Listening to NPR I heard the columnist from the LA Times, David Lazarus, recount the experience of his recent stay at the UCLA Medical Center, a result of his cat trying to devour him.  Fifty-two thousand dollars; four thousand a night for the room and there was no HBO—more than the cost of the Premier Suite at the Beverly Hills Hotel.  Remember this little fact about the room; we will come back to it.

For any given patient, the highest that patient’s satisfaction will ever be is the moment the patient exits the hospital.  The likelihood of increasing patient satisfaction after a person leaves the hospital is no better than the chance of counting backwards from infinity…twice.

What happens, you see, is that while the patient is in the hospital the hospital believes it exercises some sort of control over the experience relationship.  Perhaps this is where the notion of patient experience management originated. 

Patient experience and patient satisfaction are always being managed.  Sometimes the management of the patient is proactive and deliberate, other times it is managed neglectfully or inadvertently.  Rarely has the experience been designed; most times it has simply evolved.  Just because the experience is being managed does not mean the outcomes will be favorable.  Unfortunately, this surprises some executives.  Perhaps this should be a ‘predictable surprise’.  When the patient is discharged nobody is managing the patient’s experience.

What if patient satisfaction and patient experience could be managed effectively for all patients and across all touchpoints, not just when they are inpatients?  Assuming healthcare was a business, what if patients were treated by hospitals as assets—assets valued at between $180,000-$250,000—patient equity management (PEM)?  Business is not a four-letter word in healthcare.  Hospitals market to attract patients.  Why not have programs to increase patient equity management, to retain patients and their families over their lifetime? 

Why not institute a program of family experience management, family equity management?

Why is nobody managing the experiences of people who call the hospital, and people who visit the hospital online?

There are a handful of major business processes each patient encounters, processes like admissions, scheduling, meals, billing, and claims.  Each of these processes impact a patient’s experience and satisfaction.

Let us jump back to the point about the four-thousand dollar room, not the charge itself, rather the room.  A hospital’s nonclinical business processes can be mapped almost one-to-one to those of large hotel.  One difference one finds when comparing the business processes of a hospital to a hotel is that the satisfaction levels as measured against those processes of the hotel will almost always be higher.

When patients use social media to comment on their stay at a hospital, these are the processes on which they comment.  Patients rarely complain about the doctor replacing the wrong hip.  They do however complain about not being able to schedule an appointment or about not being able to understand their bill.  Hospitals have no weapons with which to defend themselves against the electronic 1’s and 0’s of poor satisfaction; the internet is forever.  The hospital’s only defense against poor satisfaction is to improve the patient experience.  To improve the experience a hospital must learn which touchpoints help define someone’s experience, and then they must design the experience.

Mr. Lazarus from the LA Times met with the president of the UCLA Medical Center to discuss his bill.  The president told him that not only did he not understand Mr. Lazarus’ bill, he did not even understand his own bill.  Mr. Lazarus reported that in his article and on NPR.  The circulation of the LA Times is slightly above a million.  No amount of effort is going to put that toothpaste back into that tube.

Some, who feel their way along in near-perfect darkness, have what might be described as the fatally limited hypothesis that there is not much to be gained by improving nonclinical processes.  The individual with a single hypothesis about how to improve matters feels more comfortable with the status quo. 

These same people believe that they have patients, not customers.  People who think that way may soon have neither.