PRM Roadkill

(AP) New York. CNN reported that PRM died. Services will be held next Monday at Dunkin Donuts. Patients are asked not to attend, but instead to forward their complaints to Rosie O’Donnell.

A fellow, David Phillips, wrote, “Relationships should be considered part of the intrinsic value of the corporation”—he is an auditor. I read a paper co-authored by a slew of PhDs who concluded that the six components for measuring relationships include; mutuality, trust, commitment, satisfaction, exchange relationship, and communal relationship. I feel better just knowing that.

Patient Relationship Management—PRM. I hate being the one to break the news but, PRM is dead. I didn’t kill it. It’s dead because it never existed.  Relationship Management.  Who is actually measuring a relationship? What unit of measure do you use? Inches, foot-pounds, torque? PRM Carcasses are strewn about. You can’t manage what you can’t or don’t measure.

“What are you talking about?” She hollered. “We measure. We measure everything. If it’s got an acronym, we’ve got a measure for it. KPIs. CSFs. ACD. IVR. ATT. AHT. Hold time. Abandonments. Churn.”

Just because something is being measured, it doesn’t mean that the measure has anything to do with the desired outcome. I’d wager my son’s allowance that nobody uses a single quantifiable metric that precisely points to the health of an individual patient relationship. Seems silly? No sillier than really believing you have an ability to manage something as ephemeral and esoteric as relationships.

Just how good are those relationships everyone thinks they’ve been managing? Five percent higher than last month?  Down three percent over plan?  Permit me a brief awkward segue. Joseph Stalin said, “One death is a tragedy, one million deaths are a statistic.” The point is that scale matters—a great deal.  One death versus a million.  One patient interaction versus millions.  It makes a difference. The things we do that impact patients impact them individually, one at a time.

Technology metrics apply to patients—plural. Technology metrics are averages—patients aren’t.  You are measuring against the masses.  The mass does not churn, does not leave your hospital, does not ask to speak to a supervisor.  If I am the patient, not a single metric, not a single measure in your hospital accurately depicts the success or failure of our interaction.

So, what’s a mother to do? Stop pretending you are managing your business by managing relationships—since it’s not possible to do the latter, it follows logically that you can’t possibly be doing the former.

Here’s what you can do, manage your hospital using things you can measure. You can start by defining metrics for the following;

Patient Referral Management—how many patients came via referral?

Patient Resolution Management—how many patient problems were fixed?

Patient Recovery Management—how many patients did you win back?

Patient Retention Management—how many patients did you prevent from going elsewhere?

Show these to the VP of Operations and all of a sudden you have something to talk about. Show the VP how much you reduced some global metric—so what?

The parabolic parable

The bad thing about being a former mathematician in my case is that the emphasis is on the word former. Sometimes I’m convinced I’ve forgotten more than I ever learned.—sort of like the concept of negative numbers. It’s funny how the mind works, or in my case goes on little vacations without telling me. This whole parabola thing came to me while I was running, and over the next few miles of my run I tried to reconstruct the formula for a parabola. No luck.

My mind shut that down and went off on something that at least sounded somewhat similar, parables. That got me to thinking, and all of a sudden I was focused on the parable of the lost sheep, the one where a sheep wanders off and the shepherd leaves his flock to go find the lost one, which brings us to where we are today.

Sheep and effort.  Let’s rewind for a second. Permit me to put the patient lifecycle into physics for librarian style language—get the patient, keep the patient, lose the patient.  These are the three basic boxes where providers focus resources. How well do we do in managing that lifecycle to our advantage? We have marketing and sales to get the patient, we have patients care to keep the patient.  Can anyone tell me the name of the group whose job it is to lose the patient?  Sorry, I should have said to not lose the patient. Freudian—actually, we probably have our pet names for the department who we fault for patients leaving.

Where do most providers spend the majority of their intellectual capital and investment dollars? Hint—watch their commercials. It’s to get the patient. Out comes the red carpet. They get escorted in with the white glove treatment. Once they’re in, the gloves come off, to everyone’s detriment. Nobody ever sees the red carpet again. A high percentage of a firm’s budget is to get the patients, and another large chuck for existing patients. Almost nothing is spent to retain exiting patients.

Existing versus exiting. Winning providers roll out the red carpet when patients exit. They do this for two reasons. One, it may cause a patient to return. Two, it changes the conversation. Which conversation? The one your ex-patient is about to have with the rest of the world. How does your firm want that conversation to go?

An idea for improving Patient Relationship Management

This won’t solve all of your problems, but it’s a good start–sort of like 1,000 lawyers on the bottom of the ocean.
www.nophonetrees.com

Who knows, perhaps your organization is included.

What’s the ROI from Social Media for a hospital?

Did you know there’s a hospital in the US whose web site gets 2,000,000 hits a month?

Did you know that same hospital tracks how patients made the decision to use their services?

Did you know that more than $2,400,000 dollars in fees came about as a direct result of the web site?

I’d bet the ROI on that exceeds everything else in the hospital.

can you apply social media to Patient Relationship Management (PRM)

A consultant was on one side of the river; his client was on the other side. The client hollered, “How do I get to the other side?”  The consultant thought for a moment and hollered back, “You are on the other side.”—don’t try this at home kids, we’re professionals.

It goes without saying that rarely am I regarded as one with a high capacity of tolerance.   When things get tough or when meetings are exceedingly dull I like to go to my happy place. Sometimes I get to go to my happy place when I least expect it. Like the time my coffee machine started leaking all over the floor.

Having met such unheralded success repairing my mixer, naturally I took apart my Capresso coffee maker. Not many parts. I put it back together thinking the simple act of dismembering it might have caused it to self-heal. Fill it. Turn it on. Puddle. I called Capresso started to explain my problem. Before I had a chance to finish the rep told me what caused the problem, asked for my address, and said they would mail a new gasket overnight for free, as in F-R-E-E. No proof of purchase needed.

Talk about managing the customer experience and taking the lead on social networking.  What types of things could you be doing to improve Patient Relationship Management (PRM)?  How could social networking help you improve PRM?

Let’s talk.

Patients Relationship Management-why not think like one?

I met last week with a number of 1st Year MBA students who have a consulting club to help them figure out if they are suited for this noblest of all professions–supposedly the second oldest profession. “How can you tell if you’ll be any good at it?” They asked.

As far as I can tell, there are two basic requirements. One, you have to be a bit out of kilter, a tad of ADHD doesn’t hurt either. You have to hate repetition.   Second, it helps if you have a belief that there is almost nothing you couldn’t figure out how to improve. While thinking it doesn’t make it true, the attitude is a critical success factor.

For example, I just returned from the post office.  Noon on the Wednesday before the holiday–lunch time rush hour.  I’m standing in a long line underneath a banner with a message emphasizing quality.

There are two clerks, postmen, postpersons, postladies–I’m not sure which one is most appropriate, but as we both know, I’m not going to lose any sleep over it either. The line is out the door. Clerk ‘A’ tells clerk ‘B’, “I’m going on break.” At which point I turned to the person next to me and uttered, “And I’m going to UPS.”   It’s not that difficult to improve.  Not letting half of your customer-facing employees go on break during your busiest time would be a good way to start to improve things.

It’s not rocket surgery. Patient Experience Management, Patient Equity Management. Whatever you call it, big inroads can be made.  Quit thinking like an executive and start thinking like a patient and you’ll have plenty of ideas.

Taking Care of Patients (TCOP)

 

 

 

 

That’s me in the back row–just kidding. There are approximately 640 muscles in the human body. Yesterday I pulled 639 of them. In anticipation of the onset of winter I’ve been ramping up my workouts, and at the moment am scarcely able to lift a pencil. I came across an article that describes the full body workout used by the University of North Carolina basketball players. It involves a ten-pound medicine ball, and 400 repetitions spread across a handful of exercises. I’m three days into it and giving a lot of thought about investigating what kind of workout the UNC math team may be using. At my son’s basketball practice last night, the parents took on the boys—they are ten. That 640th muscle, the holdout, now hurts as bad as the rest of them.

So, this morning I’m running on the treadmill, because it’s cold and the slate colored clouds look heavy with rain. While I’m running, I am watching the Military History Channel, more specifically a show on the Civil War’s Battle of Bull Run—I learned that that’s what the Yankees called it, they named the battles after the nearest river, the Rebs called it the Battle of Manassas, named after the nearest town. The historian doing the narration spoke to the wholesale slaughter that occurred on both sides. He equated the slaughter to the fact that military technology had outpaced military strategy. The armies lined up close together, elbow to elbow, and marched towards cannon fire that slaughtered them. Had they spread themselves out, the technology would have been much less effective.

Don’t blink or you’ll miss the segue. You had to know this was coming. Does your hospital have one of those designer call centers? You know the ones—wide open spaces, sky lights, sterile. Fabric swatches. The fabric of the chair matches that of the cubicle, which in turn are coordinated with the carpeting. Raised floors. Zillions of dollars of technology purring away underfoot. We have technology that can answer the call, talk to the caller, route the caller, and record the caller for that all important black hole called “purposes of quality.”

The only thing we haven’t been able to do is to find technology to solve the patient’s problems. Taking Care of Patients (TCOP).  We’ve used it to automate almost everything. If we remove all the overlaying technology, we still face the same business processes that were underfoot ten years ago. Call center technology has outpaced call center strategy. Call center technology hasn’t made call centers more effective, it’s made them more efficient. Call center strategies are geared towards efficiencies. Only when we design call center strategies around being more effective will the strategy begin to maximize the capabilities of the technologies.

Patient Relationship Management: Got Pigeons?

 

 

 

 

 

I was recently in a large call center of one of my clients. Supervisors and CSRs were scurrying about clearing their desks of binders and cheat sheets in an effort to make the center look paperless. I looked up just in time to see an ominous looking flock of people being given the nickel tour. They swept through in a scene reminiscent of the gathering of fowl in Hitchcock’s The Birds. In an instant we knew the flock was from corporate. The suit-people were tethered to their Blackberries and they kept glancing at their watches as though doing so was going to make lunch arrive quicker.

They encircled a cubicle, a few of them preening themselves, leaned forward, pretended to be interested in what they were being shown, nodded appropriately, scribbled down a few notes, and moved on. At one point, a few of them donned headsets to monitor a call. Within thirty minutes, it was all over, just like in the movie.

The next day the memo filtered down from corporate customer care and marketing, outlining all the new procedures the flock deemed necessary based on all the information they’d gleaned during their brief flyover.

Remember, pigeons happen.

Patient Relationship Management-there are some easy answers

MANUALSThere’s a reason penguins don’t play the viola—maybe that’s why they don’t have a home page. I used to try to approach things with an open mind, but people kept trying to put things like that in it. Did you ever notice that it’s difficult to encourage people to think outside the box especially if you haven’t seen evidence that the people inside the box are thinking? I’m sure there are those who think these ideas are mere snake oil, but who among you has ever seen a rusty snake?

There is often an inverse relation between the relevance of a document and its brevity. Roemer’s Law 17: the value of a patient user manual used in your call centers is approximately equal to the square root of the number of chapters. (That bit of insight is the equivalent of 4.6 raiments, where one raiment has been universally established as the amount of consulting insight needed to awe a frog for one hour.)

How many different patient user manuals are there in your patient call center? How many pages do those manuals occupy? I think user manuals are so long because call center managers believe busy people are effective people. People who aren’t busy all the time might start to think, and what good has ever come from that?

The United States Constitution is about 9,000 words—that’s about thirty pages. What is it about the interactions between patients and call center reps that requires more verbiage than the amount needed to keep 350,000,000 people living in prosperity and at peace with one another for more than 220 years?

For some people, work takes place in the fast lane. For me, it often takes place in oncoming traffic. To conclude, let’s agree to quit viewing things from the dark side of the sun. Sometimes instead of complaining about the darkness, it’s better to ignite a flame. The next time you are at your desk, open the user manuals, take out all the pages, and replace them with this one rule:

DO WHATEVER IT TAKES TO SOLVE THE PATIENT’S PROBLEM.

I guarantee that will improve performance. Some executives argue that the chances of something so patently absurd actually being true are a million to one. But consultants have calculated that million-to-one chances crop up nine times out of ten. It’s also fair to state that all mushrooms are edible, however it’s equally fair to state that some mushrooms aren’t edible more than once.

To those who want to prove me wrong, go ahead. Destroy the fabric of the universe, then call me.

saint

What if your patients controlled their relationship with you?

There are no atheists in foxholes.  The corollary is that there are no bloggers on bright sunny days.  The best blogs come from angst, gloom, from something amiss.  Things that can take the sun right out of the day.

Today is such a day.  I begin with a question.  How important are patients to your practice or hospital.  Is the attitude that they were coming here one way or another because that’s where the ambulance took them, or we’re the only hospital their payor covers?

If so, you’re home free—it’s like having a built-in retention model.  It reminds me of the line in The Eagles song, “Hotel California”—you can check out any time you want but you can never leave.  You don’t need to be good; you just need to be there.  You can eschew PRM (patient relationship management).  As long as people continue to get sick year-over-year at an increasing rate, your PRM, Marketing, and Social Media strategy can be that of Alfred E. Newman, “What, me worry?”

However, if having good PRM is important because of what it adds to the bottom line, or simply because it’s the right and polite way to relate to patients, here’s an example of how not to keep your patients.

I was on the phone with HP, trying to get someone to answer a question about why my desk-top speakers are filled with static.  Prior to calling, I replaced the old speakers with new ones, same model, and heard the same static.  No answers on line, no answers on Google.  I wind up be handled by an ESL/ASC person, English as a Second Language, America as a Second Country.

We spend nine minutes and fifty-four seconds on the phone as I give him my phone number, my wife’s email which somehow confirms I’m not a mirror image of myself, and crawl under my desk and flip over the HP trying to find and read a serial number that is written in smaller text that the directions on a bottle of cough syrup.  Purchase date, operating system, product ID.

“Now, while I’m waiting on my system, tell me your problem.”

I did.  To which he said, “I can help you for a nominal fee.”  Ten minutes into the conversation before he’s able to tell me that answers cost money.  I shared my dissatisfaction with him and his firm and his country—not really.  I suggested he could have answered my question nine minutes ago for less cost than HP had already incurred for this service call.  I suggested he could point me to a helpful web site, or save us all additional embarrassment and just whisper something like, “you have a bad sound card.”  No, no, and no.

For those who may be new to the idea of PRM and social media, this is how it works.  I will not buy another HP even if the ambulance takes me to the HP store.  Since I can’t listen to my music on my HP, I will make it my mission to go out of my way to convince others that HP is not worth their money.  I will post and Tweet until I grow tired of the exercise or until I simply plug in my iPod.  Whatever happens, I will have done my best to take all of the toothpaste out of the HP tube, knowing they can’t put it back.

This is what happens when customers and patients take PRM and social media into their own hands.  It may also be what happens when the 12-step program proves to have been a few steps short of complete therapy program.

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