NewYork-Presbyterian CXO Rick Evans: Improving healthcare access is really about culture change and trust

Last week, I had the opportunity to speak at the Dreamforce Conference in San Francisco. It was a valuable chance to learn about what organizations are doing across the country to improve the experience for their customers. I shared the journey that NewYork-Presbyterian is on to make our organization more customer- and patient-centric and had the chance to hear what other healthcare organizations are doing. A common theme was that, although customer- centric transformation is built on technology, it is still primarily about people. Even more specifically, it is about changing the way we work to better meet the needs of people – both those we serve as well as our own teams.

We’ve had a very busy and productive year working to improve access at NewYork-Presbyterian. We’ve revamped the digital experience on our websites and stood up customer relationship management-powered contact centers to meet patients’ needs on the first call. We’ve made it easy for customers to make appointments online and migrated practices with over 1,000 physicians onto our new call center platform. We will double that amount again next year. 

So far, the results have been very positive — more appointments being made, excellent feedback on our call center experience, and happier providers, practice staff and call center agents. We are thrilled with the progress so far, but much work still lies ahead to meet the needs and expectations of our very digitally-savvy and convenience-driven marketplace.

But, as I said above, most of the hardest work of the last year has been about people and culture change. What have we learned?

Behind our organization’s “front door” — our websites and call centers — are care teams working in practices or other treatment sites in our community. The front doors don’t mean anything without available appointments behind them. This means that the entire team — both the websites and call centers at the “front” and the practices at the “back” — need to work together as a team to make the right appointment available to the right patient at the right time. To make it all work, we need to be transparent with one another and build trust between all parties. For providers, this can mean letting go of scheduling functions they previously had total control of. For call center teams, it means using technology in new ways to manage an encounter to a successful conclusion. Quite honestly, our journey has meant a leap of faith for us all — that we can structure ourselves in new ways and get a better result. So far, we are seeing that trust pay off. But, it’s still a journey in progress.

We’ve also learned that to be successful, many of the silos in our organization need to come together in new ways. Our effort has required enormous collaboration between our hospital and two medical schools. Although we are separate organizations, we constitute one continuum of care for our patients and our destinies are intimately linked. We also have learned how critical it is that our various teams — IT, finance, human resources, marketing, patient experience, quality and others are in sync for this to work. If we aren’t clear on our roles and our collective goals, we will not succeed. We’ve learned that to truly transform into a more customer-centric organization, we need to collaborate as never before, especially if we want to evolve quickly.

We are also learning how data can help facilitate the building of trust. The more we leverage technology and data from our EHR and our new customer relationship management system, the more we are learning about what our customers actually want and need. We are also learning about how we can more effectively structure our practices and treatment sites to better meet customer and provider needs. We are turning many of our “access anecdotes” into “access facts.” This can really help us support our patients and give the right resources to our physicians and care teams going forward. 

We have always believed that any truly successful access improvement effort can’t just be “speeding up the treadmill” for providers and practices that are already dealing with burnout. We also are deeply aware that we are in what is perhaps the most tenuous period in recent history with regard to the well-being and engagement of our physicians, nurses and teams. A successful effort needs to be a win-win — structuring our business optimally to make things better for patients and also supporting an improved experience for our care teams. If we are going to accomplish that, we need to make culture change and building trust a foundational element of any effort to improve access. Becoming more consumer-centric should be a victory, not just for patients, but for all of us. 

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