At the Pop Health Forum last fall, Cleveland Clinic Chief Experience Officer Dr. Adrienne Boissy talked about her definition of patient engagement, and how much bigger it is than just apps. At the Personal and Digital Connected Health event at HIMSS today, Boissy expanded on those ideas, giving several specific examples of how Cleveland Clinic is realizing those ideas.
“Patients should be defining their own engagement,” Boissy said. “If you are designing technology that doesn’t capitalize on patients own values and preferences, we’re going to miss the mark."
One problem Cleveland Clinic has tackled with this mindset is the inadequacy of Yelp-like physician review sites like Healthgrades or Vitals, which display star ratings on each physician’s page.
“These star ratings are based on four comments from one patient and seven comments from another. So millions of patients are making that decision based on four comments,” she said. “That’s the problem with websites like this.”
In addition, Boissy said, there's no guarantee that the people leaving the reviews are actual patients, rather than, for instance, someone with a personal grudge. Cleveland Clinic addressed that problem by creating their own physician review system which sources comments directly from patient feedback surveys and aggregates them, good and bad, into ratings. And to combat the problem of small, skewed samples, nothing is published until the hospital has accumulated at least 30 reviews for a particular physician.
In addition to how patients choose doctors, Boissy said her organization has also been looking at their approach to patient satisfaction. A lot of hospitals see the lowest satisfaction scores for services like food or parking.
“Physicians feel that they save people’s lives and then get reimbursed based on whether their toast was warm. That’s frustrating,” she said.
But designing with empathy means hospitals should take those comments as seriously as feedback about care.
“We’re not Disney, we’re not hotels, but healthcare has a lot to do to deliver on a promise of service,” she said. “We need to avoid unnecessary suffering, which I think failures in service deliver.”
This approach of keeping the patient’s needs and wants in mind during a design process is especially important as hospitals roll out digital technology. Boissy talked about interactive TVs, which have great potential to improve services and patient experience. Through these devices, patients can access their patient portal, watch movies, order food, and more.
“I just showed you 85 things that are really neat that you can do on the TV,” Boissy said. “But according to market research, what are the two things patients want to see? Who is on my care team, and what is happening to me today. If you are solving the pickle problem – if they are able to order pickles and mustards but not figure out what’s happening to them – that’s not designing for patients.”
Over all these different examples, the takeaway is the same: Don't do anything without patient input.
“We have to make sure these technologies, which have enormous potential, are built on what matters most,” Boissy said.