What do Disney, Apple, Southwest Airlines, Mayo Clinic, USAA, Amazon, Pandora, and Kaiser Permanente have in common? They all sell the same thing.
Whoa! That’s crazy talk. What’s that you say?
Yes, each of these organizations knowingly and deliberately differentiates and competes on customer experience. In fact, each one delivers the best customer experience in its respective industry, as measured by Net Promoter Scores.* Whether delivering immersive entertainment, personalized radio or healthcare, these companies make an emotional connection and engage their customers in extraordinary ways.
Within healthcare the importance of the patient experience cannot be overstated. Our personal health and well-being is synonymous with happiness and is manifest in our personal experience. For many of us, being sick, in pain or in fear for our life (or the life of a loved one) tends to heighten our perceptions and amplify every experience. It’s during such times when a kind word can seem like a grand benevolence, and the slightest oversight feels like a cruel insult. As such, providers should invest as much energy in delivering the best possible customer experience as they do in delivering safe and effective treatment.
Patient satisfaction is not patient experience
The Beryl Institute defines patient experience as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” Unfortunately, the standard method for measuring patient perceptions about healthcare is a collection of survey questions. Don’t get me wrong; we need a consistent method for assessing patient perceptions to make apples-to-apples comparisons between organizations. The Consumer Assessment of Healthcare Providers and Systems (CAHPS**) survey offers healthcare consumers and financers just that – information by which to make such comparisons. However, the subjective survey data alone is insufficient for providers to fully comprehend and then systematically improve patient experiences.
I won’t belabor the difference between patient satisfaction and patient experience here, but I will draw your attention to Fred Lee’s work on this subject. Lee aptly compares Disney with American hospitals in his best-selling book If Disney Ran Your Hospital: 9 ½ Things You Would Do Differently. I strongly encourage you to invest 17 minutes watching his funny and exceptional TEDx talk on the fundamental difference between patient satisfaction and patient experience.
It’s obvious from the varying responses below that there are a plethora of health IT issues affecting a number of areas in and throughout hospitals. In reviewing a number of healthcare issues, the following thought leaders offer what they feel are the top IT issues in healthcare.
As is often the case in profiles such as this, the responses are diverse and varied. Do you agree with their assessments?
I work with hospitals nationwide and I find that the top issues facing the hospital are:
1. How to align the interests of the physician with the hospital in a world where the hospital takes risk? Physicians used to get paid by “time and material” in the old world and the hospital got paid by “contracted costs.” The new reality has both the physician and the hospital getting paid a fixed amount to then manage the cost of healthcare on a “fixed price” for lack of a better word. IT challenges: The tools in the “time and material” world are unsuitable to manage the new reality in a “fixed price” world. This is a top challenge.
2. Real-time P & L — If you ask a hospital CFO what the profitability of the current patients in Unit 10, they would give you a blank stare. This is because the do not know what they are going to get paid (the DRG or diagnosis-related group reimbursement) much less what their current costs are. Thus, the lack of visibility into managing costs creates havoc. IT challenges: Systems that can develop a view into costs and projected revenue require a lot of specialized people to provide the information even in hospitals that have a partial solution. Most hospitals do not know where to turn for new ways of thinking. This is a big IT challenge.
Doug Nebeker, owner and technical expert, Power Admin LLC Staying on top of compliance and auditing tasks is a top issue facing hospital IT departments today. As more and more data moves into the digital space, IT departments can easily become overwhelmed as staff gets bogged down with the tedious task of trying to keep track of what’s happening where in the system. Network monitoring software is seeing a boom as a result, quickly becoming an IT necessity for managing increasingly complex network auditing and compliance processes. Technology is meant to help, not hinder, and so as we continue to utilize it in new ways we must ensure our process management keeps pace.
Hospitals and other healthcare organizations will always have the need to exchange “unstructured” data. While there is a large focus on meaningful use, ICD and other mandates, many hospitals and organizations are not taking into account the need to quickly, affordably and securely transmit unstructured data while also staying HIPAA compliant. One of the main issues is that public cloud services are not HIPAA compliant. Healthcare organizations can work around this by extending their existing fax server solutions to the hybrid cloud, allowing both custom and popular EHR applications to communicate with each other via a private secure network, guaranteeing delivery with military grade end-to-end encryption. By eliminating the need for costly and cumbersome network fax systems, such as fax boards and recurring telephony fees, hospitals can leverage the hybrid cloud to swiftly manage all business-critical fax communications while staying HIPAA compliant.
David Finn
David S. Finn, CISA, CISM, CRISC, ISACA professional influence and advocacy committee member, health IT officer, Symantec
Healthcare is undergoing fundamental changes in reimbursement, care delivery models and the technology required to make these changes. Technology and information is no longer an adjunct to the business of healthcare — it is a strategic imperative. This information, however, is among the most regulated and protected information under the law. The data must be shared more widely with more people and organizations, all the while with stricter security and privacy controls. At a high level, the most critical issues facing health IT are:
1. Security and Privacy
Healthcare, historically, has not invested in nor staffed appropriately in terms in of Privacy and Security. Providers and business associates need to catch up with other regulated industries and those targeted for the value of their data.
2. Data Management
The digitization of healthcare has led to the massive collection of data. As healthcare becomes more dependent on this data, the storage, protection, back-up and recovery of the data is critical. It must include disaster recovery/business Continuity.
3. Interoperability and Information Exchange
Affordable Care Organizations (ACO), health information exchanges (HIE) and new care delivery models (home care, remote monitoring and other requirements) will drive information exchange.
Day 2 at HIMSS14 was much the same as day 1: Lots of walking, talking and great meetings with great organizations. I can’t thank enough vendors like Verisk Health, Omnicell, Amazing Charts and SAS for the great information they’ve shared, and for the perspectives about the market, trends and what’s ahead (and what’s behind).
Electronic health records are now foundational, and in many cases, they’ve lost their sex appeal. Though there’s an obvious and huge presence by them here, this year’s HIMSS doesn’t seem to have the same energy around the technology, from my point-of-view, that they did two or three years ago, for obvious reasons. Though their importance is still great, as we all know, other issues are taking center stage. ICD-10 is the obvious elephant in the room.
“Risk” is the biggest buzz word I’ve heard here in Orlando. I’ve heard it dozens of times. “Patient engagement” seems overcooked, according to those I’ve spoken to; an aspirational concept, yes, but actionable in an an entirely different story. Lofty goals and strategy, fewer practical best practices approaches for proceeding.
Patient engagement has only just begun, or at least is just developing past its infancy, and I look forward to seeing how it matures as a concept. Remember, just a couple years ago, those with vested interest claim patient portals would solve the ever elusive patient engagement issue. Portals clearly have not done so. Why would they? I remain skeptical that the actual patient is at the heart of this conversation rather how a systems can implement “best practices.” We’ll see, I suppose.
That said, HIMSS14 remains a wonderful experience and I’m glad to be here and meeting some wonderful people. I look forward to what today brings. Likely, more walking!
The following is a list of organizations I’ll personally be visiting with at HIMSS14, along with several others. Each has a compelling story and I’m looking forward to learning more about them.
Any thoughts on who you think I might be missing, or have overlooked?
AirStrip provides a complete, vendor and data source agnostic enterprise-wide clinical mobility solution, which enables clinicians to improve the health of individuals and populations. With deep clinical expertise and strong roots in mobile technology and data integration, AirStrip is empowering the nation’s leading health systems as the industry continues to evolve to new business models, accountable care and shared risk. Based in San Antonio, Texas, AirStrip allows health systems to unlock the full potential of their existing technology investments with a complete mobility solution that provides access to critical patient data across the care continuum. AirStrip is backed by investments from Sequoia Capital, Qualcomm, Inc., Hospital Corporation of America (HCA) and the Wellcome Trust. AirStrip’s customers includes HCA, Texas Health Resources, Vanguard Health Systems (part of Tenet Healthcare Corporation), Dignity Health and Ardent Health Services.
Allscripts delivers the insights that healthcare providers require to generate world-class outcomes. The company’s Electronic Health Record, practice management and other clinical, revenue cycle, connectivity and information solutions create a Connected Community of Health for physicians, hospitals and post-acute organizations.
Axial’s products improve the quality of patient care, and reduce the cost of providing it, by credentialing the most qualified providers, delivering point of care decision support tools, and utilizing a 360-degree cloud-based predictive model to stratify risk and quantify outcomes. Axial furthers the IHI Triple Aim of driving healthcare value by developing cost-effective, quality-based treatment pathways combined with seamless IT and workflow integration.
