Where do health systems find their inspiration?
When looking for ways to improve patient experience, health systems typically turn to the traditional competition down the road—to the next hospital or clinic—rather than the Walmart across the street or the Uber car driving past them. This is an issue. While it is dangerous to define “patients” as “customers”, people who need healthcare services do place demands on the U.S. health system to be more customer-centric.
The Experience Patients Expect
People are setting higher and higher service experience expectations, as a result of exposure to great service offerings that revolve around them in industries outside of healthcare. Positive, convenient, and fulfilling experiences stick with people, and they don’t shed these service expectations when they become patients in the healthcare space, scheduling an appointment with a doctor or recovering in a hospital after surgery.
Companies with compelling customer experiences influence how people expect to receive components of their care, which is disrupting to health systems. Why? Because patient experience metrics are increasingly being tied to how many providers and health systems are compensated. To find guidance in designing people-centered offerings, health systems must look beyond their own ecosystems.
So, what are these organizations delivering that makes them so delightful? Many beloved businesses are delivering on what we at Continuum have identified as the 3 fundamentals of customer experience:
1. Talk to Me Like I’m a Person.
2. Prove You Know Me.
3. Level with Me.
The first fundamental—Talk to Me Like I’m a Person—centers on the use of clear language and transparency. The financial planning application Mint is a good example of this. Mint uses the same language I use when talking about my finances, and explains to me—visually—how I have spent money over the month, where I can save (like avoiding those pesky foreign ATM fees), and how I’m tracking towards my personal financial goals for the year.
Meanwhile, Zappos serves as a great example of Prove You Know Me, which is all about providing individualized and personalized services. Zappos not only tracks my movement on their site so that they can point me to products they know I’ll like, but through their recent app AskZappos, I can tag #AskZappos in a picture of a nameless product I’ve pinned on Pinterest and they’ll hunt it down for me for free. This model builds upon their long-standing precedent of providing excellent customer service.
Finally, it’s probably no surprise that health systems can look to Uber as a good example of one fundamental, Level With Me, which is all about businesses being upfront about the relationship they are trying to create with their customers. Uber’s transparent business model is the core of their peer-to-peer service; the app connects the driver, looking to make some extra money, with me, the passenger looking to get from her office to the restaurant across town. This transparency is extending into unexpected places for Uber, as with the emerging “5 for 5” norm, where drivers and passengers mutually agree to give each other the highest rating, perhaps fundamentally breaking the ratings model.
If these fundamentals seem obvious, it’s because they are. Catering to basic consumer needs should be the goal of any service provider. The issue is that so few companies actually deliver on these fundamentals, and healthcare is probably the biggest offender. We see these failings across the patient experience, whether it be a clinical note that was written with the clinician in mind rather than the patient (and, therefore, is often meaningless to the patient); or the hospital stay, during which one is asked to repeat the same information to multiple different people that clearly aren’t talking to one another; or the doctor/patient relationship that feels more like a dictatorship than a two-way conversation and results in a patient feeling unable to control her care. In short, there are significant opportunities for the fundamentals of better customer experiences to be put to action in the healthcare space.
It’s important to recognize that these fundamentals span across all age groups. Often, Millennials are named as the ones bringing these higher expectations to healthcare service interactions, whereas the older generations are accepting of today’s system because it’s what they know. Not true. All patients with whom we’ve spoken hold these expectations. The days of the passive, accepting patient are gone, regardless of age, gender, ethnicity, income, or disease state. People are more empowered, and are questioning why their interactions with clinics or hospitals are so difficult and un-enjoyable. Therefore, we must think of these fundamentals as analogous to basic human needs: all patients come with them.
New Care Options Make for New Competition
People’s expectations are not the only reason health systems should take notice of these customer-centric companies and the customer experience fundamentals. Several organizations outside of healthcare, like Walmart and Uber, are building upon their customer-centric platforms to go head-to-head with healthcare and compete inside their ecosystem.
UberHEALTH rolled out a flu shots on-demand pilot in October of 2014 in Boston, New York, and Washington, D.C. In this one-day pilot, Uber drivers transported registered nurses from Passport Health to people’s homes or desired locations, to deliver free flu prevention packs and a flu shot. The service was requested through the Uber app, and each UberHEALTH request could serve up to ten people. UberHEALTH exemplifies the Prove You Know Me fundamental, delivering a flu shot directly to people’s homes—or as Uber put it, “bringing the house call back.” What’s more individualized than delivering preventative medicine to someone in his home?
Similarly, Walmart opened primary care clinics in their retail stores in 2014. Running in select markets, these clinics are staffed by lower-cost nurse practitioners and overseen by physicians, in a partnership with QuadMed. Walmart has positioned itself a little differently from other retail clinics, such as the CVS Minute Clinic. It is pushing to become a primary medical provider capable of more care services, like chronic disease management.
Walmart is not only positioning itself as a lower cost option (walk-in visits cost $40), but as a more convenient one, too. Its primary care clinics are also a good example of Prove You Know Me, providing people with a variety of options on when and where to receive care. Walmart’s clinics operate on a retail schedule rather than clinic hours, offering extended hours during the week and open hours on weekends. It’s also a one-stop shop: not only are these stores typically located next to other shopping centers one might frequent, but a patient already visiting Walmart to receive care can also pick up prescriptions, to say nothing of groceries.
Health systems face current and imminent competition. Soon (if not already for some) it will become obvious to healthcare providers that the competition is not the clinic down the road, but the UberHEALTH car passing by to make a house call, or the Walmart across the street.
For an incumbent health system to continue to compete, the goal is not to identify the next Uber of healthcare. Rather, it’s crucial that heath systems determine how and where they are falling short of these core experience fundamentals. Although “patients” are not synonymous with “customers,” people do expect their healthcare interactions to match up with the transparency and convenience of Uber, the immediacy of Prime, and the creativity of Airbnb.
For health systems, identifying these gaps and understanding the unique needs of the people they serve will reveal ways to improve upon the delivery of care, and more efficiently and enjoyably reach patients where they are. By doing so, health systems will be in a position to set high expectations for people that the Walmarts and Ubers of the world will struggle to keep up with.