In addition to presenting healthcare leaders with significant challenges, the COVID-19 pandemic has amplified systemic problems with how patients access and providers deliver healthcare in the United States. Our patchwork of insurance companies, healthcare providers and pharma businesses can be challenging to navigate.
But most providers recognize the need to address the industry’s shortcomings and have embraced the practice of service design to improve how they can leverage technology and improved processes to deliver care to digitally-savvy consumers.
This article will share some of our experiences helping healthcare companies solve service design-related problems and implement changes.
Even before the novel coronavirus hit the world, healthcare organizations were working to improve how they were delivering care amid a web of stakeholders with conflicting goals and priorities. The pandemic has created a new sense of urgency to fix the problems, beginning with the consumer experience.
Consumer experience was named one of the top challenges and opportunities faced by healthcare leaders in a Managed Healthcare Executive magazine survey. The goal of improving healthcare consumer experience? “Understanding, addressing, and assuring that all consumer interactions and outcomes are easy, convenient, timely, streamlined, and cohesive.”
Service design is a methodology that’s similar to experience design, except broader. Within healthcare service design, we typically focus on three areas: process, people and tools. Think of process as something like how a patient might schedule an appointment. People could be patients who might interact with a scheduling or triage nurse, customer support, or specialist. Tools could include anything from a digital app to a website to signage.
But service design goes beyond user experience design — recognizing that connections are person-to-person, not just between a patient and computer screen. We use UX design principles — which are inherently human-centered — to make the design process more inclusive. Service design touches all functional groups: scheduling, finance, medical records, customer service, and points of care.
The value of using a service design methodology is it unifies teams across functional groups around a shared vision of customer experience and business model from end-to-end and top-to-bottom. It forces groups to set aside their biases and think systemically, which ultimately leads to consensus.
Consensus building is also where most of the hard work gets done.
Healthcare is complex, and sometimes problems are more far-reaching than the patient journey. It’s an industry governed by broad regulations from government agencies to privacy to insurance and prescriptions, requiring disparate teams of specialists.
People can enter and exit the patient journey at multiple points, and some moments that matter are more important than others. At the same time, you’re also solving a problem for clinicians delivering patient care, which is why it’s vital to hire experts who understand both patient and provider needs and priorities.
A key tenet of service design is empathy. It’s a critical virtue that’ll help any service organization understand what it’s like to walk in the consumer’s shoes — from feelings to fears. Deeper discussions around every touchpoint in the patient’s journey can sometimes reveal barriers and problems.
For example, a healthcare provider wanted to understand why patients weren’t showing up for appointments. The provider had a hypothesis as to why, but it wasn’t until it talked directly with patients that it found the most significant obstacle was lack of transportation. It turned out many patients were disabled and didn’t have access to reliable or frequent transportation. By inserting empathy into the research and analysis, the provider met patients where they are.
Because consumers compare healthcare experiences with other industries — like online retail — service expectations have risen dramatically. Consequently, patients want flawless and efficient experiences.
But for patients in today’s complex healthcare environment, the burden is on them to make the necessary connections and follow up when engaging providers. For some, however, this is too much responsibility to bear, especially if they face barriers or fear going to the doctor. Conversely, we need to think about how we can remove barriers to access and reduce the responsibility burden for our patients while quelling their fear. The goal is to make them feel guided and cared for through handoffs and transitions, such as specialist referrals and inpatient discharge.
Many problems arise in handoffs when siloed technology adds a layer of complexity. One typical handoff (and concern) is when a family physician refers a patient to a specialist who’s “out of network,” for instance, which increases the out-of-pocket cost to a patient who may decide they can no longer afford treatment. Siloed technology also results in incompatible electronic medical records between healthcare systems, which exacerbates appointment scheduling problems.
A recent analysis of more than 100,000 referrals from a large primary care network to specialty clinics, for example, found that only 35% of the patients completed their follow-up appointments with specialists. The inability of patients or out-of-network providers to seamlessly share information and communicate with primary care clinics was cited as one of the top reasons why patients were continually thwarted from closing the “referral loop.”
Beyond referrals to specialists, other typical handoffs include moving patients from the ER to an ICU to Acute Care; or general care to follow-up care like physical therapy.
Within healthcare, patients want friction-free handoffs and a choice of in-person and telehealth options to meet with caregivers. Providers that focus on patient goals and make them feel heard — and leverage technology that shares data across organizations — will create a distinct competitive advantage.
To look for the best examples of service design, we encourage our healthcare clients to find inspiration and ideas in analogous industries. Scores of startups in sectors such as financial technology (fintech), retail, and e-commerce have disrupted industries with innovative technology and an outsider’s verve.
The article, “Sometimes the Best Ideas Come from Outside Your Industry,” from Harvard Business Review, explains why:
“When you’re working on a problem, and you pool insights from analogous areas, you’re likely to get significantly greater novelty in the proposed solutions, for two reasons: People versed in analogous fields can draw on different pools of knowledge, and they’re not mentally constrained by existing, ‘known’ solutions to the problem in the target field. The greater the distance between the problem and the analogous field, the greater the novelty of the solutions.”
To be sure, while working with clients across industries, we often import service design insights and innovations from one industry into another to improve a process, extend digital capabilities, or share a best-practice.
For instance, Nerdery worked with a food service company to improve the customer experience from the moment customers engage a digital ad to when they make their second purchase. Using service design principles, we worked with the firm’s teams to envision a future state customer experience. Once the new customer experience was “ratified,” we helped reinvent business processes and an organizational structure to support its unique customer experience model.
Like nearly every business, the application of service design within healthcare will continue to make inroads as providers strive to improve patient experience. The best tools providers can use to fuel improvements include technology, customer experience strategy, service design and digital strategy.
Improvements will likely come through iterative change, not seismic shifts. But the most formidable tool we have for solving patient or customer experience challenges is something we all have. Ears. Listening to your customers and understanding what it’s like to walk in their shoes—empathy—is the absolute first step.