Healthcare consumers are demanding the same level of price transparency for medical care they have in other transactions—particularly as healthcare moves away from a fee-for-service model and patients are responsible for larger portions of their medical bills. Meanwhile, as of January 2021, federal regulation requires health systems to make their service charges publicly available. The healthcare industry, however, hasn’t historically succeeded with consumer-grade price transparency. Organizations must now figure out how to bridge the gap between their costs and patient charges. Doing so requires comprehensive understanding of all the costs behind a service and consumer-friendly explanation of how these expenses translate into prices.
Patient Experience, Engagement, Satisfaction
While patient access challenges have been ongoing in healthcare, COVID-19 further stressed access infrastructure. Stay-at-home orders, temporary halts on in-person primary visits, transportation challenges, and more resulted in deferred or missed care. Meanwhile, pandemic-era workarounds, such as a shift to virtual care, have pushed a more digitized patient experience. As healthcare consumers and providers increasingly relying on touchless and asynchronous processes, health systems are discovering opportunities to improve patient access and the overall experience.
With the following five steps in a patient access improvement framework, organizations can scale and sustain innovations and lessons learned during the pandemic:
Create a patient access task force.
Assess barriers to patient access.
Turn access barriers into opportunities.
Implement an improved patient access plan.
Scale and sustain better patient access.
Juggling financial demands, uncertain healthcare legislation, and COVID-19 can distract healthcare leaders from the most important aspect of care—patients. Delivering patient-centered care in this volatile market can be challenging, especially when traditional healthcare methods (e.g., in-person visits) are on hold. These sudden disruptions to routine care have highlighted the importance of keeping patients at the center of care, whether care delivery is in-person or virtual. Health systems can manage competing priorities, adjust to pandemic-induced changes, and deliver patient-centered care by focusing on three strategies:
Improve the patient experience.
Implement the Meaningful Measures Initiative.
Transition in-person visits to virtual.
While most consumer-oriented industries have turned to mobile-first, cloud-based platforms for consumer interaction, healthcare lags behind in digitization, particularly when it comes to self-service consumer engagement. As digital consumer interaction increasingly drives enterprise success, healthcare must join the modern digital playing field. To get there, organizations need to establish digital investment and enablement frameworks and can then follow five strategies for stable, scalable transformation:
Formally define “digital” for the organization.
Follow 10 guiding principles to support digital.
Divide technology into appropriate portfolios.
Develop an analogy to explain the integrated portfolio approach.
Strategically select vendor partners.
After a tumultuous 2019, healthcare organizations are pivoting to make sense of the latest changes and prepare to face the top 2020 healthcare trends:
Consumerism—Can health systems respond to the consumer demands of better access and price transparency?
Financial Performance—With mergers, acquisitions, and private sector companies entering the healthcare arena, how will traditional hospitals and clinics compete?
Social Issues—How will health organizations respond to the opioid crisis and consider social determinants of health as part of the care process to provide comprehensive treatment?
As health systems struggle to survive amidst constant change, they must look forward and proactively prepare for what’s to come in 2020.
Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim.
But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:
Use patient satisfaction as a balance measure—not a driver for outcomes.
Evaluate entire care teams—not individual providers.
Use healthcare analytics to understand and act on data.
Leverage innovative technology.
Improve employee engagement.
This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.
Customer journey analytics uses machine learning and big data to track and analyze when and through what channels customers interact with an organization, with an aim to influence behavior (e.g., buying behaviors among retail customers). Similarly, healthcare organizations want to influence health-related behaviors, such a taking medication as prescribed and not smoking, to improve outcomes and lower the cost of care. In a partnership with an analytics services provider, a payer organization is leveraging customer journey analytics among healthcare consumers to identify the best opportunities and channels for patient outreach. With this analytics-driven engagement strategy, the payer has found an opportunity to significantly improve patient engagement—a predicted overall increase from 18 percent to 31 percent.
Health systems are challenged by the need to keep patients and employees satisfied and engaged. This can be especially difficult for organizations in flux, growing, merging, and changing. And as leaders of these organizations know, poor patient satisfaction ratings lead to reduced reimbursements, which affect the bottom line.
To meet this challenge and improve patient satisfaction, health system leaders are taking advantage of technology, such as rounding software, that supports effective communication and drives the type of culture change that boosts both caregiver and patient satisfaction and encourages engagement. Embedding rounding technology into current processes makes rounding better and easier. The correlation between effective, efficient rounding and high patient satisfaction scores is clear. Rounding can and does increase engagement and satisfaction, which in turn leads to higher reimbursement potential. Learn how health system leaders can move from talking about rounding technology to incorporating it into daily workflow.
Health systems attempt to measure an ever-increasing amount of clinical measures, these often miss the mark of what matters to patients. Patient-Reported Outcomes (PROs) are the missing link in empowering patients and helping to define good outcomes. This article walks through how patient-reported outcome measures (PROMs) can help identify best practices and drive system-wide quality improvement. PROMs can help health systems do the following:
Serve as a guide for appropriateness and efficiency.
Lead to better shared decision-making.
Demonstrate value and transparency
This article also discusses the effect of PROMs on providers in a culture of “one more thing,” and tips for effective implementation.
Overcrowding in the emergency department has been associated with increased inpatient mortality, increased length of stay, and increased costs for admitted patients. ED wait times and patients who leave without seeing a qualified medical provider are indicators of overcrowding. A data-driven system approach is needed to address these problems and redesign the delivery of emergency care.
This article explores common problems in emergency care and insights into embarking on a successful quality improvement journey to transform care delivery in the ED, including an exploration of the following topics:
A four-step approach to redesigning the delivery of emergency care.
Understanding ED performance.
Revising High-Impact Workflows.
Revising Staffing Patterns.
Setting Leadership Expectations.
Improving the Patient Experience.
Every day, healthcare professionals face the challenge of determining how to get patients to make good healthcare decisions and follow recommendations. The Four Tendencies framework, developed by The New York Times bestselling author Gretchen Rubin, can make this task easier and improve patient compliance by revealing how each person responds to expectations. By asking this question, healthcare practitioners can gain exciting insights into how patients respond to expectations to in order to help them achieve their goals.
This report covers the following:
An overview of each of the Four Tendencies.
An understanding of how these tendencies can affect behavior in a healthcare setting.
Practical tips for working with patients and colleagues that fall into different tendencies.
We know that patient engagement has a powerful effect on outcomes, but we haven’t yet truly harnessed patient’s power. Maureen Bisognano, former president and CEO of the Institute for Healthcare Improvement (IHI) discusses the effect of patient engagement across the IHI Triple Aim: improving the experience of patient care, improving the health of populations, and lowering costs.
She shares examples of how increased patient engagement can help improve healthcare outcomes and deliver a better care experience while reducing costs. Such examples from her experience in the field include how lessons from the “flipped classroom” can be translated to healthcare, how technology can improve patient accountability and decision making, and other impactful stories.
It might be a bit of a leap to associate quality data with improving the patient experience. But the pathway is apparent when you consider that physicians need data to track patient diagnoses, treatments, progress, and outcomes. The data must be high quality (easily accessible, standardized, comprehensive) so it simplifies, rather than complicates, the physician’s job. This becomes even more important in the pursuit of population health, as care teams need to easily identify at-risk patients in need of preventive or follow-up care. Patients engaged in their own care via portals and personal peripherals contribute to the volume and quality of data and feel empowered in the process. This physician and patient engagement leads to improved care and outcomes, and, ultimately, an improved patient experience.
According to the Robert Wood Johnson Foundation, health equity is achieved when everyone can attain their full health potential and no one is disadvantaged from achieving this potential because of social position of any other socially defined circumstance.
Without health equity, there are endless social, health, and economic consequences that negatively impact patients, communities, and organizations. The U.S. ranks last on measures of health equity compared to other industrialized countries. Healthcare contributes to this problem in many ways, including ignoring clinician biases toward certain populations and overlooking the importance of social determinants of health.
Fortunately, there are effective, tested steps organizations can take to tackle their health inequities and disparities (e.g., incorporating nonmedical vital signs into their health assessment processes and partnering with community organizations to connect underserved populations with the services they need to be healthy). Some health systems, such as Allina Health, have achieved impressive results by making health equity a systemwide strategic priority.
What do the best care management teams in the industry have in common? They engage and empower their patients to play a leadership role in their healthcare. After all, patients without the skills to manage their care incur costs up to 21 percent higher than engaged patients.
Engaging and empowering patients as the most important members of the care management team makes sense on many fronts—as health systems assume more responsibility and financial risks for patients’ outcomes and costs, there will certainly be more interest in expanding the role of patients in their care.
This blog explains why engaging patients like 68-year-old Abdel not only instills a gratifying sense of empowerment, but also improves outcomes and controls costs—the many benefits of an effective care management team.
A comprehensive care management program organizes many moving parts into an efficient workflow and brings order to the complex, often messy, world of healthcare. Care coordination harmonizes the workflow of clinicians, patients, family, social workers, and therapists, to name a few. It facilitates medication reconciliation, care compliance, appointment scheduling, and communication with patients, as well as engagement between patients and the care team. Care coordination concentrates on the highest-utilization, highest-cost patients to produce better clinical, operational, and financial outcomes, the bottom line goals for healthcare systems involved in population health and value-based care.
This article details the benefits of, and barriers to, care management and coordination, their role in population health, and the technology that’s helping to automate this area of healthcare.
Patient engagement is critical as we move toward population health—as patients who engage in their own care by following medical recommendations and making healthy nutrition and lifestyle choices will have better outcomes and experiences.
There isn’t, however, a clear path to successful patient engagement. Fortunately, public health can lend several established principles that may help us better involve patients in their own care:
Using systematic, population-level solutions that require less individual effort.
Engaging patients on interpersonal and community levels as well as personal.
Identifying root-cause, assessing and capitalizing on strengths, and engaging stakeholders.
Using strategies from behavioral economics to help individuals make good choices.
Anticipating failure and learning from it.
Good patient care means patient-centric care. Relying on good mentors during residency training, physicians can learn how to put patients first. For example, during one rotation of mine, I saw a mentor consistently use humor and expertise with patients to connect with them and help them change their environments at home. I was also part of patient-centered teams that worked together to identify potentially life-threatening conditions, and intervene to save lives. We can put people before projects and be patient-centric.
Patient engagement is the cornerstone of effective patient-centered care teams. But what if care teams could do more than engage patients? What if they could turn these patients into care team leaders?
Patient-centered care teams can transform patients into proactive leaders who have the knowledge and motivation to take ownership of their health by following four key recommendations:
Make decisions using data.
Make it personal.
Make it easy to share information.
Leverage new technology when appropriate.
In what often feels like a fragmented system, patient-centered care teams provide a personalized environment and care continuity. And while patient engagement is a top priority, leveraging predictive analytics to move beyond engagement to empowerment will lead to better health outcomes for individuals and entire patient populations.
Patient satisfaction metrics are being put in the spotlight and are becoming more important as healthcare organizations transition from fee-for-service reimbursements to alternative payment models. While healthcare and the entertainment industry may seem disparate on the surface, there is much organizations can learn about improving the patient experience from companies like Disney who utilize data to understand their customers’ wants and needs in order to provide a superior guest experience. Disney creates the idea guest experience in 5 ways: 1. Understanding the guest; 2. Everyone is a performer; 3. Seeking out interactions; 4. Owning the guest; and 5. Accountability
With the major shift to value-based care sweeping across the U.S. landscape, healthcare organizations are looking for ways to significantly improve their patient satisfaction metrics. Thibodaux Regional Medical Center has done just that by creating a culture of patient-centered excellence. Their formula includes three key promises that have become the heart and soul of their operations: (1) provide great clinical care, (2) provide great emotional care, and (3) invest in great technology and processes.
Cleveland Clinic wanted to improve their patient satisfaction scores, so they put the patients first and at the center of everything they do. Health systems may believe they’re already prioritizing their patients’ needs, but in reality, they may not be addressing the real issues. To uncover this information, health systems must dig into their patient satisfaction scores and analyze all of the data, including patient comments, anecdotes, and verbatims. Armed with these insights, they’ll be able to drive effective improvement initiatives and improve their scores, just as Cleveland Clinic did.
Technology is growing at an exponential rate and while healthcare has experienced some effects of this, nowhere is this more evident than in the field of health sensors. The Internet of Things is the idea of an ecosystem of devices that connect to software giving feedback and analytics on the person or object using the device. Clinically, this can mean improved monitoring of vital signs, infusions, etc. Outpatient care is also affects by sensors and has the potential to lower the annual costs of managing chronic diseases.
Would customers go to a restaurant where they didn’t how much they owed until 90-days after finishing dinner? From workflow to customer service, see how a restaurant would operate if it were run by healthcare. Then ask yourself – why do we put up with this in healthcare if we don’t have to?
The Rule of Rescue has held particular significance in the United States where the importance of the individual has long been a part of our cultural fabric. In the U.S., we tend to count ourselves as not fully human unless we pull out all the stops. Increasingly, however, healthcare ethicists and policymakers are asking whether this same moral instinct to rescue, regardless of cost, should be applied in the emergency room, the hospital or the community clinic.