Patient expectations are changing rapidly—and your approach to patient experience should follow suit. Learn how the right data can help you elevate patient experience and improve delivery of care.
When it comes to patient experience, the stakes are higher than ever. As healthcare providers move past the COVID-19 crisis and look to the future, it’s clear that many of the changes made during the pandemic are here to stay, ushering in new ways of doing business for providers and new expectations for care from healthcare consumers.
Patients are looking for updated protocols from providers and healthcare systems: they want seamless technology, the utmost in cleanliness, and a customer-first attitude. Providers are responding. From large hospital systems to multi-specialty practices, forward-thinking healthcare organizations are updating patient journey maps to account for different touchpoints and considering how new protocols and technologies affect the patient experience. The shift is significant—in our research of healthcare industry professionals,* 84% said that understanding patient experience is now somewhat or much more important than before the pandemic. That number is even higher among the healthcare executives in the group, at 88%.
In this new era of patient experience, determining what’s working, what isn’t, and adapting quickly is the next frontier. According to Joe Kvedar, MD, professor at Harvard Medical School and editor of Npj Digital Medicine, now, perhaps more than ever, is the time for healthcare providers to use the tools at their disposal to understand patient behavior, patient expectations, and patient satisfaction—and to quickly act on that understanding.
The pandemic prompted many organizations to focus more heavily on patient experience: 28% of healthcare executives we surveyed say they’ve started asking patients for feedback more often. However, simply asking more questions may not be enough. As the landscape of healthcare shifts, both your approach to tracking patient experience and the tools for assessing it need to keep up. Here are 4 steps to take.
In the post-COVID environment, patients are more willing than usual to switch caregivers. Poor patient experiences have ramifications: according to a 2020 consumer health experience study by Accenture, 64% of patients are likely or highly likely to switch to a new health system if their expectations are not met regarding sanitary and safety protocols, access to up-to-date information, and the availability of virtual care options. With higher-than-normal levels of patient churn, having comprehensive and customizable data-gathering solutions at an enterprise level is crucial.
“Everyone is competing for patient loyalty, but as they do so, they need to start asking different questions,” said Lewis Mattison, managing director and founder at healthcare consultancy Mattison Advisory. While 63% of healthcare executives we surveyed report using CAHPS® and HCAHPS® surveys to capture patient feedback, these standard surveys aren’t enough. “If you're trying to practice for a 3-mile race and you only run 3 miles every single time you train, you’re going to be a very average runner. CAHPS is not enough to ensure a positive patient experience.”
That’s because standard surveys like HCAHPS—first implemented by the Centers for Medicare & Medicaid Services (CMS) in 2006—focus heavily on factors like customer service and wait times but fail to assess whether or not the patient’s need was fulfilled, a factor that’s crucial to improving patient trust and creating a high-quality experience. “The concept of patient experience, which clearly should be associated with patient-centered care, has become, over time, however, tied to HCAHPS scores … and this is where patient centeredness has completely lost its way,” said Adrienne Boissy, MD, MA, chief experience officer at Cleveland Clinic, in a July 2020 report in a New England Journal of Medicine publication.
The patient experience scores provided by HCAHPS and CAHPS also fail to examine another critical factor, Boissy notes: whether or not the patient felt cared for.
Given these shortcomings, it may come as no surprise that nearly 1 in 10 industry professionals in our research said they’re not really satisfied or not at all satisfied with their organization’s ability to track patient experience, and 26% are only somewhat satisfied with their ability to take action based on patient feedback.
"CAHPS is not enough to ensure a positive patient experience."Lewis Mattison, managing director of healthcare consultancy, Mattison Advisory
So how can you ensure the patient feels well cared for and that their need was fulfilled? One thing healthcare leaders seem to agree on is this: taking a cookie-cutter approach to patient experience surveys is no longer sufficient. Some organizations have taken heed—just over half of the executives we surveyed are looking beyond CAHPS and HCAHPS to capture patient feedback.
While implementing digital surveys with HIPAA-compliant features is a great start, it’s also crucial to ensure you’re asking the right questions. For example, if your organization is looking to improve the logistical side of patient care—scheduling, dealing with a patient portal, follow-up communication, and more—you may consider using the customer effort score (CES), which measures ease of use or interaction.
“If you want your healthcare needs fulfilled but there are multiple steps that need to occur before you get to the doctor’s office, that’s [customer] effort,” Mattison said. “In healthcare, people are trying to look at where extra effort is getting in the way of what the consumer wants and trying to minimize it, because if not, they’ll lose their patient or member, or they’ll get a lower score on CAHPS, particularly those tied to bonuses.”
Dr. Kvedar—who also serves as both a virtual care senior adviser at Mass General Brigham and chair of the board of the American Telemedicine Association—believes that CES will become an increasingly important metric, particularly for healthcare organizations working to improve patient experience among Gen Z and millennials. Combined, these generations currently comprise over half of the U.S. population, outnumbering both Gen X and baby boomers. These digital natives have become accustomed to doing everything on their phones, and they expect the same when managing their healthcare. So putting more emphasis on telehealth is becoming important to healthcare organizations. Meanwhile, consumers across the board will increasingly begin to compare their service experiences to other day-to-day digital interactions, like ordering a package from Amazon or a pizza through a delivery app.
“When I talk to providers, they’ll say, ‘Oh my gosh, my biggest fears are that big tech companies will come in and take all our patients,’” Dr. Kvedar said. “Then my response is, ‘Don’t be so negative about digital health. Instead of whining about it, compete with it.”
Measuring CES is one example of how your healthcare organization can update its approach to data gathering. Another is examining Net Promoter Score® (NPS®), which is a metric Dr. Kvedar’s organization added in recent years. The basic idea of NPS is simple: how likely are you to recommend a provider or healthcare organization to a friend?
Using NPS to measure patient satisfaction is appealing for a few reasons: for providers, it’s qualifiable, standardized, and benchmarkable, and for patients, it’s simple and quick. (Learn more about running a customer feedback program.)
“I love it,” Dr. Kvedar noted. “It used to be once a year you’d get this kind of arcane look at what patients thought of you.” Now, he says, because of the ease and simplicity of the question, he gets an email update once a month. “The idea that something comes a little more frequently keeps it top of mind. It’s a little more digestible, too, to have a simpler system of numbers and comments.”
Another important factor that can impact the effectiveness of your patient satisfaction surveys is timing and frequency. HCAHPS surveys may be returned within 6 weeks—a factor that Dr. Boissy explains can ultimately impact their value. “If feedback has to be timely and specific in order to be maximally valid to the person receiving it, then HCAHPS feedback fails,” she noted in her report.
As Mattison points out, timing matters to patients, too. “At the end of the day, the most important thing is asking the right questions at the right time. The closer you can get to real time, the better,” he said. “People’s memories of what is good or bad are better when asking them in the moment. If you can ask them immediately or even 3 hours after you go home, those are going to be much different and better responses than if you ask 1 week or 1 month later.”
One strategy is to survey patients when they’re already digitally engaged—for example, when checking in for a visit. By incorporating patient experience surveys into existing touchpoints, you can help boost survey completion rates while reducing survey fatigue. This approach also provides an added benefit: the ability to address your patients’ experience in person.
“By asking them to fill out an NPS survey while they’re still at the desk, you’re giving them a chance to have a dialog with you and discuss feedback directly while they’re there,” Mattison said. This approach is particularly valuable given that many healthcare organizations struggle to take action based on the information gleaned from patient surveys.
The ability to respond to feedback quickly and with real progress has always been important, but the rapid change that occurred during the pandemic made it imperative. In our research, 52% of healthcare industry professionals said their organization has changed protocols due to the pandemic. With that kind of rapid transformation, asking follow-up questions takes on increased importance, since implementation doesn’t always guarantee success.
Take bedside manner, for example. At 53%, this is listed by our respondents as the most common reason for losing patient trust. Given that 57% of executives we surveyed plan on expanding their organization’s telehealth offerings, it will become increasingly essential to also assess “webside manner”—the art and science of connecting with patients when they’re on screen. Consider, for instance, subtle distinctions such as the seemingly simple but not-yet-second-nature need to look into the webcam to simulate eye contact. Training healthcare providers on the fundamentals of webside manner can make a huge difference when it comes to telehealth patient experience.
Agile patient experience feedback solutions can allow you to determine if your organization’s efforts are paying off in your patients’ eyes. For ease of turning data into action, Dr. Kvedar once again points to the frequency and simplicity of something like NPS. “I like reading the comments in addition to the numbers,” he said, “to see if patients are picking up on my intent on certain things like building trust.”
No matter the metric, data also offers an opportunity for another, crucial touchpoint with patients. Once you know where the problems lie and are addressing them organizationally, you have a chance to follow up with the patients who filled out your surveys. “If you have the opportunity to try to close the loop by making contact, that human element of healthcare can come in,” Mattison said. He points to the example of one healthcare executive who reaches out personally to the patients who give the institution a low NPS. This method is about the personal touch—letting them know the institution cares about them—but it’s also about following up and following through on the feedback you receive.
"Patients who are involved in decision-making do better. We’re learning that all of these soft-science tools we have are incredibly important."Joe Kvedar, MD, professor at Harvard Medical School
That human element is key to the new era of patient engagement. Data isn’t enough. Any data-gathering solution your healthcare organization decides to use needs to incorporate and measure the key patient experience goal: to put patients front and center.
Ultimately, as we enter a new, more patient-centric era of healthcare, your patients will increasingly expect your organization to meet or exceed their expectations. The good news is improving patient experience isn’t just good for business—it’s good for patient outcomes, too.
“Patients who are engaged do better,” Dr. Kvedar said. “Patients who are involved in decision-making do better. We’re learning that all of these soft-science tools we have are incredibly important.”
*This SurveyMonkey study was conducted from April 30-May 8, 2021. We surveyed 321 U.S.-based healthcare professionals. The sample was balanced by age, race, among other demographic variables, according to the U.S. Census.
NPS, Net Promoter & Net Promoter Score are registered trademarks of Satmetrix Systems, Inc., Bain & Company and Fred Reichheld.