by Jim Dwyer –
National Research Corporation recently reported that 80% of patients would switch providers for “convenience factors” alone. While every provider by now knows that the market landscape is changing rapidly, this fact points out just how much things are changing and how important convenience is to consumers. This unexpected market fluidity can be viewed either as a threat requiring a defense (“we must enhance our digital presence to keep patients”) or as a growth opportunity by providers looking to expand their market share. We believe “the best defense is a good offense” and that all providers should be looking to differentiate their service on consumer engagement, experience, and convenience.
To truly reach a competitive advantage, the modern healthcare system must compete against other providers and systems, but also against modern patient expectations. Customer expectations are established not by other healthcare encounters, but by their experience ordering from Amazon, getting a coffee from Starbucks, and traveling with an airline or hotel company.
A Digital Patient Experience
Imagine a visit scheduled in the morning on the way to work, pre-registration completed before arrival, an online wait time counter while in the office, and then checking out and paying any applicable copays while walking out of the office. What sounded far-fetched in our historic system of healthcare visits is used daily in multiple consumer industries and represents the experience and expectation of today’s consumer. When renewing your driver’s license is easier than scheduling and completing your annual physical, the opportunity for improving leveraging digital tools stands in stark contrast. Fortunately, tools exist today to enable a vastly improved patient experience – healthcare just needs to learn the lessons from the consumer, travel and technology industries.
Factors that influence patient experience can be grouped into four categories:
- Pre-Appointment (scheduling, reminders, travel)
- Appointment (check-in and registration, waiting room, rooming and provider encounter, checkout)
- Post-Appointment (follow-up and billing)
- Non-episode (wellness updates, communications, monitoring)
Providers are getting comfortable focusing digital strategies on easing scheduling, trying to speed registration and cut wait times, and simplifying checkout. However, patients now also expect immediate access, multiple real-time communication channels, and an app that brings it all together on their phone. Customers are comparing their Doctor’s visit to this morning’s Starbuck’s latte order on the way to work; not the multiple phone calls, paper forms, and telephone follow-ups of the past.
The patient experience starts well before the appointment, with:
- Online scheduling – The right mobile app platform allows patients to manage their appointments with self-service scheduling. This critical feature is already showing its value and use in the capture of new patients in the urgent and walk-in care market. Consumers often choose urgent care centers, in particular, for their ability to book online same-day appointments and pre-register for appointments. Traditional ambulatory offices are struggling to catch-up faced with the technical debt of legacy practice management systems coupled with the change management challenges of expanding provider schedules and availability. But the consumers who visit a convenient urgent care center will also be willing to switch providers when they find one that works the way they do.
- Telemedicine – The “entry point battle” for the initial appointment of a new patient is also facing the pressures from the telepresence industry and their ability to begin to offer immediate access. The use of online scheduling coupled with enhanced hours and availability is the minimum response and a critical, immediate strategic directive all providers must be actively offering and enhancing in 2020. Better yet, providers should start offering their own telephonic services, leveraging provider downtime and offering at-home services whenever medically integrated as a part of the overall patient relationship. Visits are faster, providers can see more patients, and the patients are happier when the trip to the office is dispensed with altogether.
- Online Pre-Registration – One of the most common complaints patients voice when describing their visits is filling out the registration forms and releases required for each visit. The ability to pre-register, particularly pulling existing data and asking for updates compared to asking for the same data each visit, rates as an area of high return for enhancing the patient experience. Integrated systems are making strides in this direction, eliminating most redundant and repetitive form-filling. But more can be done by adding other data sources and proactively prompting when those sources indicate possible changes in address or insurance or medical conditions.
Even in the appointment category, consumer convenience should start before they leave home.
- Wait-Time Notification – The waiting room is one of the single highest areas of patient dissatisfaction. Real-time wait-time updates and text notifications are an area where technology is being used to improve communication and interaction with the patient. Simply being able to provide an accurate measure of expected wait time and where the patient is in the queue turns the unknown wait time into an area to improve interaction and satisfaction. Many states now offer this feature for services like motor vehicle inspections and license renewals.
- Travel, Traffic and Weather Guidance – Providers can and should learn their patients’ preferences for travel to assist them in planning and making the trip to the office. For consumers with limited mobility, a truly integrated digital system will facilitate and assist them in getting an appropriate ride-share or specialty transport service. Even customers with cars and full mobility appreciate a time-to-leave notification taking into account weather and traffic conditions.
- Rooming and Provider Encounter – Digital engagement should not cease when the patient walks into the office. Displays in the waiting room should provide updated provider status and waits. Once the provider and the patient are in a room together, seamless digital convenience allows them to focus on signs and symptoms and having a productive relationship, instead of on paperwork and “administrivia”.
- Online Checkout – Building on the tools used for the online pre-registration, advanced systems are also implementing online checkout. Using the same app, patients can check out and pay their patient responsibilities while completing their visit. These tools require both integration with the billing system and the ability to collect payment from the patient with digital payments (e.g., ApplePay, Zelle, Venmo).
Digital tools support the consumer experience after an appointment as well.
- Pharmacy Integration – Modern data integration approaches allow providers to incorporate pharmacy communication as part of the unified digital experience. By now paper prescriptions should be a thing of the past, but beyond that, providers should know whether the patient is filling the prescription they received. Just as importantly, patients’ prescription renewals schedule for routine medicines gives the provider important information about their compliance with the regimen.
- Follow-Ups and Monitoring – How effective is after visit care today? This is an opportunity for automated reminders to both providers and patients to ensure the patient absorbed all treatment and care instructions and that the recovery is going as expected. Follow-up is also a situation where a telemedicine presence can eliminate unnecessary return office visits, replacing them with a check-in video call.
The bullets above describe digital tools that are leveraged to improve the primary interaction between provider and patient, at the appointment. But what about all the time between visits and interactions in the cycle of care?
- Intelligent Notifications –The advent of artificial intelligence in healthcare is helping to more quickly and efficiently identify gaps in care and recommended interventions and allowing for intelligent notifications to be pushed to the patient/consumer.A simple example is notifying a patient that has not had a physical in more than a year that they are due. But the tools now allow for far more valuable notifications. Instead of just notifying the patient they are overdue, why not augment the notification with:
- A reminder after a prescription with suggested dosage and frequency and a link to answer any questions
- Upcoming appointment availability based on the patient’s historical day and time preferences and medical need
- A “click to book” link that schedules the appointment in one click and offers to add to their calendars
- A pre-registration link to confirm all data before arrival with pre-visit fasting instructions
- An easy way to set and update reminder notification preferences
- A confirmed address with parking information and validated parking, along with instructions for public transit or ride-sharing where appropriate
- A link to their physician’s bio and system fast facts to build loyalty
- An online check-in function when they arrive at the parking area
- An estimated patient responsibility with an option to “pre-pay” (with the payment processed automatically at the conclusion of the visit)
- An integrated wayfinder tool to guide the patient from the parking area to the office
- Reminders and offers to complete, for instance, screening blood work and x-rays immediately before or after the physical, or a dermatology full skin scan to ensure a holistic visit with improved preventive care, not to mention to provide opportunities for revenue enhancement.
- Automated and Autonomous Communication – Chatbots provide 24/7 communications for simple questions around scheduling, collections, and initial screening with a hand-off to clinical personnel as needed. This instant chat capability is already leveraged extensively in consumer and technology segments and can bring the same immediate access and convenience the consumer enjoys in other environments into the healthcare realm.
- Integrated Prescription Refills – Calls about prescriptions represent one of the highest request volumes and the most frustrating experiences for the patient. At the same time, these calls are often straightforward to handle with and autonomous IVR systems and integration to pharmacy systems. These digital tools allow providers to automatically collect and document requests, as well as process simple requests for refills or pharmacy changes.
Patient Experience and Strategic Imperatives
For providers, the key strategic imperatives for the new Roaring ’20s are to:
- Improve the quality of care
- Improve care delivery efficiency
- Grow and build brand loyalty
The development of a differentiating customer experience through the use of digital tools is a critical foundation for meeting all three goals. Engaged customers are much more likely to play a positive role in their care. Each of the digital tools listed above allows providers to automate where possible and spend more time delivering care and expertise to patients.
And of course, a happy customer, enabled by user-friendly digital tools, is much more likely to stay loyal and evangelize for the provider that treats them like a valued partner.
Providers who embrace these tools will succeed with the 80% of patients that are willing to switch, at the expense of those who fail to seize this opportunity.