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The Beryl Institute invites members to submit posts on patient experience related topics. For guidelines and information on submitting a post for consideration, please contact us at info@theberylinstitute.org.

 

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Top tags: patient experience  healthcare  communication  culture  patient  HCAHPS  Leadership  patient engagement  empathy  physician  survey  compassion  perception  physicians  technology  caregiver  community  data  employee engagement  family engagement  healing  Hospital  improving patient experience  collaboration  Consumerism  Expectations  interactions  patient and family engagement  pediatric  person-centered care 

Thoughts from a Commodity

Posted By Brandon Parkhurst MD, Monday, May 4, 2015

From the perspective of the patient, healthcare is a commodity. I’ve spent the last 15+ years of my medical career getting my head around that statement and coming to an understanding of it. Today I accept it as fact. Commodities are exchangeable one for another. From the perspective of a patient, the technical aspects of treating high blood pressure, or asthma, or heartburn, or even having a hip replacement or heart bypass surgery are going to be based upon the diagnosis and aren’t going to change much from one provider to the next. I was smart enough to get into, and through medical school, but otherwise I don’t know how to prescribe blood pressure medicines in a way that’s wildly different from anyone else. The experience of a patient receiving care from my practice is the only thing that sets us apart from everyone else.

As it turns out, in this age of decreasing physician and medical provider autonomy, I do control, or at least significantly influence, the experience of receiving care from me! I control my priority of placing my patients’ medical needs before everything else. I can insist on my patient not leaving my office until I know that patient understands what I’ve said, the diagnosis, what signs/symptoms to watch for, the follow up plan. I can model patient-centeredness and raise the performances of those who assist me and are integral to my practice. I can work to ensure access to my care is meeting my patients’ needs. We can all demonstrate empathy and caring.

A patient’s experience is of the highest priority when the service one provides is a commodity. As Pine and Gilmore wrote in their landmark 1998 article Welcome to the Experience Economy, commodities are interchangeable and experiences are personal¹. When I provide an optimal experience, my patients should not only be healthier, for a wide variety of reasons, but should also be more loyal and more likely to return to my care. They might even promote my care services to their friends, promotion that is surely good for business. In general, providing optimal medical care and a positive, memorable experience for my patients is good for my patients and good for me.

As I’ve been writing this blog, I’m reminded of the difficulty of delivering an optimal patient experience and truly patient-centered care. A colleague just sent me a link to an article dated April 17, 2015 and published in The Atlantic. The title of the article is "The Problem with Satisfied Patients.”² The article is well written yet falls into the trap of treating patient satisfaction and patient experience as synonyms. Improving our patients’ experiences isn’t about satisfaction, happiness, or scores; improving our patients’ experiences is about understanding, collaboration, patient-centeredness, and most of all, personalization to the one situation we are a part of at a given time. Improving patients’ experiences isn’t about turning hospitals into 5 star hotels or restaurants; improving our patients’ experiences is about tailoring care to maximize every patient, resident, or family’s ability to Flourish³ and enjoy life on their terms.

My medical expertise is a commodity, yet the experience of receiving that medical expertise is unique to me. I firmly believe that providing an optimal experience of care improves the lives of those with whom I interact. I will spend the rest of my medical career seeking to improve their enjoyment of life and seeking to make their experience of receiving care from my medical practice, optimally positive and personal.

¹ Pine II, J. and Gilmore, J. (1998, July). Welcome to the experience economy. Harvard Business Review ² http://m.theatlantic.com/health/archive/2015/04/the-problem-with-satisfied-patients/390684/?utm_source=btn-facebook-ctrl3 ³ See Seligman, M. (2011). Flourish: A visionary new understanding of happiness and well-being. New York, New York: Free Press

 

Brandon Parkhurst is the Assistant Medical Director of Patient Experience for Marshfield Clinic and splits his time between the practice of Family Medicine and leading patient experience improvement. Brandon was born and raised in rural north Missouri where his parents and grandparents consistently taught him that you do right by people because it’s the right thing to do.

Tags:  healthcare  Interaction  medicine  Patient Experience  physician 

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Survey Finds that A.C.A. and Triple Aim Creating Re-Think that Enhances Value of Integrative Medicine

Posted By John Weeks, Thursday, February 19, 2015
Updated: Thursday, February 19, 2015

The Center for Optimal Integration: Creating Health has announced results of a survey found that integrative health and medicine is increasingly viewed by involved health systems as integral to advancing the values of the "Triple Aim."

The term "integrative health and medicine” typically applies to such therapies as mind-body and yoga and practitioners like acupuncturists, massage therapists, chiropractors and naturopathic doctors.

The area of most significant engagement of integrative medicine leaders by their parent systems was found to be in initiatives to enhance patient experience. Nearly 9 in 10 (87%) agreed that, under the new incentives of the Affordable Care Act, their parent systems are increasingly interested in how integrative health and medicine can help meet patient experience targets.

The survey, through the Center's Project for Integrative Health and the Triple Aim (PIHTA), found other positive alignments. These leaders of health system-based integrative centers perceive they are increasingly valued as part of their system’s efforts to "reduce hospital re-admissions" (72%) and "lower costs"(75%). Many report new outreach from system specialty groups to explore partnerships. A subset are finding increased financial investment.

When the exploration of complementary and integrative medicine originated in the mid-1990s, the relationship with conventional delivery systems was quickly hampered by misalignment. The prevailing "perverse incentives” from a payment and delivery focus on procedures proved an inhospitable environment for these typically high-touch, time-intensive and human-centric integrative services.

I served on the PIHTA team that developed the survey. The questions we asked essentially tested an assertion of Allina Health’s CEO Ken Paulus as the A.C.A. was coming into being in 2011. Allina’s integrative health and medicine program, is the most significant in the United States. At that time, the in-patient and outpatient integrative initiative at Allina had been nurtured for a dozen years via substantial philanthropic investment from the George Family Foundation started by Penny George and her spouse, Bill George. The latter is the former Medtronic chair and present author-professor at Harvard Business School.

Paulus told a New York City audience of integrative medicine leaders that when he took the job at Allina in 2006, he judged integrative medicine to be "a cost center.” But as now the A.C.A. "is paying us to keep people healthy,” Paulus sees integrative medicine as an ally. He believes that as the A.C.A.’s payment structure "kicks in that supports keeping people healthy, integrative medicine will be an asset."

The data in this survey suggest that Paulus’ assertion is correct. Surveyed were leaders of 28 integrative medicine clinics most of which are part of academic health centers. The set of participants was the same as those in the widely reported Integrative Medicine in America (2012) project engaged by the Bravewell Collaborative of philanthropists in integrative medicine. Seventy-five percent (21/28) took part in the PIHTA survey.

Many of these health system-based integrative medicine centers were originally developed for marketing purposes. The core interest was to gain competitive advantage by showing responsiveness to patient interest in complementary and alternative therapies and practitioners.

These data make abundantly clear that interest is deepening from these early adopters. Integrative approaches and practitioners are edging into core business models of hospitals and other delivery organizations. Data charts on the all survey outcomes are available here.

The PIHTA survey team also included Jeffrey Dusek, PhD, the research director at the Penny George Institute (PGI) to Allina, Melinda Ring, MD who directs the Osher Center for Integrative Medicine at Northwestern and Jennifer Olejownik, PhD, PIHTA’s manager.

Some outcomes on integrative care that are shaping system interest are contained in the PGI reports at this link. In addition, the PIHTA initiative that engaged the survey has posted what we hope are useful links to resources on lowering costs and others on enhancing patient experience.

Both existing data from pioneers and the timing in health system maturation suggest that integrative practices will continuously be woven more tightly into strategies to provide accountable, values-based care.

John Weeks is the director of the Center for Optimal Integration: Creating Health where he is actively involved in the Center’s Project for Integrative Health and the Triple Aim (PIHTA). He is a 30-year veteran as writer, organizer, speaker and executive in the integrative care movement.

Tags:  integrative health  medicine  survey  triple aim 

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Applying Patient Experience Thinking to Medicine-Taking and Medicine-Making

Posted By Robbie McCarthy, Tuesday, December 3, 2013
Updated: Monday, November 25, 2013

After two decades of working in pharmaceutical company marketing and healthcare advertising, a fellow industry veteran and I had come — independently — to the same conclusion: "Something is rotten in the state of Denmark.” To use the line from Shakespeare’s Hamlet 

With both the healthcare and regulatory environment undergoing constant changes, and patient access to information and overall empowerment level dramatically increasing, the marketing of healthcare products was simply not keeping up — remaining, by and large, how it was a decade ago.

It was time to usher in a new way of thinking. Observing the application of patient experience thinking to healthcare provision made us ask,"Could this same approach be applied to the marketing of pharmaceuticals?”

We decided to look beyond the traditional pharmaceutical marketing approaches that entailed influencing physicians with data and encouraging potential patients to ask their physicians about drug X or Y. Inspired by patient-experience-based thinking, we thought instead about being the patient: you, me or our loved ones. We asked ourselves: "Do we have a tangible experience of our medicines when we are ill and in need of treatment? Do those experiences influence our treatment success? Our relationship with our physicians? Our choice of options available?” We concluded that yes, they did, and began working on a new way to market medicines.

The patient-centered approach to medicine-taking and medicine-making stems from a shockingly simple six-point epiphany that we share with pharmaceutical manufacturers:

  1. As patients, we use the products that pharmaceutical companies make.
  2. Our use of those products results in an experience.
  3. This experience is physical, emotional, cognitive, psychological and financial in nature.
  4. Based upon our experience, we (as patients) are more or less likely to continue using a product.
  5. We report our experiences back to our HCP teams.
  6. Based upon these reports, HCP teams are more or less likely to prescribe a product again.

It is our belief that the way for a pharmaceutical brand to compete in today’s competitive environment is to employ this behavioral science approach to understanding the beliefs and behaviors that shape a patient’s relationship with medicine brands. Adopting this approach opens the door to addressing core experiential questions, such as what should an optimal brand experience look like? Once you break the patient brand experience down into its core components — those that result in a good, bad or indifferent experience for the patient — it’s possible to invest in making the brand experience for your medicine as good as it can possibly be by applying this insight to your core marketing platform. What’s good for patients and physicians is also good for business, while providing us with an ethical, authentic approach in the new world of healthcare — which is the right way to pursue medicine marketing.

A time of change is here, and pharmaceutical manufacturers are beginning to embrace what their health care counterparts already know: to build a stronger brand, you must start with the patient experience.

Robbie McCarthy is Principal and Managing Director of The Patient Experience Project (PEP), a behaviorally based communications firm that specializes in marketing for the pharmaceutical, medical device and patient care industries. His current mission is to help organizations reap the benefits of re-framed, patient-first marketing strategy. Connect with Robbie on LinkedIn, and Google+.

Tags:  marketing  medicine  patient access  patient experience  patient-centered  pharmaceutical  physicians 

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