My phone had ceased to function as a phone and so I was at the Verizon store with little to do.  I was counting backwards from infinity, twice, and I got stuck when I got to the number fifteen; I hate when that happens. 

I think originally what I encountered at Verizon may have happened like this.  One of Verizon’s mail clerks, Ferguson, wanted to change his phone to the iPhone. He went to the Verizon store and learned he could trade in his old phone for a shiny white iPhone and receive a thirty dollar refund for doing so provided that he signed a two-year contract.  Deal done.

Ferguson went back to work in the mail room, and since nobody actually mailed letters and packages anymore because the world had gone digital, he started to think.  He knew he was going to get the iPhone, and a $30 refund had no influence over that decision.  He thought others would have acted accordingly and would have upgraded to a new phone even without the rebate.

Using his Jot Stylus on his iPad, he channeled Jethro Bodine and commenced to ciphering.  Roughly one hundred million mobile customers.  Figure twenty-five percent of them upgrade their phones each year.  Ferguson estimated the refunds cost Verizon seven hundred and fifty million dollars a year.  Now Ferguson guessed that those customers, if for no other reason than the panache factor of having the newest, coolest phone, would have upgraded even without a rebate.

Ferguson’s hamster wheel started spinning and he wondered if the desire to have a new phone was so strong that customers would still upgrade their phones even if Verizon charged a thirty dollar upgrade fee instead of offering a thirty dollar rebate.

Ferguson gets an idea.  He scribbles out a postcard on the back of his rebate card, addresses it to Verizon’s CEO, and hand-delivers it to him on the executive bocche ball court.  The postcard posits Ferguson’s idea as follows; If we charged customers the same amount to upgrade instead of rebating them, we could swing revenues by one and a half billion dollars.

Ferguson is now the Executive Vice President of Innovation & The Heck With Customer Experience.

Nota bene, I paid the thirty dollars.

Does the fact that there are so many different definitions of patient experience among hospitals belie that fact that there is no definition of patient experience? 

Most patient experience definitions seem to be missing a few things; they do not exist much beyond the four walls of the hospital—sort of like EHR, they are highly, if not exclusively, focused on interactions clinical interactions and on things having to do with HCAHPs.

Every day many more patients and prospective patients try to access (interact) with the hospital using the internet and their phones. Much determination on patient satisfaction is made in these venues. Retention, referrals, and ‘win-backs’ are influenced here. “Buying” decisions are made and lost here.  The hospital either met or did not meet expectations.

Yet most hospitals invest almost nothing in the two areas that have the highest number of touchpoints.

If I were asked to define a goal for patient experience I would recommends “A remarkable experience for every patient every time, on any device.”

To move towards the goal of being remarkable, one must talk to patients and observe them in those access points all patients use. Surveying patients puts out the fire, it does not prevent fires.  Their bad experience has already happened. 

Surveying patients, paying for patient experience data, and paying for coaching does nothing most of the people in your radius of influence; for all of the prospective patients and nothing for former patients whose next visit to the hospital you never learn of because it happened somewhere else.

The level of satisfaction for these individuals is determined outside of the hospital’s four walls.  There are gobs—a consulting term of art—who never decide to become patients or to become patients again that make their decisions based on a hospital’s internet presence and how their calls are handled.  HCAHP surveys will not entice people to become your patients.  There is not a prospective patient in the entire country who knows a hospital’s HCAHPS score or what that score means.

These people belong to a group called the unsurveyable.   They also represent a healthcare spend higher than your total revenues for last year.  Why not pay attention to their experience?