Several weeks ago, I wrote a blog post titled Terrible healthcare customer service. It was a rant based on my experience as a patient and as a family member of patients where I argued that the healthcare industry has the absolute worst customer service there is. That’s the bad news.
The good news is I’ve met clinicians who are doing fantastic customer service and today I introduce you to one.
According to a report by the Center for Information Therapy, patients remember only half the information conveyed to them just five minutes after a healthcare consultation. This disconnect between doctors and patients means a huge customer service problem in healthcare.
Clinicians assume patients understand the terminology we are using with them about their diagnosis and the plans for treatment and clinicians are assuming their understanding and cognition can occur very rapidly. These are two very incorrect assumptions,” says Kate Burke, M.D., an emergency physician at Milford Regional Medical Center in Massachusetts who also serves as president of Orion Emergency Services, her group practice employing 22 physicians, and as Clinical Associate Professor, University of Massachusetts Medical School. “Patients are not in our heads as we are rifling through our differential diagnoses of what’s wrong with this patient, nor do they have the training, background, or vocabulary that we spent a long time learning. Is it not acceptable to think they can remember things as quickly as we frequently speak. This leads to a real communication gap between what the clinician believes they have communicated clearly with the patient and what a patient understands about what the clinician was trying to communicate.”
Dr. Burke became interested in this disconnect through personal experience with an orthopedic injury she suffered while skiing. She struggled to recall exactly how to do her physical therapy exercises at home. Then she had an idea: On the next visit to her therapist, she took her video camera, asking him to record her correctly performing her exercises in his office so she could remember exactly how to do each movement at home.
“It was a real 'a-ha' moment for me as a doctor,” Kate says. “I thought ‘Wow, this is unbelievable. I can play my own rerun to revisit my physical therapy sessions and store them on my computer. I can have all of the content that was shared with me from three and four years ago to use regularly and routinely, not requiring me to go back to the provider.”
Since that experience as a patient, Kate has introduced video in her own practice, shooting clips for patients at the end of an emergency room visit explaining the treatment and what to do upon getting home. And she’s become involved with The Center for Information Therapy, whose sole focus as a not-for-profit organization in Washington DC is working to closing the gap of patients only remembering 50 percent of what a clinician was trying to communicate. “This led me to trying to figure out a way to share HIPPA compliant videos with patients in a more scalable fashion,” Kate says. “Video shot during a healthcare consultation can help patients recall important information and instructions later. It is a game changer and will become the standard for ongoing physical care and in other areas of healthcare, too.”
HIPPA is a U.S. government act protecting the privacy of individually identifiable health information and which sets national standards for the security of electronic protected health information.
The disconnect between what doctors say in a visit with a patient and what patients recalls is a hidden problem because doctors are expected to communicate well and patients are afraid to speak up when they don’t understand. Together, these issues lead to a terrible customer service problem in the way healthcare is delivered.
“We are talking about communication, basic skills that everybody assumes any clinician who goes into healthcare—whether you are a doctor or therapist or nurse—has as routine,” says Kate. “But communication skills are not necessarily inherent in every individual in medicine. But this is a skill that can be amplified and taught, and clearly now with the ability to capture that critical piece of information in the simplest of manners, by using technology at our fingertips, our smartphones.”
Dr. Burke films herself discussing the patient’s condition and treatment near the end of the emergency room visit. Depending on the situation, she might film the patient or a member of the patient’s family such as when family members need to learn how to safely lift someone who needs help moving. Or she might film herself talking directly to the camera when detailing after care aspects of treatment such as how to take medicine and what foods to avoid. She then shares the information via Postwire Health, a web-based, HIPAA-compliant patient engagement tool used to create a private, customer-friendly place for each patient. She may share articles and links to other content on the Postwire private page too.
“We all have iPhones or Androids so clinicians have the ability to capture and share information that’s critical and curated to a particular patient,” Kate says. Patients already have the tools required to view the content, simply by firing up their computer or tablet. “It can be shared literally within seconds and integrated into a clinical encounter. I shared my passion with many different clinicians of every flavor and type that you can imagine that you would find it a community hospital and through my work at the medical school. Now I am teaching a fourth-year elective, Best Practices in Communication, and have integrated this into the curriculum. When I discuss this with students, their response is ‘Yeah, of course we would do that.’ I have seen an amazing growing acceptance.”
Dr. Burke describes the problems faced by those who receive a cancer diagnosis. It is a very difficult time for patients and their families while they come to grips with the nature of their disease. Many do a great deal of research on their own. “There are many confusing opportunities for patients relative to cancer care,” she says. “Patients have all these questions and learn how important it is to get different opinions. But how, as a patient, can you keep track of this? How can you remember those nuanced suggestions by these incredible experts that are trying to fit all this information into the visit? A clinician can help by curating the content. They can help direct each patient to really good sources that are germane to them.”
A major additional benefit to providing video based after care information and links to external content on a personal site is patients can share with their family members. “This is very powerful way to take care of a human being,” Kate says. “This creates some wonderful equalization so we can all share. There can be transparency. We can stamp out any confusion or misunderstandings very early in the doctor-patient relationship.”
The tools required to do this sort of information sharing and thereby significantly increase patient satisfaction are simple to implement and use. All that’s needed are a smartphone camera and a secure online place to store information.
Real-time engagement for any business
You don’t need to be a physician to use the benefit of this approach because content curation for individual customers and video customer service can work in any business. In your business, just substitute the word “customer” for “patient” in this example.
People are naturally reluctant to change the way they work with customers and doctors dealing with patients are no different. A radical change in how we communicate is not difficult. All that’s required is eliminating fear of the unknown and learning a new routine. Sure the first few weeks might involve a learning curve. But after that, there should be no additional effort to required to communicate with customers in a way they will appreciate.
“The evolution in medicine using technology and digitized information is happening at an exponential fashion,” Kate says. “Several years ago there were many clinicians who could not imagine using an electronic medical record but that is current routine now. It is incumbent upon physicians to improve this egregious situation of how we communicate with patients, the information we want them to carry forth in their recovery process, and sharing with their families. Once you admit you have a problem with communication and patients remembering what we are communicating, then you can move on to the solutions. One wonderful way to do it is to leverage technology, which is in their hands practically every minute of the day. For me, this is incredibly exciting because finally we are going to address the problem of understanding on the patients’ side.”
Photo: Milford Regional Medical Center
Disclosures: I am an advisor to Postwire and Kate is a friend.