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A New Framework for Putting Patients at the Center of Digital CARE

Posted By Niall O’Neill, Tuesday, May 15, 2018
Updated: Wednesday, May 16, 2018

"Oh great." I hear you say. Yes, this is another article about consumerism in healthcare. McKinseyForbesDeloitteNYTimesHarvard Business Review, you name it – industry leaders and commentators have all called this trend in recent years, and consumerism was a hot topic at HIMSS. But the truth is, this conversation started at the turn of the century.

A long, long time ago, in the year 2000 AD...

The Institute for the Future made some alarming projections about healthcare. They identified early connections between healthcare spending and consumerism.1





Passive recipients of care

Actively making choices about care


A healthy economic market requires competition, and therefore, informed and engaged consumers empowered by choice. Other industries like retail, travel and technology2 have adapted rapidly, and consumers expect the same in healthcare services.

This isn’t about Siri replacing your primary care physician or Amazon’s robot surgeons replacing hips at Whole Foods. While we might get there one day, let’s dim the science-fiction fantasies for now and focus on the present reality.

We need a simple framework to drive today’s digital solutions so we can adapt quickly to healthcare consumerism, put patients at the center of care, and create a meaningful, interoperable platform to enable the future. Solutions for this new landscape must adhere to four fundamental principles of digital CARE:

  • Convenience
  • Accessibility
  • Relationships
  • Empowerment


Once upon a time, patients may have had one choice - the community hospital. With the ongoing consolidation in the US market, super-systems now compete regionally for consumer loyalties.

Today, consumers have a choice, and are influenced by the same drivers as other industries – a need for convenience and responsiveness.3 When we look at the evolution of digital tools like smartphones, convenience drives us.

A zero-friction customer service model isn’t just “nice to have.” It’s absolutely necessary for acquiring and retaining consumer relationships. For patients, particularly those with ongoing care needs, convenience will reduce the burden of these interactions.

One technique is to map the consumer’s journey, starting from the point at which they have a need for care. Try thinking from the user’s vantage point. Even if a process works well for you and your staff, it may not optimally address your consumers’ (or their families’) needs. When we walk in our consumers’ shoes, we better understand what they are thinking and feeling, and can identify new opportunities for improvements.

Only when you understand your opportunities for improvement should you identify digital solutions.

When you can anticipate your consumers’ needs and think holistically about their interactions with your organization across multiple channels you can design personalized solutions that make it easy for them to get the information and communication they need, at the right time, in the right way. Reduce the friction, make it easy for your consumers.


Ron Mace, founder of the Center for Universal Design has defines Universal Design as the “design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.”

To achieve this, involve as many consumers as possible in your design process. Connect with patient leaders through Patient Advisory Boards, or through organizations like WEGO Health and the Savvy Coop. Ask them to share their stories, and let them shape your diverse, realistic user personas. For those who don’t speak software, that just means your consumer experience must work for everyone, even outliers. Real life is messier than fiction, so let them inspire you to test your design in ways you wouldn’t have otherwise. And remember, your consumers speak many languages – emotionally, culturally and literally. Will everyone know what to do? Feel understood? Heard?

Technology creates new possibilities for accessibility.


It is the best of times, it is the worst of times. Providers that meet or exceed expectations will gain and sustain relationships with consumers. Sounds great if you’re a consumer, but do providers have the time to be heroes?

They do if you leverage technology to automate their routine administrative and clinical tasks, so they have time to spend enriching patient interactions. Look for tools that enable them to focus on care and the interpersonal relationship, rather than data entry.

But remember, technology can do A LOT more than automate. Think of a time when you talked to an old friend living 10,000 miles away, or followed a new friend on Instagram because they had the best kitten memes...we are delighted in these moments. Can you foster the same humanity between doctors and patients using technology?

Digital tools have the power to improve communication in our relationships and foster partnership among consumers and caregivers. Today’s open, secure platforms for video and text-based dialog with “carers” (providers, family, friends) allow consumers to access care, share preferences, ask questions, and make shared medical decisions in the hospital or at home.


Knowledge is [em]power. *Knowledge (noun), the application of information through actions. We need to transition from information-sharing to knowledge transfer.

Patient portals are the standard patient engagement tool, thanks to Meaningful Use requirements. They give patients a view of some data captured in an EHR, but in many cases that information lacks context or helpful next steps about disease management. It’s not actionable.

Tools that empower consumers impart knowledge to facilitate self-care, give context and ensure that patient preferences, fears and motivators are factored into a longitudinal plan of care. We live in an exciting time for innovation in healthcare, and I believe that digital technologies can help truly put patients at the center of CARE.



Niall O’Neill is the Vice President of Business Development at Oneview Healthcare, a health technology company focused on improving the experience of care for patients, families and providers. Based in Dublin, Ireland, Niall turned to healthcare after over a decade of management consulting in other industries with Accenture and Deloitte, driven by a belief that technology can make healthcare better for all.

Tags:  choice  Consumerism  patient experience  relationship  technology 

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Social Media and the Patient Experience

Posted By Andy Roller, Thursday, July 9, 2015
Updated: Tuesday, July 7, 2015

The patient journey is rapidly changing. The old patient journey went something like this:

  • Scenario 1: You got a referral from your primary care doctor and unquestioningly followed the directive. Based on your experience, you became a loyal patient, advocate (for better or worse), or indifferent.
  • Scenario 2: You asked a trusted friend or utilized some form of word of mouth. Based on your experience, you became a loyal patient, advocate (for better or worse), or indifferent.
  • Scenario 3: You became aware of a particular doctor, specialist, or practice – maybe through some form of traditional marketing (TV, Billboard, Newspaper, Direct Mail). You then considered and evaluated. You proceeded to set an appointment. You went through with the procedure or treatment. Again, based on your experience, you became a loyal patient, advocate (for better or worse), or indifferent.

Of course, every reputable practice will work to make the experience and the resulting word of mouth the best it can be. But my, how things have changed. With a rapidly increasing digital population, the patient experience starts much earlier. The journey-experience increasingly begins with online search. It continues through their experience with care they receive; then through online reviews and social media posts they publish.

According to 2014 Pew research, 86 percent of patients search online before booking a doctor’s appointment. And, as of 2013, 41 percent of patients were using social media to determine their choice of Healthcare Provider (HCP). 43 percent of medical visits originate from a search engine. These numbers are rising at a rapid pace.

A full 90 percent of patients 18-24 of age trust and make decisions based on what they find on social media. And over 25 percent of conversations on Facebook are about a health-related experience. Yet only 26 percent of hospitals in the US actively engage via social media. It's true that prospective patients don't often convert based on a single Facebook update. But the influence on patient decisions and advocacy is foolish to ignore. 

The new patient journey looks more like the following: 

The patient searches online related to symptoms, providers, reviews. They may share social updates and interact as they search. Keep in mind, what they're finding is largely the result of other patients who have posted about their experience. Marketers call this the the Zero Moment of Truth. 







Once the prospective patient finds what they are looking for, they make a decision to move forward. This is often called the First Moment of Truth. They may call or send an online form, make an appointment or schedule a consultation. Again, this moment may also be something they share with their social networks. 

The patient then attends their first appointment or procedure or hospital stay. This is their Second Moment of Truth. We most often think of this moment as the patient experience. It may be the core of their experience, but it's only part of the journey and experience. 





During and after the stay or procedure is when the majority of social sharing takes place. This sharing becomes the next prospective patient's Zero Moment of Truth. 








What will prospective patients find? How well are HCPs facilitating the patient experience along this journey?

At Expio, we teamed up with TCU's Neeley School of Business to create the following short report. We present the information in the context of a true story from the perspective of a Father dealing with his young son's medical care. View the full report here.

Andy Roller is the Founder and Owner of Expio. As a believer in the power of entrepreneurship for commerce and community development, he is also a community volunteer, board member of Panhandle Twenty/20 and part of Leadership Fort Worth. Andy was named one of Amarillo Chamber of Commerce’s Top 20 Under 40 Business Professionals in 2011. Andy is a fitness and health geek, guitar player, father to 5 super cool kids and husband of an Enchantress.

Tags:  Consumerism  patient experience  social media  voice 

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The Place for Patient Narratives in Healthcare

Posted By Senem Guney, PhD and Devon Santoro, Wednesday, February 11, 2015
Updated: Friday, February 6, 2015

The consumerization of healthcare has neglected the needs of the patient. Due to recent regulatory changes, unhappy patients have become very expensive for both payers and providers. The key to improving outcomes and patient experiences lies in the voice of the patient.

Patients have been treated as consumers throughout their healthcare experience. Medical professionals and hospitals, as for-profit institutions, provide services for consumers. The very word "consumer” is driven by the expectation that patients are the passive receivers in their own healthcare.

Much attention is paid to efficiency of medical providers and staff in creating timely, quality services. However, hospitals and medical centers are so overwhelmed with the volume of consumers they serve, that quality care and the concept of patients as individuals, gets drowned out while trying to improve all aspects of care all at once. In many cases, only one or a handful of individuals are charged with improving the quality of patient care. The resources simply aren’t available to properly address the complicated problems in these enormous institutions. Such change is often referred to as "turning the titanic.”

Regulatory changes have attached significant financial incentives to providing patients high-quality care and a great care experience. The CAHPS surveys that measure patient satisfaction give hospitals general suggestions but no insight into the patient experience context. Treating patients as a consumer mass does not solve the problem of learning from and improving patient experiences.

How can we make a patient experience professional’s job easier? We can start by breaking it down patient by patient (or rather person by person). Their experiences are the stars in which healthcare professionals, providers and administrators need to guide their practices.

First we need to pay attention to these individual experiences. Narratives are important. There is no single patient narrative, and so there is no single approach to better patient experience. In addition, the narratives patients tell do not start when they enter a hospital or physician’s office. A person’s health is a culmination of all things relative to their individual life narrative. Patients bring much more than signs and symptoms into the healthcare delivery system. The sooner that is recognized, the sooner we can understand how an individual’s interactions in the healthcare delivery system can be improved.

Perhaps if we give patients’ narratives an opportunity to be heard and understood, we can balance the financial responsibilities of providing healthcare services with the clinical responsibility of providing high-quality care with a great experience.

Senem Guney, PhD, is the Founder & CEO of NarrativeDx. The NarrativeDx patient experience management platform provides actionable insights from unstructured patient feedback to improve care and maximize reimbursements. Senem's research and consultancy prior to founding NarrativeDx span across healthcare and technology development industries.


Devon Santoro is completing a Master's in Health Advocacy at Sarah Lawrence College and is on the staff of NarrativeDx.

Tags:  Consumerism  healthcare  patient experience  patient stories 

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The New Reality in Customer Experience: Raising Our Standards

Posted By Kevin J. Gordon, Monday, March 10, 2014
Updated: Sunday, March 9, 2014

Here are a few of new phrases being added to the healthcare manager’s vernacular:

  • Competitive advantage
  • Consumerism
  • Marketplace differentiation

Historically, American consumers have often looked for best prices and perceived value. However those same Americans are now patients and have given the healthcare industry a scholarship in perpetuity. Well, as the saying goes, all good things do come to an end.

The intersection of events such as rising insurance costs, a greater shift of the cost being pushed to the patient, significant competition amongst healthcare facilities and Obamacare, sprinkled in for good measure, has left patients more actively involved not only in their clinical path of care, but also in the costs and the options available when receiving healthcare services.

Fortunately, healthcare has not lowered its standards to the point of Super Bowl advertising for bargain price open heart surgery with the cute doctor’s kid as a pitchperson, but you can’t drive down a suburban road without seeing how long the wait time is at one of the many local hospitals.

All of this brings me back to the three new phrases the healthcare universe needs to grasp and accept as their new reality. We must finally accept the fact that "the patient is our customer,” we must each take a deeper look into how we will differentiate ourselves in the marketplace and we must look at ourselves and ask "How we are viewed competitively to the other facilities in town?”

Today’s healthcare facility cannot rely solely on quality of care as its strategy. While obviously still a critical aspect of the patient’s experience, the comparison would be Disney only focusing on rides and not paying attention to the rest of the park. In the end, the clinical interaction of a patient’s visit in terms of percent of time is roughly equal to the time spent on the actual rides, about 20%. The remaining 80%, whether at a healthcare facility or walking Main Street USA, is what forms the patient’s opinion of the healthcare experience.

If the healthcare world does not want to sink to the level of pitchmen and infomercials, the last bastion of hope is working on the entire experience we provide for the consumer, I mean patient, from scheduling to post-discharge follow up.

As the automobile industry knows so well, a customer might be a fan of a specific brand (or doctor), but that in no way guarantees the customer will return to the same dealership (or hospital) for his or her next purchase unless the entire experience, over and above the end result, is what he or she has come to expect.

Kevin J. Gordon is currently the President of PatientEase, a technology company dedicated to bringing customer service automation techniques into a healthcare facility.

Tags:  competitive advantage  consumerism  customer experience  Obamacare  patient experience  quality 

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