Too often in health care, we forget that the patient is at first a human being. Health care speak is a complex language that removes the humanity from those we serve. Terms like patient experience are used interchangeably with patient satisfaction, patient engagement, and consumerism. But the experience of becoming a patient changes the fundamentals in profound ways. So let’s differentiate these terms.
Here, I’ve tried to distinguish and separate the qualities and conditions of a consumer of goods from a patient, which is critical in order to fully appreciate the differences between the two. If we consider a consumer of any other good, they have certain luxuries. They have convenient access when wanted, they manage their own information, enjoy full transparency of costs, and engage from a neutral or positive emotional state. When one enters the Kingdom of the Sick, these characteristics morph — transparency becomes opaqueness, fear rises, and control falters. The very fundamental capabilities and luxuries afforded to a consumer are disrupted. If we can partner more effectively with patients and enable self-efficacy and control, the potential exists for the patient to evolve into an “engaged patient.”
In other words, becoming a patient is disruptive and life altering. If you had them to begin with, the luxuries of access, communication, control, service, emotional/physical well-being, and transparency erode. At a more profound level, becoming a patient challenges your identity. Your humanity. So the opportunity lies in not only making sure we return these capabilities, but also in ensuring that our patients feel like human beings. Not an iPatient. Not a bed #. Not a disease.
Technology is already radically changing the patient experience landscape. Interactive TVs are rolling out across health care systems and enabling patients to order appropriate diets, cue education, and allow virtual visits with clinicians and perhaps even loved ones — a much different experience than a 1970 TV hanging from the corner wall. The new, evolving use of Customer Relationship Management (CRMs) is also a step forward, prompting us to call patients by the right name, knowing their appointment preferences, and knowing how long they’ve been a loyal patient (getting these things wrong creates not only a bad experience, but also a brilliant “disengagement” strategy). Virtual reality capability is rapidly shifting into a custom-designed virtual experience that would allow them to be “virtually” home with their families or in their favorite place at the end of their life.
These technology innovations drive a different experience for patients based on what capabilities we want to give back — and might make them feel more human. However, many of them are enhancements to existing frameworks; we still round the same way we did 30 years ago, we still have front desks, patients still complete paper surveys, we still have 9 to 5 scheduling templates. If we are to believe, as many of us do, that the caregiver or clinician experience also impacts the patient experience, technology has even more work to do. A frequently quoted study published last year highlights that for every hour of clinical time, physicians spend an extra 2 hours at home completing work. Technology and its designers must appreciate the potential impact they will have in giving back time — and meaning — to our clinicians.
A great example is expediting the log-on process so that we tap and go, rather than spend 30 seconds logging onto the EMR every time we see a patient. Another homegrown solution is a mobile application that allows clinicians to access patient data from their mobile device rather than having to find a computer (or workstation on wheels) to log in. Voice-activated solutions are around the corner, and may move us even further from the virtual scribes or transcription technologies of today. Information itself is being generated at a rate no human brain can keep up with, much less from multiple, disconnected channels. I’m beginning to get excited about throughput solutions that help eliminate waiting, but also better predict who will be admitted, so we can start searching for a bed before the consultant even sees the patient. Solutions like IBM Watson or AI will become most interesting — and not just clinically — when they can help us understand how to best connect with the patients in front of us based on their historical data, appointment patterns, preferences, emotions, and social determinants.
The future vision of health care experience and technology will be in a redesign, a reimagining, of just about every patient touch point. Furthermore, the reimagining must fully appreciate the losses — emotional and tangible — that can accrue when we become patients. Because if you really knew the losses, you would design processes, systems, and communication in a way that gave patients back their power and humanity.
The digital experience will be most powerful when it intentionally enhances the human(e) experience: the uniquely profound experience of feeling connected, seen, known, and valued. The most humane experiences happen when we meet patients where they are by designing the types of touch points they want and need. Of course, there will be places where technology cannot go. Yet, the virtual or digital touch could nonetheless be warm and empathic, if we design it to be so. That touch won’t be the warmth of another human hand in your own. We should hunt for, and preserve, the most intimate of exchanges between clinicians and patients. For me, it’s the moments when I can bear witness to your darkness and suffering, when I can listen, I can cry, I can stay. For my colleagues, empathy amplifiers, and designers, please help clinicians do our required, overregulated tasks more efficiently — or digitize them altogether — so we can immerse ourselves in what we really love, which is, and has always been, caring for humans.