Is Healthcare Designing the Wrong Patient Experience?

Patient experience.

It what’s in. It’s what’s vogue. It’s all the rage.

There is a not a day that one cannot open a paper, a medical journal, Twitter, FaceBook, email, or a conference brochure and not see something about patient experience.

In the U.S. its healthcare’s new version of a best practice. It’s another way to share best practices across an industry. It provides another bandwagon to hop on and spread across the great plains.

But are we scaling mediocrity?

In 1998 Joseph Pine II and James Gilmore wrote a paper published in the Harvard Business Review entitled “The Experience Economy” that was part of a similar book they published by the same title. (paper here

In the paper the economists discuss the evolution of the American economy. One from commodities, to goods, to services, and now to a new offering called experience.

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I recreated their slide using birthday cakes as their example in the progression in our economy. As the industrial revolution continued to evolve, so did our economy.

The paper was so influential that it caused Fred Lee to write a book in 2004 entitled, “If Disney Ran Your Hospital.” Fred’s premise was that healthcare was more closely aligned to Disney than it was to the service industry.

Fred did a great job at demonstrating that service is a payment for the work we can do ourselves that we want others to do for us. Whereas experience in healthcare is about meeting the emotional needs of a family going through fear, pain, and even tragedy together.

A movement was born.

Leaders of healthcare organizations and hospitals ran to learn more, share, and discuss their best practices on patient experience.

I challenge that they ran to design the wrong experience.

Experience is defined as a particular instance of personally encountering or undergoing something. It is our perception.

Healthcare again is staging an encounter on behalf of the patient, not with the patient. Jason Wolf and the Beryl Institute have done extensive work and a great job on defining patient experience as:

“The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across continuum of care”

The key word in the definition is “culture.”

When I go to a conference or talk to people in leadership roles of healthcare organizations and hospitals they jump to things like: parking, the color of paint on the walls, artwork, water falls, reiki, massage therapy, and robes that are like the ones you get in a spa.

Great. Now more and more hospitals are trying to be like Disney. They are trying to stage an environment for patients. Healthcare is jumping to what they think will make a patient forget that they are in a clinic, or an exam office, or a hospital.

Healthcare is designing the wrong experience.

Enter the “Connection Economy.

Seth Godin defines the Connection Economy as the following:

“In a world of abundance of choice and endless options, there is a premium on credibility and trust.”

Stop and think about that for a moment.

We are no longer in the industrial age. We are in the age of the Internet. Our economy has evolved from commodities, goods, services, and experiences to connection.

As demonstrated on a daily basis, anyone with a computer and/or a smart phone has the ability to connect with anyone else in the world. There are no more boundaries. There are no more limits. There are no barriers other than having a device that allows you to hop on the super highway of the Internet and travel to the other side of the world to meet and connect with other people.

Instead of healthcare focusing on staging an experience for patients, why are we not designing opportunities for us to truly connect with our patients?

When most patients have a pain, injury, or a medical related question they go to those they trust and connect with like Dr. Google, their friends and family, their co-workers, and then if everyone indicates they need additional care they ask those same people for advice on where to go for care.

Why? Because people that become patients rely on other people that they connect with on a more frequent basis. Humans thrive off of bonds, links, and relationships. We want to know that we are not the only people in the world experiencing our current condition or diagnosis. So we seek others with similar lenses to our own.

We connect.

The 4 pillars of the connection economy as stated by Seth Godin are:

1. Permission 2. Trust 3. Exchange of Ideas 4. Coordination

I have applied the 4 pillars of the connection economy to healthcare. Based on interviews, discussions, and observations with patients I have come to realize that there is a direct relationship between the connection economy and my original 3T’s of Patient Expectations. There is so much correlation that I realized that I overlooked a 4th T, transitions.

The 4T’s of Patient Expectations:

1. Time 2. Trust 3. Transparency 4. Transitions

Remember, patients today have more choices then ever. Patients can go to Walgreens, CVS, retail clinics, urgent care, local hospital in their neighborhood, community hospitals, academic medical centers, destination medical centers, or even telehealth for care.

As most healthcare leadership teams focus on inputs such as parking, paint, chairs, couches, windows, lighting, and background music their patients are busy connecting with other people.

Maybe a competitor that decides to interact via social media versus using it to broadcast more information about what you do versus why you do your work. (Thank you Simon Sinek for your Golden Circle)

Patients care less about your EHR/EMR and even less if you have reached meaningful use stage 1/2.

Patients do care if you walked into the room, introduced yourself, silenced all of your technology interruptions, and gave them your undivided time and attention for the next 15 minutes of the exam. Patients are giving you permission to spend time with them.

Patients do care if you made the effort to give them uninterrupted time to build trust in your relationship. When patients and physicians trust one another they begin to understand how they can best work with each other, collaboratively.

As patient trust grows so does the dialogue, the sharing, the storytelling. The transparency. The exchange of ideas and information with one another.  Patients may have time to read a recent article that a physician doesn’t due to time and interest. The sum of us is still greater than any of us.

When we connect and focus on the 3T’s above it enables us to effectively manage the 4th T, the transitions, from one stage to the next. There is great value in bringing people together in a coordinated manner. In healthcare when we focus on those transitions to connect with patients, physicians, and other care members it improves our “quality” of care.

What healthcare needs are not prettier buildings. Healthcare needs more and improved spaces to connect patients and physicians.

I would rather have patient loyalty built by connections versus a pretty building.

If the building burns down patients will go to the next pretty building.

When I spend time building connections, relationships, and bonds with patients it matters less about the building and more about the next time we can connect with one another in a meaningful way.

Forget transporting me to a different world that will try to make me forget that I am not well.

Disney is staged for me, not by me.

Please stop scaling the mediocrity.

Start designing a healthcare that allows us to connect. A system that rewards building relationships proactively.

Reward us for what we do today, one patient at a time, the one that is staring us back in the eyes.

Right now, at this very moment, that is the only patient that matters.

Let’s connect.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek


Andy DeLaO, aka Cancergeek, is a healthcare professional with 15 years of experience leading and developing healthcare service lines, marketing, and challenging the status quo of healthcare delivery to improve connecting patients and the world of healthcare.

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3 replies »

  1. Good points. I agree. Docs have to devise ways to be better agents for their patients–so that trust comes back. When we see pur patients treated badly–eg given static over a bill from the hospital–we should help the patient resolve this. Patients are forced to run a gaintlet of registration hassles when they come into the hospital. We should fight to simplify that. We should demand that insurance contracts be simple and that all paperwork be understandable. And much more….

  2. Fantastic state of the state of healthcare.

    People don’t scale, large enterprises scale; processes can scale – empathy does not scale; time does not scale – it is linear (and often feels compressed).

    We need to do more listening with our eyes!

    ping me @drshlain

  3. There’s no communication, much less coordination, of anything without connection of some sort.

    We don’t connect with Disney because of theme park features, we connect because of Mickey, and all his character pals. In following the “be like Disney” dictum, healthcare leapt past the real essence of branding – which is the gut feeling your name, or logo, inspires in those who are aware of you; your brand IS NOT your logo on its own, it’s that gut feeling – and thereby pretty much nailed getting stuck on the “see hospital name, feel desire to avoid at all costs or creeping dread of illness/death” spiral.

    People don’t WANT to be sick. They don’t seek out hospital experiences like they would a hotel recommendation. They’re at their sickest, and most vulnerable, when they arrive at a hospital’s door. When it comes to a relationship with their healthcare “best friend” (their primary care provider), connection is thwarted much of the time because of … well, time. Hard to become besties in 15 minute chunks, and then there’s the whole “Dr. So’n’So has left the practice, you’ll have to select another doctor” trap door that yawns in narrow network/managed care scenarios.

    E.M. Forster used “only connect” as an anchoring theme in his novel “Howard’s End” in 1910, when the first iteration of wireless – radio – was in its infancy. A century later, “only connect” is still a bedrock yearning for all humans. We all crave, and thrive, on human connection. The settings in which that connection occur run a distant second to that. Healthcare fails to understand that at its peril …