PRM

Patients Relationship Management-why not think like one?

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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)

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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?

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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

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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?

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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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Social Media: Learn from Patients

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Ever notice how the computer can shave about fifteen years off your looks? This is especially true when you post old photos of yourself. High School friends, which you know you will never see again, find you on Facebook and comment as to how good you look. That’ll show ‘em.

So, how’s your day going? Mine’s fine—thanks for asking. I’ve been meaning to write about a few customer care experiences I liked, and then see who we can apply the idea to healthcare and Patient Relationship Management (PRM), so here goes.

It recently occurred to me that very few of today’s children know how freshly baked bread smells, so I decided I would learn how to bake. For those who know me, I’m neither big on details nor on taking direction—not a big detail when it comes to mowing the lawn, but rather significant in baking since it’s almost all chemistry. I like sourdough, so I thought I’d start with that.  It turns out you can’t.  You can start to start, but you can’t actually bake any until you’ve created a ‘starter’.  The starter is somewhat akin to creating life where there was none.  From a concoction of flour, water, sugar, and salt (basically the recipe for Play-dough) wild yeasts will infest the mix and begin to grow.

With my science project growing in a Ball jar on my counter, and after several rather impressive attempts at white bread, I decided to whip up a rather large batch of pizza dough.  Since I was in a hurry I ignored the admonition to slowly add the remaining three cups of flour, and dumped it into the mixing bowl.  Thwump!  As the bright red mixer ground loudly to a halt I learned why they’d included that little warning. A faint smell of burnt ozone wafted through the kitchen as the cloud of flour settled slowly on the granite counter top.

The KitchenAid mixer was dead. The last thing I fixed was the bell on my tricycle when I was four, so I don’t know what made me thing I could fix this. I went to Kitchenaid’s web site, typed in the model number, and hit enter. Nothing. I searched their site. Nothing. Went to Google. Typed in, “repair Kitchenaid mixer.” Within two minutes I found a web site that matched exactly my problem. I clicked the link. There was a step-by-step set of instructions and photos instructing how to disassemble the mixer right down to the broken part, the worm gear. The author also provided a link to a parts supplier, the price of the part, and an estimate for how long it takes for it to arrive.

Painless. Within a week my mixer was working although I did have one screw left over. I didn’t have to box it, ship it, pay for it; nothing. Some kind soul had taken it upon himself to make my day by posting his success on the internet. Could KitchenAid have done the same thing? Yes, for almost no cost. Another example of a firm who hasn’t learned to color outside the lines. Thank goodness one of the customers had.

Chances are good that your patients have posted more information about how to help their fellow patients than your hospital has posted.  It’s worth a look.  Chances are that they’ve also posted information that is wrong, things you would like to correct, but if you don’t know about it, you can’t correct it.  Want to know a good place to start a social media strategy?  Learn from your patients.

saint

Patient Relationship Management, start at the top

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The customer in this news article wrote a letter to Sir Richard Branson, Chairman of Virgin Atlantic. His letter is a must read for anyone who is in need of a smile. The text below is from Fox News. Paste the link-the photos are critical to the story.

A passenger who wrote a letter of complaint to Virgin Atlantic expressing his dissatisfaction with the in-flight food is now being offered the chance to be a food tester for the airline, the Daily Telegraph reported.

The passenger’s complaint to Virgin chief executive Sir Richard Branson was written after a flight from Mumbai to Heathrow on Dec. 7 last year and has been widely praised for its humor.

http://www.telegraph.co.uk/travel/travelnews/4344890/Virgin-the-worlds-best-passenger-complaint-letter.html

saint

 

Patient Equity Management; Rome wasn’t burnt in a day

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There’s the scene in Young Frankenstein when the character states, Could be worse, could be raining. The line is followed immediately the by sound of thunder and pouring rain. Lately, I’m reminded of that each time I ready the industry news and blogs. The message is that it is raining. Forty days and forty nights worth. Wet. Getting wetter. No towels in sight.

How’d we get there? We worked hard at it. What surprises me is how many providers are surprised by the situations in which they find themselves. During times like this patients discard marginal providers, the providers who never got around to valuing them. This is when it comes down to patient equity management (PEM)–providers who continue to manage by reacting to social media are going to continue to get wet.

It took years of mismanagement and lip service to make patients feel like they weren’t valued. Without a concentrated program of PEM it may take just as long to get them back. Rome wasn’t burnt in a day.

saint

Patient Relationship Management (PRM) – where to start

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I was watching something on the Smithsonian channel and caught a clip of an interview by Gary Powers, Jr. He was discussing his father, and the interviewer asked him about his dad’s ill-fated U2 flight—Gary Powers’ spy plane was shot down over the Soviet Union in 1960 by a surface-to-air missile.

“I asked him how high he was flying when the missile hit his plane,” the son replied. “His answer was, ‘obviously not high enough’.”

Not high enough. A bit of an understatement. When you’re piloting the spy plane and you can see the SAM’s contrail you’re about to have a bad day. By the time you see the smoke streaking towards you it’s already too late. Would’a, should’a could’a don’t matter. At this point all you can do is make the best of a bad situation. The time to prevent the problem has passed; the only option left is to minimize the consequences.

I look at Patient Relationship Management (PRM) pretty much the same way. For the most part, by the time the phone rings, it’s already too late to have done what was required to have prevented the need for the call.  Would’a, should’a could’a don’t matter. At this point all your organization can do is make the best of the situation. The time to prevent the call has passed; the only option left is to respond to the caller’s request.

If your hospital or office is like most others, almost all of the attention and technology are focused at responding to the caller once the call’s been received, kind of like trying to put the toothpaste back into the tube.  There are very cost-effective ways to evaluate providing excellent PRM prior to having to do it via a call center.  Social media can play an important role.

saint

Patient Relationship Management–why patients and hospitals collide

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When universes collide, or is universi the plural? Not that is matters. I was watching NOVA.  The show focused on the lead singer of the Indie group The Eels.  The show walked through the singer’s attempt to understand was his father had done for a living.  His father was a physicist, in fact he was the person who came up with the notion of colliding universes. Colliding universes has something to do with quantum mechanics and cosmology—did you also wonder what makeup had to do with particle physics? In its rawest meaning, parallel universes have something to do with the notion of identical worlds living side-by-side, with no notion of each other, with differing outcomes from similar events. Got it?  Me either.

I’ll try to illustrate if for nothing else than my own attempt to understand. Let’s say I’m concurrently teaching my two sons to play two different card games, Poker and War. Poker, albeit a game of chance, is heavily rules-based—when to bet, when to fold, when to raise. On the other hand, War is purely a game of chance. The poker player likes rules and order. The one playing war—he’s seven—likes to win, and will do what is required to bring about that outcome. Each one plays independent of the other, using the tools at their disposal to direct the outcome of the game in their favor. They are oblivious to the goals and tactics employed by the person sitting beside them. Parallel universes.

What if we allowed these two universes to collide, to come into conflict with one another? For example, let’s say I have them play each other and I re-deal the cards, giving one the cards he needs for a poker hand, and the other the cards to play war. I then instruct them to play one another. The poker player becomes focused on the rules, and the one playing war has a laser focus on one thing—winning. The poker player quickly caves, knowing that he is engaged in a futile endeavor. This does not bother the other one whose only focus was to win.

Imagine if you will—sort of Rod Serlingish—two other games going on simultaneously, one team whose sole focus is winning, the other whose focus is on the rules. For the rules-based team there is no winning. The best they can ever hope to do is to measure up to the rules by which they are judged. Millions have been spent on technology to help ensure that adherence. Adherence to the rules will be monitored, recorded, reported, and measured. The rules-based team’s ability to continue to play the game will be based solely on how well they follow the rules. Now imagine that the universes in which these two teams are playing collide and these two teams play their separate games but against each other. One team having never been told how to win, never been instructed to win, never even given permission to win. The other team’s only purpose is to win.

This is a nonsense game. One we play every day.  One team is the hospital’s patients the other team is the employees who are tasked with patient customer care, patient relationship management (PRM).  The patients are focused on winning, those tasked with customer care or PRM are not permitted or equipped to win.

It’s possible for these two groups to change the outcome, to take away the nonsense.  To make that happen, the rules must change.  PRM can be very effective provided that it is designed to help the patients “win”, designed to facilitate favorable outcomes for patients.  The trick to changing the outcome is that the hospital must understand that a win for the patients in most cases is also a win for the hospital.

saint