The Challenge of Patient Experience

Much is being written these days on patient experience as a critical part of the value equation (value defined as patient safety, quality outcomes and patient experience divided by cost/price point).  

The Beryl Institute’s current definition of patient experience – “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions, across the continuum of care” – seems a reasonable definition.

I never really thought much about the patient experience portion of the equation until recently.  I view patient experience through the lens of my wife, who has been treated for an acute, then chronic condition over the last eight years.  She has experienced active and ongoing treatment with three health systems:  a national/regional specialty/research hospital, a widely-regarded academic medical center and a regional healthcare system.  (Why three different providers?  It all comes down to employer insurance coverage and the economic choices the employee is forced to make!  Don’t get me started on this issue – it’s a blog for another time.)

The patient experience in each of these three settings has been radically different.  But why should one’s experience vary so much?  Granted, these are three different organizations with varying ways of organizing, managing and providing care, but why should they be so different?

My wife can report on so many examples of suboptimal hospital/physician/patient relations out there it sometimes boggles the mind.  Here are a few examples:

• You get an email from your provider telling you there is an important message for you on your patient portal.  You go there, knowing the site has always been difficult to navigate, and can’t find any new message.  Was it important or not, and how would you know if you can’t find it?
• You get the first appointment of the day so you can come in, get your outpatient treatment early, get out and go to work.  You sit and wait while the employees stand around, drink coffee and discuss what they did over the weekend in front of you, until they are ready to get their day going (not your day, their day).
• You access the highly touted email services of your physician in the hospital’s medical group and send them a message regarding a prescription issue.  The reply arrives several days later.
• You call up your primary care provider for an appointment, someone you have seen for almost twenty years, and are informed over the phone that she has already retired and another physician is taking over her practice.  No communication; not even a letter in the mail!

You will notice that these examples are not clinical in nature, per se – there are plenty of examples of those as well.  The point is that, if patient experience is the sum total of all interactions, then the smallest and seemingly most insignificant example can negatively impact one’s overall perception.  If a billing practice or an appointment screw-up is indicative of how a provider runs its business, then doesn’t this also reflect negatively on its clinical care?  It shouldn’t, but unfortunately, the perception is that it often does.

As cardiovascular services professionals, how many of these examples do our customers (patients or physicians) experience each day?  We must be vigilant, lest small issues negatively reflect the overall experience.  Take time regularly to look at interactions from the perspective of your customers – you may find small tweaks that can have major impact on their perceptions.   

My wife is the ultimate “mystery shopper.”  You know, the person that is paid to go into an organization as a customer and report on how she was treated?  She is a healthcare manager with many years of experience and can spot a flaw in the system or poor communication a mile away.  She is a sophisticated consumer.  Can you imagine what the perception of most healthcare consumers would be in the same situation?

Perception is reality for most people.

As always, CFA welcomes your comments, suggestions and questions.