Houston Methodist comprises a leading academic medical organization in the Texas Medical Center and six community hospitals serving the greater Houston area. Houston
Methodist Hospital, the system’s flagship, is consistently listed among U.S. News & World Report’s best hospitals and has earned worldwide recognition in multiple  specialties including cardiovascular surgery, cancer, epilepsy treatment, and organ  transplantation.

As the number-one hospital in Texas for patient care and safety, Houston Methodist is
nationally ranked in 10 specialties and ranked number 15 in the nation—proof that its
reputation for outstanding care, treatments, and research attracts patients from Texas,  the nation, and around the world. To continually achieve these top rankings, Houston  Methodist ensures patient safety with integrity, respect, and compassion, continually measuring, assessing, and improving systems and processes to serve its patients better.

With the complexity and demands associated with healthcare delivery today, leaders at Houston Methodist engage with NRC Health’s Human Understanding™ Program to better deliver the communication and metric capabilities they need to turn their strategic aspirations into action to improve care, enhance performance and catalyze growth.

Highlights on Outpatient + Magnet Survey Mode Pilot Evaluation:

• NPS numbers of all hospitals have increased since the start of the pilot
• Response rate of SMS is lower than email; however, both methods have comparable NPS scores
• IVR appeared to have the highest response rate and lowest NPS
• Regardless of age or gender, NPS scores from SMS appeared to be higher than IVR

HUMAN UNDERSTANDING PROGRAM CAPABILITIES UTILIZED

Houston Methodist began studying patient-centered technologies to learn what motivates patients and family members from an activation standpoint during the last five years. Houston Methodist’s leaders understand how NRC Health surveys greatly impact their overall perception of delivering personalized care, whether that’s through trying to encourage patients to engage in healthcare maintenance or suggesting lifestyle adjustments through apps, texting, and emails.

Houston Methodist aims to be as responsive to patient preferences as possible through every touchpoint across the entire continuum of the patient journey, from the time patients are on the website deciding where to go for their healthcare, all the way to their inpatient
hospitalization procedures and follow-up care and bill payment.

As Houston Methodist focuses on learning patients’ communication preferences while obtaining consumer feedback, the organization has leveraged NRC Health’s Experience capabilities to access more voices, engage more patients, and leverage the power of Human Understanding to enable more personalized care. The combined preliminary results? Patients and prospective patients prefer communicating by text and email over automated phone calls.

Using NRC Health’s Experience capabilities to capture what matters most to each patient before, during, after, and beyond the clinical encounter, Houston Methodist recently designed a pilot study to evaluate its current survey-outreach modes with its very diverse
outpatient population. The organization’s research was designed to address the consumer’s increased use of mobile phones, lower patient-satisfaction scores associated with surveys collected by Interactive Voice Response (IVR), and patient complaints about being bothered
by phone calls for surveys.

PILOT SCORES:

• Texting and email appear to have higher NPS than IVR in all settings
• Texting and email are comparable in terms of NPS
• IVR is associated with the lowest scores in all settings

PILOT RESPONSE RATES:

• Texting and email appear to be associated with lower response rates than IVR (though most of this could be attributed to re-fielding surveys and back-sampling)
• When IVR is dropped entirely, landline-only individuals are excluded, which impacts overall response rate

As the organization conducts the analysis again in a few months, they will follow the formula of using text and email as primary modes of outreach in all settings, not dropping IVR from any setting but using it as a second or third mode of outreach.

NRC Health’s patient-experience survey enables Houston Methodist to look at demographic breakdowns and questions based on the mode of outreach to see what population is impacted the most in each case. The organization can also use aggregated data when looking at population and service-line segments. Previous research was stuck on the notion that older individuals would not use texting and email because they weren’t tech-savvy or open to change, but Courtenay R. Bruce, JD, MA, Houston Methodist’s Director of System Patient Experience, has found those assumptions to be false and outdated.

“The response rates are higher when texting, and email is compared to automated phone calls, as much as 7 to 10% in most service lines,”, says Bruce. “Email is a little bit higher for most specialties. The response rates are higher when texting, and email is comparable to automated phone calls, as much as 7 to 10% in most service lines. But you cannot drop automated phone calls altogether. We tried it, but it didn’t work; it backfired immediately. We saw a huge drop in response rate. Some people can only afford a phone, or they really only have a landline available to them. So if you drop automated phone calls altogether with the thought that, ‘I’m just going to use email and texting to reach people,’ you could actually impact not only response rates, but equity considerations.”

Bruce advises hospitals to personalize their messages based on a patient’s known communication preference. She has also found that if hospitals can maintain a conversational tone through the texting—making it very personalized in the sense that they use some exclamation points every now and then, use patients’ first names when possible, try to have a nice, pleasant opening and a great closing, and so on—it just shows that you care.

“The response rates are higher when texting, and email is compared to automated phone calls, as much as 7 to 10% in most service lines. Email is a little bit higher for most specialties. The response rates are higher when texting, and email is comparable to automated phone calls, as much as 7 to 10% in most service lines.”

—Courtenay R. Bruce, JD, MA, Houston Methodist’s Director of System Patient Experience

“Sometimes I think it’s less about the information being transmitted and more about just the fact that we are transmitting it compassionately,” she says. Bruce also authored peer-reviewed articles on the qualitative study of the design and integration of mobile health technology in the treatment of orthopedic surgery, further demonstrating the outcomes of communication preferences.

Patients treated by participating surgeons received and read text messages using mHealth 83% of the time and read emails 84% of the time. Patients responded to 60% of the text messages and 53% of the email surveys. Patients were least responsive to digital monitoring questions when the hospital asked them to do something, and they were most engaged with emails that did not require action, including informational content. A total of 96% (558/580) of patients indicated high satisfaction with using mHealth technology to support their care. Only 0.40% (75/2059) of patients opted out of the mHealth technology program after enrollment.¹

Bruce’s pilot and studies confirm that patient-facing mobile health technology can positively impact patient outcomes and patient-reported experiences. These technologies can also empower patients to play a more active and meaningful role in improving their outcomes.

NRC Health’s Experience capabilities empower Houston Methodist’s leaders to better understand the interactions between patients, technology, and healthcare providers, unlocking insights to know each unique person they serve.

“Sometimes I think it’s less about the information being transmitted and more about just the fact that we are transmitting it compassionately,”

—Courtenay R. Bruce, JD, MA, Houston Methodist’s Director of System Patient Experience