The Oaks Ignore Their Pleas

Healthcare and Customer Service in the Digital Age

Posted in General by Jeff Graves on January 17, 2014

Like many people my age, I’ve spent my share of time visiting doctors, going for lab work, and having assorted medical tests done over the last several years.  While our national political dialogue is focused primarily on the cost of healthcare, I’m fascinated by the state of the healthcare customer experience.  It’s very clear that our current system is designed around two priorities: cost management, and risk mitigation (for the provider, not for the patient).  Our insurance system mandates so much of the customer experience, and yet that doesn’t provide for a very positive experience for the patient (customer), not does it seem to drive much value in terms of patient outcomes.

This is what today’s healthcare experience is like from my experience:

  • Nearly every healthcare provider today asks you to sign some kind of document when you arrive for your appointment, typically to acknowledge an understanding of their Privacy policies, and to authorize them to bill your insurance carrier for the visit.  This usually is captured on a paper form with a ton of boilerplate language, and I’m guessing that at least 95% of people just sign the document at the “x” without reading a single sentence.  That paper form gets filed away somewhere, or maybe it gets scanned and filed digitally, and is probably never seen again.
  • Then there’s the “interview”, in which the receptionist validates all of the information the provider has on file for you – do you still have the same insurance?  same address? are these people your emergency contacts?.  This entire process typically takes place as the receptionist is looking at a screen, clicking through the data on a keyboard and mouse – there’s no eye contact here, and rarely any sense of personal service.  After completing this process, which takes between 5 and 10 minutes, you might be given a wristband to identify you in case you keel over while onsite, and then you’re asked to wait.
  • Once your name is called, in most cases you’re first brought to a station to take your vital signs and get your weight and sometimes height measured.  This is all typically recorded on a clipboard, for later transcription to digital records.  When you finally do see the provider, often he or she spends much of the allotted 15 minutes looking at a computer screen and recording your responses to the questions posed.  Again, hardly a warm and personal experience for something that’s the most personal of services, when you get down to it.

In addition, based on my observations and conversations with doctors and nurses, the systems that providers use to capture all of this vital patient information are extremely difficult to use and likely contribute to errors in data capture.  More than once, when finding out that I work in software, a nurse or doctor has said to me “ah, so maybe you can help fix this system!”, and then goes on to catalog their frustrations with the technology.

What if we could reimagine that experience, using tools and techniques that are becoming standard in other parts of our lives?  It might look something like this…

A few days before my appointment, I get an email from the provider reminding me of the appointment day and time. This email contains a quick survey that I can complete to verify or update all my personal information and record acknowledgment of the required privacy and billing approval info. This would also include a link to a short video explaining exactly what I’m acknowledging, so I actually can understand it if I choose. I could also be invited to download the providers mobile app (this might be an interesting product opportunity for a startup – more later, perhaps). The day of the appointment, I’d receive a reminder notification, along with directions to the office and an estimate of the time it will take me to get there from my current location.

Upon arrival at the provider’s office, I find a comfortable reception space, with a concierge carrying a tablet. If I’ve downloaded the provider’s app, my presence is detected via a local beacon network, and I’m automatically added to the list of patients who have checked in (I might confirm my presence via a prompt on my phone). If I have any questions, or if the provider needs additional information from me, the concierge can approach me and resolve anything right on his/her tablet. My smartphone app can also tell me approximately how long I can expect to wait. When it’s my turn, I might be prompted via smartphone alert to proceed to the intake station, where a nurse greets me and takes my vital signs. All of the equipment (scale, BP machine, etc) are networked to automatically update my records, and the nurse simply verifies them on his tablet. I’m then brought to the doctor’s examining room, where the doctor is waiting for me, having reviewed my history on her tablet. She’s able to have an actual conversation with me about the issue that’s brought me there, recording her notes and observations on the tablet. When the visit is complete, I’ll receive a summary of the visit, including my vitals and any notes or any actions to take, via the provider’s app. Any prescriptions needed are automatically sent to my local pharmacy, and I’ll get a notification when the prescription is ready to pick up.

Aside from the potential cost efficiencies that this model might offer, I think the smart use of technology allows a provider to design an experience that’s much more personal and welcoming to a patient. Of course, the key here continues to be the people involved – better systems won’t fix much if the provider staff isn’t focused on offering a positive experience. But at a minimum, eliminating some of the frustrations inherent in today’s systems and procedures should make it easier for providers to focus on the experience and that’s certainly better for us all.


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