NewYork-Presbyterian CXO Rick Evans: Access is the new patient experience

If the core of patient experience has been focused on compassion in the past, it now is also increasingly focused on convenience. 

The work of improving the patient experience often focuses on clinical encounters, whether they be in hospitals, office practices or procedural environments. We ask our patients about these experiences in surveys. The surveys probe issues that patients are uniquely positioned to give us feedback on — courtesy and respect from the team, education about conditions and treatments and communication from the team about each step in the care we provide. We also ask them about the things that happen before and after an encounter — preparation for procedures, check-in processes and how we prepare patients to care for themselves after a clinical encounter. 

Based on this feedback, we work constantly to make communication better and more coordinated. We strive to create deeper connections during our interactions in clinical settings. This has long been the core of PX improvement work.

In this consumer-driven age, however, the focus has expanded. If the core work has been focused on compassion in the past, it now is also increasingly focused on convenience.

In previous columns, I have talked about the need for us to reconcile the notions of "patient" and "customer." Healthcare needs to address basic human needs for care and empathy for patients and families. But it also needs to address customers' expectations regarding access, responsiveness and loop closure. We know that before patients have clinical encounters, they are often customers seeking a service — whether that is finding a physician, making an appointment or paying a bill. There is a journey that patients are on that includes many "moments of truth" before and after they find themselves on an exam table or in an inpatient bed.

It's also true that if our patients experience frustration and friction as customers seeking care, it colors their experience while we are providing care. It can also force them to seek healthcare elsewhere — in other health systems or in other settings. 

What does this friction look like? Websites that don't allow people to easily search and schedule doctor's appointments, long wait times on the phone, transfers between departments without resolution, duplicative paperwork are all examples. My guess is that anyone reading this column has experienced this.

It's interesting that the Latin root of the word "patient" is "one who suffers." From a clinical perspective, this makes sense. Illness brings suffering. The fear of illness — searching for a diagnosis and treatment — brings suffering. Even getting a check-up and flu shot can bring suffering. (My 10-year-old son will validate that last one especially!)

But friction brings another form of suffering. Poor access, processes that are not intuitive or clear, giving our patients administrative "homework," and just plain waiting for a call back all create frustration and, increasingly, anger. 

The COVID-19 pandemic has only increased the need to address these longstanding issues in healthcare. Just as the pandemic has laid bare serious equity issues and disparity, it has also heightened the need to provide better access virtually. The time has arrived to wrestle these customer-related issues to the ground.

At NewYork-Presbyterian, we are transforming the patient journey and reimagining our "front door to care." We are turning our websites into places where customers and patients can get their needs met, not just learn about our services. We are changing how we answer calls and enhancing the capability of the places and people that are on the other end of the phone line for our health system. We are working to assure that anyone seeking care with us can reach out in the way that they prefer, at the time they prefer. 

This is big work, and frankly, it is also a significant culture change. It is also long overdue — both here where I work, and across our entire industry. 

As I talk to my colleagues around the country, I see this work — the work of becoming ever more compassionate but also becoming more convenient — as more and more a part of the work of patient experience writ broadly. Our roles and focus are expanding to address not only the clinical encounter but also the experience "before" and "after." We are bringing the patient and consumer voice to the table and putting the right systems and strategies in place to address these needs and preferences.  Access is the "new PX."

If we go back to that meaning of the word "patient," this evolution and expansion of patient experience work makes absolute sense. We are here to reduce suffering. That needs to expand to include striving to prevent "non-clinical suffering." It's part of our mission. It's also a business imperative in the era we are in. 



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