Patient Experience: The Ultimate Test

In this age of convenient and personalized commerce, why is the patient experience so limiting? Dave Wattling rounds up the shortcomings of the system as lived by patients and suggests some solutions. Psst: Ask patients!

The other day as I killed time in the drugstore waiting for a prescription, it occurred to me that today’s patient experience in Canada isn’t all that different from the consumer experience of olde.

A century ago, you’d go to the general store when it was open and wait in line for the man behind the counter to bring you the standard sack of flour, sugar and beans. Choice was limited and service was at the seller’s convenience. Catering to consumer wants and needs was a thing of the future.

Over a century, the consumer experience has evolved past the superstore and onto the Internet. Now you can get a rare book from a shop in Fargo shipped today, or book a flight to Lima tomorrow, all without leaving the house or picking up the phone. Fast, convenient, accessible and effective.

It makes you wonder. Why can’t my experience as a patient be even a little bit like today’s consumer experience? In some respects, we have a whole century to leapfrog.

Why the gap
Obviously a big part of the problem is that not all Canadian healthcare providers are using electronic medical records.

We all know about the inefficiency of manual, paper-based systems for the professionals using them. But the fallout for patients is less considered.

There’s the waiting and the inconvenience. There’s the risk of medical errors like harmful drug interactions through prescription error. (Whoever said the pen is the most dangerous tool in a doctor’s kit bag wasn’t far off!)

But perhaps more widespread is how manual systems prevent patients from engaging with their own health. Isn’t it odd that we leave health, one of the most personal of things, utterly in the hands of healthcare professionals? Highly-trained and competent professionals, mind you. But still: someone else.

For and by patients
Luckily, we’re catching up to the rest of the world. EMR use in Canada rose from 50 to 75% between 2012 and 2014. That’s a great start. Once every healthcare organization is using a system of some sort and the systems are interconnected, then we’ll be equipped to take healthcare delivery to an entirely new standard.

But something’s still missing here. Who designs and builds these systems? Usually software companies in consultation with healthcare organizations and clinicians. By extension, in considering patient-centred applications, should we not consult patients? Yet we rarely ask patients what they think, need and want.

If patients designed our products, what would they look like? Given a patient portal, what would the main tasks be? To what end? With patients influencing development and implementation, the conversation could change completely.

What do patients want?
I can think of a few things I’d like to be able to do as a patient. I want to book an appointment online. I want my doctor to send my prescription electronically so I don’t have to carry a scribbled paper to a pharmacy and then peruse toothbrushes for half an hour.

I’d also like to have access to my health profile. I can easily check on the health of my car. But if I want to check my blood type or vaccination status, look at an x-ray or see test results, I have to physically sit down with my doctor in her office. I can’t even get information over the phone.

I want an experience that’s more akin to other modern consumer experiences like Amazon, Air Canada or my bank, where I can access my online profile, preferences and past transactions to speed up searches and purchases. From home, any time of day.

Those are just my wishes. But what’s the best way to ask a statistically significant number of patients how to save time and have better outcomes?

Gathering needs
What used to be done by focus groups can now be done through online surveys, analytics and crowdsourcing.

Retail provides some great precedents. Companies like Starbucks and Dell have been formally gathering customer ideas for almost a decade. We could look to the Pareto Principle – the 80-20 rule that’s common in the business sector – and concentrate first on patients with chronic conditions who represent a relatively small proportion of the overall population but consume nearly 70% of all direct healthcare costs.

Who knows what interesting ideas patients would suggest to improve their experience?

Criteria for a healthy health system
Patient experience is the ultimate test of a health network’s well-being.

When Canadian patients can say their experience was fast, convenient, easily accessed and, ultimately, effective, we’re on our way to better health.

Fast progress from discovery of a health issue to diagnosis and treatment reduces pain or discomfort and makes recovery more likely. Widespread, interconnected EMRs allow quick sharing of the latest test results and rapid handoffs among the right specialists in a patient’s circle of care.

Convenient service can come in the form of telehealth to remote locations, home health monitoring, secure file sharing to speed referrals, continuity among many caregivers and e-prescribing. Empowered and less burdened patients are more likely to manage their own health proactively and more effectively.

Accessible records let patients place themselves at the centre of their health, monitoring and driving progress. Handheld and wearable mobile technology will let patients track blood pressure, cholesterol or fitness goals, shifting the responsibility of health into patients’ hands.

Successful service, of course, means an accurate diagnosis and an effective treatment. When all caregivers share a complete and accurate patient profile, they can prescribe the best medications, avoid errors and easily follow best-practice guidelines. This becomes more critical with more serious, complex or chronic conditions.

The art of the possible
Software development is the art of the possible. Apps, programs, systems: they give us the ability to do things we couldn’t before. When it comes to supporting healthcare, what would the best possible system be? How would it look and feel? Are we there yet? As we gather the vision, we need to include patients. It will open up whole new worlds.

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