Latest / Becker’s Healthcare Podcast / The Currency of Time: Driving Patient Loyalty Through Better Experiences

Transcript

The Currency of Time: Driving Patient Loyalty Through Better Experiences · Becker’s Healthcare Podcast

• 0:00
  - Hi, everyone. This is Lucas Voss with Becker's
• 0:02
  - Healthcare. Thanks so much for tuning in to
• 0:04
  - the Becker's Healthcare podcast series. It's great to
• 0:06
  - have you. Today's conversation is built around a
• 0:09
  - new insight report from NRC Health called the
• 0:12
  - currency
• 0:14
  - of time. The premise
• 0:16
  - is that patients judge health care through two
• 0:19
  - different lenses,
• 0:21
  - whether an organization respects their time by making
• 0:24
  - care easy to access,
• 0:26
  - and the second part, whether the time they
• 0:28
  - spend receiving care
• 0:30
  - actually
• 0:31
  - feels worthwhile.
• 0:33
  - And I'm so excited to have two wonderful
• 0:35
  - guests to discuss the insights
• 0:37
  - of that report to dig in with them.
• 0:40
  - William England, strategic advisor research at NRC Health
• 0:43
  - and also the author
• 0:45
  - of the report. Great to have him. Casey
• 0:47
  - Aaron is the director experience strategy at Fairview.
• 0:50
  - Welcome to you both. I wanna hop right
• 0:51
  - in because, again, we have so much to
• 0:53
  - discuss. There's so many great insights
• 0:55
  - in this report. And, William, I'll start off
• 0:57
  - with you.
• 0:58
  - The report, again, looks at the patient experience
• 1:01
  - through those two different lenses, time saves and
• 1:03
  - time well spent.
• 1:05
  - What do those two mean, and why are
• 1:08
  - both
• 1:09
  - important to patient loyalty today?
• 1:12
  - Yeah. Thanks, Lucas, and, happy to be here.
• 1:14
  - This is second time, I think, we've met
• 1:16
  - on one of these podcasts. Yes. It's great
• 1:18
  - to have you. So so happy to be
• 1:20
  - back.
• 1:21
  - So the idea comes from a book called
• 1:22
  - The Experience Economy
• 1:24
  - by Joe Pine and James Gilmore.
• 1:27
  - And the idea is that,
• 1:29
  - increasingly, we've we're solving for and this is
• 1:32
  - just writ large, not just in in health
• 1:34
  - care, but but in in we're in
• 1:37
  - consumerism itself, we're solving for, like, maximum efficiency,
• 1:41
  - convenience, and speed.
• 1:43
  - And increasingly, folks are especially younger consumers are
• 1:46
  - looking for things that are more, like, meaningful
• 1:49
  - engagement, personal connection,
• 1:50
  - memory making.
• 1:52
  - And so the idea sort of comes from
• 1:54
  - that book
• 1:55
  - and then applied to health care. Essentially,
• 1:58
  - the the idea is that that patients have
• 2:01
  - sort of two at least two clocks sort
• 2:03
  - of in mind or at least the way
• 2:04
  - the way concept conceptual frameworks for how they
• 2:07
  - think of time. One of them is, you
• 2:09
  - know, did I how long did it take
• 2:11
  - me to get an appointment? Was scheduling easy?
• 2:13
  - How long did I have to wait when
• 2:15
  - I got there? Did my test start on
• 2:17
  - time? Those kinds of those kinds of issues.
• 2:20
  - But then a second conceptualization
• 2:22
  - is more like, what did you do with
• 2:24
  - my time, when you had it? Did you
• 2:26
  - listen to me? Did you explain,
• 2:28
  - what was happening? Did I feel reassured?
• 2:30
  - Those kinds of things. And so that's that's
• 2:32
  - how we're defining time well spent. We have
• 2:34
  - a bunch of survey questions
• 2:35
  - surrounding each of these sort of frameworks, and
• 2:38
  - so we were building statistics and and and
• 2:40
  - measurements
• 2:41
  - from there. And and to answer the second
• 2:43
  - part of your question, why are both important
• 2:44
  - to patient loyalty?
• 2:46
  - I mean, health care needs both, and and
• 2:48
  - I'm excited to to to hear what Casey
• 2:50
  - has to say. I think, you know, if
• 2:51
  - you have a wonderfully compassionate physician, but it
• 2:54
  - takes six months to see them and 10
• 2:56
  - phone calls to get, you know, to get
• 2:58
  - in front of them, that could be a
• 2:59
  - problem, I I would think, for a lot
• 3:01
  - of people. But on the other hand, if
• 3:02
  - you can get me through the door incredibly
• 3:04
  - quickly, but it feels something like a, I
• 3:06
  - don't know, a NASCAR pit stop or something,
• 3:09
  - that's not a great experience either. And it
• 3:11
  - just turns out, though, through the data and
• 3:13
  - through the analysis, the patients are often
• 3:15
  - much less forgiving when their time is not
• 3:17
  - well spent.
• 3:18
  - Casey, just as a as a follow-up to
• 3:20
  - that,
• 3:21
  - again, how did this report and and again,
• 3:24
  - this this lens change your own view of
• 3:26
  - experience
• 3:27
  - and should really should health systems be looking
• 3:30
  - at this more like what William just described?
• 3:33
  - Well, I think so. And, you know, the
• 3:35
  - the fence straddling answer, of course, is that
• 3:37
  - they're both important, but I think what this
• 3:38
  - helps do is provide some insight into how
• 3:41
  - important are they, and it also helps explain
• 3:45
  - what's in a team's control and influence. And
• 3:48
  - the time well spent metric is clearly more
• 3:50
  - within the influence of the clinical care team.
• 3:52
  - And, obviously, there's operational and facility considerations to
• 3:56
  - how patients experience their time when they're actually
• 3:58
  - with us. But foundationally, that's super important. And
• 4:01
  - William laid it out clearly, I think, that
• 4:04
  - if you hurry up and get more people
• 4:06
  - into a poor experience, it's probably not gonna
• 4:09
  - produce the long term results that you're looking
• 4:10
  - for. So I think it's a great double
• 4:13
  - down and reinforcement
• 4:14
  - that we've been sharing with our ops leaders
• 4:16
  - that you have to make the most of
• 4:18
  - the time when the patients are there. You
• 4:20
  - have to make sure that the patients are
• 4:21
  - heard and that they're confident in the next
• 4:23
  - steps. That's foundational and kind of table stakes.
• 4:26
  - Having a strategy for access is just that.
• 4:28
  - It needs to be a strategy, something that
• 4:30
  - you're aligning your investments to, your capacity to,
• 4:33
  - and then it complements
• 4:35
  - your ability to provide time well spent.
• 4:37
  - And I I wanna
• 4:39
  - dive a little bit deeper into an another
• 4:41
  - element of this. You you filed the operational
• 4:43
  - piece too, but, again, there's also
• 4:45
  - something generationally
• 4:46
  - here. I know this and and you know
• 4:48
  - this and and people from different generations, of
• 4:50
  - course,
• 4:51
  - really treat health care differently.
• 4:53
  - Younger consumers report significantly
• 4:56
  - more barriers to accessing care
• 4:58
  - than older consumers.
• 5:01
  - Casey, where do you see those generational differences
• 5:04
  - showing up, and how should health systems respond
• 5:06
  - to that specific piece?
• 5:09
  - I wish I had an easy button, for
• 5:10
  - how to handle that. I you mentioned
• 5:13
  - the generational differences. A lot of it probably
• 5:15
  - comes down to expectations and what people are
• 5:17
  - looking for. And so I think that the
• 5:20
  - easy response for health systems is to make
• 5:22
  - sure that our digital tools
• 5:24
  - that our online experience or our virtual experience
• 5:27
  - is as seamless as possible. And for those
• 5:29
  - who are looking for that efficiency,
• 5:30
  - that kind of DIY
• 5:32
  - control over their health care experience,
• 5:34
  - have as much of that as possible to
• 5:36
  - make sure that we're kind of meeting those
• 5:37
  - needs.
• 5:38
  - On the other side, we're not going to
• 5:40
  - have a different access pathway or different wait
• 5:42
  - times for people based on their age, and
• 5:45
  - so we need to make sure that we're
• 5:46
  - setting expectations appropriately. And I think with our
• 5:48
  - younger patients and families, that's a lot of
• 5:50
  - our work is to setting those expectations clearly
• 5:53
  - and then making sure that we're reinforcing that
• 5:55
  - when we do see them, it is the
• 5:57
  - right care, that it's okay to wait, and
• 5:59
  - that we'll be, you know, taking really good
• 6:00
  - care of them once we do have the
• 6:01
  - chance to see them. William, did that surprise
• 6:04
  - you, that piece, that generational piece?
• 6:06
  - Not especially because a lot of our,
• 6:08
  - research from the last twelve months has been
• 6:11
  - about has had that generational lens.
• 6:14
  - And we've and we've just and one of
• 6:15
  - the arguments we've made is that one of
• 6:17
  - the issues that health care, writ large is
• 6:19
  - facing is that most of the most of
• 6:22
  - the patients and consumers
• 6:24
  - are older folks
• 6:25
  - currently,
• 6:26
  - but design has to have in mind what's
• 6:29
  - coming towards the future. And so that is
• 6:31
  - an issue that health care has not faced
• 6:33
  - in the history of health care in this
• 6:34
  - country, maybe in any country. I don't know.
• 6:36
  - I haven't I haven't I haven't done a
• 6:38
  - comparative, international analysis. But but the striking finding
• 6:41
  - was that fifty nine percent of older consumers
• 6:43
  - reported no access barriers compared with thirty seven
• 6:46
  - percent of Gen z millennials in this case.
• 6:48
  - That's a 22 difference, and that is striking
• 6:51
  - on all of our consumer research. Usually, we're
• 6:53
  - like, oh, six or seven points. Like, that's
• 6:55
  - huge. So this is, you know, three or
• 6:57
  - four times what we normally see as a
• 6:59
  - difference. And so I don't think I think
• 7:01
  - the takeaway is not that young people are
• 7:03
  - impatient.
• 7:04
  - I think that's too easy even as too
• 7:06
  - easy of a story.
• 7:08
  - But I think the definition of convenience is
• 7:10
  - maybe changing. Like, you know, I can book
• 7:11
  - a flight and change a hotel reservation, order
• 7:14
  - dinner, move, you know, my Bitcoin around or
• 7:17
  - whatever at 10:30 at night. And the the
• 7:19
  - environment you know, that's the environment that health
• 7:21
  - care is competing against, for for many younger
• 7:24
  - consumers' expectations. And I think solving for that
• 7:27
  - while still maintaining
• 7:28
  - the the good work that a a lot
• 7:30
  - of health care, organizations are doing with older
• 7:32
  - patients and consumers is is is the is
• 7:34
  - the challenge.
• 7:36
  - We're so conditioned towards those experiences too as
• 7:39
  - consumers
• 7:40
  - because we're experiencing
• 7:42
  - them in every other sector but health care
• 7:44
  - oftentimes,
• 7:45
  - right, and shopping, etcetera. I love that you
• 7:47
  - highlighted that because it's so crucial to this
• 7:49
  - conversation.
• 7:51
  - Now we talk about speed a lot, and
• 7:53
  - and, again,
• 7:54
  - speed is an important factor, but there's also
• 7:56
  - a limit to what improving speed alone
• 8:00
  - can actually accomplish. Again, we know access and
• 8:02
  - efficiency also matter. It's important.
• 8:05
  - William, beyond making,
• 8:07
  - again, care faster and easier,
• 8:10
  - where should health systems focus today
• 8:13
  - to strengthen patient loyalty?
• 8:16
  - Yeah. I mean, I can tell you that
• 8:18
  - that what the data says, and you mentioned
• 8:19
  - it and Casey you said it too. But
• 8:21
  - just to reiterate, like, if if I can't
• 8:23
  - get you through the front door, I don't
• 8:26
  - have much of an opportunity to create loyalty
• 8:28
  - with you. So that part matters, but we
• 8:30
  - did find diminishing returns to efficiency alone. So
• 8:32
  - at a certain point, you know, shaving a
• 8:34
  - a a few minutes off of a waiting
• 8:36
  - time or or, you know, getting you know,
• 8:37
  - shaving a couple days off of a a
• 8:39
  - of an appointment when process,
• 8:42
  - isn't necessarily where the biggest returns to loyalty
• 8:45
  - and and, are going to lie. So we
• 8:47
  - ask a separate a separate question. You know,
• 8:49
  - once we consider
• 8:50
  - these different parts of the experience together, what
• 8:52
  - actually distinguishes loyalty? And that's where the human
• 8:55
  - interaction
• 8:56
  - metrics start sort of winning. Confidence and trust,
• 8:59
  - clarity, and, understanding, reassurance, communication, those things rise
• 9:03
  - to the top of predictors
• 9:05
  - of,
• 9:06
  - nines and tens or or good scores on
• 9:08
  - on on on NPS questions, which I love
• 9:10
  - because after crunching all the numbers, you know,
• 9:12
  - we find something that's sort of profoundly human
• 9:15
  - where, people are willing to forgive to a
• 9:18
  - degree some delay
• 9:20
  - as long as they know they're in good
• 9:21
  - hands afterwards. And I think,
• 9:23
  - I think that's an important lesson for for
• 9:25
  - people in in in this business.
• 9:27
  - Casey, do you feel like organizations understand that
• 9:30
  - or have an understanding for why this is
• 9:32
  - so important?
• 9:33
  - I think we're getting there. And one of
• 9:35
  - the challenges that probably not unique to health
• 9:37
  - care but is,
• 9:38
  - very prolific is the
• 9:41
  - silos in which we both provide care and
• 9:43
  - then measure those experiences.
• 9:45
  - And so,
• 9:46
  - it really is challenging for us to connect
• 9:48
  - the dots between a scheduling experience
• 9:51
  - or a, you know, a call center experience
• 9:53
  - and then a point of care experience and
• 9:54
  - follow-up.
• 9:56
  - And we have such a need to do
• 9:58
  - better at
• 9:59
  - connecting our data to understand how friction upstream
• 10:03
  - in those early experiences
• 10:04
  - is flowing into our our point of care
• 10:06
  - experiences. So I think we're learning that. We're
• 10:09
  - evolving how and where we measure experience to
• 10:11
  - get a better understanding of what those pain
• 10:13
  - points are. I'm excited about this research because
• 10:16
  - I think it helps us have a way
• 10:18
  - to kind of weight those different experiences a
• 10:20
  - little bit in terms of the importance or
• 10:23
  - impact, and is it a recoverable,
• 10:25
  - you know, issue that we have, where do
• 10:26
  - we point our very limited resources and attention
• 10:29
  - units. So evolving our understanding of how important
• 10:32
  - that friction is and what effect it has
• 10:34
  - on patient loyalty is super important in terms
• 10:36
  - of strategy and decision making.
• 10:40
  - You described a very important process there, which
• 10:42
  - is there's a ton of different touch points.
• 10:45
  - And the more touch points we have,
• 10:48
  - the more friction it generally creates because there's
• 10:50
  - more point of errors that can be involved.
• 10:54
  - The process that you've just described of trying
• 10:56
  - to you know, going through these multiple stages,
• 10:59
  - of their journey.
• 11:00
  - Right? How can health systems get better
• 11:03
  - at identifying
• 11:04
  - and addressing those compounding pain points that that
• 11:08
  - chain, so to speak?
• 11:09
  - Yeah. I think some of it is improving
• 11:11
  - their measurement systems, like getting really adept at
• 11:13
  - understanding what are patients looking for out of
• 11:15
  - each interaction.
• 11:17
  - And I think there's a lot to be
• 11:19
  - said in the research that William shared here
• 11:22
  - about what really matters to patients. And so
• 11:24
  - you think about where you should measure that
• 11:27
  - versus where should you measure access. I I
• 11:29
  - know that, sometimes people are asking access questions
• 11:32
  - on the point of care survey.
• 11:34
  - I feel like that's a little bit frustrating
• 11:35
  - for the care team. They have limited levers
• 11:38
  - to pull to change access or wait times.
• 11:41
  - And so if you kind of think about
• 11:43
  - the data as a way to say where
• 11:44
  - do we need to gather this insight and
• 11:46
  - then who's positioned best to do something about
• 11:48
  - it, it can kind of ask some interesting
• 11:50
  - questions about your measurement strategy of what are
• 11:52
  - you actually asking of who and what are
• 11:55
  - the patients trying to get out of that
• 11:56
  - particular step.
• 11:58
  - Obviously, there's a lot of room for opportunity
• 12:00
  - and we're no exception to that. Getting better
• 12:02
  - at connecting the dots of patient A had
• 12:05
  - this experience here and here and here, what
• 12:07
  - were the themes, the comments, the
• 12:10
  - experience scores across those critical things to the
• 12:12
  - outcomes for that patient each of those steps.
• 12:15
  - We don't do a good job of tying
• 12:16
  - those things together. We kind of view scheduling
• 12:18
  - as one experience and paying your bill as
• 12:20
  - one experience and the care encounter as a
• 12:22
  - separate one. Then we can look at themes
• 12:24
  - in aggregate. We're not as good at tracking
• 12:26
  - what that looked like for patient a all
• 12:28
  - the way through, and that's a growth opportunity
• 12:30
  - for us for sure. William, I know that
• 12:33
  - the
• 12:34
  - the report specifically shows that piece, that friction
• 12:37
  - becomes more damaging
• 12:38
  - when it follows patients across multiple stages. Right?
• 12:42
  - Anything to add here on that specific piece?
• 12:44
  - Yeah. Just the the thing that I emphasize
• 12:46
  - is that that is the accumulation
• 12:48
  - of friction
• 12:50
  - matters. I you know, I couldn't get an
• 12:51
  - appointment when I wanted, then I had trouble
• 12:54
  - finding where to go when I got there.
• 12:55
  - Then I waited a long time in the
• 12:57
  - waiting room. Then I had to repeat the
• 12:59
  - information that I'd already provided prior to the
• 13:01
  - visit. And then I left without being sure
• 13:03
  - what happens next, and I don't understand my
• 13:05
  - medications. And it's like none of those are
• 13:07
  - individually catastrophic.
• 13:09
  - But piece that together and hang it together
• 13:11
  - in the mind of of the person experiencing
• 13:13
  - this this care journey.
• 13:15
  - And and that's the story that hangs together
• 13:17
  - and gets and gets repeated, you know, beyond
• 13:19
  - the four walls of the care setting. So
• 13:21
  - it's the so
• 13:22
  - yeah. It's there's there's a there's a difficulty
• 13:25
  - or or there's a hazard of of fragmentation
• 13:27
  - across
• 13:28
  - teams or across the journey that that I
• 13:31
  - think, you know, the patient experiences while maybe
• 13:34
  - only the the care providers experience only segments
• 13:37
  - of that
• 13:38
  - of that,
• 13:39
  - process.
• 13:41
  - I wanna wrap us up with sort of
• 13:42
  - an an overarching view of all of this.
• 13:46
  - Again, improving the way patients experience the time
• 13:49
  - touches so many different elements
• 13:51
  - in this conversation. Right? We talked about operations,
• 13:53
  - digital
• 13:54
  - to clinical care, obviously,
• 13:56
  - and the patient experience at the end of
• 13:58
  - the day.
• 13:59
  - I'd like to close this out with this
• 14:01
  - question here. Who should ultimately own all of
• 14:04
  - this work,
• 14:05
  - and how do you keep it from becoming
• 14:07
  - fragmented
• 14:09
  - across the organization when there's so much to
• 14:12
  - think about? Casey, I'll start off with you.
• 14:14
  - I think that's foundational by any improvement that
• 14:17
  - you're gonna get experience is being really clear
• 14:19
  - about who are the ones who are delivering
• 14:21
  - the experience
• 14:22
  - and making sure that they can see themselves
• 14:24
  - in your measurement device, whether that's your key
• 14:26
  - driver questions you're asking on a survey or
• 14:28
  - your operational metrics for a team. And
• 14:31
  - if you don't have that kind of buy
• 14:33
  - in from those who are delivering the experience
• 14:35
  - and that the data represents their work,
• 14:38
  - it doesn't matter how great and well connected
• 14:40
  - your data is. They're not gonna take action
• 14:41
  - on it and not gonna take it into
• 14:42
  - consideration. So I think it's so important that
• 14:45
  - we're really clear
• 14:47
  - that we set the expectation with our leaders
• 14:49
  - and our teams that you're the ones delivering
• 14:51
  - this experience, and here's how we're evaluating you
• 14:54
  - in a way that is reasonable and fair
• 14:56
  - and representative of the work that they're doing.
• 14:59
  - Who owns this work? Yeah. Well, yeah. No.
• 15:01
  - I'm actually very curious. I have maybe a
• 15:03
  - question of my own for Casey and and
• 15:04
  - how it works with his organization. But so
• 15:06
  - the the way that, you know, we've always
• 15:08
  - thought about this
• 15:09
  - from from our end,
• 15:11
  - which is not the same way that Casey
• 15:13
  - thinks about it, I'm sure, is that in
• 15:15
  - the what I was mentioning before is that
• 15:16
  - there's a continuity in the patient experience. Like,
• 15:18
  - sometimes it gets broken up across departments
• 15:21
  - for people delivering care. So the access center
• 15:23
  - might own one piece or digital teams might
• 15:26
  - own, you know, the the back end of
• 15:28
  - the app of the, you know, down or
• 15:30
  - a clinical team might own another nursing, etcetera,
• 15:32
  - discharge teams.
• 15:33
  - But the patient doesn't, you know, say, well,
• 15:36
  - my access center experience was a seven, but
• 15:38
  - my clinical experience was a nine. You know,
• 15:41
  - they say, like, this is my experience with
• 15:43
  - my with with my with this health system.
• 15:45
  - So I I I don't know. I don't
• 15:47
  - think we need, like, a c a new
• 15:49
  - c suite title, like chief time officer,
• 15:52
  - although,
• 15:53
  - I'm available for consulting. I think, Casey, if
• 15:56
  - you're not gonna
• 15:57
  - start a new little side gig. But no.
• 15:59
  - But I'm curious, like, the you know, what
• 16:01
  - does it require
• 16:02
  - from an organizational standpoint, Casey, to to
• 16:05
  - hold some,
• 16:07
  - yourselves or or organization accountable across those seams
• 16:11
  - that are often run by other departments. Is
• 16:13
  - that your experience, and and how do you
• 16:14
  - account for that? Yeah. I think it's really
• 16:17
  - complicated, and I know we're trying to be,
• 16:19
  - reasonably succinct here as well. I I will
• 16:21
  - just say that from the most basic standpoint,
• 16:25
  - having really clear operational owners within each care
• 16:27
  - team getting the results of the experiences for
• 16:29
  - that area. So, right, the billing call center
• 16:31
  - gets their experience data and is accountable for
• 16:34
  - that. The clinic team gets their experience data
• 16:36
  - and accountable for that. Now when it comes
• 16:39
  - to things like how do those teams advocate
• 16:41
  - for, how do friction points that patients experience
• 16:44
  - on other teams get connected, I think that's
• 16:46
  - where the rubber really hits the road from
• 16:48
  - an organizational strategy standpoint in, like, system CX
• 16:50
  - teams where we can help bring value by
• 16:52
  - helping connect the data and tell the story
• 16:54
  - and provide
• 16:56
  - avenues for people, even if it's not in
• 16:57
  - our measurement and data, to be able to
• 16:59
  - escalate concerns and have a contact or a
• 17:02
  - friend in another department that you can say,
• 17:04
  - hey. You know, this patient came, and they
• 17:06
  - told us they had a really bad scheduling
• 17:07
  - experience. You've got a partner who's able to
• 17:10
  - receive that information and take accountability and kind
• 17:12
  - of take that data onboard to improve.
• 17:14
  - Obviously, we'd like our measurement systems and our,
• 17:18
  - kind of strategy of how we think about
• 17:20
  - evolving patient care to take both those things
• 17:22
  - into account. But in absence of that, I
• 17:24
  - think you really have to have that partnership
• 17:26
  - across teams.
• 17:29
  - Chief time officer, I will add to my
• 17:31
  - LinkedIn profile. I think this is a great
• 17:33
  - title to have. William, Casey, same for you.
• 17:36
  - I feel like you should all have that
• 17:37
  - title. It works very well. I wanna thank
• 17:39
  - you both so much for taking some time.
• 17:41
  - What a great conversation. Thank you for being
• 17:42
  - here. It's great to have you. Thanks, Lucas.
• 17:45
  - Pleasure. Thank you. And we also want to
• 17:47
  - thank our podcast sponsor, NRC Health. You can
• 17:49
  - tune in to more podcasts from Becker's Healthcare
• 17:51
  - by visiting our podcast page at becchershospitalreview.com.