Remember the Patient

tags: HealthIT, patient, patient portal
created: Sat 24 September 2016; status: published;

In Healthcare IT we are often focused on the internal aspects of running large Healthcare System. We focus on the operations at a clinic level. We focus on the EMR interface for providers and staff. We think about Meaningful Use, claims, and government incentive programs. We focus a lot on ourselves and often forget the largest concern: the patient.

I would (and will) argue that by not optimizing the patient experience, healthcare organizations are overlooking valuable cost savings and better patient outcomes.

Burden: Lack of Online Scheduling

To state the obvious: I can book an appointment with my hair stylist. I cannot with my doctor. Doctors are protective of their schedules and reluctant to open it to direct booking. The medical system thinks in terms of Encounters yet the first step of an Encounter - the patient arranging to visit the provider - has zero online facilitation.

CMS is encouraging openness and patient engagement through Meaningful Use incentives, yet the very first engagement step are only accomplished with a phone call and a protracted calendar negotiation. This is not an efficient use of anyone's time and a burden to the patient.

Burden: Arrival and Checkin

That dreaded clipboard when you as a patient walk into the clinic for an appointment! It is paper so the patient in 2016 suspects it is not recorded in any permanent way. The paper is blank, so the patient knows the staff did nothing in preparation for their visit and happily treats them as a nobody.

With small effort, the forms would be pre-filled from previous visits and only need updates or corrections. The time savings for both patient and staff are massive and change the whole process from a raw data-entry process to a review-accept workflow.

From a patient perspective: Why does the staff not know who I am and my family history since I have been here four times in six months? Blank clipboard forms are a burden to patients.

Burden: Excessive Communication

In a desire to measure outcomes and efficiency, clinical staff are calling patients to survey them on outcome and satisfaction. In fact, the individual staff of every group a patient interacts with calls that patient once, maybe twice. An outpatient surgery can trigger a dozen calls from staff about the patient's satisfaction with the registration desk, the billing team, information packet/farewell team, insurance provider, and others.

Excessive communication has become a serious problem for patients. Medical systems seek to measure their performance and incentivize patient surveys which all happens without regard to the patient herself. No group is monitoring the fact a patient has been called for a survey already and preventing further calls.

Patients are being overwhelmed by the satisfaction surveys, health advisories, and marketing communications they are being bombarded with.

The result of just these three areas is not patient dissatisfaction. It is patient anger. It is patient frustration. Patients wonder why their time is so little valued. Do you not ask yourself, when needing to arrange an annual physical for your child or a wellness visit, "why has this process not gotten better in the last century?" We should all be asking that question and driving our organizations to improve by treating the patient better.