Every person has a unique story: How Human UnderstandingTM is transforming patients’ and consumers’ healthcare experiences

Research published by NRC Health indicates that, when compared to other services, twice as many people say being treated as a unique person is important in healthcare. Yet only 38 percent say that the personalized healthcare experience they want actually occurs.

To learn how hospitals and health systems are reinventing their approach to the patient experience using concepts like Human Understanding, Becker’s Hospital Review recently spoke with three patient experience experts:

  • Ryan Donohue, strategic advisor, NRC Health
  • Chris DuFresne, vice president, digital and marketing operations, Minneapolis-based Allina Health
  • Gregory Makoul, PhD, chief transformation officer, NRC Health

Healthcare must focus more broadly on the consumer experience

So much of the work of health and wellness happens outside the sliver of time that a person spends receiving traditional healthcare services. Yet, many organizations still focus exclusively on the limited time spent in the physician’s office.

“Health systems, from a clinical care perspective, have done well at understanding the human component of their work,” Mr. DuFresne explained. “But they haven’t done as well when it comes to the consumer perspective, specifically, making it as easy to get care as it is to book a flight, reserve a table, or purchase a product.”

This is problematic because people have high expectations for their healthcare providers. According to Mr. Donohue, “Consumers expect healthcare providers to meet or exceed their expectations. NRC Health compares consumer expectation across industries — and consumers hold healthcare to a much higher standard than any other sector. Yet, other industries consistently do a better job closing the gap between consumer expectations and the actual consumer experience. Healthcare must learn how to understand consumers’ expressed and unexpressed needs and then build services or products using understanding as the foundation.”

One of the obstacles to improving the consumer experience in healthcare is that most provider organizations don’t solicit feedback from people until their episode of care is over. “The traditional approach is to measure experience after an encounter or after someone leaves the hospital,” Dr. Makoul said. “Limiting the scope to asking, ‘How did we do?’ puts organizations in a reactive stance where they can’t do anything but apologize if things didn’t go well and try to make sure that problems don’t happen again.”

Mr. Donohue agreed. “I think every healthcare leader and doctor would agree that we want to meet expectations, but if we find those out after the fact, it’s too late. When we don’t ask about expectations up front, we simply rely on blind luck during patient encounters which is not a very good strategy.” Focusing on consumer experiences rather than patient experiences represents a significant mindset change. However, it’s something that leading health systems are thinking about. They are discovering that they must look differently at multiple stakeholders.

“It’s not just about the patient in the bed. It’s about the adult child who’s a caregiver for their parent who is a patient,” Mr. DuFresne said. “That adult child will help the patient recover after a hospital stay as much or more than anyone in the healthcare system. How do we think about them in the work we do? That’s why we look at consumers, not just patients.”

Every person has a story — and every story must be heard

Human Understanding takes a much broader view than clinical care alone. “Whether we are in front of a doctor, at home, at work or out living our lives, we are human beings,” Mr. Donohue said. “Human Understanding focuses on everything that an individual is and how healthcare can serve them as a whole person.”

NRC Health’s Human Understanding program is a systematic approach to help health system partners understand what matters to the people they serve. It focuses on how consumers expect healthcare to work and what is best for them. Taken together, the program covers five strategic areas: experience, marketing, institutes, reputation and workforce.

“If you think about experience, we want to know what matters to every patient as a person, starting before they come in for care,” Dr. Makoul said. “We generate an inSIGHT Summary that members of the care team can view within the electronic medical records – it takes about 15 seconds to review, and we have published results showing double-digit gains in the proportion of patients who report that their care provider treated them with respect, showed care and concern, showed interest in their ideas, and spent the right amount of time with them.”

The inSIGHT Summary tells each patient’s unique story, based on information about their preferences, perspectives about their health, perceived barriers to achieving their wellness goals and the greatest sources of stress in their lives. This data helps healthcare providers make a personal connection with patients. According to Dr. Makoul, “One of my studies in primary care demonstrated that, if a doctor made a personal connection in the initial encounter – the very first meeting – patients rated that doctor as knowing them markedly better. If you feel that your doctor knows you well, good things happen in terms of trust, truth-telling, and adherence.”

Allina Health leverages NRC Health’s tools to understand people’s health objectives, stated in their own words. “The big goal for a 70-year-old with knee issues might be the ability to walk around the yard with their grandchildren. Understanding these goals humanizes care,” Mr. DuFresne said. “When providers reference this information, they have the context which drives connectivity and makes conversations resonate with patients. Our hypothesis is that stronger relationships with primary care providers drive better outcomes over time. It also helps with provider ratings, which matter more and more as people go to the web to see what others have said about a particular provider.”

NRC Health also provides consumers with an Experience Survey which asks how their visit went. This survey serves many purposes. The results are used to update the inSIGHT Summary. In addition, if something requires clinical follow-up, a service recovery or a safety intervention, an alert management system lets the right people know within the organization. The Experience Survey can also be used to invite people to digital communities to codesign health services, as well as to share reviews on third-party sites.

“Personalizing care doesn’t mean that you aren’t following clinical guidelines,” Dr. Makoul said. “It means that you follow clinical guidelines with the recognition that they were written for ‘average’ patients and you can’t apply them to each person in exactly the same way. Personalizing care is adapting the care plan to what a person is ready, willing and able to do. Or figuring out what it will take to help someone be ready, willing and able.”

In the journey to personalize care, health systems must look to consumers as the North Star

The COVID-19 pandemic uncovered new opportunities for healthcare innovation, as evidenced by telehealth, on-demand testing and more. Looking ahead, many hospitals and health systems are hoping to maintain that spirit of innovation and apply it to personalization of care.

“We have to take this opportunity to reimagine the patient experience,” Mr. Donohue said. “How do we interact with patients and consumers? What could be different and better now? We’ve seen how powerful consumer perspectives are and now we have a clean slate opportunity to listen to them and put them at the center of their care. Consumers will tell us what they want next. It might seem impossible, but it’s important to know as we build the future.”

Allina Health has taken this advice to heart and is helping patients navigate the myriad care options that exist today. “We added a lot of alternatives for consumers during COVID which has added to the confusion,” Mr. DuFresne said. “Should they do virtual urgent care or in-person urgent care? Should they schedule a virtual visit with their provider or an asynchronous visit? We need to find ways to reduce that confusion and make it easier for people to engage and interact with us.”

During the pandemic, the retail industry figured out how to guide consumers seamlessly from one channel to the next, whether it was ordering online and picking up at the store, or having products home delivered. One of Allina Health’s goals is to learn from retailers and to eliminate jarring handoffs as people transition from one care setting to the next. According to Mr. DuFresne, “We must make sure that patients feel that the health system and the people within it are holding their hands along the way, from primary care to specialty care to a hospital stay to post-hospital care and PT after surgery. Healthcare experiences need to feel seamless and like one organization.”


Providing personalized care is more than putting a tagline on a billboard or website. Health systems must make it easy for clinicians to personalize care by finding out what truly matters to people. The key is to ask, listen and respond.

“Our goal is to help busy and well-intentioned organizations turn aspiration into action,” Dr. Makoul said. “The way they do that is by moving beyond beautiful words and working on consistent behaviors. Our tools make that process more reliable. Personalized care is good for patients, and it’s fuel for the soul of people delivering care.”

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