My presentation, according to Slideshare, “Defining a global patient experience for your health system” is being talked about on Linkedln more than anything else on SlideShare…http://www.slideshare.net/paulroemer/defining-a-global-patient-experience-for-your-health-system
Patient Satisfaction: Why are Car Dealers are Better at it?
I do my best writing from ideas I get while running. For those who are thinking, ‘it must have been a while since you’ve run’ I saw that one coming. I’ve run since I was fourteen, minus the last twelve months. I started again Monday; even my teeth hurt.
By the way, it may be time to fire Ferguson.
I was listening to Imus this morning as he was interviewing a famous music promoter, Jerry Weintraub. The promoter relayed a story about one of his clients, John Denver. Mr. Denver was constantly complaining about a number of things on one of his European tours, and he demanded the promoter come speak with him. Here’s a replay of the conversation.
“Yes. Well, he was in Europe, and he was on tour. And everything was wrong. He hated everything. He hated the venues. He hated – the airplanes were no good. The sound systems were no good. Everything was no good. And he said to me, you know, I’m going to fire you; everything is wrong here. I said, yeah, I know, I know.”
I sat down with him; I said, John, everything is going to be fine. He said, why? Why? I said, because I fired Ferguson. He said, why did you fire Ferguson? Why? What is firing him – going to do? I said, he’s been responsible for all the things that you’re troubled by: the hotels, the sound system, the venues, yada, yada, yada. And he said, Is it going to be OK now? I said, Yes, I’m putting other people in. Great.
And that evening, Denver and I went out to have something to eat. At dinner, I said to him, John, you know, I feel really terrible about firing Ferguson. He asked, why? I said, because it’s not like you and it’s not like me. Besides, it is almost Christmas, and Ferguson has a family. And John Denver said to me, I agree with you; it’s not like us. What can we do to help the guy? It’s really not like me. I’ve got to help him. I said, I’ll put him in another area in the company. He’ll be fine. We’ll take good care of him. He said, that’s great, I feel so much better.
Of course, there never was a Ferguson.” Where does Ferguson work in your hospital?
It might be an interesting exercise to discover just how much patient experience data your organization has purchased since when it began purchasing data. I bet there is a lot of it. It might even be a more interesting exercise to discover what improvements in patient experience, if any, can be tied directly to the aforementioned purchases.
Have you ever wondered where your hospital keeps all of that data? I envision all of the purchased data being locked away and stored in hundreds of shoe boxes, healthcare’s version of Al Gore’s lockbox. If that is the case, maybe the data can be streamed and sold to Al Jazeera—the more liberal readers are throwing tomatoes at their screens.
Hospitals have reams of data, and there are plenty of firms trying to sell them even more; customer experience data, business analytics, EHR reports. What does a hospital do with all of that data? Does it have more data than it can put to good use? Of course it does.
Here is a little something for all of the folks in the hospital’s business development and sales and marketing, a little something that all of that purchased data does not tell anyone. The average spend for an inpatient procedure for one hospital across the sixty procedures they listed was around fifty thousand dollars.
It is estimated that a person is admitted to the hospital once every seventeen years and goes to the ER once every three years.
The average cost for an ER visit is around twelve hundred dollars. So, net net, the value of an average patient, when viewed as a potential asset of the hospital that needs to be managed is around $225,000 over their lifetime. For a family of five that comes to one and a quarter million dollars—roughly the equivalent of treating a sprained ankle in Beverly Hills, or treating Michael Douglas for “throat cancer”.
So here is the question nobody seems to have answered and few are trying to answer. Why not spend the hospital’s scarce resources trying to keep that patient as your patient for as long as they both shall live? (Please pardon the wedding metaphor.) Even car dealers have figured this out, they want you to buy all of your future cars from them.
If a hospital starts losing a laptop a day, they will soon figure out how to stop losing laptops. Twenty-five hundred dollars versus two hundred and fifty thousand dollars. A hundred-fold difference.
Imagine with me that you just underwent one of the above mentioned sixty procedures. Statistics show that in the next seventeen years you will undergo another one and have six trips to the ER. As will every member of your family and your extended family and your friends—tuck away these two words for later; retention and referrals.
The hospital wheels you to the front door; you clutch your bouquet of roses and wave at the people who helped you. The hospital does not know, will not know, and has no way of knowing whether your wave meant until next time, or goodbye. The scenario resembles a first date in high school where one person says, “I’ll call you” and the other person has no idea whether they will ever hear from that person again.
Two hundred and fifty thousand dollars may have just waved goodbye. Plus the two hundred thousand from every member of your family, plus your extended family, plus everyone you did not refer. That amounts to a lot of plusing.
What if every hospital, your hospital, took its business development and marketing strategy and divided it by its inverse? The current strategy, the one for which the hospital pays hundreds of thousands of dollars a years for a Chief Marketing Officer has nothing to do with retaining you as a patient. (Let me share an unspoken secret, a secret everyone knows—existing patient experience management strategies exist for one reason, scoring high on the HCAHPS surveys.)
Press Ganey, Studer, the Disney Institute, et al. Your hospital’s 1980’s growth strategy; an NPR radio public interest spot about the hospital’s ability to treat beriberi, the billboard showing the hospital’s beriberi specialists, and a shotgun telemarketing campaign trying to find people inflicted with beriberi. Don’t know what to do, buy more data, and hire a coach.
What is the return on investment of this approach? A million people hear the ad, ten thousand people a day see the billboard, and the hospital pays thirty dollars a call to solicit beriberi patients. How many drive-byes result in a new patient, how many telemarketing calls?
Whether one call in a hundred or one call in a thousand results in a new patient, it does not matter, it is not a good business decision. Three thousand plus dollars, or thirty thousand plus dollars to get someone to walk through your door. Are your margins so good that your hospital’s current approach is cost-effective?
Even if you acquire this patient, will the person return? Who knows? Who should know? Your hospital should know. It should be focusing its resources on knowing and ensuring two things; retention and referrals.
What is the Patient Experience of the “Unsurveyable”?
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 it 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 Hell With Customer Experience.
Nota bene, I paid the thirty dollars.
Segue.
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 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, obtainable on any device, at any time, at any facility.”
To move towards the goal of being remarkable, one must talk to patients and observe them in those touchpoints that 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 them to become your patients.
They 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?
Patient Experience: Your Lobby is Better than your Internet Presence; Why?
Yesterday began with the quest for a bunny my dog hid somewhere in the house, and no, we have not yet found it.
Today started with two gerbils having escaped from the cage in my son’s room. One of the gerbils, the one I know to be the ringleader, actually has noticeable biceps. Like in a movie of a prison escape, I halfway expected to see a chain of small tissues tied end-to-end, secured off at one end to the running wheel, and the rest of the makeshift rope dangling over the side of the cage—I decided to stop the sentence after having already used four commas. I have trapped the gerbils in his room and will sort out that problem later.
My more immediate need is figuring out how to remove a bit of malware from my PC. Google suggested the name of a firm and the software to use. The link took me to a page with screenshots, sort of a Malware Removal for Dummies approach. That approach worked only long enough when step one, start the system in safe mode, failed to work. Fortunately, the site provided a number for me to call, and call I did.
“Oh that is not good,” replied the lad from India. “If it will not start in Safe Mode, you need a Microsoft Certified technician for which Best Buy will charge you $350. However…today only…we will provide you with this service for only $250.”
“No, you will not,” I said as I hung up. I then did what any Neanderthal would do in this situation; I banged on the PC really hard and began hitting a number of keys all at once. At the moment I am downloading the malware fix for $220 less than my buddy’s suggested approach.
Customer experience. I had one. Every customer does. The rub is being able to know whether the experience was good or bad, and if it was bad what you can do about it.
May I make a suggestion? Pick you battles and your platforms; have a targeted plan. Facebook does not constitute a targeted plan. Some social media experts would argue that having a Facebook account is a necessity. It may be necessary, but it is far from meeting the criteria of being both necessary and sufficient.
Last week I read that a certain children’s hospital has more than 700,000 ‘likes’ on Facebook. Good for them, or not. To me that is a little like seeing how many Twitter followers you can collect, or how many friends you have on Facebook. It is about as relevant as you ‘liking’ Justin Bieber or Justin Timberlake—maybe there is something to the name Justin.
That hospital has not had 700,000 patients in its combined history, so having 700,000 is almost irrelevant. Hospitals in its area also have hundreds of thousands of ‘likes’ and still acquire patients. It may not have gained them a single extra dollar of revenue.
Is there appoint to having someone holed up in IT, marketing, or business development whose role is to try and perform Social-CRM acts of prestidigitation that in turn yield delighted patients? Or are all of our efforts simply boosting our feelings of self-worth, sort of a, we don’t know where we are going but we are making really good time, approach to patient experience?
Mindless self-promotion. (I borrowed some of the best phrases here from Gabriel Perna’s May 24th piece in healthcareinformatics.com.)
Here is what I think. Your hospital cost somewhere between eight and nine figures to build, and salaries and operating expenses run well into the millions. The lobbies in some hospitals probably cost several million dollars to build. And why is that? Because you know it is important to make a good impression.
Permit me to get way off track for a paragraph. The above photo of a hospital’s lobby looks more like a Hyatt than a hospital. That seems to be a trend. Make the lobby feel customer friendly. And yet, most hospitals would rather close than acknowledge that patients are also customers. If people can be both customers and patients, why not have programs that improve both patient experience and customer satisfaction? They are not the same. QED.
But guess what?
Every day more people ‘visit’ your hospital on the internet and on the phone than visit the facility. How much did you spend on making impressions in those venues? Can patients and non-patients accomplish the same tasks on the phone or by visiting the internet as they could if they went to your hospital?
If they cannot, your hospital has wasted its money. The navigation for most hospital websites appears to visitors like someone took a five hundred piece jigsaw puzzle and dumped all the pieces on your monitor. Most visitors will spend a few seconds looking for the corner pieces and then will give up.
If your hospital has not fully rethought its entire web strategy in the last two years it does not have a web strategy.
If you need a hint for one here’s mine—a remarkable experience for every patient every time that is mobile and available 24 x 7 on any device.
It will cost less than building a new lobby and will have a much higher ROI.
Patient Experience: Why Second Opinions may be Killing you
Today started on an off note with the question, “Did you find the bunny?” The question resulted from the two furry legs dangling from my dog’s mouth. He would not drop it so thinking I would find it before he did whatever dogs do with bunnies I let him inside knowing he would hide it somewhere in the house. Apparently I was wrong about being able to find it. I did however find my putter wedged under the cushions of a love seat along with a remote for a television we had donated to Goodwill because it had no remote.
I then dropped in to see the neighbors, great people who were born on the other side of the pond we call the Atlantic. They’ve been in the states for ten years and we got to talking about sports, baseball and soccer—soccer, which I learned is a sport in their country. Tying the two together, I learned that yesterday they attended a soccer match at Yankee Stadium. The husband explained that he could still see the place on the ‘pitch’—an erudite term of affection for the field on which all English sports are played—where baseball pitchers pitch the ball.
He also mentioned that the dirt track at the stadium had not been sodded. After a few minutes of questioning I learned that the dirt track was in fact the infield. I then suggested that without developing a better understanding of baseball that he was likely to lose his green card.
The conversation then turned to their trip tomorrow to DC. They were going to see some of the things, like the really tall pointy thing with the scaffolding on it, the building with the round roof, and the lake. I’ve been to DC a lot, but I could not tell them how to get to any of those sites.
After further questioning, I learned that the tall thing they wanted to visit is actually the Washington Monument, the round-roofed building is the Jefferson Memorial, and the lake is the reflecting pool. Maybe they have square lakes in England. I suggested that since we thrashed them in the war—think 1776—they could spend a little more time learning our history. The husband replied that the bit about England losing the war was a canard, it did not lose the war, it merely retreated. Like General MacArthur, England would be returning to finish its business.
Is the notion of patient satisfaction a similar canard? When people come to the hospital to ask a question or request information do you tell them to come back tomorrow? Of course not.
Why then when people make a request of your hospital on the hospital’s website does the website not give an equally quick response? In fact, why do people have to request a response? Why can’t they get what they want or do what they want online? The reason they can’t is because the website causes the person to reach a dead-end without being able to complete the task they set out to complete. The website is broken.
Most hospital websites have dozens of dead-ends and missing functions. I have not seen a hospital website that could not be greatly improved. I have also not seen my pancreas, but that does not mean it is not there.
Surveys show that about half of the people who are thinking about being treated will use the hospital’s website to decide whether they will seek a second opinion. A purchasing decision is about to be made. Stated another way; many will make the decision not to purchase based on the information on your site.
Another phrase that can be substituted for the term ‘second opinion’ is that prospective patients want an opinion other than yours. So let’s say the hospital Our Lady of Zero Retention treats a thousand patients a week. The two extremes if you do the math are that all of those second opinioners picked your hospital. That is good news. But what if five thousand people went to your web site for a second opinion and each of them selected another hospital?
And you know what is really scary if you are the hospital’s CEO or a member of the board? You have no idea who went to your web site to look for a second opinion. You do not know who picked your hospital, you do not know who picked another hospital, and you do not know what influenced the decision. That is a tough way to run a business.
Instead of retrofitting your lobby so that it looks like the Four Seasons why not retrofit your hospital’s website?
The Democratization of Patient Satisfaction
So, how can you tell how the hospital’s patient experience improvement effort is progressing? Perhaps this is one way to tell.
A man left his cat with his brother while he went on vacation for a week. When he came back, he called his brother to see when he could pick the cat up. The brother hesitated, and then said, “I’m so sorry, but while you were away, the cat died.”
The man was very upset and replied, “You know, you could have broken the news to me better than that. When I called today, you could have said the cat was on the roof and wouldn’t come down. Then when I called the next day, you could have said that he had fallen off and the vet was working on patching him up. Then when I called the third day, you could have said the cat had passed away.”
The brother thought about it and apologized.
“So how’s Mom?” asked the man.
“She’s on the roof and won’t come down.”
If you ask someone how the patient experience improvement effort is going and she responds by saying, “The project leader is on the roof and won’t come down,” it may be time to get a new leader.
There are more than 120,000 URLs returned when searching “’Why do patients choose’ hospital”. Based on what I read, the URLs all take the reader to something written by the hospital.
Sixty percent of people say they use the internet to make a healthcare decision. Sixteen percent of hospitals use social media. Eighty-one percent of prospective patients stated that a hospital with a strong social media presence is likely to be more cutting edge—you do the math.
Whether your hospital has a strong social media presence may be less relevant because your prospective patients certainly do. So what does that knowledge do to your organization’s patient experience strategy? Do you double or triple you social media output? Does your one or two person internet department try to out-social-media thousands of prospective patients, Twittering away, and constantly posting to Facebook? Trying to catch up is like trying to walk across a room, and with each successive step cutting the remaining distance in half—you never get to the other side.
The social media “experts” would tell you that is exactly what you need to be doing—more is better. I think the experts are wrong.
If the experts are wrong, what is the right approach? The internet is a powerful touchpoint for both patients and prospective patients. The internet is a large component of patient satisfaction, patient experience, and patient choice.
Rather than going wide and shallow with social media or social-CRM think about a narrower mobile digital strategy that goes deep. For example, think about your hospital’s website. For starters, what you have is probably just that, just a website.
There are dozens and dozens of reasons a patient or prospect would go to your site. A high percentage of them go there because they do not want to try to accomplish something by dialing any of the hospital’s multiple phone numbers. When they go to the website if it does not entice them to stay on the site, bookmark it, or make it their homepage, the website might as well not exist.
Your website is where purchasing decisions are made and lost by prospective patients, and where satisfaction is raised or lowered for patients. If a patient cannot accomplish the task they set out to do in an intuitive and user-friendly way, their satisfaction with your entire organization just dropped.
Many more people go to your website than go through the front door of your hospital. The good news is that you control the user experience of someone on your site. The bad news is that most organizations are controlling it in a way that gives users a poor experience. The list of things users cannot do on your website is much longer than the list of things they can do.
Having a tab that reads ‘schedule a visit’ is worth nothing unless the patient was able to schedule a visit, in fact, it probably kills satisfaction. Having a tab that reads ‘get your health records’ that requires someone to download a PDF, print it, and mail it is equally bad for patient satisfaction.
What should your website be? At a minimum it should be some combination of a patient portal and a knowledge management system. It should also be your billing department, your scheduling department, admissions, discharge, housekeeping, food services, support groups, and education services.
Your website should offer every service your hospital offers with the possible exception of a hip replacement—a 24 by 7 virtual hospital minus patient care. Two-way. And mobile. Available on any device at any time.
If you want to interact with your community, patients and non-patients, you need to go to where they are. And where they are is online. It is not good if someone with heart disease can watch an angiogram on YouTube or on a competitor’s website and on your website they cannot even find a meaningful cardiology link. Online patient support groups at the best hospitals provide a real-time referral group—can your patients do that on your site or do they have to go to someone else’s?
Patients are democratizing information. If the information provided by your organization is asymmetrical, it has some catching up to do.
Patient satisfaction—a remarkable experience for every patient every time; in the hospital, on the web, and on the phone.
Patient Acquisition: Inverting the Sales Funnel
The link below is to a presentation of mine on Slideshare about patient acquisition; how it is done and my thoughts on how it ought to be done. In today’s world most hospitals spend a lot of money chasing people. However, the people they are chasing are researching from which hospital they will purchase services.
If you know the cost to acquire a patient the traditional way please let me know. The cost to have a patient choose your facility is almost zero.
How to acquire patients on http://www.slideshare.net/paulroemer/how-to-acquire-patients-21677042
Please let me know what you think
Could a Zagat-type Patient Satisfaction Rating Work?
The woman next to me on the plane was eating a croissant. I asked her if she could hear Paris if she held it to her ear. Maybe you had to be there.
The rest of this piece will make more sense if you have Wagner’s Valkyrie from the scene in Apocalypse Now playing in the background. This weekend we did a once in a lifetime family activity. Paintball. It was once in a lifetime because I knew we would never want to do it twice. Wearing our best WASP outfits, which made us look more suited for viewing the US Open than traipsing around in the woods, we drove two hours to a remote spot in the Poconos where we stumbled upon what looked like an interracial survivalist training camp; Pennsylvania’s version of Ruby Ridge.
The car next to ours had a bumper sticker printed with the words, “Honk if you are Amish.” I told my son that I was surprised the Amish would play paintball. He told me that it was meant to be funny since the Amish did not own cars. Anyway.
Hundreds of people in the non-erudite crowd were dressed the way I wished I could have dressed when I played army at the age of eight though none of these people had been eight for quite some time. Those whose arms were exposed displayed militaristic tattoos—while the men were wearing long-sleeved shirts. Some of the GI Joes were dressed like SWAT, the rest were kitted head to toe in camouflage. Several wore ghillie suits. There were head and shoulder-mounted video cameras, and a few of the survivalists had wireless communication devices. Most wore backpacks and other paraphernalia that would have made SEALs envious.
We passed one group as they were retrieving their rifles from the trunk of their car. Their gear copied the design of Uzis and AK-47s. I started wondering what someone from a nearby town would have thought had a few of them walked into a liquor store to buy beer, imagining the clerk handing over the tens and twenties and then fleeing out the back door.
Our ammo belts each held over a thousand paint balls. We gathered our guns and put on our face shields, the visors of which made us look like oversized ants, and headed into the woods to one of the seven hundred acre’s fifty laid out battle areas. Our group of eighteen was divided half. Being the only one with the math degree, I explained each team should have about nine players.
Fallujah awaited.
My two sons and I were on the team opposite my wife and daughter. I smelled payback and before the referee blew his whistle signaling the start of the game I began a flanking maneuver to what would have been the field’s starboard side had we been on a ship. Passing through a copse of birch, I came upon a pile of logs. Within five minutes I had taken out three of their nine players.
Did I mention it then started pouring? Now we were wet WASPs and my son appeared to be doing the backstroke.
One thing I learned quickly is that breathing heavily into your face shield during a downpour makes your vision about as clear as looking through your glass shower door twenty minutes into your shower. The fog of war? In the shower not being able to see is merely an inconvenience whereas in the woods people were shooting at and hitting me.
My vision was totally obscured. I could see shapes and vestiges of light and dark. Unfortunately I could not see the vestiges that were shooting me. With a fogged visor, standing alone, and holding my gun I resembled a blindfolded person at a birthday party swinging an object at a moving piñata, only this time I was the piñata.
Did I mention that the paintballs leave the barrel of the gun traveling at one hundred and ninety miles an hour? Through painful personal research I learned that exposed skin can instantaneously drop the paintball’s speed to zero.
I think sometimes executives find themselves shrouded by the fog of war, unable to see what is right in front of them. When was the last time people on the uppermost floors in the hospital sat down with a patient and spoke to them about their impression of the hospital? It has probably been a while.
If it were possible to rate patient experience and patient satisfaction for your hospital using the prestigious Michelin and consumer-loved Zagat restaurant ratings, how do you think your hospital would score?
Michelin uses secret inspectors to rate restaurants—think CMS, HCAHPs, and patient satisfaction because patients are asked to completed surveys—customers have no say in the ratings. Restaurants can be awarded one, two, or three stars. Only about two thousand restaurants in the world have received a Michelin star.
Zagat ratings are formulated by people who ate in the restaurant—think patients and patient satisfaction. Customers are not asked to rate the establishment; they do so on their own; customer driven. Think also YouTube, Twitter, Facebook, and blogs.
What would happen to the flow of first-time and returning patients at your hospital if patients had an independent, online, patient-driven rating site? Now before you bust a blood vessel, I am not suggesting that this approach could be used to rate physicians or treatment. I do think there may be merit in using it to rate patient touchpoints of nonclinical things. What sorts of things? How about things like:
- The usefulness of the website and the call center
- Parking
- Food service
- Admissions
- The clarity of the bill
- Social media aides
- Appearance
- Scheduling
One CEO told me that the two things he could do that would have the greatest impact on patient satisfaction were expanding the parking lot and improving the food service. Might be a good way to add another rating star to the hospital’s website banner.
Why Satisfying Patients is Dysfunctional
Technology creates trust among people who have never met. Individuals, grouped via the web into “smart mobs” are sharing and collaborating in ways hospitals cannot. The individual has transformed from being a passive consumer into one having the collective intelligence of a mob of educated collaborators.
And guess what? Hospitals are still marketing to and doing business development with individuals. How well is that working? These groups of patients and prospective patients are interacting en-mass while the hospital continues investing its resources erecting billboards and telemarketing prospective patients using Salesforce.
Using 1980’s technology hospitals are chumming the universe of potential patients armed with less information than they could find about a person using Google. Their quarry, on the other hand, is armed by having access to information that represents the collective intelligence of every member of its smart mob. The smart mob has developed a metasystem of information and opinions about organizations and they will use that metasystem to help them decide whether they will purchase services from your organization.
It is not a fair fight. A battle of wits in which one side is unarmed.
Disrupting the business model and changing the way you do something are not the same. Motion is not movement. Lean in not disruptive. If your organization can be counted among the fans of the lean sigmaists and you want to be really lean all you have to do is turn of the lights and lock the doors; you can’t get much leaner than that.
After a while there will be nothing left to cut or change except to change what you do. Building capacity for every sub-specialty is not disruptive, it is dysfunctional. Having more MRIs in your facility than there are in Manitoba is the opposite of lean. Isn’t it nonsensical to be lean in a few areas and obese in others? Offering the same services as every other hospital in the area is not disruptive, it is duplicative. It simply divides the revenue pie for any given procedure into smaller slices.
Hospitals know what they charge, not what their procedures cost. They can’t pull a P&L per patient, or per procedure. Healthcare does not know the ROI or NPV of retaining a patient or what it costs to acquire a patient. If it did, it would invest more resources trying to retain patients, obtain referrals, and win-back former patients.
Can hospitals make a sound financial argument for having a business development executive instead of a patient retention executive? It costs ten times more to acquire a new patient than to retain one.
Is having a business development group in a hospital disruptive or is it dysfunctional? Does it add value?
I ran the question through my head and discovered the following. In the last decade my immediate family has purchased some form of healthcare at eight different hospitals within twenty-five miles of our home. Each time we purchased healthcare from a hospital the other seven hospitals never knew we were looking to make a purchase.
To be more specific, once a year I take a cardiac stress test at one of the hospitals. A cardiologist is present during the test. Not once in the last ten years has anyone from the hospital told me about their cardiology services or invited me to tour their facility. But they have a business development group and they advertise their cardiology practice.
Every hospital’s business development group is competing by pitching the same services as every other hospital in their market, and they are pitching those services to the same people as the other hospitals’ business development groups. Don’t believe me? Ask your CFO how much revenue the urology billboard generated or whether the business development group covered its costs.
Why are none of the hospitals competing on having the best patient experience? If a hospital sells customer experience and customer satisfaction it will retain patients, get referrals, and win-back former patients.
Selling customer satisfaction in a market where none of your competitors is selling it is disruptive. Disruption of an antiquated approach is a good thing. How can your hospital disrupt its approach to improving patient experience? Doing the same thing this year that you did last year is not disruptive it is dysfunctional.
If you need a vision statement for patient satisfaction how about using the phrase, A remarkable experience for every patient every time? It sounds a lot better than ‘a satisfied experience.’ Simply being satisfied isn’t saying much. If someone tells you that the place they had dinner last night was satisfying it probably doesn’t make you want to rush out and eat there.
With so many hospitals competing for the same patient perhaps simply satisfying patients is dysfunctional. The disruptive approach would be to plan to deliver a remarkable experience for every patient every time.
The Joy of Sox–how to deliver a great presentation
I think what a lot of presenters miss is having an understanding of what makes for a good presentation. Here are a few of mine.
Presentation Rule 1—be entertaining. The audience are pulling for you to do well for your sake and theirs. There seems to be an inverse relationship between ones title and their ability to speak in front of a group of people without sounding like you are reading an eye chart.
Presentation Rule 2—most of the audience can read. If your slides are filled with text and bullet points, their natural inclination is to read what you’ve written. They are doing this while you are reading aloud the very same text. If they are reading, you become superfluous.
Presentation Rule 3—the audience cannot walk and chew gum at the same time (they can’t read your words and listen to you.) For those presenters who favor text on their slides there are two choices; read from the slides, or try to offer commentary about the slides. For those who do not read directly from their slides and want to offer commentary it gets even more awkward. You look at the audience and see them reading the slide. Your natural tendency is not to interrupt their reading because you are trying to be polite and you do not want them to miss your words of wisdom. Then your mind starts to wonder if what you are about to say is so important if you should have written it on a slide.
Presentation Rule 4—if you wear wild looking socks–see mine above–you had better be delivering one heck of a good talk.
My philosophy about presentations is not wanting people taking notes based on what is on my slides, hence I use pictures to convey an idea. I hand-draw concepts from which I can then speak. Since there is nothing of import on the slides, people start staring at you, something which will make a lot of presenters even more nervous.
The downside of this approach is that since everyone will now be listening to you instead of reading or writing, you better have something worth hearing. The issue then becomes how to craft your words in a way to get your audience to remember your message.
I favor humor and telling a story.
Will these steps work for you? I hope they do.
I felt they were working pretty well for me the other night right until the end when an attractive woman approached me me after my presentation and said, “You look like Jack Nicholson, only not as unattractive”—so at least I’ve got that going for me.
Pale Rhino Consulting 