An article published by Erick Wicklund at mHealthNews describes the rising position of the patient experience officer in the U.S. The author identifies two drivers for this trend. First the growing trend towards consumerism in American healthcare and second the new laws linking reimbursement with patient satisfaction. He also links the growth of the profession to the trend to restore humanity in healthcare.
What is the purpose of an American patient experience officer?
Currently there are 50 chief patient experience officers (PXO) in the US, according to Wicklund and hundreds more who are not in the highest level of the organizational pyramid. If you take a look to the career centre of the Beryl Institute there are more than 5.000 open positions related to patient experience, though not all in management levels, but nursing, IT (we will see tee importance of big data) and others.
A recent survey among American PXOs shows what the contents of this new profession are. It is interesting that only 7% of PXOs have a medical background, while most of them had non clinical experience at all (32%), 23% come from nursing, 34% jump in from an MBA and 19% have a financial background. It is interesting that being patient experience in the U.S. a translation of customer experience, there are is not a clear marketing background of the patient experiences professionals. There is also no defined quality management background although metrics and measurement are key function of the job.
Their main responsibilities range from experience strategy and improvement up to complain management, including also quality performance and improvement. Families and friends of the patients are not forgotten and they are attended too.
In Europe we can only dream of American patient experience budgets. Big hospitals with more than 1.000 beds have over 2 million dollar patient experience budgets, while clinics with less than 400 beds afford ca. 600.000 dollar yearly.
The importance of the function is also seen in the salaries. 150.000 dollar yearly earns the lowest paid PXOs. It is interesting that the top institutions with over 1.000 beds pay less (180.000 dollar) than those ranging between 600 and 1.000 beds (217.000 dollar), possibly because competition in this segment is tougher.
In the 90s Edgar Schein said that the only thing really important a CEO had to manage in future was culture. Since 20 years have passed, we must be in the future from Schein’s perspective. And indeed, for 70% of PXOs managing cultures is their top priority, followed by experience improvement initiatives. Measurement and metrics are the 4th priority followed by patient and family advocacy. It is a job fully involved in the healthcare organization strategy, leadership and governance.
Culture is the key. 69% of PXOs say their main tasks are related to culture, while 39% affirm culture is their main barrier. Among culture activities they name:
- Increasing Staff Awareness and Engagement in Experience Improvement
- Improving Communication Skills
- Creating a More Patient-Centric Culture
- Driving Accountability for Experience Excellence
- Creating Consistency
- Physician Engagement Creating
- Spreading Behaviour Standards
Until now 50% of the job has been described. The other 50% is very technology oriented. As the report says: “59% of respondents’ organizations have or are in the process of integrating experience data into enterprise data warehouses. On the frontlines, leadership rounding, post-discharge call platforms and bedside patient engagement systems will see strong growth in 2015.” The main technologies they are working at are:
- Bedside Patient Engagement
- Post-Discharge Call Platform
- Enterprise Data Warehouse with Experience Data
- Alarms management systems
- Leadership Rounding Platform
- Compliments & Complaints Management
Patient experience management in Europe
Except for the United Kingdom and a bit in the Netherlands, the public and private healthcare systems seem not to go beyond quality management and patient satisfaction. This may be due the fact that healthcare in Europe –even the private sector- is not open for consumerism. For many reasons this is a good approach, yet were Patient Experience is most developed in Europe is the British NHS, an institution clearly devoted to a public mission. The King’s Fund is a think tank providing the NHS with practical tools as well as studies for improved patient service.
Is patient experience related to consumerism?
As the NHS shows, the approach toward an improved patient experience does not have to a consumer oriented one. We have talked several times about the lack of convenience of treating patients as consumers and have analysed the failures of companies that have tried an “American” approach to patients.
My own experience in fertility
As responsible of patient experience at IVF-SPAIN which is a 100% private clinic not depending on subsidies nor on insurance agreements I can only agree with a patient centred approach that is not based on consumerism. Of course there is a commercial side in quality management, patient satisfaction and designing (or co-designing, better) improved patient experience. There is no need to hide that.
But we have learned that the best marketing are pregnancy rates. A pregnancy is the ultimate goal of our patients. The key of a true patient centric organization is to design all processes around this goal. It seems easy, but what we see in our sector is a business centric approach (small clinics), an industrial approach in larger groups (economies of scale) or a financial approach when clinic chains are owned by funds. In the latter, huge marketing investments are needed to make the patients feel “kings” and create a luxury experience (that hides the fact that theeir treatment is ROI driven).
What is the difference with a patient driven approach? When you start with patient in the centre, then medical processes will be oriented towards personal solutions (for instance endometrial receptivity); technology will not be used for efficiency purposes (only), but in order to ensure the highest embryo survival chances (like time lapse technologies); staff friendliness should not be a marketing question; instead the driver is the true purpose to deliver the best possible care.
In this sense, without using the consumerist approach of my US colleagues, it is true that the main task of a PXO is to create, develop and manage culture.