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Bridging the Clinical Divide

November 3, 2012 By Leave a Comment

The point of reception in the clinic represents the opportunity to define patient engagement or the process of engaging patients. For as long as that desk or counter has been there in the clinic, the receptionist’s desk been the starting point for the patient who just decided it was time to make an appointment to talk about a problem with her health. From completing the necessary forms regarding health history to listing insurance coverage, reception area has long signified the beginning of the hurry-up-and-wait experience.

As we continue to evolve the nature of care from just outpatient service to comprehensive health outcomes for each person and the population at-large, the coordinated staff in the clinic will be more important as active listeners who are aware of how they can appropriately participate in the clinic’s culture of care.  Because this also requires having access to the right information at the right time as much for the fully engaged staff as for the patient – it is a convergence of people, processes and EHR.

I invite you to follow the link below to my guest post at EHR Intelligence:

http://ehrintelligence.com/2012/11/02/bridging-the-clinical-divide-through-collaboration-meaningful-use/

Filed Under: Coordination of Care

The Experience Only You Know and the Personal Story

September 11, 2012 By 4 Comments

As I reflect today on the anniversary of the 9/11 attacks, I remember that even though those events did affect me it’s not really about me.  While the events on that day are something that we certainly have in common, the experiences that so many people who truly suffered on that day are their own.  Those experiences belong to each one of those people because no level of empathy or imagination can put you there if you were not.  On that day, I was a listener not knowing what to expect but realizing that it really was not about me speaking.  I hope that everyone who, like me, was only an observer to these tragedies has time today to reflect and remember those who did suffer.  As I write this post, the commemoration ceremony at the 9/11 memorial is just few minutes away.  I’ll be watching and listening during that ceremony, because it’s not about me but the those personal stories of those people who managed to survive and those who died.

http://www.911memorial.org/

Filed Under: Coordination of Care

Journey to Patient Engagement

June 29, 2012 By Leave a Comment

It’s been a journey for me that has involved many miles of travel, candid conversations and client relationships with physicians, administrators and staff members.  For these people its been a journey as well that may not involve so many miles of travel, but more of a sustained commitment to care for patients everyday.  While the scenario is at least somewhat different in every clinic, one common thread is that somehow the experience of medical care became less personal than it should be.  It’s not a simple matter of pointing a finger at one person to assign blame, but it is something that makes for a transactional experience with unfulfilled expectations nonetheless.  What can make this scenario even more complicated is that its not even as simple as one person (the patient) who feels like something is missing.  The outcomes from these transactions are also complicated and diverse.  From missed opportunities to extend communication and interaction between the clinic and the patient following a visit to staff members feeling overwhelmed by the chase of sustaining the operations in the clinic on a daily basis, it is a relational dialogue that is long overdue.  For people on either side of the reception desk, its too often a transaction that is as expected as it is despised.  Everyone has stories about experiences in their lives, and medical care is one of those personal stories that is clearly important.  For patients, its a personal experience with such a high level of trust that same person gives to the physician and the clinic staff throughout the experience – that may even be lifelong.  For physicians, its a lifelong commitment that transcends the concept of ‘doing a job’.  So as physicians, administrators and patients continue to define expectations of terms like “patient experience” and “patient engagement” within the clinic’s culture, the dialogue among all of these stakeholders has never been more important.  I welcome everyone to join in this story of healthcare as we find the common ground among people for coordinating care, engaging people, and strategically using health information technology for the purpose of a better experience for all concerned in the clinic.

Filed Under: Coordination of Care

Listening to that Noise in the Clinic

June 23, 2012 By Leave a Comment

There is certainly no shortage of activity within the clinic to keep everyone busy long past the last patient appointments each day. But in all of the noise throughout the day that often times seems to serve no other purpose than to keep the stress level high, there is a collection of valuable insight that staff within the clinic are experiencing. So consider this for a starting point: If you could capture the pockets of knowledge that exist among the staff within all of that noise, is it possible that you’re not giving yourselves enough credit about what you know? Knowledge such as: what might be an improvement in the patient experience in the clinic, or an opportunity to improve an aspect of the business process with some training or mentoring for clerical staff, or even a small step in communicating with patients after the clinic visit to demonstrate a culture of care after the clinic visit. Too often we elevate awareness of external factors such as pending standards (i.e. health care reform law, ICD-10 coding changes just to name a few) to a level of concern that causes paralysis within the organization. The awareness of issues that have a long term impact on the clinic is important, but even more important is that physicians provide the care for people and they know how to do it best. Bring together those pockets of knowledge in the clinic by listening to each other every day in the clinic. You will find that with this level of concern directed more toward learning from each other some incremental improvements are easily within reach. What’s more, the benefits will serve both the staff and the patients.

Filed Under: Coordination of Care, Human Resource Management, Patient Experience, Staff Development

Patient Engagement & Quantified Self

June 19, 2012 By Leave a Comment

There is a compelling intersection between the terms patient engagement and quantified self that serves as an incredible opportunity to impact the patient experience. From data within electronic personal health information (ePHI) to tools such as the HCAHPS survey (http://www.hcahpsonline.org/surveyinstrument.aspx) there is real opportunity to quantify and measure the patient experience. It’s that discrete data that is so valuable in leading to metrics for management decision-making and actionable items. However, not everything that falls within the patient experience is necessarily discrete or even quantifiable. So here’s the opportunity – there is a remarkable set of transferable skills within the clinic regarding diagnosis and treatment. It’s going to be an journey into the gray area in between those metrics that define patient engagement and real patient satisfaction. The challenge is engaging the entire staff (that means clerical too) within the clinic with a shared recognition that patient engagement involves more than data.

Filed Under: Clinic Awareness, Coordination of Care, Healthcare Social Media, Patient Satisfaction

Health Data and the Junk Drawer

June 13, 2012 By Leave a Comment

I can remember conversations that I had with physicians several years ago when their favorite benefit of the EMR software was the ‘readability’ of the electronic charts. They had finally put in the past the days when each one of the physicians in the clinic would struggle to read the handwriting of another. So while one physician filling in for another on a given day was still a busy day – at least that variable of trying to decode handwriting in the patient’s chart was gone. Now that all of that patient data has been accumulated within the clinic, the conversation has evolved to the accessibility of that data to the patient. Whether its a genuine interest in participating or managing one’s own health or compiling a personal health record (PHR) or seeking transparency in that clinical documentation process or extending the patient experience with mHealth, one thing is true: it’s going to be messy. This whole scenario reminded me of the ‘junk drawer’ in the kitchen. I’m not sure where the term junk drawer originated, and I don’t even consider the stuff in that drawer junk. But what I do know is that no matter how many times in my life as a child and adult either I or someone else organizes that drawer, it always seems a bit messy to me. One of the reasons for this apparent messiness may be that there is such a variety of stuff in there. It’s interesting how many items that lie next to each other have nothing in common except their presence in that drawer.

An interesting dichotomy has developed from the time of physicians and patients wanting that readability of charts for the benefit of flexibility and continuity of care for patients of the clinic to one of disappointment with that same idea because the next appointment for the patient may not be with the clinician who provided care today. The team approach does provide real value in terms of both the in-person clinic visit for the patient and will be very important in the evolution of mHealth and healthcare social media. However, there is also real value in that individual level of trust that a patient develops with a particular clinician. Data is good, but its even better with guidance. There’s no reason to turn back now, just ask those people who as patients want access to their health information and to participate in their care. As much as we may like to put labels on everything for the purpose of neat and tidy organization, the reality is that just like the stuff in that junk drawer the use of mHealth and healthcare social media is going to seem a bit messy. One thing is true: the more people who have access to that junk drawer will only further assure it’s going to be complicated (and it’s not really junk in there).

Filed Under: Coordination of Care, Health Information Technology, Healthcare Social Media, Patient Experience

Word of Mouth Affects the Clinic

May 1, 2012 By Leave a Comment

And the patient is on their way…

So sharing the clinic reputation is placed in the hands of the patient who just came in or called on the phone. The hope that this patient will carry it forward and convince someone new to contact the clinic. What we know about customer stories is that people tend to talk a lot more about the bad experiences they’ve had than the good ones. In the context of both recognizing the patient’s experience and driving the good stories, a quick take on the 5 W’s for the clinic:

Who made the most important impact on the patient? We hope the physician, but what if someone else among the staff is creating their own reputation that upon further review might be classified as ‘non-compliant’ with the physician’s expectations and level of care?

What does the ‘clinic reputation’ and ‘value add’ mean to everyone who either directly or indirectly serves patients of the clinic in any way?

Where are the patients turning for issues such as compliance with a treatment plan, additional guidance, and how much of it involves this clinic?

When the patient has a question, concern, request, testimonial or complaint does everyone on staff know the path for this communication within the clinic?

Why – because medical care is a personal experience for all concerned.

Filed Under: Coordination of Care

Value-Based Patient Outcomes

April 26, 2012 By Leave a Comment

It is an ongoing challenge, how to engage the patient in a way that best suits their specific needs. Some people have suggested that social media tools are the key to patient engagement. While these tools are compelling, in many cases the real problem is what the clinic is trying to accomplish with them. Is it sharing a vignette about a particular condition and the implications on the one’s health? Maybe its sharing patients’ stories? What about sharing important updates? One thing I’ve learned in my experiences is that physicians have a precarious balance to maintain when considering how they will engage in social media while providing personal care to patients in the clinic. For those physicians who are participating in social media community some meaningful way – it’s an impressive addition to any already incredible commitment.

The perception of the patient experience is one that in a conversation among the entire clinic staff, or even friends and neighbors (since everyone is a patient at some time) is in the eye of the beholder. In a conversation this week, a friend shared a thought with me of how great it would be if social media and patient engagement could be as easy as having each patient fill out the next appointment reminder postcard at the end of the visit just like in the dental clinic. Just under six months later, the patient receives a postcard in their own handwriting as a reminder for the next clinic engagement! The truth is that value in the patient experience is nothing without the physician in the clinic. However, there are also so many other staff members on the payroll in the clinic who must have something to add to the patient experience. If they do not have anything to add in this context, then it must be a great opportunity for an immediate reduction in payroll expense. What I know from my experiences is that these staff members are very important to the patient experience. Beyond the roles they fulfill in support of the physicians and the clinical workflow, they are most often the witnesses to a variety of patients’ needs from the mundane to the urgent and important. When I talk to patients about an experience that was well below their expectations, the common complaint is that communication among the physicians and clerical staff just fell short.

So while social media provides some really interesting ways to connect, collaborate and share, it does not replace the need for clear rules of engagement between the entire clinic staff. It sets the expectations for not only what patient engagement means in the clinic, but how it will be executed by every person on staff based on their roles. Patients expect social interaction among all clinic staff, and everyone on staff has an important view of patient outcomes during, after and between visits through their interactions. Recognizing that patient outcomes are in many ways in the eye of the beholder is an important step in developing better ways to capture those perceptions among all of those witnesses among the clinic staff. It’s not a social media campaign, but a philosophy of care campaign with respect for social interaction.

Filed Under: Clinic Awareness, Coordination of Care, Healthcare Social Media, Patient Satisfaction

The Social in Media

April 23, 2012 By Leave a Comment

There is a dialogue going on around the country about how to engage patients in social media. Some of these conversations at the clinic level get started and stop just as quickly as soon as someone mentions HIPAA. Other conversations in the clinic involve one person who takes on the challenge of building the face of the clinic using various social media tools. The interesting common thread from my experiences with these folks in clinics is that this conversation about social media too often looks past the very nature of current communication between all clinic staff and patients. What currently happens with every patient phone inquiry that comes into the clinic? Do we always return messages with the patient’s best interest in mind? Whether its just one person in this role or a team of people, it is a very important starting point to what social media can add to this process.

Filed Under: Coordination of Care, Healthcare Social Media, Patient Satisfaction

Trust & Success

April 18, 2012 By Leave a Comment

The trust between the patient and the physician is one that is clear in the clinic. The nature of medical care requires this trust in diagnosis, guidance and treatment for the patient experience to result in any level of success. But what about the trust between the clinical and clerical staff as it relates to the patient experience? What patients know beyond any doubt is that the majority of communications between the clinic and patient will not be with the physician. These people in clerical roles represent the first point of communication in many different circumstances for the patient before, during and after the clinic visit. So the question is, what would it take to build this trust in the clinic?

One issue involves the common problem of clerical staff retention. What toll has turnover taken on the culture in the clinic? It may be as obvious as a ‘feeling’ that people experience from the time that they arrive in the morning to start each work day. Making a transition from ‘tolerance’ to ‘trust’ among colleagues will make a difference for the entire staff and translate directly into the patient experience as well.

Another concern might be the recognition within the office between “helping the patient in any way that I can” versus “helping the patient in the way that he or she needs it.” This level of trust (or tolerance) among the clinical and clerical staff is often manifested in too many unresolved messages and inquiries from patients. If there is any question about where to begin with a measure of patient satisfaction, start here. It may be as simple as a patient saying, “I know the physician cared and my visit was a good one, but when I called to change an appointment or ask a question about my bill I just felt lost in the process.” What staff know in each of their respective roles in the clinic are the common questions that patients, both first time and ongoing, tend to ask. What every staff member needs to know is how to respond to these inquiries based on their training & skill level, and who else to engage when the question or issue is beyond their influence in the clinic.

Recognizing that patient engagement involves the entire clinic staff will make the difference in changing behaviors about what both patient and staff satisfaction represents in the clinic experience. Building trust among the clinical and clerical staff everyday will solidify the confidence every staff member has in being the “face of the clinic” in precisely the way the patient needs.

Filed Under: Coordination of Care, Healthcare Industry
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