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Which Comes First: Patient Experience or Health Outcomes?

Patient Experience

The most common question of causality—that of the chicken versus egg variety—has intrigued minds for millennia. Aristotle pondered it; Stephen Hawking weighed in as well. These days, healthcare executives and clinicians have their own causality dilemma to ponder: Does patient experience lead to positive health outcomes, or do positive health outcomes dictate patient experience? The answer may lie in viewing experience and outcomes, not as two separate elements, but two halves that make a whole.

Using Technology to Optimize Engagement

Many hospitals seek to engage patients with technology—from patient portals to automated post-discharge follow-ups—and for some, the approach is paying dividends. A.O. Fox Memorial Hospital in Oneonta, New York, for example, is using a platform that flags patients at high-risk for health issues and engages them through a combination of automated and personal follow-up. The system enables the organization to focus preventive and on-going chronic care on the most vulnerable patient populations to drive better health outcomes.

John Remillard, the hospital’s CEO notes that in addition to aiding in resource allocation, “This technology gives us a way to help improve the health of the community by reaching more patients who are in need of recommended care. It will also lay a great foundation for us as we make the transition to more shared risk and value-based care.”

The process includes:

  • Using evidence-based protocols for identifying patients in need of preventive and chronic care
  • Automating notifications to patients due for care
  • Tracking patient compliance
  • Measuring both quality and financial results

This isn’t the only option for using technology to support patient engagement and activation. Given that patients, even those with a shared diagnosis, have unique perspectives when it comes to attitudes about health and preferences for communications, hospitals and other healthcare providers need to develop a multi-pronged approach to enhance the patient experience.

Psychographic segmentation provides guidance, allowing greater insights into where, when and how to communicate with different patients more effectively. Perhaps a self-diagnosis tool that guides the user to make an appointment may be more effective for a Balance Seeker for example, while a follow-up call may work well for a Direction Taker.  The bottom line is that personalized patient engagement tactics improve the patient experience.

PatientBond not only customizes outbound communications according to patient preferences via email, texts/SMS and phone calls, but it also tailors its messaging according to a patient’s psychographic segment.  Because different psychographic segments are motivated by different things, a one-size-fits-all approach will not work.  PatientBond ensures patients are engaged the way they want to be engaged, to optimize activation for better health outcomes.

Influencing Positive Health Outcomes

Recently, Christina Dempsey, MSN, MBA, and chief nursing officer at Press Ganey, spoke at Vanderbilt University School of Nursing on the topic of patient experience and health outcomes. With 29 years of clinical and management experience in the healthcare industry, she understands more than most the role patient experience plays within the grand scheme of things. It’s not just HCAHPS scores.

Dempsey told the audience, “Many leaders leap to HCAHPS scores when thinking about patient experience, however, those scores don’t drive improvement.” Instead, she contends that hospital staff need to find opportunities to connect with patients on an individual level so they feel like they are supported, and as a result stay more engaged, leading to better outcomes. She went on to say that “Caring transcends diagnosis—the real caring goes beyond delivery of medical interventions to the patients.”

That’s precisely what some hospitals are discovering. Like many hospitals, Atrius Health in Boston broke down vulnerable patient populations by their diagnosis. Upon forming its own ACO, however, the healthcare provider decided to change its approach.

Eliza Shulman, chief innovation engineer for Atrius Health, told Fierce Healthcare that they began looking at factors that influence risk, such as how well they function physically, emotionally or cognitively. This functional status, along with their attitudes and behaviors related to health and wellness, has a tremendous influence on health outcomes. Similarly, the University of California San Francisco’s Office of Population Health deployed a tiered system of patient support based on risk levels and achieved “significantly improved lengths of stay and emergency department visits” with the added bonus of more positive patient experiences.

In the end, two parts do make a whole—and the chicken or egg question is just a distraction.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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