By Randi Redmond Oster & Kathleen Cattrall
Today, customer experience is considered the new battlefield to increase sales and 89% of companies expect to compete mostly on the basis of customer experience, up from 36% just four years ago.1
Patient experience is no different: 92% of hospitals cited reduced reimbursements as their greatest threat2 because they are being measured and rewarded based on patient satisfaction surveys.
If the healthcare industry is to improve its scores in this area, it has to follow through on its promise to really listen to the patients. How can you help physicians in their communications with patients?
In our work, we often hear patients say, “My doctor makes me feel stupid.” “I don’t get enough time to absorb what the doctor is telling me.” “I feel like it’s the doctor’s decision, not mine.” “The doctor’s office rushed to schedule surgery before I had a chance to think about it.”
Most doctors’ appointments are scheduled for less than 20 minutes. That’s not enough time to fully absorb all that medical information, let alone ask questions. And that shows in patient survey results. According to Hospital Compare, a website of the Centers for Medicare & Medicaid Services, only 52% of patients strongly agree that they understood their care when they left the hospital.
TIME SPENT WITH PATIENTS
Medical information is complicated and patients are unfamiliar with the terminology.
Getting a diagnosis is personal. Patients have questions. Treatments often require behavior and lifestyle changes. Each patient has their own values, preferences and goals that need to be incorporated into the best treatment solution for the individual. Coping with new realities, learning terminology and patient and loved one’s emotional states are just a few of the factors that we find complicate and color the patient’s evaluation of their experience. All this in an appointment that lasts less than 20 minutes.
HOW TO HELP DOCTORS HELP PATIENTS
Are you preparing the doctors and hospitals to be ready for their new activated patient who wants to feel knowledgeable?
Last year we conducted a survey of patients and their loved ones around this concept of “feeling knowledgeable” and we learned that when they felt “stupid,” they also felt “ill-advised,” and that they thought they had made rash or unwise decisions about their treatment. Whew! That’s a ton of regret to live with, especially if you’re making the decision for a loved one and your loved one has to live with the consequences.
The Help Me Health study led us to a deep understanding of what patients mean when they say “I want to feel knowledgeable.” Feeling knowledgeable has three dimensions.
Help us be fully informed: We want to know all that is relevant to our situation in a way that we can understand. We also want our healthcare professionals to provide trusted sources of information so they can review and research on our own at a later time, when we are ready, emotionally, to explore the diagnosis.
Help us feel understood: One of our study participants (we’ll call her Maria) told us her OB/GYN’s office sent her a long questionnaire prior to the first appointment. But at the appointment, Maria handed the questionnaire to several people who said, “Oh, the doctor will take that.” Maria handed it to the doctor—who tossed it over to the side of the desk and never referred to it, saying “Oh, that’s something the office sends out to all new mothers. I don’t use it.” Maria never went back to that practice.
What if the questionnaire was online with links to your company’s educational site appearing as questions are answered? The links would provide the necessary education for this stage of Maria’s pregnancy and prepare her for the questions she felt necessary to ask her new doctor. What if, at the end of completing the questionnaire, a “preparing for your first appointment” worksheet appeared?
Help us feel educated: Third, “feeling knowledgeable” means feeling educated. Mark, one of our survey respondents, said, “I want time to process the information the doctor gives me. Even after 15 minutes with the doctor, I want to step away, think about it, absorb it, do more research if I have to, discuss it with my wife. It’s how I make important decisions at work. Why would this be any different?” Again, an opportunity for companies to help the patient process the information, and assist in doctor/ patient communication.
Here are just a few suggestions on how to help us be informed, understood and educated:
• Create well-designed point-of-care (POC) marketing efforts can help promote effective discussions between doctors and patients that result in patients feeling knowledgeable. Sorting through and choosing the right POC tactics and messaging is key to maximizing your POC budget
• Identify patient personas for your product. Personas are fictional characters represented by detailed definitions and illustrations of your typical patients and their loved ones. The best personas define patient wants, needs, fears, aspirations and decision-making styles. While personas can be created by interviewing doctors, nurses, receptionists and nursing assistants, you’ll get more accurate information by speaking directly with patients and their loved ones. Randi and Gary, for example, each needed different information and guidance. What Gary got was a cartoon brochure, not appropriate for a 15 year old. Randi was handed a photocopied handout that scared her to death. Use your patient personas to guide your decisions about what doctors need to help them communicate with patients so that patients feel knowledgeable.
• Decision making tools. Like the three ring binder Kathleen’s geneticist used (see below), design collateral material that reveals information in layers
• Time-saving tools like checklists. Help doctors and patients make the most of the time
• Combat all the questionable information that patients discover on their own.
• Translate and define medical terms
• Conduct patient focus groups. What information do they want? How much information do they process at any given time?
• Engage patients in focus groups, rewriting, editing or reorganizing information
• Co-create. Tap into the creativity and needs of patients to develop your informational handouts, videos and apps; in your co-creation sessions, make sure you have all of the personas represented
• Whenever possible, customize warnings
• Organize information into digestible chunks. Have you bought an appliance or a tech product in the last 10 years? Quick Start Guides are standard now. What do you need to know right now to get the product working?
• List trusted websites/links or patient support groups
• Design for today’s technology. How and where you present information can be as important as the information. Patients and their loved ones want to be able to access information that is dynamic, interactive and available on demand. Design communication that can be presented on tools like tablets, kiosks, wallboards and other digital devices.
If there’s one lesson to be learned from this list, it’s “Resist the temptation to be content-centric; instead, evaluate the needs of the patient and loved ones personas and build out from the “patient-centric” perspective.
FOR US, IT’S PERSONAL
Both of us came to this advocacy due to experiences in the healthcare arena that made us feel significant changes were necessary.
Randi’s son, Gary, has Crohn’s disease, and at his appointments felt that the doctor was delivering clinical information without any attention to patient needs or the emotional toll it was taking on the family. Gary was often in great pain, and Crohn’s has no cure – just medications to keep it under control. The only other option is surgery to remove diseased intestine. When the doctor suggested a new medication and offered literature on it, Randi saw the phrase “increased risk of lymphoma.” She began to think of this as “the cancer-causing cure,” but got little reassurance and not much time from the doctor.
Kathleen’s sister had been in hospice care with breast cancer. Kathleen had done a lot of investigation to try to understand her own risk factors. Her mammographer had also suggested gene testing for the BRCA1 and BRCA2 gene mutation3 , and shown Kathleen a book she had compiled of charts, diagrams and drawings of normal and mutated genes. She explained how cancer can be caused by mutated genes passed down through the generations. Only 5-10% of breast cancers in the U.S. are linked to an inherited gene mutation, and Kathleen didn’t meet the criteria. She decided not get the test. But because of this experience, she felt empowered and confident to make the decision. It was the work of that mammographer that indicated to Kathleen how patient communication could be handled properly.
Randi Redmond Oster is founder and president of Help Me Health™ whose mission is to transform how healthcare thinks about the patient experience. She is also the award-winning author of Questioning Protocol, which helps patients navigate the healthcare system and medical professionals understand the patient perspective. Randi spent the first 18 years of her career at GE working on complex aerospace systems and building profitable financial services businesses. The skills gained at GE empowered her to effectively navigate the healthcare system for her son, find opportunities for process improvements for hospitals and launch Help Me Health.
Kathleen Cattrall is Chief Experience Officer of Help Me Health. She is a customer experience trailblazer credited with establishing new standards and methods for companies dogged by customer challenges. She believes that the experiences customers have with companies offer economic value in the same way that a company’s products offer value. And she’s proven it with the results she gets for her clients. Her reputation as a subject matter expert in the customer experience space makes her a sought-after contributor to Forrester Research white papers, for blogs, and as a speaker.
Help Me Health
Help Me Health transforms how healthcare thinks about and delivers patient experiences to achieve better outcomes and a better bottom line. Our solutions help hospitals create large-scale patient-focused culture change. www.helpme-health.com
1 Gartner Research 2015
2 HealthLeaders Media 2013 Report on Patient Experience Beyond HCAHPS
3 American Cancer Society. Breast Cancer Facts & Figures, 2015-2016, 2015. See more at: http://ww5.komen.org/BreastCancer/LowerYourRiskReferences.html#sthash.