Customer 'Think'
A customer-centric healthcare organization is defined as one that has a mission of creating meaningful value for customers across all touch points, leading to sustained competitive advantage for both short-term and long-term organizational success. It doesn't take a genius to figure out that the current market conditions are forcing healthcare organizations to reduce their costs constantly. Both hospital and physicians are under tremendous pressure to do more for less. So how does a hospital go about protecting the customer experience while the financial people are trying to drive down costs to ensure that the business survives? Well, there is a wrong way of cutting expense, and a right way of driving down expense while maintaining and even enhancing customer experience. First one needs to decide which costs we want to reduce, and understand how they impact the customer experience. This tends to be problematic for most healthcare organizations due to the fact that they are functionally organized, and therefore have great difficulty correlating between their cost centers and the customer experience. Cost optimization is fast becoming the latest industry buzzword. But what do you optimize costs around? If it's just cutting cost for the sake of lowering expenses, then it will almost certainly impact the customer experience.
What to do? Who is a Customer?
What we need is to look at these old problems in a new light. We need to look at these challenges from the eyes of the customer. We need to think of not only cutting cost but also ways of increasing revenue via customer ‘think’. Yes, that’s right---there are lots of revenue enhancing opportunities also in ‘customer think’. But before we get too far ahead of ourselves, lets define who are our customers, and how can one become a ‘customer think’ organization. Most hospitals have defined their customers in two broad categories: Patients and Physicians. Let’s take each one and see how we can enhance their experience across the healthcare touch points.
PATIENT as a Customer
For many, the word "design" conjures images of sleek architecture, or avant-garde fashion. But for designers at progressive hospitals, it wasn't plans for a new building or new product that brought them together. It was the prospect of designing a better healthcare system. The idea of using "design thinking" to solve big problems may be a relatively new idea in the world-at-large, but progressive healthcare organizations a project aimed at understanding and improving the interaction between patients, physicians and hospital is key to future success. "For too long we've looked at the healthcare system—a system on the verge of collapse—from the perspective of healthcare providers and insurers, not from the perspective of the patient," said Nancy Stone. "This project will bring new visibility to how patients experience care and open up opportunities for improving this experience, bringing us closer to our goal of providing higher quality, lower cost healthcare." Led by Mark Anthony, the project is creating a detailed depiction of the experience patients have interacting with providers across the spectrum. From the physical spaces where this interaction takes place to the systems and processes that dictate how information is exchanged, the designers are mapping how each component contributes to the quality, patient safety, and outcome as patient moves across the healthcare landscape.
Moving Customer-Centric Healthcare Forward Customers are also becoming more actively involved in the healthcare process due to Internet availability and the shift towards higher co-payments. Internet usage in USA has surpassed 75% of the households. A national Kaiser Family Foundation survey of older Americans found that a third (31%) of seniors (age 65 and older) have gone online, but that more than two-thirds (70%) of the next generation of seniors (50-64 year-olds) are even more active Internet users for healthcare inquiry. The differences among seniors and 50-64 year-olds are striking and indicate that online resources for health information may soon play a much larger role among older Americans. Notably, Women have reached parity with men in the wired senior population. In the year 2000, about 60% of wired seniors were men and about 40% were women. In February 2004, the gender ratio among wired seniors has shifted to 50% men and 50% women – the same ratio as the general Internet population.
Wired seniors are often as enthusiastic as younger users in the major activities that define online life such as email and the use of search engines to answer a specific question. Also, wired seniors are as likely as younger users to go online on a typical day. Internet is now also quite prevalent among poor and low income families. Even though low income fathers might not be quite as active on the internet, their children on the other hand are active and especially mothers work with their children on the internet to assist with school activities. The healthcare IT marketplace is responding to this by offering powerful browser based Patient Portal solutions that enhances the patient experience while reducing administrative costs and allowing healthcare organizations to offer a level of service with operational excellence. Because of this tsunami of readily available internet users, healthcare organizations that do not take advantage of emerging Web-Base solutions to attract and retain patients will miss out and loose current and future potential customers to those hospital who are willing to offer Internet based services so that patients can effectively manage their financial, administrative and clinical aspects of their healthcare.
What can these solutions do for your Customer?
- Patients can register themselves via a browser interface. If they are already registered, they can update their demographic information and all this can be integrated with MEDITECH.
- Patient can make request for scheduled appointments using an easy to use calendar
- Patients can search for available physicians and based on insurance and specialty and find a provider with a few clicks.
- Dynamic content management system so that when customers come to your website, based on their profile, automatically receives timely clinical service information for preventive care.
- On-line access to all their accounts and their dependent accounts, for viewing of detail bills and an integrated bill payment.
- Patient can go on-line to request Rx refills, and it can be automatically routed to the appropriate provider, and based on rule based queue management system, the request will be reviewed and routed to the patient preferred pharmacy for completion.
- Publishing of education and other classes offered by the hospital and on-line payment of these classes and reminder management system.
- Secure access to patient clinical data and EHR based on clinical rules
- Eliminate calls to physicians and hospital departments and reduced paperwork and customer inconvenience
- A “one-stop” solution that combines administrative, financial, and clinical portal where they can come for all their needs in a self service and empowered manner.
PHYSICIAN AS A CUSTOMER For most CEO’s, physician relationships are their top concern. Relationships once built on mutual commitment to quality and facilities are not enough today. They have been complicated by money, regulatory stress, malpractice, etc. The growing divergence between hospital and medical staff needs require that you consider new approaches to looking at physician as a customer. A customer, whose loyalty is fragile, requires new understanding of what a physician is going through, and how a hospital can create a win-win solution that can not only meet the needs of the physician but also positively impact its bottom line, quality and outcome.
So what can hospital do to attract and retain physicians?
Efficiency Drivers
- Provide a Physician/Provider Portal which allows them to access all their patients’ data in an easy to use manner like ‘Google’.
- A solution that alerts physicians via cell phone/PDA for abnormal alerts and they can with a simple click view their lab results on a PDA in a secure manner
- Be able to have dinner with the family and walk to their child’s PC and to respond to their deficiencies and E-sign the legal chart from the comfort of their home.
- Be able to do electronic rounds if required in the morning with two clicks per patients rather 99 clicks per patients.
- Be able communicate with other physicians via secure messaging on a patient in an efficient manner
- The portal should be single-sign-on solutions from which they should be able to launch much different application in a longitudinal manner.
Relationship & Revenue Drivers
- Outreach for Laboratory so that physician’s office can easily orders Labs from hospital thus generating additional revenue and enhancing physician & patient satisfaction.
- Automate the Medical Necessity process at the point of order which is costing hospital lost revenue.
- Offer on-line physician query capability so that Coders do not have to chase physicians with questions for MS-DRG, and physicians can answer them on-line in an expedient manner.
Let’s face it; physician/hospital relationship is not what is used to be. But physicians need an electronically connected hospital to survive and succeed. On one hand they drive tremendous amount of revenue to the hospital, on the other hand hospital’s needs to offer an efficient electronic solution that will make the physician’s job more efficient and effective.
Key Factors in becoming a Customer ‘Think’ organization:
- Be a listening organization
- Respond to the information
- Be innovative and creative
- Anticipate—ahead of the curve
- Lead by example
- Align business processes and technology
In conclusion, it’s all about achievements not lip service that matters. Technology and social changes are creating a potent mix of forces that will transform the way all businesses operate, offer service, and relate to customers. These portals will enable organizations to aggregate customer data, analyze that data, and automate workflows to optimize customer-facing business processes. We recommend that hospitals look at their portfolio of electronic solutions that they are currently offering today to their customers and ask themselves are these technology solutions really helping their customers?
In Greek mythology, Sisyphus was cursed to roll a huge boulder up a hill. As he neared the top, the boulder would tumble back down, and he would have to repeat this fruitless task for all eternity. This can be fate of many hospitals if they are not careful with their IT strategy.
 Recently I was part of an IT strategy session with one of our customers who had invited us in evaluating various options for their HIS migration strategy as they geared up for meeting the ARRA mandate and the upcoming healthcare reform. The hospital evaluated the history of their current HIS vendor’s performance at the hospital by looking at all the options the HIS vendor offered, its value proposition, and what other hospitals with similar circumstances and technology mix were doing around the country. The hospital concluded that Sisyphus fate would have been their fate if they had blindly chosen one of the migration options their HIS vendor had presented to them. Now that’s some life to look forward to as you prepare for the healthcare reform.
The HIS vendor was aggressively pushing for adoption of a particular migration which would cost this hospital millions. More so, this would put tremendous stress on the organization’s human and financial capital with little assurance of value return. The team realized that it was all about putting a pretty face-lift on an old and tired technology with little ‘meaningful’ clinical transformational value. This was discovered by the IT Director who took upon a leadership role of creating a team of hospital professionals whose job was to bring in new insights and knowledge into the IT decision making process.
The team started by educating everyone on the hospital’s current strengths and weaknesses of the existing HIS vendor platform and the critical technology factors required to meet the needs of the upcoming healthcare reform.
The team came up with 5 key drivers for ARRA and future success:
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The ARRA requirement is not an IT project but a clinical transformation project where the IT solution is one of the key component for success
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Hospital will adopt technology where at the DNA level it facilitates and promotes clinical transformation
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Hospital will adopt a technology architecture that ensures it is totally interoperable both with current HIS and other internal and external systems in an efficient and effective manner
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Hospital will adopt an IT solution which will lead away from technology dependency to technology empowerment.
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Hospital will adopt technology which is easy to use like Google so that physicians, nurses, interdisciplinary clinicians, HIM and patients can be easily use with least amount of frustration & errors
By coming up with the above 5 key drivers the team of professionals had concluded that in the last decade the hospital led by the IT department had made great strides in many areas of IT implementation. On the other hand, the biggest area where IT success has yet to be felt was in the area of clinical transformation. They also understood why that has happened and what needs to be done to correct this going forward. They also understood that they have travelled too far with technological success to be forced to roll backward by some HIS vendor options that were being presented to them.
As you evaluate upcoming healthcare reform and plan for clinical transformation and episodic of care, you must make sure that Sisyphus must not become your fate. No one said change was easy and we all know something must be done to make our broken healthcare system better but it will require critical thinking on part of every hospital to decide what they want for their future.
Hospitals must embark on educating their IT steering committees and establishing key guidelines on what will be needed for future success. External input must be brought in to ensure that decisions are being made based on key value proposition. Few hospitals have internal resources or time to look underneath the pretty facelift offered by some vendors to see what is profoundly new and dynamic that will allow you to meet the upcoming healthcare reform. We highly recommend you get external input from players in this marketplace who can assist you in asking the tough questions that need to be asked. Strategizing and asking tough questions is the first step in a rocky road to a national healthcare reform.
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