What is patient centricity, anyway?

patient centric.jpg

Healthcare often gets a bad rap for lagging behind commercial enterprises in areas like customer centricity and digital transformation. While plenty of reasons are given, it all comes down to the fact that healthcare is a different beast -- a massively complex ecosystem of players and data that all need to be connected in order for it to work more effectively.  

But here's what healthcare is doing right: it's ahead of the game when it comes to breaking down silos inside organizations, which is one customer-centric principle that most other types of businesses have yet to grasp. Mayo Clinic put integrated clinical practice on the map back in the 1920s, demonstrating that collaboration improves outcomes and lowers costs. Numerous studies since then have corroborated the benefits, and by the year 2000, there were 850 integrated healthcare delivery systems. 

So where do we go from there? It seems like every article and report on patient centricity focuses on the technology needed to match consumer expectations, including health apps, online bill pay, and personalization. Other articles are peppered with should's on business and operating models and culture, without much guidance on "how the heck will we do this?" All the advice floating around must be overwhelming to healthcare leaders. Where do you start? What fixes do you prioritize? 

A new definition of patient centricity

The plethora of advice is only matched by the plethora of definitions of patient centricity. Most definitions center on listening to patients and involving them in decisions, engaging, empowering, etc. I fear that this definition can hurt more than it helps, because a focus on thousands of individual patients is no focus at all; it amplifies complexity. While listening is critical, for which of these patients should you create your overarching patient experience? These definitions also leave out key elements of customer centricity that are essential to shift your organization to be more future-ready. 

I believe that top-down strategy is essential to minimize complexity and get laser-focused on what matters most. With that in mind, I'd like to add one more definition to the pot based on my definitions of customer centricity: 

  • Customer/patient experience is the sum of the interactions that a customer/patient has with your company... which creates your brand perception.   

  • Customer/patient centricity is a way of doing business that starts with your priority customer/patient and their desired outcomes, then reverse-engineering your experience, capabilities, competencies and culture in order to deliver that outcome.

There's a lot to unpack here; let's start with the controversial idea of "priority patient." 

Patient prioritization

I can hear it now. "But we serve all kinds of patients! There's no way we can prioritize!" Yes, I understand. But unless you know who you're designing your experience for, you'll continue to get tripped up with overwhelming complexity, and a continued inability to focus and align your investments where they'll pay off most. 

So how do you prioritize patients? I use a model called the Experience Portfolio™ to categorize and prioritize various types of customers. I developed it in response to the fact that there is no "one size fits all" experience design in sectors like B2B, healthcare, utilities, airlines and government that serve a complex medley of customers and stakeholders. 

As you can see in the 2x2 below, the goal to create quadrants that necessitate different experiences for each. It's a forcing mechanism to see the most important differences in your patient population that will impact your patient experience design. 

  • The vertical axis should be your definition of patient priority or value. This varies by sector and by company, but for healthcare I'd propose an index of variables like: Accesses higher-value care (specialists) vs. generalists, chronic care vs. 1-time treatments, low/high risk of non-payment, etc. 
  • The horizontal axis also varies by sector and organization, but Complexity is a good place to start. Does the patient typically require cross-department collaboration or not?  

Once you've created your categories, you can then define strategic goals, service levels and experience guidelines for each category. You'll also assign specific patients to each category, ensuring that the scoring is dynamically done in your database so that everyone knows what experience is needed by patient (understanding that patients can move into different categories, but this portfolio provides structure and guidance). 

Screen Shot 2018-09-10 at 3.14.13 PM.png

The ripple effects will ensure a greater ROI for initiatives in each quadrant. If you design your optimal experience for “A,” your investments in a more seamless experience will ripple to D; your higher-touch focus will ripple to B. Likewise, If you design your experience for "C" patients with the goal to lower cost to serve (usually through digital), your investments will also have ripple effects to patients in all other categories. So everyone benefits, but you also have clear guidance on how to achieve specific goals for each persona represented by each category. 

Patient Centricity - A way of doing business 

In my definition above, I include the 3Cs: capabilities, competencies and culture.

Culture: As everyone is aware by now, a big mindset shift is required to become more patient centric. Personas, well done and communicated, can help all employees orient themselves around your priority patient profiles. Other best practices include regularly sharing patient success stories in weekly meetings and rewarding patient-centric behavior in terms of recognition and compensation. 

Capabilities are the WHAT: What are you, or should you, be capable of delivering? In addition to what you're already great at (perhaps surgery or diabetes or heart health or...), put all those shiny technology-related initiatives here like personalization, patient portals (collaboration), health apps (transparency & control), etc. How do you prioritize these shiny initiatives? By your customer portfolio and strategic objectives for each quadrant. 

Competencies are the HOW, and what is usually missing in the discussions and definitions of patient centricity. These are the practices and processes that the organization does systematically and pervasively, and the required skills that are developed throughout the organization over time. These include:

  • Decision-making: How are decisions made, and what are they based on (includes prioritization)
  • Metrics: Departmental metrics that ladder up to shared patient perception metrics 
  • Voice of Patient: Ongoing listening that is strategic (not boiling the ocean) and helps drive everything else
  • Experience diagnosis and design: Includes tools like journey mapping, co-creation, innovation. 
  • Alignment/coherence: How well is the organization functioning as a system with shared priorities and outcomes
  • Strategy: Last but not least, the ability to set and maintain your strategic direction from the outside in. The best way to do that is to define how you want patients to feel when they interact with you. Emotion drives loyalty, and choosing a single priority emotion -- that spans all customer types -- is the best way to both align all departments and differentiate you from your competitors. 

What next?

1. I'd love a conversation around this topic, either here on the blog or on LinkedIn. Your comments and questions welcome!

2. If your healthcare organization is drowning in complexity and you're unsure where to start, schedule a call with me for a no-obligation consultation. I'm happy to advise you on what to tackle first. My specialty is simplifying complexity and getting everyone aligned around shared patient-centric goals...so that you can go farther, faster, together.