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What’s missing from care experiences? 1.4 million patient comments weigh in

This article can also be viewed on Becker’s website here.


There’s a fundamental contradiction at the heart of today’s healthcare industry.

If you judge by HCAHPS scores, patient satisfaction is hitting an all-time high. Yet some signs indicate that patient loyalty has never been lower. Patients praise their doctors, but change providers about as often as they change their mobile phone plans; a recent NRC Health Market Insights survey found that 80% of patients say a shorter drive would be enough to convince them to make a switch.

What should healthcare leaders make of this? Is it even possible to earn patient loyalty?

The answer is an unequivocal yes—so long as leaders focus their attention on what matters most to their patients. A little operational triage can go a long way toward winning customers’ favor.

Julie Kennedy Oehlert, chief experience officer at Vidant Health, brings a keen eye to the challenge. She has insights to share on what drives consumer healthcare decisions.

Her advice is backed by NRC Health’s 2018 real-time feedback data, which draws from natural language processing of over 1.4 million patient comments.

Here’s what an expert—and the patients—have to say.

Patients want to be heard

Attentive listening and strong care coordination help make care experiences feel less disjointed and more attuned to patients’ needs. The data suggests that, for the most part, health systems have grown adept at creating these cohesive experiences—at least while patients are actually in the hospital.

Patients admire the customer service they receive from clinicians: 87% of comments about clinician courtesy and respect were positive, as were 68% of comments about staff communication and 87% of comments about staff responsiveness.

This all reflects a sense of gratitude for the way patients are treated by clinical staff. That’s likely why patients rave about their clinical encounters. Overall, positive comments outnumber negative ones by more than two to one.

Patients want a smoother process

Unfortunately, patient attitudes about other aspects of the healthcare system are not as sunny.

“It takes me less than sixty seconds to buy something on Amazon,” Julie says. “It takes me five days to pay a healthcare bill. Twenty-seven days to get an appointment with my doctor, if I’m lucky!”

NRC Health’s data confirms that it’s these additional parts of the care encounter—like billing and access—that are the sources of many patient complaints.

It will surprise few to learn that 77% of patient comments about wait times were negative. And only 26% of patient comments about billing said that bills were clear or understandable.

Worse, when patients turn to health-system staff for guidance with these issues, they often report being ill treated: 67% of patient comments about the courtesy of administrative support staff were negative.

A call for change

Julie sees these problems as some of the biggest needless errors of the healthcare industry. “It’s silly that we can’t make this work,” she says. “We’re capable of fixing these things right now, but we haven’t let the solutions become part of our strategies yet.”

She calls for two interventions that could make a dramatic difference in how patients feel about healthcare encounters:

  1. Billing transparency

For some healthcare leaders, this is a contentious issue. Julie, however, anticipates a common counterargument when she says, “You hear a lot that hospital bills are too complicated for patients to understand. But when you get down to it, isn’t that an insulting and presumptuous idea? Shouldn’t that be a notion that we, as an industry, all try to outgrow?”

She believes that health systems have little to lose by making their billing more comprehensible—more and more, they emphasize, it is what modern consumers expect from their providers.

  1. An emphasis on compassion

In Julie’s ideal world, patient-feedback surveys would only have one question: “Did you feel that we truly cared about you?”

To her, that question represents the sum of an entire system’s efforts, the ultimate distillation of what healthcare is all about. To improve how patients answer that question, technological or process-oriented initiatives aren’t always the answer.

“Human innovation needs to come first,” Julie says. Health systems today can do more to inspire all team members—not just front-facing clinicians—to bring a spirit of compassion and caring to their interactions with patients.

Still more to learn

Julie’s words are very much in the spirit of NRC Health’s mission to bring human understanding to the healthcare industry. And the topics covered above are just a small sample of consumer concerns tackled in the 2019 Healthcare Consumer Trends Report.

The full report is packed with more data-driven insights and expert recommendations. In it, you’ll find:

– The one modality that will maximize patient feedback responses

– The single most important factor behind healthcare consumer decisions

– The individual operational measure that’s the best predictor of care quality and patient satisfaction

…and much more.

If you want to learn what your customers said in 2018—and you want to use that information to prepare for the year ahead—click here for the full report.