Playing a trivia game as an ice-breaker at a networking event, the question was, “A five-letter word for a reptile.”

The woman next to me shouted out, “Spider!”

Foolishly I hoped she wasn’t actually replying to the question, but was responding to the fact that perhaps a Brazilian Wandering Spider—the deadliest spider on the planet—had just entered her alimentary canal.  (I thought I would reference Brazil since we just completed the World Cup.)

As it turned out, there was no spider in her ear, and there was not much between her ears. My IQ dropped several notches. I decided that I had broken enough ice for one day.

I looked at my wife.  She told me she had to call Dallas.

“All of it?” I asked. She rolled her eyes at me. I am a stickler for syntax, for terminology. I think when we use words we should, at a minimum, know the meaning of the words we use.

Let us take a minute to define who and what we are talking about when we use the word patient.

I posit that from the patient’s perspective the word patient has a broader definition than the way the hospital defines it. Hospitals, for the most part, define patient as someone undergoing a billable event. Someone producing revenue in real-time.

I believe there are five patient personas, each of which had a question they need to answer:

• Prospective patients
• Outpatients
• Inpatients
• Discharged patients
• Former patients

Prospective patients: Will I buy healthcare from this institution

Outpatients: Involved with the institution—Will I but more healthcare from this institution?

Inpatients: Committed, at least for the moment to the institution. (The chicken is involved with breakfast, the pig is committed.)  Will I buy healthcare again from this institution?

Discharged patients: Will I buy healthcare again from this institution?

Former patients: Will I buy healthcare again from this institution?

The only personas for which the hospital knows the experiences of a particular persona are the inpatients. And what do they know? Do they know your experience if you happen to be the inpatient? Of course not. The only thing they know about the experience of an inpatient are the aggregated experiences as those experiences relate to the HCAHPS scores of a sample of inpatients several months after those people were discharged, a ‘generic inpatient’.

If the personas of a person’s patient life-cycle can be traced from prospective patient, to outpatient, to inpatient, to discharged patient to former patient, the hospital knows almost nothing of those experiences, and they know absolutely nothing of the experiences of you as an individual.

The value of what a hospital knows about the experience data it has collected is the hospital’s ability to try to avoid CMS penalties.

The value of what a hospital does not know about the experiences of the patient personas is substantial.