Energesse

1. Health Insurance Summit 2017
THE VALUE OF THE PATIENT EXPERIENCE
Dr Avnesh Ratnanesan
CEO, Energesse
@energesse

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PATIENT EXPERIENCE. CONSUMER ENGAGEMENT. INNOVATION
Western Sydney Local
Health District
CSIRO Health & Biosecurity

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THOUGHT
LEADERSHIP TECHNOLOGY TRAINING
IMPROVING PATIENT REPORTED MEASURES &
CONSUMER ENGAGEMENT
Research
White Papers
Consulting & Advisory
Speaking
MES Experience –
Patient Survey Platform
Amplitude – PROMs
platform
Patient Experience
Program - 6 E’s

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TRENDS IN AUSTRALIAN HEALTH FUNDING
1. Flattening / Declining PHI participation rates
2. Cost of claims rising
3. IHPA price signals on unplanned readmissions, HACs & sentinel events
4. Public sector policy trend to shift funding to be more consumer-directed e.g. NDIS
and Aged Care reforms
5. Integrated care – shared PREM’s and PROM’s in primary and secondary care

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‘Future Solutions in
Customer Experience &
Retention’
Research White Paper for the PHI industry
FREE DOWNLOAD
www.energesse.com/customer-experience
5

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Patient
expectation
Health Insurers
expectation
Product & Service
experience
Growing
Customer/
Patient
Experience
Gap

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PHI CORPORATE STRATEGY REQUIRES INNOVATION BEYOND
H 1
Business Model Innovation
Health Megatrends
5-10 years (H3)
Product
(Policy) &
Service
Innovation Customer
Expectations
0– 2 years
(H1)
Customer Expectations
2-5 years (H2)
Tice, M. 2017 Insurgence-Energesse

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HEALTHCARE
QUADRUPLE AIMS
1. Don Berwick et al Health Affairs 2008 Triple Aim, Insitute of Healthcare Improvement 2. Bodenheimer et al Annals of Family Medicine 2014

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WHAT IS Patient Experience (PX) ?
The sum of all interactions, shaped by an organization's culture,
that influence patient perceptions across the continuum of care.”
-Beryl Institute

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Patient
Satisfaction
Customer
Service
Net Promoter
Score
Consumer Engagement
(Standard 2 NSQHS)
Feedback &
Complaints
Surveys
Qualitative Research
Quantitative
Research
Patient Stories
HOW DO WE MEASURE ‘PATIENT EXPERIENCE’ NOW?

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WHAT DO CONSUMERS/PATIENTS
NEED and WANT?
WordenI, MMD, MHI, Better patient engagement

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HEALTHCARE MANAGEMENT CHALLENGES
Measuring the Experience
1. Surveys paper/telephone – disparatesystems
2. Quantitativeonly, not WHY(qualitative) – difficult fixes
3. Tick-boxexercise
Analysing insightsand pain points
1. Delayedsurvey results - up to 18 months
2. Reports & Benchmarks – Too high level, uncoordinated& lack intelligence
Translatefeedback & survey data into improvements
1. Low priority (too survey-focussed)
2. ComplexROI
3. No clear KPI’s
4. Ad hoc actions
5. Poor front line engagement

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BENEFITS OF IMPROVING PATIENT EXPERIENCE
The Benefits of a Quality Patient Experience and Exceptional Patient Satisfaction for Medical Practices and Ambulatory Care http://www.languageofcaring.com/resource/the-benefits-of-a-
quality-patient-experience-and-exceptional-patient-satisfaction-for-medical/
Deloitte – The Value of Patient Experience https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-dchs-the-value-of-patient-experience.pdf
Employee Engagement: Key to Exceptional Patient Experience
http://www.languageofcaring.com/resource/employee-engagement-key-to-the-exceptional-patient-experience/
Patients
Improve satisfaction with
care
Improve compliance with
treatment (medications, post
surgical care)
Reduced readmission rates
Reduce frustration and
anxiety
Health Outcomes
Improve individual patient
outcomes
Improve population health
outcomes
Increase service safety &
quality
Meet accreditation
standards
Financial Value
Reduce expenses from
• Inappropriate or wasted
treatments
• Poor administrative
solutions
• Reduced complaints
management
• Reduced length of stay
• Medicolegal claims
Improve profitability
(Can also increase
expenses with increased
revenue)
Staff Experience
Improve staff engagement
Better job satisfaction
Reduce burnout

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PX AND FINANCIAL OUTCOMES (PROFITABILITY)

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6 E’s - IMPROVING PATIENT REPORTED EXPERIENCE & OUTCOMES MEASURES
E1.
Experience
E3.
Engagement
E4.
Execution
E2.
Emotions
E5.
Excellence
E6.
Evolution
Patients and
Consumers
Stakeholders
(Staff, Clinicians &
Management
PatientExperience &
Outcomes

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E.1 = EXPERIENCES

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E1. EXPERIENCE - MAP WHOLE PATIENT JOURNEY
Surgery Hospital Inpatient
General Practice
& Allied HealthRehabilitation Medication/Chemo
OutpatientHome
Workplace
Supplements
Health/Life Insurance

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UTILISE MULTI-CHANNEL APPROACH
Online
Text Message (SMS)
Email
Kiosk and Tablet
Automated Telephone Surveys
Postcards and Drop-boxes

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CAPTURE EXPERIENCE E.G. REAL-TIME SURVEYS
Survey Customisation= Evidence-BasedApproach x Patient (User)
Testing

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FREE TEXT COMMENTS = ACTIONABLE ROOT CAUSES
“Nurse Sarah was pleasant but the doctor was very
rushed and I did not understand his advice.
The exit door slams all night, I haven’t been able to
sleep for 5 days since my operation”.

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E.2 = EMOTIONS

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Detractors Promoters
PX : IT’S NOT WHAT YOU THINK ABOUT THEM,
IT’S HOW THEY FEEL ABOUT YOU
e.g. Family & Friends Test (FFT)/ Net Promoter Score (NPS)
Frustration & Anger Delight & Excitement

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EMOTION ANALYSIS OF PATIENT FREE TEXT COMMENTS

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MEASURE STAFF COMMUNICATION, COMPASSION & EMPATHY

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E.3 = ENGAGEMENT

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FRONT LINE WORKFORCE CHALLENGES
1. Engaging Staff and Clinicians to take action
2. High demands – Time constraints, fatigue, burnout
3. Resource constraints
4. Behaviour change - Defensiveness towards results
5. Internal competition and staff ‘politics’
6. Prioritise Outcomes vs Experience e.g. “I treat the
tumour, not the patient”
1. Harvard Business Review May 2013 Healthcare’s Service Fanatics 2. Bodenheimer et al Annals of Family Medicine 2014

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WESTERN SYDNEY LOCAL HEALTH DISTRICT LAUNCH 2017

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MES EXPERIENCE – REAL TIME FEEDBACK

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WESTMEAD HOSPITAL – TRANSPARENCY OF PX RATINGS

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E.4 = EXECUTION

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HOSPITAL
MEASURES OF
‘PATIENT
EXPERIENCE’ &
PERFORMANCE
Ref:
Report on Government Services 2017: Volume E: Health Productivity
Commission http://www.pc.gov.au/research/ongoing/report-on-
government-services/2017/health/rogs-2017-volumee.pdf

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E.5 = EXCELLENCE

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BEST BENCHMARKS FOR IMPROVEMENT CULTURE:
AGAINST YOURSELF OVER TIME?
VS
AGAINST OTHER WARDS?
VS
AGAINST OTHER HOSPITALS?

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CASE STUDY EVIDENCE OF OUTCOMES
Hertfordshire Partnership University NHS Foundation Trust
Service Question
July-
Sept
2015
Action Taken
Oct-Dec
2015
Change
Albany Lodge
If you came here from another
service, were you kept informed
throughout the process
22%
At all staff meetings the team now discuss
how the Trust can improve the transfer
process so patients are better informed
54% + 32%
Aston Ward Do you feel listened to? 57%
1:1 time was put aside for service users to
express all their thoughts and feelings
100% + 43%
RAID (Lister)
Do you know how to mental health
support out of hours?
90%
Service Users provided with mental health
helpline cards with relevant contact details
100% + 10%
Holly Lodge
Has your mental health medication
and any side effects been
explained to you?
50%
Staff time was put aside to explain and
provide more information on medication in
1:1 and group sessions
73% + 23%

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E.6 = EVOLUTION

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REAL TIME PROMs
Mostly widely used
e-PROMs tool (UK)
amplitude-clinical.com

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HOW CAN PHI LEADERS IMPROVE PATIENT EXPERIENCE?
1. Self educate on methodologies to improve PX
FREE DOWNLOAD www.energesse.com

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HOW CAN PHI IMPROVE PATIENT EXPERIENCE
2. Improve Clinician & Provider engagement with performance mgmt by PHI
• Collaborate with other health funds
• Standardise patient surveys across industry – core question set
• Real time data collection
• Consolidate Data Lake on hospital performance measures e.g. PREMs and PROMs
• Transparency – open source?

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HOW CAN PHI LEADERS IMPROVE
PATIENT EXPERIENCE?
Research the value drivers, financial outcomes &
ROI on patient experience in hospital(s)
• What is correlation between PX and financial
performance in Australian hospitals?
• Which areas are incurring unnecessary costs due to
poor experience, losing revenue, over-investing or
under-investing?
Interested parties please contact
avnesh@energesse.com

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6 E’s - IMPROVING PATIENT REPORTED EXPERIENCE & OUTCOMES MEASURES
E1.
Experience
E3.
Engagement
E4.
Execution
E2.
Emotions
E5.
Excellence
E6.
Evolution
Patients and
Consumers
Stakeholders
(Staff, Clinicians &
Management
PatientExperience &
Outcomes

44. HOW DO WE ‘HUMANISE’ OUR HEALTH SYSTEM
Dr Avnesh Ratnanesan
CEO, Energesse

45. Thought Leadership Research Consulting Speaking
Technology Surveys & Solutions
Training PX Improvement
For a copy, SMS 0438 614 233 (your name & email)
or email avnesh@energesse.com