Healthcare Experiences Aren’t Satisfying Patients

I recently wrote an “Expert Opinion” article on the 1to1 Media site called Patients Have A Soul. It looks at the need for healthcare professionals to improve the patient experience. That article also included a couple of new data graphs that I want to also post on this site.

The first graphic looks at satisfaction with different groups in the health care system. About three-quarters of consumers are very satisfied with their doctors and nurses, but only about half are that enamored with their health plans. And only two-thirds of patients are happy with the overall experience. So there’s a lot of opportunity to improve!

The second graphic looks at overall satisfaction of consumers at different ages. Clearly, satisfaction increases with age. Only 57% of the youngest group are fully satisfied with their medical experiences while 83% of the oldest feels that way.

The bottom line: My diagnoses: Patient experience has a chronic problem

10 Lessons From Asheville: Healthcare, Wayfinding And More

I was recently in Asheville, NC to speak with a group of customer service/experience executives from large health care companies. We decided to add on a few days to the trip to spend some vacation time in the city. Here are some of my thoughts from the trip:

  1. Biltmore Estate is worth a full day. We visited the Biltmore Estate, which is owned by the Vanderbilt family. With 240 rooms, it’s the largest home in America. It is a beautiful property; we had a great time. The tour of the house was spectacular; with lots of details about what it was like to build and live in this house over the decades. I was particularly struck by the detail in the ballroom and the fact that it has an indoor swimming pool and a two-lane bowling alley. The grounds are spectacular as well. We walked more than a mile through the gardens and grounds that were manicured by Frederick Law Olmsted, who designed Central Park in New York. As if that was not enough, the estate also has a winery (fun to taste, but we didn’t love the wine) and an adventure center. It’s a must-see attraction.
  2. Wayfinding is not a lost art. The self-guided tour through the Biltmore Estate was considerably enhanced by an extremely well-designed flow. As you walk through the building, the signage clearly marks where you are and where you need to head next. The guide book, which provides an easy to read paragraph about each room, uses numbers that correspond to signs in each location — so there is never any confusion about connecting the description with the location in the house.
  3. Chronic care requires more experience design. A lot of the structure of health care was built to deal with acute issues, but the world is shifting to be more about ongoing care of chronic issues. This shift requires people to have a more lasting and deeper set of interactions with the health care system. As this happens, experience design will become an increasingly important component of overall health care success.
  4. The Grove Park Inn is spectacular. We stayed at The Grove Park Inn in Asheville, which is a magnificent site. The hotel lobby is on the top floor and overlooks the mountains. There are places all over the hotel to grab a rocking chair and hang out with great views. The hotel is full of Arts & Crafts mission style furniture, which is one of our favorites. I only wish I had time to try out the golf course that looked fantastic.
  5. Doctors will become more experience-minded. During my session, we discussed getting doctors to care about experience. Yes, doctors are not the easiest population of people to influence. But the entire health care system is changing and doctors will increasingly care about things beyond just diagnosis and treatment — especially younger doctors who are entering a different environment. The key to getting doctors to “care” is to relate patient experience to some of the things that they do care about. There’s research that shows that better experience leads to better medical outcomes (they care about that) and it also leads to better word of mouth and utilization of facilities (which leads to more money to invest n research and medical equipment, which they also care about).
  6. Delta messes-up the little things. I’m a Gold Medallion member of Delta’s frequent flyer program. One of the benefits that the airline touts for this level (and higher) is early-boarding, which shows up as “Group 1″ on our tickets. However, in about half of my Delta flights the gate agent calls out Group 1 with other groups (e.g., Group 2 and Group 3) — eliminating the “Group 1″ benefit of early-boarding. Also, on our flight from Atlanta, the airplane sat on the runway for 45 minutes before take-off, but the pilot never bothered to give us any status during that long wait. As I’ve said in the past, good experiences often come down to these little things.
  7. Emotion is a critical component of patient experience. We’ve identified three components to an experience: Functional, Accessible, and Emotional. When it comes to healthcare, the emotional element is even more important than it is in many other industries. So companies need to understand how to design experiences to deliver the desired emotional response — and measure themselves against that goal.
  8. Noise is not the same as the perception of noise. One of the things that the attendees were struglling with is the noise in a hospital at night. It’s one of the areas that is negatively affecting their Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores. While they were discussing ways to minimize the noise levels, I urged them to also examine options for lowering the patients perception of the noise levels. For instance, if they made a point of explaining that it might be a bit noisy, explaining what causes the noise (keeping track of patients), apologizing in advance for any inconvenience, and offering ear plugs — then the patients would likely have quite a different perception of the noise levels.
  9. Asheville is a great destination. What a gem. The airport is right outside the city and the Asheville area is full of lovely vistas, good restaurants, and many, many interesting artisans. Here’s a piece of art that I found particularly meaningful.
  10. There’s hope for healthcare experience. The group of healthcare executives with whom I spoke, who are part of The Leader’s Board, are focused on important elements of healthcare experience. They are struggling with the same types of things that we see in other industries like measurements, customer feedback, and employee engagement. As long as groups like this continue to wrestle with these issues, and help their organizations master customer experience competencies, then the healthcare system will definitely improve the experiences that it delivers.
The bottom line: I enjoyed Asheville; personally and professionally

Health Plans Fail On Customer Experience

Forrester’s 2010 Customer Experience Index (CxPi) ranks 133 firms across 14 industries. I recently analyzed the results of the nine health plans in the CxPi. Here are the overall results:

Some interesting tidbits from the research:

  • Health plans were the worst scoring industry for the third straight year.
  • The average score across health plans was the same as it was in 2008, a “very poor” 51%.
  • Kaiser was in top place again, although it dropped a bit from 2008.
  • The public plans, Medicare and Medicaid, had the largest improvement.
  • Anthem (BCBS) and United Healthcare dropped the most since 2008.

The bottom line: Health plan customer experience needs resuscitation.

Can Health Plans Provide Better Member Experiences? Yes!

I was a speaker at Microsoft’s Health Plan Executive Forum in Jacksonville, Florida last week. As you might expect, I talked about customer experience.

Dennis Schmuland, MD, Microsoft’s Health Plan Industry Director kicked off the morning with a video that showed how current and planned Microsoft technologies would revolutionize the healthcare experience — for both patients and providers. It was pretty cool; like something from a Sci-Fi movie. You can see the video posted on Microsoft’s HealthBlog.

Next up was Anthony Nowlan, Chief Medical Officer, CentriHealth, Inc., and former Director of the NHS Information Authority. He gave a great speech called “Organizing Health Care in the Information Age.” He started by walking through the history of healthcare starting in the 1800s. It turns out that one of the key problems that we have today is that our current institutions (hospitals, labs, etc) were created in a period where the primary issue was acute care. As Dr Nolan said, “patients came in, got treated, and then they either got better or died.” But in today’s environment, the majority of costs come from chronic care. And you can’t solve the current problem with the old institutions; consumers need to be more involved. So his speech focused on how to use electronic health records to reorganize the healthcare system.

My speech was titled “Health Plan Member Experience: From Enraged To Engaged.” I borrowed some material from Liz Boehm (one of Forrester’s healthcare analysts) to show that member experience was becoming more important for health plans. One of the reasons is that cost containment for chronic care requires some behaviorial changes. But consumers don’t trust health plans for basic interactions, never mind listen to their wellness and disease management recommendations.

I then showed some of my research on customer experience, loyalty, and satisfaction. Here’s a small snapshot of that information:

  • Health plans came in last place out of 9 industries in our Customer Experience Rankings; and were also lowest in each of the individual areas: useful, usable, and enjoyable.
  • The highest rated plan in the rankings, Kaiser, only ended up 75th out of the 112 firms we examined.
  • 40 year-olds give health plans the lowest customer experience ratings.
  • Seniors give health plans the highest customer experience ratings.
  • Health plans have the lowest rating for satisfaction with online interactions and virtually tied for last place in satisfaction with phone interactions.

Of course, I couldn’t leave the attendees without a path to follow. So I explained how they could use Experience-Based Differentiation as their blueprint for improving customer experience.

After the presentation, one of the participants asked a good question: “Can we (health plans) ever have satisfied members, since we need to reject many of their claims?” My answer was “You can absolutely raise satisfaction levels. While you may never be as enjoyable as Borders, there’s no reason for interactions with health plans to be any less useful or usable than with any other industry.”

The bottom line: Health plan member experience is a chronic problem, but it’s curable.

(P.S. I don’t generally write about my work with specific clients, but Microsoft approved this blog post)

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