Patient experience isn’t a nice to have - it’s core to the long-term productivity and sustainability of a health system.
In general, patient experience is poorly understood by the health sector. It is mostly considered discretionary – ‘we should do this because it will make customers happy’ – but as secondary to the ‘important’ issues such as health outcomes and patient safety.
As such, it’s generally considered somewhat discretionary, especially in terms of investment, and something that can be traded off: ‘we should improve the patient experience, but can we afford more cost and time?’ What would be the return on it?
In fact patient experience is something that goes to the very heart of the productivity and sustainability of the system, whether that be an organisation or a health system.
So how do you put a value on patient experience? To answer this, it is important to put the question within the right framework. To understand the causality between patient experience and value so that it can be understood and measured.
Defining customer experience
In terms of customer experience, many other industries including banking, retailers, education and food and beverage, have exactly the same question and misunderstand experience in a similar way.
Every business or organisation is designed around meeting a customer need with a solution – solve customer problems and they will pay accordingly. Successfully matching the design of the offer to the customer need, whether it is the product range in a supermarket or whether it is in a health system where the treatment matched to the diagnosis, is the core of any organisation.
It is, however, equally important to match the experience to the customer journey. The experience is the context that the product is delivered through. It considers the end-to-end journey a person goes through in experiencing the service – from prior to consumption to the end of the relationship. It is important to match this experience to the journey to ensure the efficacy of this meeting of the solution and the need.
When the service delivered across the journey doesn’t match to the customer’s needs, you get friction in the system. This friction can take the form of many things - interfaces that are hard to use, complicated paperwork, hard to navigate locations, unclear processes or next steps, and seemingly rude, uncaring staff.
In turn, these frictions create waste in the system – rework, additional customer effort, repeated visits, reliance on service channels. All these frictions - the barriers and complexities that are put in front of customers - create effort, confusion and frustration. They create distrust over time, and ultimately, disengagement. They see customers opting out, and acting out. In essence, it drives increased cost and lower conversion, and reduced loyalty over time.
The reason that this occurs is because most customer experiences are not actually designed around customers to start with. They have grown organically out of the organisation, reflecting the organisation’s internal structure, e.g. the way the layout of supermarkets reflects the internal category management structure of those supermarkets rather than the way people shop, in a similar way that the patient experience today reflects the fragmented structure of health specialists and care delivery.
Similarly, they often fail to consider the customer in ‘full’ – their context, background, education. They fail to consider the emotional meaning of interactions and experiences. They fail to consider the ‘irrational’ behaviour of human beings.
It’s for this reason that improving the customer experience isn’t about ‘more for more’ – investing to make customers happier. It’s about removing friction, getting out of the customers way, and in doing so, making them happier, letting the product shine, and removing cost out at the same time. Customer experience is a fundamental driver of productivity of the system, not a discretionary nice-to-have.
Patient experience in the health system
In the health context we see exactly the same dynamics. The experience is the context through which the care is delivered. A patient with multiple, interconnected health issues finds themselves bounced around the system from specialist to specialist, prescribed various different medications, their emotional needs not met and creating confusion and mistrust. In time, the lack of co-ordination and poor patient experience leads to the patient to ‘acting out’ and opting out of treatment altogether.
In essence, it doesn’t matter how effective the diagnosis is, or the efficacy of the treatment, if the patient opts out or doesn’t adhere to it. At the same time, costs are increased due to the additional handling, rework, wasted treatment – and over time, worse health outcomes. Friction in the context fundamentally reduces the efficacy of the treatment.
Alternatively, a better fit between product delivery and patient experience results in reduced effort, increased clarity, confidence, trust and engagement, and better follow-through and future engagement. This in turn delivers better health outcomes on the one side and a more efficient system, with less waste in terms of duplication, repeat visits and readmissions, on the other. Cost is taken out of the system as waste is reduced and patients become more engaged as trust and reputation are built.
Simply, patient experience is not about simply making people happier, it is about aligning the delivery experience to the needs of the patient to drive a productive and sustainable system.
The value of patient experience
Despite all of this, it is interesting to note that no-one asks the question on ‘the ROI on patient safety’ or clinical effectiveness, yet it’s not uncommon for the same to be asked of patient experience. It’s for these reasons that patient experience is not something that can be considered somehow lesser than clinical effectiveness and patient safety. Instead, all three should be seen together as an equation towards productivity of the health system, both financially and morally.
In conclusion, putting a value on patient experience is less about ascribing specific values. It is about putting patient experience in a framework and understanding where it sits in any particular system and how it drives value – how it drives improved outcomes on one side and how it drives reduced costs on the other, ultimately leading to better returns from investment.
The opportunity for payers
There are few entities that benefit more from lower costs, from better health outcomes and from happier patients, than payers.
The opportunity that has probably gone unmet to date is for payers - including insurers - to act as advocates for patients in the system, to champion the consumers' rights. Because it works for them.