Health systems look to mend fractured consumer experience

MINNEAPOLIS—When Terry Shaw's wife was still in a hospital bed recovering from a car accident, a nurse handed her a packet of discharge instructions several inches thick.

The packet included recommendations to follow up with three physicians. But finding an outpatient neurologist who would treat a car accident patient was even difficult for Shaw, CEO of Adventist Health System.

“I pulled in every favor for two straight months before I could get this figured out. It was crazy,” Shaw said at Modern Healthcare's Consumerism Symposium July 11-12 in Minneapolis. “That process frustrated me so much, I said, 'We are going to stop behaving like this as a healthcare system.' ”

That process is symptomatic of a healthcare industry that has largely been unable to meet consumers' expectations. Confusing charges fill surprise bills. Appointment wait times span weeks or even months. Nearly every part of the process is complicated.

This deters people from getting care and often ends up costing providers more in the long run. “We are really bad at making it easy for people,” Shaw said, adding that healthcare is 10 years behind other industries. “Waiting three months to see a doctor is unacceptable.”

A group of health system and physician group executives shared with symposium attendees how they plan to change that. Shaw touted Adventist's app that allows patients to quickly pull up lab results and other medical data as well as schedule appointments. The health system also assigns care navigators to the most acute patients to help figure out insurance coverage, transportation and nutrition plans—even how to combat loneliness, an often-overlooked factor in one's health, Shaw said.

What consumers do in between appointments is as important as the medical data, said Sven Gierlinger, chief experience officer of Northwell Health who has worked for the Ritz-Carlton Hotel Co. “If we capture that information, we are truly building a lifelong relationship,” he said.

Providers should remove what doesn't add value to the consumer experience, including the tediousness of registration and booking an appointment, Gierlinger said.

Some health systems are eliminating waiting rooms. Others are waiving co-pays if consumers didn't have a good experience or offering free follow-up care after surgeries. Many are turning to telemedicine to facilitate a two-way conversation or setting up shop at old shopping malls to offer more convenient access points. More are working directly with employers to streamline the process.

If consumers have to come to an office, many providers are partnering with ride-hailing companies to cut down on missed appointments. More health systems are offering out-of-pocket price estimators to prevent sticker shock.

“How do we transform as a business that has traditionally been built around hospitals and instead create an integrated care ecosystem that has a common platform by which our patients interact with us?” asked Dr. Henry Capps, chief operating officer of Novant Health's physician network.

Some providers set up GPS wayfinding systems in their hospitals akin to Google Maps. Real-time tracking technology uses staff member badges to put a picture of the clinician on the TV when they walk in, so patients know who they are talking to. Sensors in the floor alert staff when a person is walking around or has fallen.

“How do we in healthcare quit being so self-referential?” asked James Hereford, CEO of Fairview Health Services, adding that great companies start with the consumer. “How do we appeal to a generation focused on immediacy and ease of use and create a system that is responsive?”

Hereford said that healthcare organizations need to stop putting patients in the middle of the “administrative merry-go-round.”

But providers are caught between two worlds. About $7 billion of the roughly $10 billion in revenue at Adventist is tied up in brick-and-mortar facilities. That dynamic speaks to the struggle systems have moving from how things always operated to a more consumer-oriented approach, Shaw said.

It's all about shifting control, said Dr. Jeffrey Le Benger, CEO of Summit Health Management, a New Jersey-based physician group. “We have to get away from brick and mortar,” he said. “It's going to be the network that controls the system, and the physician will have the control of that network.”

Hospitals and health systems could free up capital for more staff by outsourcing real estate management or selling part of their property, said Sylvia van Loveren, senior vice president of the real estate management firm JLL.

“Know that you are sitting on an untapped resource to bring strategies of patient engagement to life,” she said.

But health systems have had trouble adapting, in part, because training and changing culture is hard, particularly when consumers have different expectations.

And consumers have differing expectations for their healthcare experience. Some want to control all parts of the process, while others want to let pros take the lead. Employee engagement is key, said Preston Gee, vice president of strategic marketing at Christus Health. “If employees aren't engaged, then it's game over,” he said.

But while health systems are trying a variety of ways to reach the consumer, be more transparent on pricing and make care more accessible, most efforts fail to address the core reason why care costs so much. Costs have been skyrocketing, inflated by rising administrative costs, a lack of coordination and unnecessary care. “Waste is everywhere in healthcare. No one gets a pass,” said Nance McClure, chief operating officer at HealthPartners. “Price and affordability is the pain point. We have to figure out how to do a better job on price transparency.”

But providers—outside of a group of forward-thinking health systems—are not making significant strides in adapting to evolving consumer needs, according to a new survey from the consultancy Prophet.

While they have been able to incrementally improve specific pain points in the healthcare delivery system, they struggle to change the entire experience, Prophet researchers found. That's partly due to the outdated way healthcare measures patient satisfaction, argued Jeff Gourdji, partner at Prophet.

Only 23% measure relationship metrics like net promoter score, which gauges customer loyalty and is often a more telling measure than hospital consumer assessment scores. “The dominant form of patient satisfaction metrics is pretty transactional,” Gourdji said in an interview with Modern Healthcare. “They're not getting at the nature of consumer engagement. We need to change that.”

Still, Gourdji said he is optimistic because things are moving in the right direction.

Ultimately, widespread change will only occur as healthcare organizations develop more personal, human-to-human relationships with consumers, Adventist's Shaw said. “We have to own it and make it easy for people,” he said.