The longitudinal patient journey

Nov. 11, 2016

A wide range of platforms and solutions exists today for collecting patient data within and outside hospital systems, and yet hospital and health systems remain far behind other industries in actually using experience data to deliver a high-quality, modern consumer experience. Increasing competition, transparency, and patient empowerment are quickly driving healthcare organizations to get much smarter about gathering and leveraging data to create experiences that are more like Ritz-Carlton and less like the IRS. What forward-thinking organizations are learning today about creating data-driven consumer experiences, and making the required cultural, technological, and staffing changes required to deliver those experiences, will dramatically change the way patients feel about healthcare.

Lack of data is not the major obstacle to delivering a better patient experience. EMRs with detailed clinical information and history are ubiquitous; hospitals perform many varieties of rounding and collect important first-hand feedback from patients. Other processes collect and manage data from the grievance process – third parties administer CAHPS, and other surveys gather retrospective feedback from patients and family members. Social media reviews offer another important, often untapped, source of feedback.

Despite this veritable wealth of information, health systems are unable to build a complete picture of experience and preferences on any given patient. Data is siloed in incompatible formats and locations, and health system executives lack tools to effectively discern trends at a patient population level. The result is that most initiatives to increase patient engagement and satisfaction are based on anecdotal and out-of-date information.

Improving our ability to understand and adapt to direct, specific patient feedback is foundational to the strategic effort underway across the United States to make the experience of healthcare more consumer friendly. Healthcare organizations are looking to the more sophisticated practices employed in other industries to craft experiences that attract and retain lifelong customers. Healthcare brands can learn a great deal from the successes of organizations such as Apple and Disney in looking at the broader consumer experience –
capturing real-time data, driving continuous improvement, and arming staff with tools, training, and tactics to make patients feel valued and listened to.

One example of a persistent source of dissatisfaction for healthcare consumers is waiting for services longer than they deem fair or necessary. Hospitals have clear data to measure this: When a patient is taken to surgery or the imaging lab, existing hospital systems accurately capture arrival and departure times. But, in most organizations that information is not accessed or acted upon today, so long delays or wait times go unaddressed and patient discontent is unresolved. Sadly, healthcare consumers are accustomed to inconveniences and oversights such as this. In services experiences in other parts of their lives, however – hotels or restaurants, for example – they expect a long delay to be acknowledged, and expect an apology for it. There is no real barrier to hospitals delivering exactly the same type of proactive service – the data is all there. What’s missing is the mindset to identify when target service levels are not being met, and processes to respond appropriately.

The wait-time example illustrates the kind of data-driven “tweak” that is well within reach for most hospitals. The fact that this kind of improvement is rarely implemented is less because of technical constraints than a belief structure in many healthcare organizations that only clinical outcomes matter. As organizations seek to build cultures focused on the consumer experience, they need to think about their customers the way other consumer-centric organizations do: longitudinally. Great brands know that the brand experience is about far more than a transaction, it’s a journey that starts long before purchase and continues long after.

Hospitals can start to create the same kind of coherent consumer narratives by gathering and analyzing more comprehensive patient information and feedback data: What does this individual patient like, dislike, and care about? Further, they can then aggregate that data to draw insight about what different groupings of patients report as being satisfying or dissatisfying. This allows the kind of data-optimized approach that looks beyond individual clinical experiences, and lets the organization treat the patient as a person travelling one of many possible clinical journeys, defined as much by the individual’s specific demographic profile, preferences, and personal history as by the specific clinical treatment they will receive.

Take the “journey” of a middle-age knee-replacement surgery patient who has been to this hospital in the past. We can intelligently craft an experience for this patient that combines things we know about him individually, and the preferences of other patients with a similar background. We can look at his past experience and pull that data forward to inform the new journey: Did he have a good experience with anesthesia in the past? Has he expressed any specific concerns and fears? Do we know of any specific sports he participates in to anticipate his questions and needs around physical therapy? Based on these data points, this patient’s journey could include such customized interactions as a pre-surgery discussion of how he will get his knee ready for tennis again, and suggestions for a physical therapy location near his home that specializes in sports recovery.

This scenario is very different from the typical consumer experience of care today. The big change is starting to think about the patient’s experience as a journey that begins long before – and ends long after – the hospital visit, with opportunities throughout to capture data and modify service accordingly. Once organizations adapt to this way of thinking, they can access and understand data that is already available, derive specific actions and approaches appropriate to each patient, and give staff tools that guide them through delivering a very focused, personalized service that will be far more satisfying to patients and staff alike. With proper training and technology, they can also start to gather much more useful real-time satisfaction and sentiment data throughout the journey to support better process improvement as well as interventions that happen in-stay, not weeks or months down the road.

Leading U.S. health systems have been pioneering the shift toward this kind of longitudinal perspective, focused analytics, and data-driven transformation of traditional service delivery into a modern consumer experience. They have found that the key to success has been to continually expand on their use of relevant patient data to keep refining their understanding of preferences, fears, and family concerns, as well as group-level insights into patient needs and sentiments. Their data indicate a kind of “biorhythm” of patient sentiment over time that correlates to specific clinical events, and that tailoring interactions to these rhythms can yield tremendous benefits for both patients and health systems.

Another important finding that seems to be indicated by these efforts is that hospitals may need to employ new kinds of staff to balance patient experience with clinical efficiency. Today, nurses often deal with many patient concerns relating to their non-clinical needs. While these interactions are critical to ensuring a positive experience, highly trained clinicians may not be the most efficient staff to handle such issues. In the hospitality industry, staff receive very specific training, and are given the autonomy and information needed to personalize a great experience. In mapping this strategy onto healthcare, health systems can employ different kinds of staff to address their patients in ways that they have come to expect based on interactions with other consumer-oriented industries, without putting an undue burden on their clinical teams.

Healthcare is an industry poised for a consumer revolution, and patients are already demanding that their health experiences be tailored to their needs. For health systems to accomplish this goal, they must unlock the experience data sources in their walls, invest in analysis, and craft longitudinal patient journeys based on the similar needs of patient groups, yet customized to each individual’s situation and history. Marrying clinical excellence with state-of-the-art consumer experience and service, delivered by specially trained staff, will be the key to meeting the demands of today’s emerging consumer healthcare market.

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