How can service recovery impact the patient experience?

Mistakes happen; for as healthcare organizations we are only human. And those errors whether they are care or everyday decisions can impact the patient experience positively or negatively. So the question becomes do you recognize when service recovery is needed acting swiftly and decisively, or do you wait until there is a complaint and then act after it was already realized that an error occurred?

I think it’s a valid question from a marketing standpoint for several reasons. With the growth of social media and actively engaged adults, they have become the new paparazzi and can do wide spread reputational damage in literarily the blink of an eye.  Taking accountability and doing what is right improves the patient experience and satisfaction scores. And finally, when everyone is talking about what a high quality provider they are and to look no further, service recovery can positively impact brand by reinforcing the brand promise and brand message.

For example, I take 4,000mg daily of pharmaceutical grade fish oil to help me manage high triglycerides.  I am also in an auto ship program with omegavia. Lovaza is not on the drug formulary for my PBM so I worked with my physician to find a suitable replacement. Well in November I received two emails on the same day that my monthly supply has shipped. I thought that maybe an error had occurred and a duplicate email was sent out.  Sure enough the next day I received two separate shipments of my fish oil.

I contacted omegavia and talked to the off hours answering service and was told I would receive a call the next day. I also explained in the initial call that I wanted my December shipment suspended until January 2014.

The call did come the next day, but it wasn’t the please explain to us what happened call. The call was the customer service representative apologizing for the double shipment.  They were suspending my shipment in December and would resume in January 2014. Oh and that there was no charge for the second shipment because it was their error. Not only did I receive the call, but a confirmation email as well.

The omegavia service recovery effort was: timely; accurate, responsive, courteous; exceedingly satisfactory; improved the experience; and made me a customer evangelist.

And it does have a financial impact to the company in terms of the free months dose, the suspension of one month shipment, as well as shipping and handling costs of probably around $120 or so. I know it’s not a great amount of money in the grand scheme of things, but the point is there was no hesitation on their part to make it right.

The real kicker in all of this was when they told me that they were proactively working with their shipping department to understand the root cause of the process failure and understand how the double shipment resulted to fix the process.   Notice here that they did not throw anyone under the bus or say it was some unnamed person on the back office somewhere or a computer error. They owned up, realized the process had a built in error potential and saw this as an opportunity to improve.

Now when was the last time in a hospital or health system service recovery efforts did all of the above take place?

Please don’t go down the, “well this is pharma and retail and we are different argument”. Not really. While omegavia operates in healthcare retail environment, hospitals and health systems are moving to a semi-retail environment. In this  environment where the healthcare consumer with high deductible plans are paying higher premiums with significant out-of-pocket expenses,  they will be expecting more from providers in the service recovery effort and patient experience. It is no longer about what the hospital or health system wants do, it’s about making the healthcare consumer, aka the patient, a customer evangelist and that can only be done through the patient experience and a service recovery process that is second to none.

Repeat after me, service recovery and experience is about the healthcare consumer not the hospital or health system.

In the interest of full disclosure, I did not receive any kind of remuneration either in payment or in-kind gifts.  This post was about my experience and where I believe hospitals and health systems need to go in their service recovery efforts as part of the  patient experience management program.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Is your healthcare marketing driven by HIPPO?

I saw something the other day that really commanded my attention.  It raised that old question related to marketing effectiveness and efficiency.  Is your marketing regardless of the type of industry, driven by HIPPO?

Sounds interesting you say? What is this marketing by HIPPO?  Get ready because you may not like the answer.

HIPPO = Highest Internally Paid Person’s Opinion

And the marketing that I witnessed drove this point home. And the not so funny thing about it is that the marketing department will be blamed for the nonsense when really, the question should be was it a bad decision and performance by marketing, or was this driven in a large extent by a highest paid person’s opinion. 

That happens a lot in healthcare.  No marketing science, no qualitative understanding of markets, just opinion, hearsay and flavor of the day from reading an article or seeing a competitor’s advertisement. No primary or secondary market research or understanding customer needs except in the most superficial level. One maybe two people say something and then it’s the whole universe acts that way.  I am the highest internally paid person here, so go do this. A competitor does this, so you do this. I have made up my mind because I believe this to be true and I am the insert title here- CEO - EVP – VP, etc.

 

Do you work in a HIPPO marketing organization? Be honest now.

The characteristics of such an organization are as follows:  larger than life executive egos (big fish in a little pond); lack of sustained adherence to mission, vision and values beyond executive decree; short attention span due to constantly shifting plans and priorities; the inability to execute operationally; constant crisis and chaos; and adherence to that “this is the way we have always done it so way we are doing it that way”.  Or what I call slavery to the past because I say so.

As we continue on with HIPPO characteristics: communication is poor interdepartmentally;  marketing is seen as doing “stuff”;  and the best one of all - proposed marketing solutions are seen an “elegant” and not as the right way to build revenue and brand because they aren’t expedient.  It’s all about the HIPPO and what they believe regardless of any lack of foundation in reality.

In today’s world of lightning fast change, social media and the growing power of the healthcare consumer with more of an economic stake, you can’t afford ineffective and inefficient healthcare marketing.  That doesn’t build a strong brand. That doesn’t provide you with a competitive advantage. And most importantly, it doesn’t engage the healthcare consumer in any meaningful way.

HIPPO healthcare marketing is a prescription for failure.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

And how will you be paying for your care?

Seems like an innocuous question/statement.  But it’s a question that can be fraught with staff unease, unexpected healthcare consumer resentment, missed opportunity and bad PR if it is not handled correctly.

It’s not a question of whether not you should ask that question as a healthcare provider. No margin, no mission.  There are very appropriate reasons for asking, and includes walking a fine line with tax exempt status and the legal requirement of caring for all who come through the doors seeking medical treatment. The real question is how is the organization preparing to engage the newly insured, current patients and the healthcare consumer making choices in which healthcare providers to engage?

How one handles the question goes beyond staff training, scripting and role playing. The conversation and ask begins well before anyone ever sets foot in door of the healthcare provider. It may be that the healthcare provider has lost the potential advantage in securing the high ground in this part of the healthcare reform equation.

Individuals and families are selecting high deductible plans to reduce their premium costs. Employers are going to defined contributions, creating private exchanges, increasing employee contributions for not only the cost of insurance, but the deducible and co-pays as well.  And even the newly insured that could be eligible for the expanded Medicaid programs will still have to meet spend down requirements of the Medicaid program before full coverage will kick in. Just because the program is expanded for initial eligibility requirements doesn’t mean in the least that the base regulations of the program have changed.

Several months ago I wrote about the opportunity in the market place that healthcare providers had in educating the healthcare consumer abut exchanges, plans and choices.  It was at that moment in time that those discussions could have begun with the process of the payment ask, connecting it to high deductible plans and general changes in how they will pay for healthcare. Little if any activity on the part of hospitals, health systems and other providers recognized the new dynamics and took marketing and PR steps to head off the coming challenges.

Now that the ship has sailed, how are you going to actively take control of the conversation and educate the healthcare consumer before they ever walk in the door seeking treatment? This is about setting realistic expectations in the context of experience as well as establishing the role and responsibility of the healthcare consumer in all of the discussions.

Easier said than done and we all know that.  But with all the issues around the exchanges and failures therein,  the news that people are selecting high deductible plans and the coming sticker shock because they really don’t understand what they are buying,  you have the chance to hit the reset button and start anew.

So instead of advertising those wellness bus tours, free gifts for a colonoscopy or even connecting with all those high quality physicians on staff without outcomes transparency in any of it, maybe it should be meaningfully engaging the healthcare consumer about the real cost of high deductible plans, prices, the value of the medical service and their accountability and portion of cost they will bear?

The risk is because as we all know, that the process for asking for payment after the fact or even when someone walks in the door and is sitting at the desk, is not going to go well and there will be human error.   As a tax exempt healthcare provider, you will be the evil greedy healthcare provider, and it's a perceptional battle that is unwinnable.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

How will you explain pricing to healthcare consumers?

The eight hundred pound gorilla is in the room and it’s not going away any time soon if ever. With the newly insured, current and former patients and the healthcare consumer all facing increasingly larger out-of-pocket expenses for healthcare, how will you explain pricing?

Case in point. A couple of weeks ago I was exhibiting the signs of a heart attack. So after being sent to the ER by my primary physician, an EKG and blood work was done and after several hours I was admitted to the 23 hour observation unit. The other day I received the bill for $23,000 which works out to around $1,000 an hour.  And yes it was sent to my insurance carrier and I have my portion to pay. But there was no explanation of how those charges were determined.  Here is the bill; you owe; so pay it.

But it got me to thinking. I had no idea how the $23K was arrived at and whether or not that was representative of the most accurate value for the care received, especially when the total bill would buy a nice car for that type of money. I mean, a less than friendly radiologist, an arrogant hospitalist who was an internal medicine physician, and a cardiologist who seemed like he did not want to be there added to the wonder if it all. I especially liked being awakened at 12:30 PM for a saline IV that had to be started because a doctor ordered it.  My biggest chuckle was that I could not get a Tylenol for a headache, but there was a physicians order for morphine. Go figure. It’s probably a standard order set and no one is paying attention.

 

I wonder how many meals I was charged for since I only ate once because no one explained to me that I had to order each meal off a menu and never did have breakfast because of that little omission?

As healthcare evolves to a semi-retail model with the healthcare consumer aka the patient at the center of it all, explanation of pricing, what care and test were provided is no longer something that hospitals, health systems and other providers can afford to ignore.  Can you really imagine going to buy a large ticket item and not knowing all charges? And healthcare is a large ticket item.

This is a reasonable expectation for the healthcare consumer, to be able to know all that was done and how much it cost in detail.  The healthcare consumer is paying more out of my pocket. You can bet they want to look at billing by line item. And they really don’t have the time to chase down with your billing department the detail.

It’s called accountability and it’s a two way street.  Accountability on my part to understand the who, what and where of treatment, and accountability on your part to be price transparent. This will lead to some uncomfortable discussions with the healthcare consumer as they seek to understand it all, but that is why you have a marketing department. They need to be involved by understanding the informational needs of the healthcare consumer, design of the bills and training of staff to handle inquiries.

Healthcare is changing and the old ways of doing business no longer work.  Because if you don’t change billing practices and become more price and treatment transparent, someone legislatively, or through the courts will force you too.

Its your choice on price transparency. Inform the healthcare consumer now, or inform them later when you are forced too. Either way it’s going to happen.

Now where is the address for the FTC and my Senator and Representatives?

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer,American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Why isn’t hospital advertising changing with the times?

I have to admit, this is a pet peeve of mine, disingenuous hospital advertising. In a day and age where healthcare is evolving to a consumer centric, semi-retail model, some hospital marketers and C-suite leadership continue to treat the healthcare consumer like they are incapable of making informed choices.

With the healthcare consumer having a higher cost stake in the process with larger deductibles and co-pays, your price, and outcomes data readily available, it would seem that the time for change has come.

Remember, when you are marketing to individuals, they don't become a patient until they receive a service from you.  So in one-third of the time in their interactions with you, the healthcare consumer is only a "patient" during diagnosis and treatment. Two-thirds of the time they are not patients, and most likely are arguing with your billing department about the charges.

Arguments aside, what should hospitals be advertising to create an unassailable market position, a strong brand, as well as an enlightened and informed consumer?  

Is it the "we are unique and world-class", best doctors, hundreds of locations, even though The Joint Commission was just there for a sentential event?

Our technology is state-of-the-art.  Never mind that a new technology was just introduced and you don't have it.

Another winner; we have the most shiny trophies and quality awards for several services. Oh, and even though we don't have a quality award for all services, if everybody else was as good as us message to go with it, “a 100,000 lives would be saved annually"! Really.

How about the ever present focus on the physicians with messaging about having the best primary care or specialists in the region that drones on about everything other than healthcare.  Prove it.  Maybe the healthcare consumer will take you seriously when you finally report Dr. Hodad and remove him from your medical staff.

I think, that pretty much for the most part, sums up the current state of hospital advertising.  And when several hospitals are staying all of these things at the same time in a market, do you really believe that the consumer is paying any attention at all, when there is so little differentiation,  it all looks like "me too" and just shouting for attention?

It makes the Board, senior management and physicians feel good, while your audience receives absolutely no information that will help them make some of the most critical choices and decisions in their life.

The time has come healthcare providers to provide meaningful information in the marketplace that will allow the healthcare consumer to become informed, educated and participatory in the care decision-making process. 

You should be transparent and talking about your outcomes and prices.  The healthcare consumer is hungry for information and searching the internet as well as other sources about you and how you perform. They are paying more of the cost. Demanding more say in what goes on. And don't like being treated like they are some small child who can't make a decision.

To use an often quoted metaphor, the wave of change is upon the hospital industry as we move from provider-dominated and controlled decision-making model, to a healthcare consumer and patient-directed, controlled model. 

Your choice so chose wisely, the future of your organizations depends on it.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Does your patient experience fail the test?

True story.  "Well, you can always bring her back to the hospital if she still has trouble breathing", said the home health care nurse sent from the hospital less than 2 hours after a patient had been discharged.  Oh, and did I tell you that her eye was infected, almost fell going to the bathroom in the hospital and informed the nurse, had slurred speech and could barley ambulate?  That patient had been cleared by all to be discharged from the hospital.

And then the family hears or sees an ad about all the wonderful quality care awards from third parties that they receive, and how many lives would be saved if everyone was as good as them.

What do you think the now healthcare consumer, formally the patient thought?

Countless times every day, the patient experience goes fails the test.  Big things and small things alike that take place in the healthcare encounter all add up to one patient experience, good or bad. 

When healthcare executives are surveyed, the majority say that customer/patient experience management is a critical business success factor along with patient safety and cost reduction.  But at the same time, the majority of healthcare CEOs admit that they really don't know where to start on successfully managing the experience.

Experience management is about changing the way you interact with the individual or family from start to finish.  Not just managing the experience at isolated points along the care continuum. It's not about just focusing on service recovery like something was wrong with a hotel stay.  Managing the experience requires a complete understanding of what the patients expectations are, not yours. Experience management is culturally and organizationally uncomfortable. And that is because it's not about you anymore.

So when the patient experience fails, your reputation, your brand and your future in a risk or value-based payment environment fails as well. And then there are those readmissions penalties you face when a patient like this comes back in less than 30 days.

You should see what's being said on facebook and in social media circles from others that chime about how bad their experience was at that particular hospital. Do you still think social media is nothing more than a billboard?

Yep, the chuckle factor is really high when those quality award ads are heard and seen.  Pay attention to the patient experience, and pay attention to the marketing. They are not separated, but closely related.

The newly insured healthcare consumer is paying close attention now. It costing them money, they have too.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Are you using social media marketing for an exceptional healthcare experience?

In the new world of healthcare where price, quality and a newly insured healthcare consumer is paying more out-of-pocket costs for healthcare, social media marketing represents an opportunity that can be used advantageously to meet healthcare consumers demands for a better experience.

Social media represents a great opportunity for establishing a one-on-one relationship with the patient, aka the healthcare consumer, directed by the healthcare organization that breaks from the pack, by creating a social media healthcare experience that is memorable, exceeding an individual or families experience and expectations.

Most healthcare organizations are still stumbling with using social media and the online experience to drive differentiation, meaningful information and experience. Think of this in terms of a channel of communications and engagement that meets the healthcare consumer on their terms but with your messaging.

In any case, when you look at your social media strategy and presence, does your social media experience:

Ø  Delight your customer?

Ø  Create sustainable differentiation?

Ø  Is adaptable to new opportunities?

Ø  Leverages your investment?

Ø  Deliver in every situation?

Ø  Connect with the newly insured?

Ø  Does it engage the healthcare consumer?

Ø  Provide answers or guidance looking for solutions to medical challenges?

Ø  Define experience, outcomes, price and value?

Or, is it just pushing out information that is that you have deemed valuable to you, but carries no relevant meaning for the healthcare consumer?  

This is the lens of criticality needed to objectively evaluate efforts.  If it's not doing these things, then chances are nil in delivering an exceptional social media experience. But for that matter, neither are your competitors. 

Make your social media presence not just "good enough" but exceptional.

On another note, my apologies for missing a post last week. I was out of town with my wife and daughter last weekend. Alex is a left-handed pitcher on a 16U a fastpitch softball college exposure team and we were in Des Moines, Iowa for the ASA 16U A Heartland Showcase Series College Exposure Tournament.   Saturday was playing for college coaches and scouts. Sunday was a single elimination tournament.  There were  27,16U A teams playing. We made it to the final four and a three way tie for 1^st place because the final games were canceled due to rain. It was a good time.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.