
Patients expect a personalized onboarding experience and it’s time we, as healthcare leaders, catch up. But that isn’t our only motivation. Engaged patients are not only loyal, they are prepared for, and participate in, their visits which can have lasting impacts on their outcomes and total cost of care. Effective onboarding is one tool to help you accomplish that goal.
Reach out if you want to learn more about how Upfront helps health systems execute personalized onboarding programs.