Note: Answering the phone to speak with a patient or customer is an activity, not an accomplishment.  The second time the patient calls makes it even less of an accomplishment.

Part of what is not understood by health system executives is the amount of work, the exertion, people use to complete a single, simple task with their health system.  Executives think it works like this:

• New patient needs to schedule appointment/patient gets appointment
• Patient needs a refill/patient gets a refill

Patients know better.  Thinking something is simple does not make it so.  Let’s look at the task of refilling a prescription from a patient’s perspective.

How hard does the patient have to work?  Too Hard, way too hard.

Permit me to introduce a new term for those of you who are trying to suss out patient or customer experience: Customer Exertion Score (CES).  The CES measures the easy or difficulty of someone trying to do business with your health system.  The higher the score, the lower the person’s satisfaction.

In the refill example, the CES should have been 1; patient picks up prescription.  As a rule of thumb, the CES for every interaction should be 1.  Knowing that most customers and patients go to your health system’s website before they call, the CES for those individuals is already sitting at 1 before your agent even answers the phone.

If the customer has to wait on hold (while having to listen to recording of how important their call is) you may as well add another point to their CES.  If they had to call more than once, add another point.  The person’s level of exertion has reached the RED zone before your person uttered had the chance to say ‘hello.’  Also worth noting, once a point has been added to the CES, it cannot be subtracted.

I went to the websites and called four of our largest health systems.  I set out to accomplish three simple tasks; update my personal information—my address, schedule a new patient appointment, sign up for a program through a marketing campaign I heard on the radio.  (Note: two of these activities involve the health system trying to capture a new patient.)

I could not accomplish any of these tasks on the website of any of the four health systems.  CES 1.  The best total CES score I achieved was a 4.  That came from two health systems while trying to schedule an appointment.  The worst score came from trying to sign up for the program offered by marketing; a 7.

In other words, it took a great deal of exertion to accomplish very simple tasks.

As a point of reference, I tried to accomplish the same three tasks with Verizon.  I accomplished all three using Verizon’s website.

If your health system’s CES score is worse than your score from Verizon you have a lot of work ahead of you.