The White Elephant Of Patient Experience


Patient experience. On a daily basis there is an abundance of conversations, articles, and news feeds that discuss patients experience.

Yet what is patient experience?

The Beryl Institute defines patient experience as “the sum of all interactions, shaped by an organizations culture, that influences patient perceptions across the continuum of care.” (Beryl Institute Definition here)

In a 2010 Gallup Poll over 200 Healthcare CEO’s responded to a survey inquiring about the “patient experience.” Of those 200 respondents, 34% said that patient experience was their top priority. Almost 55% of respondents said that the patient experience was in their top 5 priorities. In the same survey, over 50% said that it would still be a priority 5 years from now.

Guess what? 5 years later, patient experience IS still in their top 5 priorities.

Yet for the past 4 weeks I have been doing my best to try and figure out what problem does patient experience solve? Why do so many CEO’s care? Why is it in their top 5 priorities? Why are there so many executives being named to positions of “Chief Experience Officer???”

What is the root of the problem.

Does the C-Suite really care about the patient experience so much that they continue to make it a top priority…..or is there something more?

Then it hit me. There it is. Sitting in the middle of the room. The big white elephant.

Dollars. Patient experience is all about the money. The cha-ching. The Benjamins. The cash. The moola. The coin.

In a recent Accenture report in the latest issue of it was stated that by the year 2019 there will be 986 Million appointments made digitally for healthcare. The average phone call to make an appointment today takes about 8 minutes. If the healthcare industry can move to performing those duties online, it can save the healthcare industry money. Big money. As in a savings of $3.2B.

Yes, that is a B as in Billions.

A portion of the way hospitals get paid for their inpatient services is via HCAHPS surveys. The survey measures the “patient experience.” The same survey methodology also impacts the performance of hospitals in Value Based Purchasing. For Value Based Purchasing, as an example, 30% of the Total Performance Score (TPS) for a Hospital is based on Patient Experience of Care Domain, which is measured by HCAHPS.

The survey is nothing more than a retrospective set of questions that do not have a direct impact to care. It doesn’t impact how you or I are cared for now, today, in the moment, when it matters the most. At best, our answers are only a set of  faceless numbers placed on a graph.

So now that dollars are on the table, and there are 27 questions that a majority of hospitals are asked, everyone now wants to focus on the “patient experience.”

It makes sense. It is the evolution of our economy.

Gas stations moved from attending to my needs and pumping my gas to allowing me to pump my own and pay outside in the cold. They market it to me as convenience, yet it is really all about taking cost out of their operating budget in running a business. ATM’s are the same concept. Instead of me having to go to a bank, I can now pull up and grab cash, or deposit a check, or buy stamps. It is for my convenience, yet it means less overhead for the banks.

Physicians want to treat patients. Patients want to have a relationship with their physicians. Yet the EMR, prescriptions via mail orders, central scheduling, benefit managers, and other “technological” conveniences do not add to the patient experience.

They may document, they may analyze, they may even appear to bring additional “conveniences” to both providers and patients, but in the end it is all in a movement to try and reduce overhead, to increase profits, and to make all of us feel better about taking on more.

That is, patients taking on more of the work, the burden, and the cost of care.

Last time I checked, patient experience is about people who are sick, in need, not feeling well, or experiencing a life altering change connecting with someone or a team that are there to help define their problem(s) and help them choose the best available answer(s).

The government, insurance agencies, healthcare systems, hospitals, and organizations can refer to “patient experience” all they want….but they are missing the point.

The balance is shifting. The tide is turning. If we are owning more of the dollars first spent, we want relationships. We want to ask questions. We want to be heard. We want to collaborate, add, edit, and revise our health, our care, and our decisions. We want to spend time with our physicians and our healthcare teams.

We do not want less time, we want more time.

We want that time when we need it the most, not when it is the most convenient to your process.

The problem that needs to be solved is time. Time is the most precious and costly commodity. Once it is given, it can never be returned.

You want to solve for time, answer it with real patient experience.

Everything else is just a box with a meaningless guarantee.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek



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