Using Business Intelligence (whatever that is) to increase satisfaction

I’ll tell you that the title of this turned me off but I forced myself to read it and then found it captivating…take a gander and see what you think. Thanks to Scott Wanless and the Business Intelligence Network. I’ve removed much of the business related info though. I think it’s interesting.

Increasing patient satisfaction is a critical goal for healthcare organizations of all types, especially in these times of increased competition, scrutiny and demand for services. Business intelligence based on satisfaction analytics can help you compete.

Our family doctor cements my loyalty as a patient every time I go to see him. He accomplishes this with one simple action combined with two sophisticated uses of patient intelligence. The simple action is to put notes into my care record that indicate what satisfies me. Currently, two of the notes in my record read: “Likes patient population statistics” and “Likes ideas that came from patients.” He has, for example, used both of these statements in a recent visit to diagnose and treat a sleep disorder I was experiencing. During our conversation, he asked one of the nurse practitioners to share statistics on the percentage of the clinic’s population who are experiencing the same type of sleep disorder, and then drill into the percentages for men vs. women and for men of my age group. This type of insight takes deep intelligence to be gathered, stored, processed and shared among the providers. This is business intelligence.

Taking this use of information one step further, our doctor then walked through a one-page sequence of events for my treatment. This included consult with a pulmonologist, an overnight study at a local hospital, education from a home health and medical equipment specialist, and finally follow-ups with both the pulmonologist and with him as my primary care physician. At each stage of this treatment, I was given information on what to expect and why, as well as homework I needed to do in preparation for the specific stage. He sealed the deal with me by telling me that this sequence of events originated with an idea from one patient, and has grown through refinements made in using it with a variety of patients over the past few years. This too is business intelligence.

What is Patient Satisfaction?
At first blush, patient satisfaction sounds like its cousin customer satisfaction. There are, however, significant differences between the two. Topping the list are the licensing and professional restrictions placed on healthcare providers, who must first consider what the patient needs before what the patient wants. In most businesses, trying to sell people what they need versus selling them what they want is an efficient way to go out of business because the competition will gladly reverse this order. I am free to buy just about anything I want in a grocery or hardware store without any regard to whether or not I need it. But I cannot just get an MRI scan or a prescription I saw advertised just because I want one.

In addition to these restrictions are the financial rules from payers, purchasers and the patients themselves. As a provider in a fee-for-service situation, another x-ray may be called for medically, and help the practice financially, but could very well be denied by the patient’s insurance plan. In a capitation situation, this additional x-ray comes out of the provider’s bottom line. Once again, need trumps want.

Patient satisfaction is the subject of numerous books, articles and studies. In Crossing the Quality Chasm, the Institute of Medicine identifies patient-centeredness as one of the six ingredients of quality healthcare. The book uses terms to describe this focus such as empathy, responsiveness to needs/preferences, involvement, respect, information, communication, education, emotional support, physical comfort, value, transparency and heeding expectations. Irwin Press (co-founder of Press-Ganey) discusses the importance of patient experiences and perceptions, and the need to go beyond technical quality to encompass service quality in his book Patient Satisfaction: Defining, Measuring and Improving the Experience of Care. Furthermore, the Gallup Organization has extended the concept of patient satisfaction to become patient engagement. In other words, involving the patient in their care and in the delivery of their care increases satisfaction, loyalty, cooperation and respect.

Common satisfaction measures were summed up in a recent study by DrScore and included:

• Accessibility – both physical access and financial access to care.
• Communication skills – of the doctors, nurses, PAs, NPs and others involved in direct patient care.
• Personality and demeanor – of the same group.
• Quality of medical-care processes – as provided directly to the patient.
• Care continuity – regarding the handoffs made provider-to-provider, as well as across time.
• Quality of healthcare facilities – in terms of having the appropriate equipment, supplies and peripheral resources available.
• Efficiency of office staff – in handling scheduling, billing, etc.

As you can see from these lists, the focus of patient satisfaction relies on providers going beyond the mechanical delivery of medical care to the delivery of a true health service.

Driving Forces for Increasing Patient Satisfaction
The list of benefits of paying attention to patient satisfaction is long and extends to virtually every corner of the healthcare organization whether hospital, physician practice, home health, long-term care and so forth. This makes sense, since the range of factors making up satisfaction is quite wide.

With greater patient satisfaction comes:

Clinical Benefits

• Greater patient trust and acceptance with treatment plans.
• Increasing buy-in for treatment plans more quickly, making best use of scarce physician time.
• Increasing trust, which allows physician to discover more factors that may affect the care needs of the patient.
• Enhancing patient involvement in their own care through preventative measures, corrective measures and so forth.

Operational Benefits

• Driving efficiency into the organization by focusing on what works well with patients, and eliminating what does not work well.
• Cross-over trust is enhanced. For instance, a good experience in scheduling appointments can cross over into a better experience with the care provider. In addition, a good experience with the patient’s PCP can cross over into a more positive experience with specialists that the PCP has referred.
• Increased internal support for other quality improvement efforts, such as timeliness improvement, care process improvement, etc.

References:
White B. Measuring Patient Satisfaction: How to Do It and Why to Bother. Family Practice Management; January 1999, Vol. 6, No. 1, pages 40-4.