Patients often confront a healthcare system that can seem baffling, difficult to navigate, user-unfriendly—and at times inaccessible physically and technically. They experience limited face time with their clinicians; overcrowded emergency departments, clinics and hospitals; confusing forms, instructions and bills; labyrinthian hospitals and uncomfortable waiting rooms; and outdated methods of scheduling and communication— conditions that would be cringeworthy in almost any other industry—retail, hospitality, even airlines.
Across the country, hospitals and medical systems are working with hundreds of startups, innovators and patient advocacy groups to develop improved technologies and processes. According to a recent study, nine out of ten healthcare organizations are actively investing in new technology to improve patient experience. These include newly designed patient portals and proprietary apps to improve scheduling, reduce wait times, track health data, answer questions and provide clinical information.
The primary point of care will be less in doctor’s offices and hospitals, and more in clinics located in pharmacies like Walgreens and CVS, as well as major retailers—starting with Walmart. As service locations proliferate, access to quality care will improve across the socioeconomic spectrum. Wealthy patients already have options outside the doctor’s office, including $40,000-a-year full-service, high-touch services like San Francisco’s Private Medical. Thanks to competition and innovation driving down costs, concierge medicine is now affordable beyond the 1%. Sollis Health offers 24-hour access to on-demand imaging services, unlimited doctor’s office visits with no wait time, and even emergency medicine at locations that include Manhattan, Beverly Hills, the Hamptons and Palm Beach for $3,500 to $6,500 a year (house calls cost extra)—an amount within reach of families with incomes in the top 10%. One Medical, with a $200 annual membership fee, has many of the logistics-improving features of the concierge services.
Eventually, most medical exams and diagnostics will take place in the comfort of the patient’s home, assisted by always-on health monitoring devices and home delivery of diagnostic assays that individuals can perform on themselves.
Equity and inclusion … represents an essential consideration in patient experience improvement efforts as healthcare leaders strive to provide more accessible, timely and affordable care within their local communities.
Editor-in-Chief, Journal of Patient Experience
The healthcare system has long relied on a fee-for-service model where insurers, Medicare, Medicaid and other payers compensate caregivers and providers based on the volume of services—incentivizing providers to do as many procedures as possible. A movement is growing to shift to value-based care, which focuses on—and rewards—preventive and positive health outcomes. Moving payments “from volume to value” will be critical in addressing racial and socioeconomic disparities in healthcare and staving off the perennially debated insolvency of the Medicare Trust Fund.
A handful of innovative medical systems are providing a blueprint for the future by embracing value-based medicine that prioritizes patients’ long-term health.
Kaiser Permanente, based in California, is at the forefront of the shift from fee-for-service, and uses detailed patient data to drive evidence-based care—which improves outcomes, like having newborns spend fewer days in neonatal intensive care.
Geisinger, based in Pennsylvania, has partnered with an AI-driven machine-learning platform to smooth the payment authorization process and allow for more timely, higher-value care.
In Florida, orthopedic surgeons at Holy Cross Medical Group are teaming up with postoperative discharge coordinators and physical therapy providers to dramatically reduce post-joint-replacement recovery times—and rehospitalization rates. The resulting savings are divided up between the doctors, coordinators and therapists, and patients benefit from a faster return to an active lifestyle.
For lower-income populations that rely on Medicaid, organizations like Oak Street Health emphasize value-based care and community outreach. Oak Street, headquartered in Chicago and serving over 150,000 at-risk patients across 20 states, organizes social events like cooking classes to engage seniors and promote healthy eating. Other caregivers are helping patients with services like teaching how to improve diets, and van transportation to cancer screenings and other early detection appointments. Over the next decade, community-oriented, patient-centric services will become commonplace and will reach diverse communities as more and more providers prioritize keeping their patients healthy, not hospitalized.
Evolv Health is removing inefficiencies from the traditional transitional care system with automated discharge plans, centralized patient data and personalized patient management that reduces hospital stay time and rehospitalization. Using a platform built on a database of 700,000 patient records, Evolv’s system cuts social workers’ time by 50% and reduces typical discharge time from three days to three hours.
Using real-time actionable data allows proactive management of deviations and complications within the transitional process
– 4 DaysPER ADMISSION
Reduced stays at skilled nursing facilities for at-risk clients by automating the discharge service coordination process
30-day post-discharge rehospitalization rate
In the value-based model, sophisticated providers understand that increasing the coordination of services will reduce high costs. The system has traditionally been focused on being a ‘care limiter’ looking to reduce services to reduce costs. Our system has shown that just by increasing a patient’s confidence, it can reduce their rehab stay by one day, which is millions of dollars when aggregated.
CEO, Evolv Health
Consumers expect a clean, spacious and logically organized building when shopping for groceries or navigating a hotel lobby. Yet today, patients visiting healthcare settings like emergency departments and inpatient wards often encounter cramped, confusing and outdated quarters. Beyond obvious privacy and infection-control implications, inadequate physical spaces are antitherapeutic to those recovering from illness or surgery. New healthcare facilities are better designed, with private exam rooms, improved lighting, curated artwork and comfortable furniture.
At UMass Memorial Medical Center in Worcester, Massachusetts, facilities leaders removed familiar Monet and Van Gogh prints in favor of locally produced art reflecting the diverse cultural experiences of their patient population. The hospital offers selfguided healing art tours for patients and visitors.
Designers working with the Cleveland Clinic Children’s Hospital partnered with Danish artist Per Arnoldi to use art to aid in touch-free wayfinding throughout the hospital.
Well-designed interactions with caregivers are as important as clean, well-lighted spaces. Some medical centers are improving patient encounters by creating new programs with an emphasis on teaching employees to be kinder and gentler with patients— training that has long been a core feature of many service industries.
At Mass General Hospital in Boston, emergency department staff who participated in a formalized “icare” empathic communication curriculum overwhelmingly reported its usefulness in improving their practice.
At Cleveland Clinic, the “Communicate with H.E.A.R.T.” model has been used to empower staff across the healthcare system to listen to patient complaints and communicate with compassion.
While rare today, patient experience ratings will be increasingly factored into healthcare payments. This will drive leaders to embrace the customer service side of medicine.
The two biggest consumer engagement platforms we have access to today are, by far, the mobile phone and messaging—and that includes mobile texting. Ninety-seven percent of text messages are opened in under three minutes. Conversational systems are powerful and they’re game-changing.
CEO, Lifelink Systems
With more than 80% of adults—and 95% of those between 18 and 29— using text messaging regularly, patients will no longer call a receptionist or wait on hold. Instead, real-time text communication pioneered in other industries will become the norm, creating new levels of flexibility and efficiency. Widespread use of new biometrics and information security, if embraced by healthcare, will reduce clumsy logins and multistep authentication procedures. Conversational AI assistants will simplify and improve information gathering and planning of treatment and follow-ups through advanced natural language processing (in multiple languages).
In emergency departments and clinics inside and outside hospitals, chatbots will integrate with the electronic health records, bed management systems and other sources to tell patients what to expect next—and when. This sort of communication can alleviate anxiety and relieve the stress of being a patient.
88%OF HEALTHCARE ORGANIZATIONS
Actively investing in new technology to improve patient experience
By 2025, being “admitted” could mean a trip to your own bedroom, where a mobile EMT team arrives to set up advanced remote heart and lung monitoring gear, video equipment and even a hospital bed. Regular visits—both in-person and virtual—from physicians, advanced practice providers, nurses, physical or occupational therapists and others will allow patients with illnesses ranging from straightforward to complex to be cared for without ever occupying an inpatient hospital room.
At Mass General Brigham, the largest health system in Massachusetts, more than 200 patients who otherwise would have required inpatient admission will soon be cared for in their homes, ultimately leaving the majority of brick-and-mortar hospital care for emergency, operative and intensive care. Given the myriad benefits of home hospitalization for select patients (including decreased rates of readmission, lessened anxiety and lowered costs), this model will grow exponentially in the coming decade, with thousands of hospitals across the US offering home-based acute care programs.
The home may not be the only place for patients to receive high-quality care. Pre-pandemic, international medical tourism was an $80B–$90B industry with $3,500-plus spent per trip. The global market is growing 15%–25% as patients flock to popular destinations in Mexico, Southeast Asia and South Asia. The medical tourism market will continue to become more sophisticated, offering services for cancer care, cardiac surgeries, stem cell treatments and organ replacements.
10xIncrease in medical tourism market by 2030
4,000+Walmart Health primary care medical, dental and vision supercenters opening soon
YOUR CHECKUP WILL BE ON AISLE EIGHT
Retail clinics like CVS MinuteClinic (offering low-complexity care at over 1,100 locations) are already well established. In addition, CVS, Walmart, Dollar General and other retail chains will increase investments in these points of care and plan to bring a greater breadth and depth to the services provided. For instance, Walmart Health has announced plans to open 4,000 new primary care “supercenters” to include medical, dental and vision care.
Putting comprehensive healthcare where people already are going will improve access to care, particularly for the most vulnerable among us such as the uninsured or those living in one of the country’s many healthcare deserts.