Executive Q&A with Brian Wynne: What 2018’s trends tell us about opportunities in 2019

The attitudes and priorities of healthcare consumers are continuously shifting, making it difficult for leaders to pinpoint the most productive arenas for their attention.

As the patient-provider relationship continues to evolve, it helps to take stock of the forces that shape consumer opinion, and capture how consumers approach the healthcare marketplace.

In this Q&A, Brian Wynne, Vice President and General Manager of NRC Health, offers some insight. He’ll discuss the trends that emerged in 2018—and some promising avenues for intervention in the year to come.

How is customer feedback evolving?

In a word: quickly. A poll of health-system leaders found that, in 2019, nearly half of all healthcare organizations plan to invest in modernized feedback-collection platforms. This investment comes none too soon. NRC Health’s data shows that patients strongly prefer digital engagement over older, analogue methodologies.

83% of patients say, for instance, that they prefer to give feedback within minutes or days after a care encounter—not during, or weeks after. In terms of outreach, 55% of patients say they prefer email over any other form of feedback. That’s more than five times the number of patients who prefer paper feedback forms (10%) or in-person phone calls (11%). Email, along with other outreach modes like SMS text and Interactive Voice Response phone calls, combine to create a powerful source of timely feedback after care events.

There is a point of diminishing returns on single-source feedback. Health systems are turning to scalable, technology-enabled feedback platforms, not just for more data, but for greater insight into the customer journey.

As health systems are beginning to realize the benefits of a more holistic understanding of their customers, we are seeing less emphasis on formalized satisfaction scores. While there will always be a place for measures like CAHPS, health systems will increasingly elevate the state of individualized, insight-driven engagement before, during, and after all customer touchpoints, versus chasing a specific satisfaction metric.

What are the key sources of consumer frustration?

Convenience, cost, and clarity.

Wait times are the most frequently recurring complaint of all, with77% of patient comments referring to wait times as being negative. Communication about wait times can ease the pain, but health systems must increase digital and ambulatory access points to assuage volume pressure on the traditional hospital campus.

Rising out-of-pocket costs, and confusion about cost responsibility, create frustration as well. Patients routinely express concern about billing, with only 26% reporting that their medical bills are clear or understandable.

These issues are not likely to surprise anyone in healthcare leadership, but they do persist, which creates a strong case for doing things differently.

What does the patient-provider relationship look like today?

Patient comments reveal a disconnect between clinical and non-clinical interactions. They can’t say enough good about their caregivers, but some aspects of wider care encounters leave them cold.

NRC Health’s 2018 Market Insights survey reflects a stark duality. 16% of consumers surveyed say that their relationship with their healthcare organization is most like an “Acquaintanceship”—far from a desired bond of trust. A further 15% of consumers label their relationship variously as “Love/Hate”, “Aversion/Hostility,” or a “Marriage of Convenience.”

This ambivalence stems from a lack of understanding between what consumers want and expect versus what they experience. Health-system leaders have an opportunity to employ modern feedback technology to understand more quickly, and with more depth, what is most important to those in their care. Without this, providers’ frustration grows alongside consumer disdain, and the divide widens.

What behaviors are arising from consumers’ feelings?

Consumer frustration largely revolves around issues of access and convenience. Long wait-times and unhelpful administrative staff, for example, detract from the ease that consumers want from their healthcare providers.

When consumers can’t find this ease in traditional hospital settings, their natural response is to seek it elsewhere. For evidence of this, look no further than the rise of the retail clinic: retail providers have grown in number by 500% over the last 14 years, while primary-care office visits have declined by 20% since 2012.

Deferment, or putting off “necessary medical treatment,” is a far more concerning trend. NRC Health’s Market Insights data shows that, in both 2017 and 2018, nearly a quarter of US healthcare consumers have deferred care, largely because they can’t afford it.

Rising costs on both sides force difficult, sometimes destructive, behavioral and operational decisions. Keeping people healthy through appropriate and timely engagement is the only sustainable way to reduce cost-spend implications.

How should organizations respond to these trends?

Consumer intelligence suggests that leaders can expect a challenging 2019 by traditional growth metrics like volume and NPR. However, health systems are not helpless to affect positive change in their customers’ experiences and attitudes for long-term brand sustainability and success.

This means shifting from an episodic focus to a model that cultivates continuous relationships with consumers. Every interaction a consumer has with a health brand—including interactions that happen outside the hospital—should be known, assessed, and improved upon to earn consumer loyalty to the organization.

Status quo is the enemy of progress. Healthcare’s consumerist future demands that leaders embrace (sometimes uncomfortable) change and commit to learning what matters most to their customer. The future belongs to organizations that relentlessly pursue true human understanding.


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