Patient experience is a very important factor that is driving change in the healthcare system today. Especially when it comes to hospitals. I think patients have started expecting the same treatment they get in other industries or the same experiences they get in other industries. And that’s why the hospital standards have also started changing. And more than patients there is a patient party, the people who come with the patient to take care of the patient and even they expect better treatment.
So, I’m reminded of an incident that happened to me in 2003. I was practicing in Delhi those days and my mother, had done a regular medical checkup, and she had failed her TMT test (treadmill test) if those of you have done, you know, these annual executive health care packages, it’s when you walk on the treadmill. There are sensors connected to you. And they increase inclination to see how much what is how much is the capacity of your heart to pump blood, and how strong it is. She had failed that and as a precaution, the doctors had recommended doing an angiography. An angiography is nothing but injecting a dye to see if there are blockages in your heart, which are blocking the flow of blood the way it should. So we had chosen Escorts Heart Institute in Delhi.
Those days Escorts was run by Dr. Trehan, who was the MD and he was very popular. If you had heart trouble in Delhi, those days you were you went to Escorts and we had booked an appointment. We were in the care of a doctor I think Dr. CP Roy, if I’m not mistaken, he was a gentleman, one of the best cardiologists in the country.
And we went in for angiography in the morning, my mom, I think didn’t have breakfast as well because it was supposed to be done on an empty stomach. But something very abrupt happened there we entered the institute, we got the admission done as we walk into the lift to go to our ward, and the guard stopped me and rudely told me that I could not go in. And I was not sure what was wrong. I insisted on going in and the guard said no, I’m not letting you go. And that was a very funny moment because here was my mom going for angiography, which we all know is not serious, but she was very anxious and she was emotional. And my father was there. My brother was there and they were okay. But I was not okay. I couldn’t understand it. And the guard was extremely rude and he won’t let the lift go. And other patients are getting hassled and they’re saying okay, why are you creating confusion let him go and he wasn’t giving me a reason and that was an extremely bad experience for me. I intended to take it up. Interestingly, my brother came down and we went to the administrator who was busy with some foreign dignitaries but he gave me a hearing I gave him a letter that your guard was rude and we deserve some attention to this incident.
And you know in the whole drama I still did not know why they don’t they did not let me up. Anyway, my mom had a procedure, I went back to check in once in the afternoon. And then in the evening, when we got her discharged, I saw a very big politician that time, someone from the VHP, who had 50 People with him, including his NSG security detail. So it was fine, letting him 50 People go in because he’s a politician he needs protection. But the security guard was not ok in a third person with a patient, just a really bad experience. And you know why they did not allow me because their rulebook said only two of the patient party would be allowed with the patient, which is fine, I would have accepted that I know, these are rules.
But you couldn’t have told me that earlier. I mean, you had to stop me, the way you had to stop was very, very strange. And then I had a chance to read this excellent book, by Fred Lee called “If Disney ran your Hospital.” And it’s a fantastic book, I would recommend all of you to read it. Because Disney has a philosophy, Disney knows customer experience. Disney knows how to engage a user and Disney does run hospitals in Florida and California. And what he explains is that the Disney philosophy is that customer experience or patient experience is the highest during admission and discharge, the two areas that I think will mess it up in hospitals. Admissions, I just gave you a brilliant example.
I’ll give you an example of discharge. Have you ever been to the hospital as an inpatient or a patient party (accompanying a patient)? And they take four hours to settle your health insurance claim? Or at least do the paperwork for the health insurance? That’s a horrible experience, you know, the patient is getting discharged, why don’t you do it in advance. Why do you have to wait till the very last minute to look at all the, you know, consumables like cotton swabs and band-aids, etc? And keep the patient hanging in there? And if the discharge is in the morning at 10, and the rounds are at 11? It’s not going to happen at 10. You know that. Why do you tell the patient you want me to start at 10?
The patient can only be discharged after the treating physician is fine with him. from the treating physician or the trading specialist. Only after that, can you discharge him? And the paperwork anyway, takes time. Why don’t you tell them you will be discharged in the evening. So everybody’s relaxed about it. But no, you have to mess it up. So I think there is a big, big gap in both our admissions and discharge, I think these are the two high points that are going to always determines consumer/ patient experience. Then there’s my point in between, you know, when a doctor or a nurse went out of the way to make you feel better, or some favors were done like some guest comes in slightly late out of visiting hours, but you let him in just because you know, you will not inconveniencing others, and the patient felt happy about it. Making sure the patient was well taken care of, you know, stuff like that it’s small things that go make a big difference. It’s not, the right diagnosis, artificial intelligence, and machine learning, and all that jazz that we focus on. Those are important and necessary but the small things are very important as well. But these are small, small things that you need to take care of. I think people who don’t like people and don’t like interacting with people shouldn’t be in the healthcare industry. We will lose all our jobs to technology, artificial intelligence, and machine learning. The only thing we’ll retain is our ability to be people and our empathy. And if you don’t like people, you probably shouldn’t be in this industry. I know we have a high attrition rate among nurses, we lose 70% of nurses, and in some cases, we have a high attrition rate among specialist doctors. But we shouldn’t have an attrition rate for our humanity. We should be able to explain to a patient and a patient party the patient party, remember are more stressed than the patient about what’s exactly going on. It doesn’t take much. It just takes basic communication but everybody’s so busy looking at operational metrics in the utilization of bed, and length of stay, but nobody looks at empathy.
I think it’s very important for us to get that fixed, in case we have to move forward as an industry. So whether you apply digital or not the first step start looking at your processes, especially can your admissions be more smooth, it has to be seamless. Your discharge has to be smooth and seamless. Then comes the in-between the areas, they have to be smooth and seamless. Then there is the option of doing a talent analysis Do you have the right kind of people are these the people you want to lead your hospital or your health organization in the next century or the next decade or the next millennia, or the next transformation? After you got all that fixed, then look at technology. I think that’s a better way of utilizing your time.
Last year I released a paper on “Patient experience in India” Adding the link here for your reference.
I would love to hear your views and do you hospital stories that you would like to share with me. I would be happy to discuss and share them further.