When does “The Patient Experience” start? Part 2

In a recent article, I explored opportunities to impact the patient experience even before the patient arrives at the provider’s office. This experience relates to the first phone call after the referral and the pre-work or preparation that takes place to receive that patient. But what happens next? What happens after your car has been valet parked, and you enter a beautifully decorated waiting room with an incredible AV system and more magazines than you could possibly ever read?

As patients, for the most part, we know that some preparation has taken place. We have sent in forms, we have gathered our records if necessary and when we show up, our records are sitting at the front desk or the receptionist can pull up our chart and confirm our appointment and key information.

The patient then gets handed an additional questionnaire that covers any changes since the last visit or since the latest records were received. This is a great way to capture information and also trigger the patient’s memory for events that are worth mentioning to the doctor since patient’s are sometimes not the best historians.

But what happens next? Much has been written and studied when it comes to the impact that long wait times have on patient satisfaction. A recent study reports that patient satisfaction tanks after a 20-minute doctor wait time. Certainly, this is an area that requires significant attention. It seems that reducing the wait time dramatically improves patient satisfaction and the patient-doctor relationship.

But we need to keep asking, what happens next? Let’s say that the wait time has been short, your records are at the doctor’s office, and you have filled out the questionnaire. After all that, the doctor comes in and asks the patient to “tell them their story.” Some patients welcome the opportunity for the conversation, but some will walk out questioning “why did they go through all the trouble of gathering and writing down information only to be asked the same question again?” “Don’t they know anything about me?”

If this is the experience after a long wait, the level of satisfaction will definitely be impacted. Both patients and doctors know that this is a problem. In a recent article, a patient complained primarily about the long wait at the doctor’s office. However, the fact that she had to repeat her medical history was not missed at all “When the doctor arrived, he asked me why I was there (um, it’s on all those forms I filled out) and when I told him, he handed me a brief questionnaire asking me to check which of the following 10 symptoms I had.”

Similarly, a doctor relates about how a patient just could not take repeating his story any more and kicked the doctor out of the room: “This man had by then recounted the long story of his bad leg to three separate teams of doctors and nurses. I was the 14th interrogator by my count, and despite my standard opening gambit (“I know you’ve been over this before”) I was the one to flip his switch: The patient ordered me and my team out of his room and pulled the covers over his head.”

This is a problem that is only bound to get worse. The consolidated medical record consists, on average, of 65 pages (not counting the questionnaire). It is an almost impossible task for a doctor to review, understand, and retain the information in this typical record for all of his or her patients. There are ways that this record can be intelligently organized to allow the doctor to easily navigate the record and look at the key information needed to have a meaningful conversation with the patient. If instead of “Why are you here?” or “I know you’ve been over this before but…”, the doctor said “This is what I understand from your record. Have I missed anything?” the patient’s reaction and therefore satisfaction would be different.

More work needs to be done to help doctors deliver the experience that patients want. Getting the doctor the information they need in an accessible format is critical to enhance the doctor-patient relationship. Patients want to know that their healthcare team know who they are, why they are seeking care and they are willing to abandon the state-of-the-art, high tech provider in order to get that experience. Perhaps this next level of personalization is the next frontier in the Patient Experience Improvement Journey. If U.S. hospitals can impact the bottom line by providing superior patient experience with a potential gain of 50 percent higher financial performance than average providers, then this improvement journey is certainly worth the investment.