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Great Expectations, Part I: Examining What Consumers Want (and Why) to Better the Patient Experience

Expectations among consumers and patients constitute an entire world of the healthcare experience that often goes untended by physicians, hospitals, and even the largest of health systems. Given the fact that the expectations a person develops over time are pivotal to their perception of their healthcare experience—and their eventual satisfaction or dissatisfaction with it—it’s unnerving that so little time is spent better understanding expectation formation. After all, countless hours are spent sifting through data on what has already happened to patients—wouldn’t it be prudent to shift some of that time and energy toward understanding those perceptions before they bear on real-life experience?

NRC Health’s Market Insights survey developed a special set of exploratory questions to dig deeper into consumer expectations. Perhaps unsurprisingly, it found that healthcare consumers expect more from healthcare than from any other industry: a whopping 74 percent across the U.S. believe that healthcare—and hospitals specifically—should meet or exceed their expectations. (The next closest industry in this regard is financial services and banks, at 63 percent.)

So why does healthcare shoulder the greatest burden of expectation? Consumers are clear on this: healthcare is an irreplaceable service of the utmost seriousness and risk—plus, it’s grown incredibly expensive. In short, consumers don’t want to break the bank or their backs. Healthcare is also deeply personal. Patients don’t want to be treated like a number; and many of their expectations center around being treated as a person, with concepts like respect, kindness, and empathy coming through loudly in survey results. After all, it’s their life and they only get one—and when given the opportunity to comment on healthcare in their own words, consumers often went out of their way to describe the importance of the human element of care.

All this means that for healthcare organizations, with great risk comes great responsibility. And there are plenty of consumers who don’t feel healthcare is measuring up. When asked if the industry actually meets their expectations, only four in 10 healthcare consumers said yes, leaving an awfully large gap between where consumers believe healthcare should be, and where it is.

So with the stakes this high, and this firmly rooted in human experience, what factors are strongest in shaping consumer expectations of healthcare experiences? From Market Insights’ explorations, it’s clear that previous healthcare experiences—good or bad—shape future expectations most strongly. Three in four consumers indicated that how they’ve been treated in the past will influence their expectations for the future. The next-most important factors were stories and information from family and friends (37 percent), media coverage (20 percent), and advertising and TV/movie portrayals (13 and 9 percent, respectively). Apologies to all those TV doctors out there!

This isn’t to say that hospitals and health systems should rely solely on experience itself, which varies greatly and is often far from perfect. Consumers also vary on which experiences matter most to them: when asked which specific healthcare services arouse their highest expectations, consumers ranked inpatient surgery and ER visits (49 and 49 percent, respectively) higher than outpatient surgery (38 percent) and MRI/CT scans or other imaging (35 percent). There’s not much separation there—and even lower-acuity experiences like an urgent-care visit (40 percent) seem to provoke similarly high expectations. It appears that nearly all parts of the healthcare experience hold fairly high stakes in the eyes of consumers.

Consumer perceptions that every healthcare experience is essential should show healthcare organizations that any “be perfect at every turn” strategy will fall flat. Hospitals and health systems must instead sift through the data to find the bright spots in the experiences they offer, and strive to share those loudly. Emphasizing what went right to past patients, and ensuring that future experiences will be even better, appear to be the best ways to continually meet today’s expectations for care.

One important point to raise in concluding. Many health-system leaders, faced with the COVID-19 pandemic, are now wondering how a worldwide health event like this one might break through and alter consumer expectations on a grand scale. Fortunately, Market Insights has been studying the effects of the pandemic closely, and as a result, we’ve been able to track some of those changes as they’ve been occurring. The growth in telemedicine has been one major change of this kind. Pre-COVID, telemedicine enjoyed relatively low expectations (11 percent); since the pandemic began to curb in-person appointments, the general appetite for telemedicine services has skyrocketed.

Another recent change is the emergence of the “healthcare heroes” movement, honoring the dedication of doctors, nurses, and other frontline care staff during the pandemic. How will this change in attitude shape consumer expectations in the post-coronavirus world? It’s possible that the high bar for healthcare will grow even higher in the future, once consumers add heroics to their expectations of their healthcare providers—or it’s possible they will come to be more forgiving of those providers, and show greater understanding when health experiences don’t go entirely their way. It will be fascinating to watch how our world—and how we see that world—changes over the coming months and years.

Whatever they entail specifically, expectations are a crucial part of the larger issue of building lasting relationships with patients—and unless we plan on succeeding by sheer luck, we need to get much better about asking people what they think, and how they want their experiences to go. Stay tuned for Part II of this topic, as we digest consumer expectations in the midst of the pandemic and report on any further changes in the consumer mindset.

For more on this topic, check out our recent webinar on this topic.