What are the healthcare providers doing to improve patient care to differentiate themselves in the new, value-based payment era? Are they thinking beyond online portals which offer just administrative convenience? How are they using emerging technologies such as AI and Robotic Process Automation to improve patient experience and healthcare outcomes?
Contributors

• • Ben Patel, Chief Information Officer, Cone Health
  • Jamie Nelson, Vice President and Chief Information Officer, Hospital for Special Surgery

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Transcript

Sanjog Aul [00:00:23]:

Hello, welcome to this segment on CTN. To learn more, please visit ciotalknetwork.com. The topic for today is Patient Experience Beyond Portals. I have with me, Jamie Nelson, who’s the vice president and chief information officer with Hospital for Special Surgery. How are you, Jamie? How’s life?

Jamie Nelson [00:00:44]:

I’m well. How are you?

Sanjog Aul [00:00:46]:

Very good. So how’s life and business for you?

Jamie Nelson [00:00:49]:

Life is very good, and business at Hospital for Special Surgery is booming. We do nothing but orthopedics and are proud of the work we do here. So things are very good.

Sanjog Aul [00:01:04]:

Oh, great. I will shortly have Ben Patel, who’s the chief information officer for Sinai Health System join us. Meanwhile, let’s get started, Jamie. The reason we wanted to cover this topic is that health care is going through a lot of transformation and we are talking about value-based care and making the patient the center of how health care is delivered. With that said, people still complain or mention that patients are primarily getting administrative convenience by just getting access to a portal where they can pay their bills. To that extent, we are being offered that so-called value-based care, but maybe it grossly undermines what health care is doing. We wanted to touch on making sure that health care providers can share what they truly are going after in order to deliver that patient experience, which is what the patient wants. So where are we with that? My first question to you will be, how well do you think patients’ needs are being met today? And do we even truly know what patients want?

Jamie Nelson [00:02:27]:

Sure. I want to preface my words by saying that we’re talking about patient digital experience and how that relates to the care they’re getting and their ability to know the value of the care. Not only the patients, but the people who are paying for that care. That’s really important. We’re not there yet. I was at HIMSS last week, which is the Health Care Information Systems Society annual convention, 43,000 people, and heard a great presentation about how we are now in the experience economy. Everything we’ve passed the service economy and really are in an experience economy. Every single industry is thinking about what the customer experience is like, and we in health care are not immune from that; that’s where this digital patient experience has to go. We’re just at the beginning. Patients are able to use a portal to pay bills or renew a prescription or look up availability for an appointment, but there’s really so much more that has to happen, including a lot around the Internet of the Patient. What’s happening with the patient beyond the hospital? That’s the direction I think we have to go into.

Sanjog Aul [00:03:45]:

Okay. So we have Ben Patel, who’s the chief information officer for Sinai Health System, joined us already. Hey, Ben. How are you?

Ben Patel [00:03:53]:

Good. Good. How are you?

Sanjog Aul [00:03:54]:

Very good. Very good. Great to have you. Now the question that I asked Jamie, of course, one leg of that question was, do we truly know what the patients want? And then are we creating all our strategies and putting our execution in place around it or is this our ivory tower view of patients’ needs which is further tainted by our profit motivation or us thinking as hospital or health care providers inside out?

Ben Patel [00:04:26]:

Alright. I don’t think that we truly know what the patient really needs from an experience standpoint. Of course, when patients come to a provider organization like ours and anyone else, they come for a reason, because hospitals are not one place. They come for a reason and then we typically take care of that problem or the issue that they have for the most part, but we truly do not have a good understanding of what that patient experience or what that patient is truly looking for before and after the visit or before and after the engagement with the provider. I think it is one of the reasons because we are all looking from a payer’s perspective. The whole value-based care model is to make sure that the providers that take risks in taking care of patients make sure the patient is healthy and does not come to the hospital or go to the clinic and make sure that he or she is taken care of mostly in the kind of a home care setting. If that has to happen, that’s what we are focusing on. So we truly haven’t gotten into the whole phase of understanding, engaging with the customer, creating focus groups, and documenting what they are truly looking for. In some health systems I’ve seen they’ve started doing that, but I think we still have a long way to go. The other thing is we truly don’t know the patient’s journey. A lot of organizations are now getting started to do journey mapping so they truly understand what the patient’s journey is and then try to identify where they can deploy their critical assets to make that patient experience or engagement meaningful.

Jamie Nelson [00:06:30]:

I’d like to make a comment about journey mapping because we’ve started doing that at Hospital for Special Surgery. Again, we are just orthopedics, so we have a somewhat limited patient journey map, and it’s still very complex. I can imagine at an acute care facility with many more services provided, those patient journey maps are very complicated. When I think about something like banking, where they certainly have done customer mapping and moved forward with the digital experience, it’s far simpler. You have maybe five or six major activities that customers in the bank go through that you can map. We are in very complex systems. One of the focuses we have to have is really what are the most important of those patient journeys or else we’ll never get anywhere. You have to start small. Maybe in an acute care hospital, it could be the whole maternity from before through delivery to post care. For us at Hospital for Special Surgery, we’re looking at bundled payments around complex joints because we are at risk for those 90 days afterwards. So that patient journey is very important to us, not only because of reimbursement issues, but also because we don’t want our patients winding up in an ER after surgery here. How do we monitor and manage their experience at home so they really have the best outcomes?

Sanjog Aul [00:07:57]:

So Jamie, based agree. Yeah. So, Ben, based on your response, you mentioned the before and the after when they come to your hospital. Jamie, coming to you, do you think the patient is actually holding you responsible or somehow connecting you to say how good a provider you are based on what their pre and post treatment experiences, or is it more about when they come to your hospital starting from the registration to them being admitted to a room and how the nurses take care of them, how the doctors take the rounds and really treat them. Where does their so-called experience journey in their mind start?

Jamie Nelson [00:08:36]:

It’s interesting because we’re trying to change that. I think at this point for them, it’s when they hit our website or call our referral service or have some friend refer them to one of our surgeons’ offices. That’s when they see it starting. That can be variable because the surgeon offices are not under our auspices 100%, so we don’t dictate exactly what that journey is like. We provide tools, but that can be a variable experience. What we’re trying to do at Special Surgery is move it back to more of the stage when people are just starting to think about orthopedic or musculoskeletal care. We want to collect information while they’re still in a relatively healthy state—identifying those patients in some way, getting questionnaires out of them in an easy digital fashion, and then following them as they come through the system, or perhaps helping them not to have surgery but have other nonsurgical interventions that will keep them from having surgery. So we’re trying to move that beginning point backwards.

Sanjog Aul [00:09:42]:

So, Ben, when you look at this journey mapping, if you were to look at the complexity, because that’s the word that’s been used in the last few responses to my questions. The complication is because there is variability, but could we not take a common denominator and get started versus waiting for you to have 100% understanding of all possible scenarios, which almost I would see as an impossible task to do?

Ben Patel [00:10:09]:

Yeah. Let me take a step back. From our perspective, when we look at patient journey, we’re looking at when the patient is at home, when the patient is in the community—that’s the starting point. When the patient is in the church or in the grocery store or those kinds of pharmacy stores, I think that’s where the patient starts having discussions or thoughts about seeing a provider or having an issue. We’re actually working on those kinds of strategies. Where do we know patients go to seek not only primary advice, but where the congregation of folks is where they can get started talking about these things? We’re trying to start there. We’re actually thinking about the whole retail aspect of things because that’s where health care is going. Even Cleveland Clinic has opened a little retail shop in my suburb here in the Northwest Side. A lot of those are where we are thinking about getting started. Health care is not a restaurant or banking; it is about health, so it will be complicated, but we have to do the journey mapping and we can start small. I think you normally start at the ambulatory side and then move on to the acute side. Typically you start small and learn. One area is the surgery center or procedures area where there is huge demand from both the reimbursement and the patient side; try to map the whole journey—how the patient gets here, who refers them—and then see how you can influence that experience, influence the cost, and influence the health. That’s what we are looking at from three different angles.

Sanjog Aul [00:12:21]:

Jamie, if I were to abstract that portion of the journey, which is more connected to so-called selling them or inviting them or attracting them to your health care services unit, and just focus on the portion where they are actually being treated—that’s the part where starting from the registration desk to what happens as you go into a hospital and get treated and thereafter as you go on for your follow-on visits—that’s where you are being given the experience as a patient. Before they have come to you, it’s more like you’re trying to attract them. So Jamie,

Ben Patel [00:13:04]:

Right.

Sanjog Aul [00:13:04]:

So when we go in that specific, what I call as quote-unquote patient experience as a patient, is there some predictability to how you would want to treat them so that they have if nothing else—if it is not all the jazz and the wooden-paneled walls or better cafeteria—just come to the treatment part. Could there be consistency and would that be a good starting point for you to say, yes, this is an awesome experience we’re giving, which the patient is looking for intuitively?

Jamie Nelson [00:13:39]:

Yes. That’s exactly what we’re trying to do. Because there are many digital ways a patient can start to interact with us, we’re trying to put a common front end so no matter where or how a patient is coming in, that digital experience feels exactly the same. It is an experience based on our population that feels like the experience they have on their smartphones with their bank or Amazon—something very simple, a couple of clicks. We are trying to get all of our pre-visit questionnaires standardized across services so patients do that in the comfort of their home, where they have their medication in front of them and can ask their kids what they think about a date or whatever the questions are. We’re trying to keep a patient from having to handle any type of paper when they walk into our offices. We’re looking to provide that experience from the moment they come in and make it consistent so no matter how they’re entering our system, they have that same experience. It’s a branded HSS experience that connotes a certain level of sophistication, quality, and technology that makes people feel very comfortable with the care they’re about to get.

Sanjog Aul [00:15:01]:

Let’s take a quick break, listeners, and we’ll be right back. When we come back, Ben, I’d like you to literally wear the hat of a strategy consultant who deconstructs this problem and the complexity that we both of you mentioned about getting your journey mapped and the other complications which prevent you from really getting to the point where you want to in terms of providing that so-called differentiated patient-centric care. What are the fundamental building blocks and where are we chronically not able to get to the point where we want to so that this discussion doesn’t continue in 2020 as well. Please stay tuned listeners. We’ll be right back.

Speaker 0 [00:15:52]:

Predict your company’s future by creating it. Is your workforce able to connect, exchange ideas, and share brilliance simply and securely? Create tomorrow, today. Empower your people to innovate any time and anywhere with secure BlackBerry Enterprise Mobility Management and document sharing solutions. To learn more, visit blackberry.com/enterprise.

Speaker 0 [00:16:19]:

Patient centered care requires a connected enterprise. Are you ready? If you’re looking to scale your health care IT efforts, visit redmane.com/health today. Whether it’s to connect data from multiple partner solutions or developing software for unique needs, RedMane can help. To find out how RedMane can help your company deliver on the patient centered care promise, visit redmane.com/health or call (773) 693-3919. Visit today.

Speaker 0 [00:16:52]:

Your growing business needs a highly productive workforce, effectively communicating and collaborating without exposing corporate data to cyber attacks. Are you looking to balance security and workforce productivity? Move beyond short term measures and securely scale your business with BlackBerry Enterprise Mobility Management Solutions. To learn more, please visit blackberry.com/enterprise. You are listening to CTN, CIO Talk Network with Sanjog Aul. To learn more about our program, please visit ciotalknetwork.com. Now back to the show.

Sanjog Aul [00:17:42]:

Welcome back. So, Ben, take it away where you could deconstruct the problem and tell where are we missing the boat for so long because this is turning out to be a chronic issue where we are not able to get a good handle on what the patient wants.

Ben Patel [00:17:58]:

So first of all, from an inpatient and ambulatory side, the patient experience that the patient goes through is measured by scores like HCAP and CGAP. A lot of these patients, when they go home, they do get a call, a survey, and they rate the providers and how we are doing. From a real experience standpoint, one of the things that we are struggling with—and this is the reason not only for journey mapping, but also some of the analytics and technology—is trying to understand how we can optimize the patient experience. I’ll give you an example. In our case, when patients come for infusion, oncology patients, if we have a backlog, that same infusion patient then has to get the labs done or see the physician or oncologist and so forth. One of the things we’re trying to understand is how can we optimize that patient’s experience by making sure that the patient does not have to wait too long for a specific visit or task like getting blood drawn. If there’s an issue with the phlebotomy area where the blood draw will take longer, we want to see if we can route that patient to the physician’s office. Or if the physician is backed up and there is a delay, then how we can get the patient into infusion a little bit faster. We’re trying to learn from a couple of health systems that have come up with a patient command center. That command center monitors patient flow and comes up with ways to optimize experience so the patient feels they were in and out within the specified amount of time. Yes, we may have to move them a couple of times, but they are not sitting and waiting half an hour or an hour just to see an oncologist or other provider. That’s one example. The other example is behavioral health. We have a lot of folks who come in for behavioral health issues, and we came up with an innovative process called critical stabilization unit process where patients are not truly seen by expensive ED physicians. We have behavioral health professionals who assess them, make sure this is what they came for, and sometimes we hold them for a couple of hours of observation and send them home versus the typical process of admitting them. Those are small but high-level examples of what we are doing from an experience team, but we’re not there yet. We’re learning. We’re going through journey mapping and learning what we can do to optimize that patient experience. From a technology standpoint, we have deployed iPads to nurses and others who go rounding on patients about their experience within our facility. That’s the inpatient side. What we are now getting after is pre-arrival—before they come to the hospital we want to make sure they are aware why they’re coming, what the procedure is, and if there is anything they need to bring. Then the discharge and post-discharge, we want to make sure they have all the tools, instructions, and help they need to take care of a wound or a procedure. We’re trying to get into that area to make sure that from a transition of care and care coordination standpoint we are in a closed loop process.

Sanjog Aul [00:22:09]:

So, Jamie, when we come to the digital experience while they are on-site getting treated, with whatever information and data that may have been gathered from the patients through their treatment journey, and given that they come from all walks of life and not everyone is very up to date on technology, do they really enjoy the new-age digital experience, and does that give you, as the provider, a thumbs up?

Jamie Nelson [00:22:44]:

It’s surprising when you look at the data around who actually is enjoying a digital experience. We often look at the older generation as not being as tech savvy, and in fact, they really are. This is becoming ubiquitous: recognition and desire for a digital experience across all strata of patients. Forget about the younger generation that just lives in technology; it’s across the whole patient population. Ben’s comments made me think about an excellent Gartner article recently published talking about real-time health systems and using digital and the Internet of Things or Internet of the Patient to know when the patient arrives, if they’re stuck in traffic, where they should park, what the wait time is for their infusion. Perhaps they need to get their x-ray done. All of this can be based on digital sensors that they are wearing, whether it’s a Fitbit or an app on their smartphone. This can go right through the journey while they’re in the hospital and follow them when they leave to help us gather data on how they’re doing. This real-time health system for us is the holy grail. I don’t think anybody is near doing it yet; we’re much more premature on our journey. You do hear a lot about command centers. We think about it for our ORs—we have 35 operating rooms running at full speed with all these surgeries, and that’s something we would love to see. What’s going to enable it is patients wearing sensors; this Internet of the Patient is going to be the future of the patient experience as they enter our facilities and right after they leave. It’s a brave new world.

Sanjog Aul [00:24:50]:

So, Ben, when you’re looking at, say, your budget, without divulging too much, do you think you get a carte blanche on anything clinical where you can enhance the experience for the patient and do the right type of procedure on them? Of course a person’s life and well-being is at stake, but when it comes to the novel omnichannel retail-style effect, is the jury still out as you present your budget to say I want to do X, Y, Z to enhance it and then you’re being questioned on that?

Ben Patel [00:25:26]:

I don’t think I’ve heard any CIO say they have unlimited budget. I think we’re all more or less in the same boat. I have to justify budget. I have some budget to play with, but I truly have to go to the board or finance committees to sell why we need it. In some cases it’s easier because, as I said before, we are being driven by the reimbursement model. If a payer contract says we have to do this, it becomes easier, but it’s by no means carte blanche or unlimited. That’s one of the obstacles we have today. The good news is most C-suite and most boards are realizing this is critical and trying to get it funded. Now it’s not a single budget line; it’s case by case.

Sanjog Aul [00:26:36]:

And of course, as you rightly said, anything you go and make a business case for has to be justified, but when it comes to budget and having to negotiate with upper management, are your line items getting approved when you’re talking about the new-age digital experience because they are coming on board that, as Jamie said, the future holds that brave new world? Are you getting that support from a funding standpoint just because we are in this digital world?

Ben Patel [00:27:14]:

There is still some disconnect. Some CIs obviously get it, but most senior leadership C-suite, I don’t think they get it. I’ve heard a lot of C-suite folks think digital transformation is another buzzword. Vendors try to come in and sell an idea. I don’t think there is a good strategic plan so far. I work in some very big and financially rich academic medical centers, so I think that stems from being driven by reimbursement. As we get into more at-risk models, I think this will change because IT technology is the only differentiating factor or catalyst to compete. That is slowly changing, but not as fast as I’d like to see. It’s primarily because if a CFO does not understand why and how the technology will work and how it will benefit the health system long term, that project and funding is going to get killed.

Jamie Nelson [00:28:43]:

I have a funding story. About 1.5 years ago an interdisciplinary team at the hospital started thinking about how we were going to push our digital transformation. We wound up working with a major IT company who had a beautiful set of ideas and objectives, all the journey mapping, their products, everything including an omnichannel patient calls solution. When we got the price estimate, it was 2/3 of the price we spent in capital on our whole EMR implementation. As you can imagine, there was sticker shock, and we had to go back to the drawing board and ask, instead of putting something new on top of what we have, what could we do with what we have now to really optimize the patient experience digitally and start smaller? I agree with Ben that there is no carte blanche in terms of spending because of reimbursement. When you figure out what it could cost to get to where you want to go, it’s pretty cost-prohibitive. By nature of how we are paid, we’re going to have to take smaller steps, do pilots, figure out what’s going to work, and use the tools we have and enhance them. It’s going to be a gradual process because I don’t know any facility that has the ability to say here’s an open bank account—do what you need. We got stopped.

Sanjog Aul [00:30:34]:

Let’s take a quick break listeners. We’ll be right back. Let’s talk about what’s the future and what’s new in technology, computing paradigms, and what people are willing to relinquish to machines—robotic process automation, AI, and other things. Is this like Star Trek for health care, or is this coming? We spoke about telemedicine, but that still has humans on either side. Are we going in that direction, and if we are, will that impact patient experience and the cost model of how things happen and how reimbursements are made? Let’s explore this. We’ll be right back. Please stay tuned.

Speaker 0 [00:31:38]:

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Speaker 0 [00:32:09]:

Patient centered care requires a connected enterprise. Are you ready? If you’re looking to scale your health care IT efforts, visit redmane.com/health today. Whether it’s to connect data from multiple partner solutions or developing software for unique needs, RedMane can help. To find out how RedMane can help your company deliver on the patient centered care promise, visit redmane.com/health or call (773) 693-3919. Visit today.

Speaker 0 [00:32:42]:

Predict your company’s future by creating it. Is your workforce able to connect, exchange ideas, and share brilliance simply and securely? Create tomorrow, today. Empower your people to innovate anytime and anywhere with secure BlackBerry Enterprise Mobility Management and document sharing solutions. To learn more, visit blackberry.com/enterprise. You are listening to CTN, CIO Talk Network with Sanjog Aul. Now back to the show.

Sanjog Aul [00:33:23]:

Welcome back. So AI, machine learning, robotic process automation—do they have a place in health care delivery? If yes, when do you expect this to happen, or is this too far out and too Star Trek-like to be practical today?

Ben Patel [00:33:44]:

I think there’s definitely a space and a need for deep learning and AI. I don’t think we’re at the point where it’ll replace humans—physicians, clinicians. At this stage we’re just scratching the surface. We’re starting with basic, not very sexy, behind-the-scenes machine learning to understand how we can improve operations. That’s the stage we are at. Once we learn and apply deep learning and create capabilities—though not every organization is capable—we can evolve from operational efficiencies like predictive analytics and throughput to something like creating virtual clinical assistants. The promise and opportunity are huge. If we can use technology to truly augment clinicians and help them diagnose faster and complete notes faster, that’s huge. Or create 3D or 4D images and objects for patients to see what’s going on and treatment options—AI has a lot to offer. Where we are today is understanding, creating capabilities, and applying them to operations. That’s where we’ll see gains. I’m not trying to create a Star Trek scenario; I’m not sure how that would work or what problems it would solve.

Sanjog Aul [00:36:06]:

Jamie, regarding the unnerving aspect of humans losing jobs and being replaced by machines—if you look at a physician or a nutritionist or someone who brings decision making based on experience, and you replace it with an algorithm that brings knowledge from many sources and decision making based on many similar people, instance by instance, isn’t that logical progress toward better patient experience and health improvement?

Jamie Nelson [00:36:56]:

I think it absolutely is logical progression, and I have no worries about massive job loss. Who has enough MDs, nutritionists, or respiratory therapists? We don’t have enough staff to do these functions. If we could use AI, predictive analytics, and machine learning as assistive technologies to suggest likely diagnoses or best practices, that would help improve health care effectiveness and efficiency, get patients to the right settings more quickly, and improve care. I don’t see this as replacing people. Look at PACS and radiology—the first to go fully digital—and we still need radiologists. PACS is an assistive technology. There’s too much information for any clinician to master today. For best patient care, having analytics to present information and assist decision making is critical.

Sanjog Aul [00:38:30]:

If the value proposition is there and the technology is here, what prevents us from embracing it, piloting it, and bringing it into the mainstream, because many resource issues, decision-making delays, or errors could be reduced and directly contribute to patient experience even when in the hospital?

Jamie Nelson [00:39:02]:

At a local level, it’s more about resources. We have a lot of people who love data, but fewer engineering resources to stand up big data platforms and do sophisticated engineering. We put our EMR in 2 years ago, so we’re just now getting a great repository and a data warehouse. There are practical limitations: staffing and processes are not fully in place yet. That’s number one—getting the data there. Then convincing clinicians the data is helpful. A lot of what we’re doing is having clinicians be part of new ventures. For instance, we’re part of a new company helping to read images and correctly diagnose. Our radiologists and surgeons are part of that company, helping build analytics and algorithms and with machine learning. Having clinicians involved in development is important because they understand the value and how decisions were made and can stand behind it with colleagues.

Sanjog Aul [00:40:33]:

So, Ben, if you were—go ahead.

Ben Patel [00:40:36]:

I was going to comment that resources are a key issue. Most IT shops spend most time in operational firefighting mode. We need a bimodal approach: have a team dedicated to innovative, creative things that can execute. Second, AI and machine learning rely on uniformly collected, structured data. Most health systems struggle even with EMRs because every physician has a style of documenting—dictating, typing—and that variability makes it hard to do AI. Make sure your data is not dirty. Those are key things before you pilot and go anywhere.

Sanjog Aul [00:41:56]:

So, Ben, is progress better than perfection? Is there a less-than-perfect model where you’re not truly relying on every possible last detail from physicians and you can still kick off these initiatives and work toward improving data quality?

Ben Patel [00:42:20]:

Absolutely. We have started here. I always say that 80% of data is better than zero. We’re not going for perfect accuracy; we’re aiming for at least 80% of the data entered to be uniform and accurate so we’re not missing critical fields. If you’re relying on AI and a couple of pieces of critical data are missing, your algorithm will fall apart. You’re right that accuracy at scale is challenging, so take sepsis as an example: a lot of those algorithms are out there; some are available commercially. It’s just a matter of applying them. Resources are the issue. Most health systems spend more time maintaining EMRs or infrastructure and have little time for innovation. That’s why I’m creating a bimodal team approach where one team focuses on operations and another focuses on value-added projects, including innovation.

Sanjog Aul [00:43:38]:

Jamie, would you say if we were to create a checklist of things we ought to be doing behind the scenes or on the front end that would constitute an excellent patient experience which exceeds expectations, and start checking them off one at a time, are we working with that approach or are we looking at the urgent over the important and that’s why this stays convoluted as it was five years ago?

Jamie Nelson [00:44:16]:

When we restarted our digital journey after the sticker shock of our partner’s pricing, we looked at the various things because digital is many things. Ask anybody in the hospital what digital is and you’ll get a different answer. We took a group of stakeholders, put them in a room for a few days, and really tried to map out the digital projects in play, how they interrelate, and what we should knock out first. We wound up with magic quadrants and identified items that were easy to do and not too expensive—those are the ones we figured to start with because you have to start somewhere. Things we were almost there with or knew would bring value and could be done with limited resources is where we started to create a digital experience. For us, much of that meant using Epic, our EMR, using MyChart, their portal, and starting to augment and build out the patient experience from there because we had it in place. Before adding fancy bells and whistles, what can we do within MyChart to start implementing patient experience? I just read a study by NTT DATA that said 78% of tech-savvy consumers say the health care digital customer experience needs to improve, and half would leave their current physicians for a better digital customer experience. There’s a burning platform if digital is becoming a differentiator, especially in communities with multiple hospital systems or big physician communities where patients have choice. Starting to roll out something patients can feel and appreciate is critical. That study also talked about basic things patients are looking for: searching for a doctor, accessing a loved one’s health records, appointments, test results, bills, prescriptions. This is not fancy stuff; just getting that right would propel any institution on a journey and get stickiness from patients that we’re trying to achieve with the digital experience.

Sanjog Aul [00:47:02]:

So to that, whatever you said, Jamie, coming to you, Ben, if that’s what patients are looking for and that’s how in their mind the digital experience is, how dependent are you on external entities which you don’t control to be able to provide that to the patients? Like, somebody trying to look up a loved one’s health records—if you have them, you can show them. Ben, I think we lost you. So Jamie, coming back to you, why don’t you look at it from your standpoint that if you said that this is what you want to provide to a patient, then why could you not provide that to them given that you have that data? What prevents us?

Jamie Nelson [00:47:51]:

I would say just resources. There are so many wants out of an IT department today. As Ben says, a lot of what we’re doing is just keeping the lights on. HSS is an IT-sophisticated community from our clinician standpoint, so prioritizing what we should do first is hard. Even something as simple as texting appointment times or visit reminders or that a result is ready involves a lot behind it—privacy regulations, cybersecurity, agreement from a patient experience committee. There are many levels to get through to push technology out, and so many technologies being requested. Prioritizing and assigning resources to the highest-priority things is the initial stumbling block. We never have enough IT resources to meet the insatiable demand of our users. It’s about prioritizing the long-term goals of the institution and which technologies to pick off a list to further that goal. There is no lack of work for sure.

Sanjog Aul [00:49:27]:

And if we’re talking about people and policies and process changes, Ben, we’re talking about transforming patient experience with or without digital. Is there a stencil you would use to say these are the bare-bone fundamentals we must have in place before you morph patient experience to what patients desire?

Ben Patel [00:50:02]:

Well, no. I think

Jamie Nelson [00:50:06]:

I mean, I think we

Ben Patel [00:50:08]:

sometimes give too much credit to technology and think patient experience truly needs everybody on tablets. I think patient experience, like when we go to other places like retail shops, is all about process and people. Health care is about people—I’d say 80% people and less than 10% technology. We need to focus on process: when the patient comes, what are they looking for, how can we greet them, how can we offer simple things? A lot of those can be doable now without major investment. Yes, there are digital components that will help, but let me give an example. We have a whole community institute here. We surveyed the community and asked what patients told us they want when they come to hospitals: respect, to be treated equally regardless of income or language. We heard that and are now improving our processes to make sure every patient feels welcome and heard. I don’t think that minimal investment is huge, but you have to tailor to the needs of your patient, create processes to help patients feel welcome and listened to, and then see how technology can enhance that.

Sanjog Aul [00:52:02]:

One final question—30 seconds for you, Jamie. Talk about the leadership style. If you were to become a better version of you, what would that be for you to enable the next level of patient experience leveraging technology under your leadership?

Jamie Nelson [00:52:20]:

Patience. It’s interesting because the decision we ultimately made around digital I knew a year before, but I could not just implement it. I needed to let our constituents within the hospital community come to that same decision. It really is about consensus and old-fashioned management principles, which are still very important. You cannot just forge forward with an IT lead; you need the patience to let your users help drive and for you to be the enabler. Continuing along that path is important.

Sanjog Aul [00:53:06]:

On behalf of the show and our listeners, thank you so much, Jamie and Ben, for sharing your views on how health care providers are evolving and trying to provide the best patient experience and where they are today. Thank you so much.

Ben Patel [00:53:21]:

Thank you. Bye.

Jamie Nelson [00:53:22]:

Thank you very much, Sanjog.

Sanjog Aul [00:53:24]:

And listeners, hope you enjoyed the conversation. Please like us on Facebook—search for CTN—and be sure to follow us on Twitter and join our LinkedIn community. There are podcasts on iTunes, TuneIn, Stitcher, iHeartRadio, Spotify. You can find us everywhere. Please listen and rate our podcast. Thank you again for listening to this segment on CTN. This is Sanjog Aul, your talk show host. Till next week, take care and God bless.