The Value of Designing the Patient Experience:
Patient Experience Extends Beyond Immediate Medical Care, So Should Investment
When the system surrounding a patient is structured around efficiency, low cost and positive short-term outcomes, the system will reveal poor efficiency, high cost and negative long-term effects. Designers practicing human centered design are adept at understanding the root causes of failed systems. By designing systems with empathy, creativity and rationality, the outcome is more sustainable and more valuable.¹ If patients have a terrible experience and association with the system, it is not just bad for them; it costs the system millions, up to billions, in revenue.
The healthcare system is shortsighted
in its approach. Currently, the patient experience is still underestimated as a potential valuable asset. One of the first responsibilities of a designer is to see if the problem statement must be reframed. In this case: Ill patients need more care than healthy patients. Jim Sabin, MD, the director of the ethics program at Harvard Pilgrim Health Care, weighs in, “Giving attention to the healthy would have to pass a fairly high hurdle of rationale, because the ultimate responsibility of a health plan starts with people who are suffering in one way or another.” ² The result is a system that only works to meet the current demand. With this outlook, there are limited areas available in which to decrease cost. Twenty percent of the population is high-risk and incurs 80 percent of the cost.³ This makes the business very vulnerable and high at risk. It also prescribes patients’ expectations of what the system will do for them; “It will take care of me when I’m sick, not when I’m healthy.”
Patients do not tend to think about self-care when they are already healthy. If healthcare organizations took stake in keeping low-risk patients healthy, the potential savings would be dramatic in the short-term and more so in the long-term. Patients would begin to see preventative care as an integral part of their lives.
The patient experience starts
the moment a child is born. There is an entire lifetime of opportunity to keep the patient loyal to a particular health insurance or hospital through creating comprehensive care beyond offering medical interventions. Yet today, the considered touch points are often only those in direct correlation with medical care.
If more healthcare organizations opted to design indirect and connected approaches,
factors that create illness such as sedentary, stressed, unsocial and unhappy lifestyles would begin to dissipate. This could mean investing in radically designed services that coordinate city infrastructure, access to fresh produce, involvement in policy regarding affordable housing and support of the local economy to name a few.
To see a higher return on investment,
the service and experience must extend beyond brick and mortar. Dee Edington, PhD, the director of the Health Management Research Center of the University of Michigan, has shown research that cost follows risk and sees a “low-risk maintenance” strategy as the best way to control health care costs. Edington says, “It’s my mantra, and it’s the only way insurance companies can survive. If we do nothing, if we just follow the same pattern and treat one disease after another, we’ll continue to pay and pay and pay.” In one study, when plan members moved from zero to one physical activity a week to more than three times, medical costs for each member went down $2,202 a year.⁴ Although providing in-house wellness centers and gym membership reimbursements help to reduce healthcare costs, are they really enough for employers and insurers to see a large return on investment?
Designing for the patient experience,
means more than relabeling ‘waiting rooms’ as ‘respite rooms’ and providing 5-star amenities. It means reducing wait time. It means creating medical record interfaces that are complex on the back end but simple on the front end allowing medical personnel to easily communicate accurate information to patients. It means serving the patient, not the technology. It means building equal access to care. It means providing better transportation options for patients to get to and from the hospital hassle-free and on time. It means reducing all barriers to entry.
The US Healthcare system
currently spends $150 billion in missed appointments.⁵ This area holds incredible potential to increase patient health and decrease costs for hospitals. First it must be determined why patients are missing appointments. Is it because they are nervous about their appointments, do not have rides, are running late, are lost? A design approach is best to successfully find these problem areas and solve for unmet needs.
When a patient does not see value
in what healthcare is doing for them (or in caring for themselves), they instantly become a much higher liability. Medical studies routinely use placebos as the controls in studies.⁶ If a patient believes in the treatment they are receiving it has a much higher likelihood of working. Designing the patient experience is about appealing to every part of the patient. If a patient receives different instructions from multiple communication methods (phone, e-mail, the nurse, the doctor) he or she is more likely to be confused and not schedule a follow up appointment. This directly impacts their health and the pockets of hospitals and health insurance companies.
The bottom line of health insurance is to reduce cost per patient. Unless it is mandated for insurance to cover the full patient experience, companies may not see reason to invest in anything that costs them extra money. However, when an experience is designed to optimize the patients’ health, it is directly correlated to the healthcare revenue stream. Health insurance companies are beginning to see monetary benefit to keeping patients healthy.
Edington notes, “When we ask members why they have health insurance and they say, ‘To help me stay healthy,’ that will be when we’ve won.”
Reaching beyond the hospital to relieve stress points
for patients will help build back trust between the patients and the healthcare system. A designed experience can enable smooth transitions between life outside and within the hospital. In the end, taking stake in designing a patient’s quality of life to inform sustainable and healthier lives saves the hospital, insurance and insurance payers money.
Footnotes:
¹ http://c.ymcdn.com/sites/www.dmi.org/resource/resmgr/pdf_files/TheRealValueOfDesign.pdf
² http://www.managedcaremag.com/archives/2004/8/spend-money-healthy-people
³ http://www.managedcaremag.com/archives/2004/8/spend-money-healthy-people
⁴ http://www.managedcaremag.com/archives/2004/8/spend-money-healthy-people
⁵ http://www.healthcarefinancenews.com/blog/author/85001
⁶ https://www.nih.gov/news-events/nih-research-matters/placebo-effect-depression-treatment
