A Visit to One of Your Employed Physicians May be the First Exposure Patients will have with Your Hospital. What Kind of “Patient Experience” will They have?



Steve Wilkins

Guest Post by Steve Wilkins
Now that over 50% of physicians are employed by hospitals, this is question that is on the minds of progressive hospital executive teams. With good reason. Patient-reported outcomes, including satisfaction and loyalty, are going to play an increasing role in determining how much hospitals and physicians are paid. This means that astute hospital marketers will be able to build a strong business case for investing in programs aimed at creating superlative ambulatory and inpatient experiences for patients.

But Our Physicians Already Have High Patient Satisfaction And Loyalty Scores

Health care executives should take little comfort in the high patient satisfaction and loyalty ratings found uniformly with just about every physician. Generally speaking, “one can assume that the quality of care is, actually, worse than surveys of patient satisfaction (suggest)”according to Avedis Donabedian, MD, the father of today’s quality movement. Donabedian goes on to say that “patients are, in fact, overly patient; they put up with unnecessary discomforts and grant their doctors the benefit of every doubt, until deficiencies in care are too manifest to be overlooked. “

Just look at the quality of physician-patient communication, a key ingredient of the “patient experience” in the physician’s office.

• In only 26% of the visits are patients allowed to complete their opening statement (agenda) without interruption (by the doctor); in 37% the physicians interrupted; and in 37% physician never asked about the patient’s visit agenda.
• Studies suggest that patients do not express their health concerns, expectations or opinions in up to 75 percent of physician visits principally because their doctor never asked.
• Primary care physicians typically spend less than 60 seconds informing patients how to take new medications…or why.
• Primary care physicians and patient disagree about the diagnosis, treatment, and cause/severity of their condition over 50% of the time.
• Over 50% of patients walk out of their doctor’s office not understanding what they were told, including why or how to take their medications.

For their part, patients today are hard pressed to rate the effectiveness of their relationship with their doctor. The evidence conclusively shows that poor physician-patient communications is the norm rather than the exception. As such, most patients do not appreciate all the ways in which their doctor could in fact do a better job communicating with them.

Why Is Any Of This Important?

Simple. In the near future, your hospital and physicians will be paid according to things like how well they communicate with patients. More importantly, high quality physician-patient communications is highly correlated to improved outcomes, fewer hospital re-admits, fewer medical errors, improved patient compliance and increased patient satisfaction and loyalty.

So if you marketing team is looking for a simple and effective position strategy, consider improving the way your physicians and patients talk to each other. This strategy is so simple no one else in your market will be able to figure out what you are doing. But that’s OK…because your patients will sure see the know!

Steve Wilkins, MPH is the author of Mind the Gap.  His posts appear regularly on Better Health Network, KevinMD.com  and the Wall Street Journal Online Edition.   Mr. Wilkins, and his company Smart Health Messaging, focus on developing evidence-based solutions for improving the quality of communications between physicians and patients...and in so doing, improve safety and outcomes, increase adherence and satisfaction and reduce costs. www.healthecommunications.wordpress.com

I do solemnly (and publicly) declare . . .

Allison Sherwat

by Allison Sherwat, social media marketer

A recent New York Times article describes a well-tried technique that is being applied in a new venue: thousands of individuals are posting New Year’s resolution videos to social media sites, and in some cases engaging in online programs that will monetarily reward (or punish) the declarer for reaching (or not) her goals. Importantly, most social networking sites make it easy to tell your friends about your ambitions. According to the article, economists say people who make resolutions public are far more likely to fulfill them.

I wonder how health systems could leverage this public declaration of intent to achieve strategic goals. Not only would this provide incentive for the provider to achieve the goal, but it would serve as a tool of engagement with consumers who would want to track your progress. For those organizations struggling to get meaningful engagement from their consumers through social media efforts, this might be just the ticket.

What goal or target could your organization share with the market? The potential for consumers to reward your achievement is great.

Click here to read the New York Times' article.

Allison Sherwat has a passion for innovative marketing, business and new media strategies that help organizations grow and better serve customers. 

Social Media: Dr. Jekyll or Mr. Hyde?

Kari Foster

by Kari Foster, social media marketer

When I tell people that I help healthcare organizations establish their Facebook and social media presence, the responses vary from “Cool!” to “I don’t have a Facebook account and don’t intend to get one.” You can likely imagine the age of those commenting, but not all of them fall within the likely stereotypes. In fact, we recently posted an article on this blog about the shrinking gap between older adults and millennials when it comes to online activity.

The commonality I find among naysayers, however, is that almost all are considering only the “Mr. Hyde” Facebook fan page. They’ve experienced the sites of the helplessly-narcissistic or recklessly-eager-to-share. Call me Ms. Glass Half Full, but what about the Dr. Jekyll’s out there?

Can we dismiss out of hand the successes of Mayo Clinic or Children’s Hospital Boston in the social media sphere? What about open source Web apps like Google Person Finder , developed by thousands of volunteers in search of a way to help after Katrina and then again after the Haiti earthquake? These apps combined missing persons’ data from sites all around the Web into a single, free place for that information to be gathered and shared.

Gathered and shared – isn’t that what we’re trying to do? When we create a place where patients, families and providers, alike, come together to find information, connect with services, share experiences and offer support to one another, we also create a community that identifies with and grows more loyal to our brand.

Today’s marketers must go where their customers congregate. Avoiding social technologies because we fear what someone ‘might’ say puts us further out of touch. Any tool works best when used correctly. After all, we didn’t stop using telephones because we grew tired of kids calling the house and asking if we had Prince Edward in a can, did we?

Embrace social technologies. Develop your strategy. Put in place solid policies and take the time to educate staff and physicians on appropriate use. Your customers will thank you.

Kari Foster helps healthcare organizations and providers create and manage social media marketing activities. Follow her on Twitter @kskipperfoster.

Make Marketing Performance Measurement a Priority in 2011

No doubt about it - strategic growth and improved financial performance are top priorities for health systems and hospitals in 2011, putting increased pressure on marketing leaders to deliver effective returns on marketing investment.

Where to start? Begin by establishing and gaining agreement on performance targets and metrics, and putting in place the mechanisms to track and report on progress against goals.

Marketing performance measurement and management (MPM) is the process of analysis and improvement of the efficiency, effectiveness and accountability of marketing investments and activities. This is accomplished through alignment of marketing activities, strategies, and metrics with business objectives.

A marketing performance measurement framework can be a useful tool for developing those measures and metrics most relevant to an organization’s strategic growth goals.  Three categories of measures are often considered:

• Enterprise growth: measurement of overall performance against business outcomes, growth goals and competitive sustainability; e.g., revenue growth, profitability, market position, brand leverage, etc.
• Marketing strategy: measurement of return on marketing investment (ROMI) from core marketing strategies and processes; e.g., high-impact segmentation strategies, service line development, market expansion, portfolio diversification, retail innovations, clinical partnerships, etc.
• Marketing activities: comparative measurement of effectiveness, efficiency and outcomes of specific marketing and sales tactics or programs; e.g., direct mail campaigns, web traffic, risk screening events, physician sales,

Some marketers use a marketing performance dashboard to monitor, manage and report results.  Marketing measurement systems can also be designed to report at health system, regional, facility and service line levels.

So what are the critical success factors for marketing performance management?

• Making marketing performance measures, monitoring and reporting systems a priority
• Targets and metrics aligned to strategic planning, business development and operations priorities
• Decision support systems with timely access to performance data
• Cross functional collaboration to set and agree on targets and metrics
• Cross functional accountability for outcomes
• Regular reporting intervals to review progress against goals
• Timely adjustments to strategy and/or course corrections

A high-performance marketing operation requires outcomes accountability for marketing activities and expenditures.  A marketing management measurement and reporting system can be a powerful tool for building support and helping health leaders better understand the inter-dependency of strategy, operations and marketing in achieving growth and marketing goals.

What have been your successes and challenges in marketing performance measurement?

"Social" Medicine

Susan Lilly

Facebook is everywhere. It was the top-visited website of the year for the first time in 2010; Google came in second. Technology companies are integrating Facebook into their gadgets, pre-installing FB as a core function in such items as mobile phones, iPads, e-readers, TVs, cameras, and video game consoles. This dramatically expands the reach of the social networking site beyond the computer to all portable electronic devices making Facebook nearly ubiquitous. 

So what does this mean for marketers? We know that Facebook has more than 600 million monthly active users, of whom more than 230 million access the site on mobile devices. We also know that consumer technology manufacturers are trying to build a social experience around their products. Meanwhile, 40% of online consumers use social media for health information!

However, hospitals and other health care delivery settings are not in the consumer product business. But they do provide services to help people get and stay well. So, the challenge is to take the natural human inclination to share information and experiences, and make it easier to build that around the health community. It can be as simple as posting job openings on Facebook, to inviting fans to watch together a broadcast on weight loss surgery.

So, while some health professionals are reluctant to join the conversation, Facebook will continue to proliferate as a means of communication, with health care consumers searching for emotional and informational support. What could be better than providing that support for your local online community?

Susan Lilly consumes vast amounts of health industry data so you don’t have to. She has worked in the healthcare field for 20 years - in both private and public sectors - and focuses on telling the story inspired by research findings to help health care clients grow and thrive.

PR One of Fastest Growing Professions; Especially for the Social Media Savvy

Good news for PR professionals. Employment is expected to increase 24 percent by 2018, making P.R. one of the fastest-growing professions. Those with knowledge of business, strategic communications, research, finance and, most important, how to use technology — especially social media — will have an edge.

Read more at the New York Times.

High Performing Hospitals Don't Leave Patient Experience to Chance

Last week, I posted a story about a hospital where parking attendants from an outsourced management company were less than sympathetic to a visitor who had spent the night by the bedside of her best friend’s dying child. The incident underscored for me the importance of alignment and accountability across an organization – including independent contractors and vendors – to deliver on brand experience and customer service expectations.

Brand experience is not created by accident. Well, at least great brand experience is not. Establishing and communicating brand service standards clarifies for employees – and contractors – the specific actions and behaviors that are expected of them in delivering great customer service and generating customer loyalty. High performing organizations define and frequently communicate the standards of excellence required to create experiences that are meaningful and valued by patients and their families – and lead to achievement of the health system's business objectives.

Kristi Peterson is a consultant (and long-time colleague) that has helped hundreds of organizations address organizational alignment to service standards. She left this comment on last week’s post – I wanted to share her advice for building accountability into your contracts with outsourced service providers. Writes Kristi:

“A poignant story that makes a very important point. It also hinges on a major concern of mine, thus an editorial comment first. We get so caught up in collecting patient satisfaction data (and feeding on percentile results) that the voice of the customer isn't heard. The numbers do the talking. The relative impact of contracted service providers on the experience is overlooked. It is challenging to capture meaningful feedback on some of these services (such as the one featured). The last thing that's needed is another survey to monitor the performance. Who experiences the customer's frustration, disgust and dismay? Employees. It's important to collect their ideas.

In terms of holding contract service providers accountable for contributing to the patient/customer experience - build into your contracts/reviews the expectations that they will:

1. Regularly capture feedback from front-line employees (e.g., "What procedures/policies create confusion, inconvenience, dissatisfaction for customers?") and internal departments/stakeholders (as appropriate);
2. Reinforce employee communication/service skills through training/coaching;
3. Adopt and hold their employees accountable for your service standards;
4. Report at least quarterly one service improvement they have instituted; and that 
5. Executive/manager representatives of contract service firm will regularly visit to watch, listen to, touch and smell your customers. That's the only way they can get a taste...correction, if they mystery-shopped their own services, they would get a better taste of what the service experience is really like, for customers and employees alike!

We should all spend time being underground bosses.”

Amen, Kristi.

Kristi Peterson consults on customer experience, patient satisfaction and leadership effectiveness. She was a pioneer in the movement to raise customer service standards in hospitals and establish the link between patient satisfaction and employee engagement.  You can contact Kristi at kristi@kristinepeterson.com.

Hospitals Must Hold Private Contractors Accountable for Delivering on Patient Experience

Just before the holidays, a colleague received word that her best friend’s two-year old daughter had been found unresponsive in her crib. She was revived and rushed to the hospital with life-saving measures underway. But the news was not good. The child had gone without oxygen for too long.

My friend, Chris, dropped everything to get to her best friend’s side. She sat in the hospital with the anguished parents for the next 24 hours, watching an endless parade of doctors and nurses running tests, conducting evaluations, trying to comfort the hopeful mother and father. Sadly, the little girl died.

I can’t begin to imagine the depth of grief that the parents and four-year old brother of this young girl are experiencing; just seeing the raw pain etched in Chris’ face brought me to tears as well.

The doctors and nurses in our hospitals are cast in these real life dramas every day. And, occasionally, despite their most heroic efforts, some patients don’t survive. But the intensity of their clinical efforts combined with caring and compassion, are essential to healing the wounded hearts of the families and friends left behind.

A child’s death is not the ‘patient experience’ we want to address in our brand and patient satisfaction discussions, but it was nonetheless the ‘experience’ that this family endured. They will remember the kindness of the staff.

When Chris reluctantly left her friends’ side to return home to her own family, she walked to the hospital parking garage (which is run by an outsourced contractor) to retrieve her car only to learn from the attendant that “this lot closed at 6 pm.”

“Can I just get my keys?” asked Chris. “I need to go home.”

Learning that the keys were sent elsewhere at 6 pm, she treks in the frigid evening air to another building on an unfamiliar campus to retrieve keys from another attendant that began to lecture her about the rules and regulations of the parking garage.

“Can you cut me a break?” she pleaded, “I’ve been with a dying child.” Then she got her keys, walked back to the garage, and drove home to hug her own kids.

The moral of the story? Everyone, from the highly specialized doctor to the parking attendant, creates experiences that live in our customers’ memories. When a parking attendant is inconvenienced rather than sensitive to the harried, worried, hurried, sad or pained needs that characterize families and visitors of the hospitalized, he or she tarnishes your brand. Outsourced operators that touch patients and visitors need to be held to the same expectations of customer care, concern and service.

Trying to Remember Your Child's Medical History Specifics? There's an App for That!

by Kari Foster - social marketer

East Tennessee Children’s Hospital has launched East TN Kids, a new app that allows you to save vital health information about your child in one, easy to find place: your iPhone, iPod touch, or iPad. This free app allows parents to save data on everything from insurance and emergency contact numbers to immunizations and surgeries. It also provides hospital directions, doctor contact info, and general medical information for easy reference.

The app can be password protected, and once the information is loaded, it can be shared with other devices via Bluetooth connection. It stands to reason that as more physicians begin to carry iPads, sharing all this data can be done even more quickly.

With today’s on-the-go families, it’s more important than ever to have easy access to your child’s medical history data, especially in an emergency. The East Tennessee Children’s Hospital website, http://www.etch.com/, includes a step-by-step tutorial to make set-up a snap. Even if you don’t live in the region, the East TN Kids app could be a useful tool, and perhaps you can let your child’s doctor know “There’s an app for that!”

Kari Foster helps healthcare organizations and providers create and manage social media marketing activities. Follow her on Twitter @kskipperfoster.