Keynote Presentation: Transformation of Health Care through Patient Empowerment Neeli Bendapudi, PhD; Professor of Marketing and Director, Initiative for Managing Services, Fisher College of Business, The Ohio State University

1. The Patient’s View of Personalized Medicine Neeli Bendapudi, Ph.D. Fisher College of Business The Ohio State University

2. I. A Journey in Healthcare

3. My research interests Customers’ relationships with firms, brands, and employees Special interest in service businesses where the core benefit is a performance rather than a physical product Good fortune to study many world class service businesses

4. Characteristics of service firms—The consumer’s perspective The offering is often intangible to the consumer until the actual consumption The offering is inconsistent across providers and in the same provider over time The offering requires some degree of participation by the consumer

5. Healthcare is a fascinating service to study because…

6. Being a patient is just about the least amount of fun one can have as a consumer.

7. Challenges in healthcare—The Patient’s perspective Consumers usually do not feel in control Consumers are often reluctant Consumers have to relinquish privacy Healthcare providers are stressed Consumers want “whole person” care

8. II. Research Problem “The Ideal Service Experience”

10. Family Medicine

11. Transplant Surgery

12. Gastroenterology

13. Thoracic Surgery

14. Urology

16. Participant Observations Hospital rounds Exam-room observations Inpatient and outpatient experiences Surgery observations

18. III. Patients’ Perspectives on the Ideal Doctor

19. Confident The doctor’s assured manner engenders trust. The doctor’s confidence gives me confidence. Refers to state-of-the-art medical practices Refers to experience in treating specific medical conditions or performing procedures Is not disturbed by queries about medical information acquired from other sources (regardless of accuracy) Is at ease in the presence of patient, family members, and medical colleagues

20. Empathetic The doctor tries to understand what I am feeling and experiencing, physically and emotionally. Makes eye contact with the patient and family Correctly interprets patient’s verbal and nonverbal concerns Repeats patient’s concerns

21. Forthright The doctor tells me what I need to know in plain language. The doctor talks to me and not at me. Doesn’t sugarcoat or withhold information Doesn’t use medical jargon Explains pros and cons of treatment Asks patient to recap the conversation to ensure understanding

22. Humane The doctor is caring, compassionate, kind. Uses appropriate physical contact Is attentive, present to the patient and the situation Indicates willingness to spend adequate time with patient through unhurried movements Helps arrange needed nonmedical assistance for the patient (e.g. chaplain or social work services)

23. Personal The doctor is interested in me more than just as a patient, interacts with and remembers me. Asks patients about their lives Discusses own personal interests Uses appropriate humor Acknowledges patient’s family Remembers patient from previous visits

24. Respectful The doctor trusts me to know my own body and feelings, takes my input seriously, works with me, and respects me and my time. Offers explanation or apology if kept waiting Listens and does not interrupt patient Solicits patient’s input Takes care to maintain patient’s modesty during the physical examination

25. Thorough The doctor is conscientious and persistent. Provides detailed explanations Gives instructions in writing Follows up in a timely manner Expresses to patient the desire to consult other clinicians or to research literature on a difficult case

26. We want doctors who can empathize and understand our needs as a whole person. We put doctors on a pedestal right next to God, yet we don’t want them to act superior, belittle us, or intimidate us. We want to feel that our doctors have incredible knowledge in their field. But every doctor needs to know how to apply their knowledge with wisdom and relate to us as plain folks who are capable of understanding our disease and treatment. It’s probably difficult for doctors after many years and thousands of patients to stay optimistic, be realistic, and encourage us. We would like to think that we’re not just a tumor, not just a breast, not just a victim. Surely, if they know us, they would love us.

27. If I knew then… Predictive: humane, confident Personalized: personal, empathetic Participatory: respectful Preventive: thorough, forthright

28. IV. A Vision for Healthcare at OSU Impetus: ProjectONE cancer and critical care Holistic view of patient and family experience A focus on non-medical (?) touch points Why do they matter? Functional: Stress, comfort, satisfaction, adherence, engagement Symbolic: Clueing in Customers The Living Brand

29. Scope: Multiple Touch Points Illustration: Food Service Pastoral services Social needs Waiting

30. The Challenge Cutting across clinical areas Cutting across different touch points Cutting across internal and external service Conducive to measurable outcomes Avoiding OADD

31. V. The P4 Framework Inspiration: Moving from disease to wellness Moving from reductionism to systems view Process: Meeting with leaders and staff Observations Interviews The P4 Framework translation Validation by respective departments

32. Prediction What can we predict about the needs of patients and families in this domain?

33. Personalization Given what we know about the individual patient and the family, how can we refine our offerings to provide better service?

34. Prevention What problems must we prevent in order to deliver excellent service to patients and families?

35. Participation When and how can we provide choices to patients and families to participate?

36. Food Service Prediction Personalization Prevention Participation

37. Measurement “ Not everything that can be counted counts; not everything that counts can be counted.” Einstein

38. Holistic Medicine Prediction Personalization Prevention Participation

39. Pastoral Services Prediction Personalization Prevention Participation

40. Social Needs Prediction Personalization Prevention Participation

41. Waiting Prediction Personalization Prevention Participation