Growth Through Patient Experience: Four Guiding Principles of PX-optimized Pediatric Healthcare Organizations

Healthcare

Future-focused organizations, no matter the industry, are making CX a strategic priority. Understanding the evolution of the Experience Economy and staking a claim in this PX-focused market is critical for healthcare organizations seeking to position themselves for enduring success.

The healthcare system in the United States is teetering on the edge of a major recalibration. Existing business models are being challenged, in large part by the rise of consumerism in healthcare, where customer experience, or CX, reigns supreme. And while matching a buyer with a seller in healthcare will never be as simple as it is on Amazon.com, the importance of CX for all organizations cannot be understated. Research shows that CX leaders consistently outperform the market – in fact, from 2007 to 2014 CX leaders’ cumulative returns were 49 percent greater than the S&P 500 Index. And those trailing the pack are similarly impacted: CX laggards underperformed the index by 162 percent during this same period.1

In no area of healthcare is the importance of CX more pronounced than in pediatrics. Nine thousand infants are born each day to Millennial parents in the U.S., and these consumers approach their children’s healthcare far differently than previous generations have.2 They turn to technology and they crowdsource, with 54 percent of Millennials reporting they look online before choosing a doctor.3 And their bad healthcare experiences go viral. In fact, 60 percent of young Millennials share their healthcare experience with friends – not their doctors or healthcare facility – when they are unsatisfied.4

In no area of healthcare is the importance of customer experience more pronounced than in pediatrics.

Yet exemplary CX is not enough to ensure success in the highly specialized world of pediatric care. North Highland has helped pediatric healthcare organizations achieve future-ready status through four focus areas, which including CX are financial transparency, digital integration and cultural competency. These offerings are what drive high-quality, value-rich patient experience (PX) in pediatric healthcare.

Achieving outstanding PX in pediatrics is not easy. But we believe that these four differentiators will help pediatric healthcare organizations position themselves for sustainable success, now and into the future.

PEDIATRICS IS DIFFERENT: LEVEL-SETTING ON UNIQUE CHALLENGES AND OPPORTUNITIES




The differences between the pediatric healthcare experience and the adult healthcare experience vastly impact the approach providers take in delivering exceptional PX. Here’s why:

A) YOU ARE NOT JUST SERVING THE CHILD, YOU ARE SERVING HIS OR HER ENTIRE CAREGIVER NETWORK.

It is critical to consider the experience of the full caregiver network for pediatric patients, a network that could extend beyond parents to include siblings, friends, teachers, babysitters, grandparents, coaches and neighbors.

IT'S CRITICAL TO ESTABLISH DYNAMIC INFORMATION CHANNELS CAPABLE OF PROVIDING CUSTOMIZED LEVELS OF INFORMATION, REAL-TIME, 24/7.

The broader the network, the more complicated and critical communication and access to information becomes.

Pediatric healthcare organizations must prioritize communication by providing resources to caregivers that can be readily shared and easily understood. Additionally, it is important to establish dynamic information channels capable of providing customized levels of information, real-time, 24/7.

B) PROVIDING HEALTHCARE SERVICES TO CHILDREN IS NOT AS SIMPLE AS SERVING THE NEEDS OF SMALL ADULT BODIES.

From prescribing treatments to thinking about patient engagement, providers must customize their approach based on their patient’s sequential developmental stage.

It is important to note that parents and caregivers feel the impact of these developmental milestones, too. Thinking about children in the following age-specific cohorts can help providers adeptly formulate the unique interaction approach that will drive excellent PX.

C) PEDIATRIC HOSPITALS HAVE LARGER CATCHMENT AREAS, WHICH TYPICALLY MEANS A HIGHER CASE MIX INDEX AND A VASTLY DIVERSE PATIENT POPULATION.

These factors necessitate robust population health management programming and partnerships with community organizations to ensure the best quality care, irrespective of geography. In addition, it is critical for pediatric providers to have an organization-wide understanding of cultural differences within their catchment area to ensure that patients and families receive culturally competent care.

D) HEALTHCARE ISN’T JUST ABOUT PHYSICAL HEALTH ANYMORE.

The healthcare experience is no longer exclusively centered on the clinical service rendered. Current thinking has shifted the focus from “healthcare” to the broader concept of “wellness,” which extends beyond physical health to encompass emotional and financial health.

THE POWER FOUR: GUIDING PRINCIPLES FOR PX-OPTIMIZED PEDIATRIC HEALTHCARE ORGANIZATIONS





With a clear understanding of the unique challenges in the pediatric healthcare industry, North Highland believes PX is an equally unique differentiator, capable of delivering improved patient care and reduced costs. Delivering exceptional PX across pediatric patients and their caregiver networks demands attention and fulfillment in the following areas: CX, financial transparency, digital integration and cultural competency.

CUSTOMER EXPERIENCE

Customer experience should be integral and omnipresent in every operational function of PX-optimized pediatric healthcare organizations. So we start here.

North Highland uses diverse competencies to design, deploy, build and embed compelling experiences in providers' care environments, everything from providing the insights and research to drive data-led strategy, to culture cultivation and employee experience programs that build patient-obsessed workforces.

Here’s how that looks in practice. A regional health insurance company found itself with an influx of new customers after the passage of the Affordable Care Act – an increase in membership that required it to adjust on many fronts. Customers were beginning to complain about a suboptimal billing process and lack of access to care, so the health plan knew that taking a customer-centric approach was the right way to tackle the challenge.

North Highland worked with the health plan to create a program to connect and engage with customers at key points in their journey to learn their needs and expectations. The health plan was already interacting with its members at various touchpoints, including surveys, but didn’t have a good process in place for interpreting feedback, reacting in a meaningful way, and monitoring whether a given solution actually fixed the problem.

To address these issues, the team identified more than 20 customer feedback channels within the organization, from online chats to social media and surveys. The team then identified channels where the customer voice was not being heard and acted upon, revised surveys and created new ones, and harnessed insights from live chat sessions and call center records.

Using an agile approach to make and test changes quickly, the team piloted five enhancements to help the health plan more effectively react to customer feedback and monitor improvements.

The team also identified hurdles and governance gaps that needed to be remedied in order to establish the voice-of-the-customer program throughout the organization and implement far-reaching customer experience improvements.

The work instilled a framework for listening and responding to customers throughout the health plan’s organization, laying a foundation that will help its teams make changes in a practical, scalable manner — and to continue to do so in both the short- and long-term. By streamlining and improving customers’ interactions with support representatives, the organization anticipates higher levels of satisfaction in addition to financial savings.

FINANCIAL TRANSPARENCY

The patient financial experience – or in this case, the patient’s caregiver’s financial experience – can have significant impact on a healthcare organization’s bottom line. Forty-two percent of customers are very confused by bills from their providers, and 47 percent are very confused by explanation of benefits (EOB) from their payer.5

Confusion is a dangerous thing. For pediatric healthcare organizations it means an increased toll on financial staff resulting from high volumes of calls from frustrated caregivers. It means assuming an increased risk of nonpayment ($42.8 billion was written off by hospitals due to uncompensated patient care in 2014 alone)6. And it means caregivers become fed up with and distrust providers – two qualities that can shake consumer loyalty and PX to its core.

THE PATIENT’S CAREGIVER’S FINANCIAL EXPERIENCE CAN HAVE A SIGNIFICANT IMPACT ON A HEALTHCARE ORGANIZATION’S BOTTOM LINE.

Improving the financial journey for your patients’ caregivers is not a silver bullet to ensuring on-time payment and total billing comprehension. But these steps can transform the financial process to be an essential element of exemplary PX:

  • Consumers expect to pay healthcare bills when and how they choose, as they do for other bills. Consider flexible payment methods that give caregivers options and support.
  • Patients and caregivers do not necessarily want more outreach. Instead they want control over the type and quantity of information they receive, and through which channels. Create processes that allow for highly customized, caregiver-mandated communication systems, with the flexibility for adjustment as needed.
  • Simplify bills and make it easy for caregivers to understand exactly what they are paying for and when it is due.
  • Financials are black and white. The emotional complexity of financial drains on caregivers – especially those already taxed by the strains of a sick child – are not. Specialized education and training can help those at the front line of healthcare financials maneuver the complicated landscape of bill collection and caregiver financial education.

DIGITAL INTEGRATION

Digital integration is no longer a nice-to-have in the care continuum. It’s a business imperative and a necessary tool for achieving exceptional PX. A powerful digital strategy supports and connects the entire healthcare ecosystem to drive cross-organizational collaboration, leverage joint ideas and data, avoid duplicative work, and ultimately be more cost effective.

Intermountain Healthcare in Utah is widely considered a digital integration pioneer. In the 1990s, this large, primarily adult healthcare system created one of the first enterprise data warehouses in the country.7 Today, all clinical programs – pediatrics included – operate with data at their core. A data manager, data analyst and an operations director, working with a medical director, direct all the clinical care activities within each clinical program for the entire system. Today, data-driven decision-making at Intermountain has enhanced patient outcomes in cardiovascular medicine, endocrinology, surgery, obstetrics and care processes, and has saved millions of dollars in procurement and supply chain processes, according to MIT Sloan Management Review. And Intermountain is extending everything it has done on the adult side over to Primary Children’s, leading to thought and behavior change at the pediatric bedside.

Others are taking digital integration further. Nearly 40 Children’s Hospital Association member hospitals have combined forces in a group purchasing organization (GPO) to reduce costs and connect purchasing information with pediatric research-based operational and clinical data. GPO participants access an integrated database that uses administrative data for benchmarking and performance improvements across the continuum of care.

DIGITAL INTEGRATION IS A BUSINESS IMPERATIVE AND A NECESSARY TOOL FOR ACHIEVING EXCEPTIONAL PATIENT EXPERIENCE.

Sharing of non-financial resources, such as internal review boards, biorepository labs and data, is another massive benefit of data integration. Take for example, Cavatica, a joint venture of The Children’s Hospital of Philadelphia and Seven Bridges. This cloud-based environment was designed to enable the secure storing, sharing and analyzing of large volumes of pediatric cancer patient genomics data. The platform's open infrastructure will provide researchers access to genomic data that will aid new discoveries and, in turn, help doctors select precise cancer therapies to match with individual patients.

"It's exactly this type of cooperation that crosscuts academic, commercial and government efforts that will transform the clinical trial landscape for pediatric precision medicine," said Sabine Muller, M.D., Ph.D., PNOC Project Leader UCSF, in a press release announcing Cavatica.8 Digital integration at its finest.

CULTURAL COMPETENCY

By the year 2020, more than half of American children age 18 years or younger will belong to a racial or ethnic minority group.9 And while cultural competency is key to achieving excellent PX, more importantly it is critical to closing the disparities gap in pediatric healthcare.

Take the Hispanic population, for example. According to the Centers for Disease Control and Prevention’s May 2015 study on Hispanic health, one in six people living in the U.S. are Hispanic - that’s almost 57 million – and by 2035, Hispanics could represent nearly one in four. In order to provide the best care possible for this growing population, pediatric healthcare organizations must understand and address significant cultural requirements. Larger exam and treatment rooms may be necessary to allow for extended family members. All materials must be offered in Spanish, and skilled interpreters must be on-hand. And because of higher degrees of health risk among Hispanics, more preventive screenings are in order to better treat issues like obesity, which impacts 38.9 percent of Hispanic children aged two to 19 (the obesity rate among white children in this same age group is far lower at 28.5 percent).10

BY THE YEAR 2020, MORE THAN HALF OF AMERICAN CHILDREN AGE 18 YEARS OR YOUNGER WILL BELONG TO A RACIAL OR ETHNIC MINORITY GROUP.

As the cultural differences of patients and caregivers change, so must the way pediatric health systems operate. Pediatric healthcare services that are respectful of and responsive to the beliefs, practices and cultural and linguistic needs of diverse patients will bring about better health outcomes. And ultimately, there is no better demonstration of exemplary PX than that.

TO THE HEALTH OF PATIENTS AND BOTTOM LINES



The pediatric healthcare market has entered the consumer realm. Proving value through the drivers that caregivers care about most will not only be critical to the growth of pediatric healthcare organizations, but to their survival.

The Institute for Healthcare Improvement (IHI) has developed a framework, called the Triple Aim, which outlines a three-pronged approach to optimizing health system performance by focusing on:

  1. Improving the patient experience of care (including quality and satisfaction)
  2. Improving the health of populations
  3. Reducing the per-capita cost of healthcare

The strategy captured by the Triple Aim is echoed consistently by practitioners, policy-makers, health insurers, healthcare consumers, and thought leaders like Michael Porter, founder of the modern strategy field and one of the world’s most influential thinkers on management and competitiveness. In sharing his ideas on how to fix the broken healthcare system, Porter states, “It’s time for a fundamentally new strategy. At its core is maximizing value for patients: that is, achieving the best outcomes at the lowest cost. We must move away from a supply-driven healthcare system organized around what physicians do and toward a patient-centered system organized around what patients need.”11

This market shift provides a unique opportunity for healthcare organizations to differentiate themselves and North Highland is unique in its ability to help in the new value-based world, especially in the pediatric setting. Those organizations that do it right, the ones that are truly PX-optimized, will organize themselves around offering unparalleled CX, financial transparency, digital integration and cultural competency. The result will be healthier patient populations and healthier bottom lines for PX-optimized pediatric healthcare organizations.



For more information, please contact:

Janice Anderson

janice.anderson@northhighland.com

971-229-1523

Donna Houlne

donna.houlne@northhighland.com

615-370-6246

Jennifer Pasteris Machado

jennifer.p.machado@northhighland.com

314-495-5552

Sarah Vallet

sarah.vallet@northhighland.com

303-864-2722




1. 2015 Watermark Consulting; http://www.watermarkconsult.net/CX-ROI

2. “How Millennial Parents Think Differently About Raising Kids,” TIME, Oct. 15, 2015: http://time.com/4070021/millennial-parents-raising-kids-poll/

3. “54% of Millennials look online before choosing doctor,” Mobi Health News, Aug. 31, 2015

4. “How Millennials shop for healthcare in a digital world,” Nuance Communications, Inc., Aug. 28, 2015

5. “Trends in Healthcare Payments Fifth Annual Report: 2014,” InstaMed, May 2015

6. The American Hospital Association, Jan. 28, 2016

7. “What Big Data Means for Patients,” Children’s Hospital Association, Oct. 19, 2015

8. Press release issued by the Children’s Hospital of Philadelphia, Feb. 26, 2016

9. “Projections of the Size and Composition of the U.S. Population: 2014 to 2060,” US Census Bureau, March 3, 2015

10. “Racial and Ethnic Disparities in Obesity,” September 2014

11. “The Strategy That Will Fix Health Care,” Harvard Business Review, October 2013

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