Is patient experience about to flatline?

By Peter Dorrington, Director, Customer Insights – TTEC Digital

It’s no secret that healthcare, especially primary healthcare, is under enormous pressure; the population is growing, we all want to live forever and do so in perfect health. However, clinicians and healthcare providers do not have an infinite budget and so are constantly seeking ways to do more and better with the resources they do have.

No surprise then that there has been enormous attention on finding efficiency gains in the delivery of healthcare – improving quality, reducing waste, lowering costs and introducing innovation – at the same time as trying to enhance Patient Experience and choice.

The majority of what has been done is to be heartily applauded – real transformation has been delivered and substantial gains achieved. Ultimately though, this is a ‘no win scenario’ – in healthcare, demand will always outstrip supply.

No doubt, healthcare providers will continue to focus on an ‘inside out’ agenda – more ways to improve their operations; developing the capabilities of their people, improving processes and introducing innovative technologies and therapies. NHS 111 is a superb example of one such initiative – offering a lower cost, more
accessible alternative to a GP or hospital visit.

Nonetheless, it is my belief that the next wave of improvement will have to actively involve patients, and it’s here that I am concerned, because if Patient Experience follows the trend of Customer Experience (and I think it will) it’s going to get harder to engage them.

In the private sector, there is a growing sense that the ‘low hanging fruit’ of Customer Experience has already been picked, and many organisations are struggling to identify what comes next; after you’ve removed all the waste you can, you have the best people and your processes are supported by world-leading technology and despite all of that, customers are still dissatisfied and disloyal.

“Customer experience performance is flat for the third year in a row.
CX results show a dangerous gap in customers’ sense
of emotional engagement and loyalty.”

Forrester Research – 2019 Predictions

We might think that healthcare is different – that patients don’t have real choice, are more compliant than customers, and that a long-standing trust in the sector means that they will do as they are asked. The reality is far more complex; patients don’t always act rationally, in the interests of their provider or even their own best interests.

The reason lies partly in human behaviour – we are all a complex mix of logic and emotions, as well as subject to internal biases and external influences. Furthermore, customer (or patient) experience is more about perception than what was delivered, and perception is dominated by emotions – what we feel, rather than what we think.

The danger with an over reliance on inside-out strategies is that it assumes that providing a more efficient and effective service is perceived by patients as being ‘better’ or more desirable - this is often not the case. Simply put, patients are not doing what we need them to.

Here is a real case study: a young, first time mother phones NHS 111 the first time her baby gets sick. She got a quick diagnosis (the child has a heavy cold), and a clear treatment plan (fluid, rest, pain relief, etc.). The following day, she presented at the emergency department after another sleepless night and worried that her child was getting worse. She got the same diagnosis and the same treatment plan, but she also received what she didn’t get on the call – reassurance. Perhaps two minutes more on the call, providing a little emotional support, could have prevented the visit to hospital and all the extra costs that accompanied it, but who ‘owns’ the cost of those
2 minutes?

The point is this; in the drive to improve quality and efficiency, we must not forget that patients are more than a collection of clinical conditions and treatments. If we want patients to be part of the solution of service transformation, we need to anticipate and address the emotions and motivations that are driving their behaviour.

One tool to do this is to use a combined functional and emotional use case – like this
simple example:

• Functional use case: I am a person that is experiencing pain; I want someone to​ diagnose the cause of my pain, so that I can receive treatment and my pain goes away.
• Emotional use case: I am a person who is worried about my pain; I want to talk​ to someone about my concerns, so that I can be reassured and stop worrying.​

Of course, this is a simplistic case, but research into the relationship between emotions and customer experience has proven the value of thinking about customers as ‘whole people’; put another way, in the commercial world…

“Forget 'branding' and 'positioning’. Once you understand customer behaviour, 
everything else falls into place.”

Thomas G Stembery
 

In conclusion
Patients need to be at the heart of healthcare transformation; without their engagement, it is going to get harder to introduce the vital changes that are needed, but to do so will require acknowledging that human behaviour is not based solely on cold, rational thought. When we truly start thinking about patients like customers, we’ve made a good start, when we all start thinking about patients as the ‘human in the loop’, we’ve made a great start.

Source: NHS Elect - www.nhselect.nhs.uk.