Dan Prince

Colleen Sweeney has found that 96% of people suffer from “clinicophobia,” a term she coined to describe patient’s fear of hospitals, providers and the healthcare system. She has data to back that up – from a 1,080-person survey she conducted for Memorial Hospital and Health System in South Bend, Indiana. Colleen is Director of Ambassador and Customer Services at Memorial, and she has made many presentations on patient fears and why the healthcare community needs to know more about them. She was the speaker at a Beryl Institute webinar on the topic August 16.

The interesting thing to people outside of healthcare is that this is news to the people inside healthcare.

But Colleen, who has worked in hospitals her whole career, says you get inured to the sights, sounds and smells of the hospital, and you don’t perceive it the way patients do. As Colleen said, “We see dead people. We see people naked. After a while you stop realizing this isn’t normal.”

Colleen is on a mission to help hospital insiders see the place the way patients do. Her own consciousness was raised when she walked down to admitting with a woman who had come in for surgery. “The woman was shaking uncontrollably,” Colleen said. “I asked her what the trouble was. She said, ‘The last three times I’ve been here to visit people, they died.’” It occurred to Colleen that every patient had some variation of that same fear – “and they weren’t telling us!”

Colleen conducted research to confirm that intuition, including a postcard request to the community to tell the hospital what their fears are. Responses ranged from “I’m afraid I’ll see a dead person” to “I fear white walls – why do you do that to us????” (This, shortly after the hospital had spent $25,000 to paint the walls white.)

She also commissioned the 1,080-patient survey, and the results have enabled her to compile and rank her “Top 11 Patient Fears” list. I won’t share Colleen’s whole list (Be sure to see her next time she speaks on this topic!) but the top 5 are: 1) Infection, 2) Incompetence, 3) Death, 4) Cost and 5) Medical Mix-up.

The list won’t be a big surprise to people who manage and work in hospitals. What Colleen is doing at Memorial is sensitizing hospital staff to the human faces, the emotion, behind these broad, abstract categories. For example, she puts senior staff – the CEO and VPs – at the front door of the hospital for two-hour shifts every day of the week so they can have the same experience she did – walking people down to admitting, finding out what they’re there for and why it scares them.

Colleen says her biggest challenge is hiring people who “care enough to ask the question: What do you fear?” I agree with Colleen that that’s a very big challenge. But the biggest is really taking the nurses, doctors, PCAs and everyone else who’s already on board – and making them “care enough to ask the question.” An idea on how to do that will be the subject for my next post.

Dan Prince

Health plans may have a significant opportunity to improve customer experience and the health of their members at the same time. In a national survey we conducted recently, one in four of the people we questioned said they expect their health plan to provide information online or via a mobile app — something health plans are only just beginning to do.

The survey of 1,500 Americans ages 18-65 revealed that 56 percent turn to the Internet for health and wellness information – more than any other source.

But will easy access to information from health plans be the silver bullet we need to get Americans to lose weight? Doubtful. Results of our survey suggest that we have a much bigger problem than online tools and resources alone can overcome.

We found that most overweight Americans are living in denial…avoiding the real truth about their health. While they overwhelmingly identify obesity as the number one threat to public health, they apparently don’t see themselves as part of the problem. In fact, seventy-two percent (72%) of the overweight or obese participants in our study actually said they were in good or excellent health!

If Americans are in denial about their weight, will the promise of fitness at their fingertips  really change anything? People must first recognize they have a serious problem before we can move forward with meaningful solutions, and unfortunately, there’s not an app for that.

Download our full report and white paper.

Dan Prince

Forty-three years ago, in 1967, a Scottish fellow named John Shepherd-Barron invented the ATM (Automatic Teller Machine, in case you have forgotten what this ubiquitous acronym actually stands for). He thought about vending machines and asked himself the question: “If a machine can dispense chocolate, why can’t it give me cash?” Apparently, the idea of an ATM caught on. Today, there are over 1,700,000 ATMs worldwide!

The first high-deductible healthplan tied to a Health Savings Account, or HSA, was introduced in January, 2004. Like the ATM, initial acceptance was slow. Only the early adopters types understood the concept, appreciated the idea, and were willing to sign on.

But roll the clock forward a few short years.

As reported just this month by AHIP, the use of Health Savings Accounts has grown to the point where ten million Americans now have a HSA-type healthplan! From zero to ten million in just over seven years – that’s rapid adoption!

It looks like in both the case of the ATM and the HSA that the product is fulfilling an important need. In the case of the ATM, it’s convenience. With HSAs, it’s a way to try and hold down healthcare costs while giving the consumer (you and me) greater control over our spending. It shows how the health insurance landscape can shift rather dramatically in a relatively short period.

HSAs offer the hope that if we, as consumers, have some “skin in the game” in terms of paying the direct costs for (some of) our healthcare, that we will make better decisions.

Just as a change in personal habits caused by ATMs foretold (and helped cause) a shift to doing banking anytime and virtually anywhere (think online banking via mobile phones), so too is the HSA part of a bigger picture.

HSAs have already sparked an interest by consumers in being able to evaluate cost and quality information about doctors, imaging centers, and hospitals. This is a seismic shift, and we’ve only felt the first tremors.

Healthcare in this country is changing rapidly, provoked by a number of drivers and events. And while significant changes in the healthcare landscape can take decades (the time it takes to train a new generations of doctors, for example), the story of ATMs and HSAs shows us it can also happen in just a few years.

Click here for more information about the penetration of HSAs.

Dan Prince

Our mission is to deliver the best insights to help you grow and prosper in our rapidly-changing world of healthcare. To that end, from time to time, we have decided to showcase what we consider to be some of the best and the brightest minds in the industry here in the Catalyst blog.

Today, it is my pleasure to welcome Daniel Fell, Executive Vice President of ND & P, a full-service healthcare marketing advertising agency based in Richmond, VA as our guest to “For the Record.”

When it comes to healthcare, few issues strike as much fear and hand wringing among executives and clinicians as the topic of quality ratings. Thrust into defending our low scores and wavering on the benefits of advertising our top ones, marketers and executives alike struggle with the relative importance of transparency and how best to manage communicating quality measures to our varied stakeholder audiences. And to top it off, for many of us, it feels as though every week brings some new third-party review, quality ranking or healthcare assessment program.

While marketers have not traditionally been as involved in the quality side of the healthcare business – either from a clinical or a customer service perspective – increasingly, our talent and leadership is being sought by organizations focused on staying ahead of the ever-evolving hyper-quality environment. Competing in the current healthcare environment often means differentiating on quality measures. But the issues go far beyond simply promoting a national award or communicating a select number of outcomes measures in an annual report. Marketers today are faced with a myriad of challenges from understanding mortality statistics and changes in government reporting requirements to strategizing on pricing for retail services and pay-for-performance programs. In short, the issue of quality is a much bigger and more significant part of the healthcare marketing agenda than ever before and will likely only grow.

The real challenge for many healthcare organizations has been moving the discussion from the tactical (“how do we show we’re number one in something” as one exasperated physician blurted out in a marketing advisory meeting for a regional provider system) to the truly strategic. Part of this lies in the fact that quality within healthcare systems has not been terribly transparent in the past and in the fact that the issue cuts across the entire organization. Further complicating matters, ownership for measuring, improving and communicating quality has never been clearly attached to one department or area of the organization. In fact, it’s only been in the past few years that something akin to a chief quality officer has even existed within many hospitals. And even then, it’s difficult for any one person to successfully oversee the clinical, service, operational and financial aspects of quality within a typical health system.

One method that is proving effective involves creating a multi-disciplinary quality team tasked with looking at all aspects of the organization’s quality efforts. By bringing together representatives from across the system and including the most diverse areas of expertise and focus, healthcare institutions are finding that they take a more disciplined and strategic approach to incorporating quality into their marketing efforts.

In an effort to help facilitate this type of approach, we developed a free tool that we refer to as the Strategic Quality Measures Readiness Assessment. The tool is meant to serve as a self-assessment checklist and strategy guide for executive and marketing teams and a foundation for management team communications and planning efforts around healthcare quality measures and transparency. It consists of three key components: 1) internal initiatives, 2) local/regional initiatives and 3) state and national initiatives and a simple rating system based on an organization having the measures in place, working on them or needing to address. After totaling the scores, organizations can review the areas where they need or want to focus resources and use the assessment tool as a general guide for developing a quality marketing and communications plan.

While the Strategic Quality Measures Readiness Assessment is only one approach to measuring quality readiness and should be used in conjunction with other planning resources to develop the best strategy for your organization, it can be a useful tool for marketers and quality teams to jump-start their planning initiatives and stay ahead of the ever-changing quality environment today. Often, additional research with consumers, patients and referral sources helps fill in the gaps identified in the assessment process and allows the organization to create better benchmarks to evaluate progress.

Successfully competing on quality goes far beyond the marketing function, but marketers can and should play a more pivotal role in guiding the organization’s approach to delivering high quality and differentiating programs and services.

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Daniel Fell is a marketing consultant and executive vice president with Neathawk Dubuque & Packett, a full-service healthcare marketing and advertising agency based in Richmond, Virginia. He recently presented on the topic of marketing on quality at the American College of Healthcare Executive’s 2010 Congress on Healthcare Leadership. He can be reached at dfell@ndp-agency.com or www.twitter.com/danfell.

Dan Prince

I’ve long believed in the power of the checklist.

A checklist of “to do” items is a potent tool to help in managing my time, and for accomplishing the most important tasks I need to do in a given day while keeping an easy-reference “registery” of “yet-to-be-done” activities.

When I’m headed out on a long trip, I make up a checklist of what to pack increasing the odds that I end up with a shirt, slacks, and sweater that actually go together. And I’m always reassured when I see the pilot of my plane consulting his printed checklist, and marking off the pre-flight items just as he’s done (hopefully!) on hundreds of previous flights.

Now, there’s strong evidence that having checklist makes a difference in healthcare, too! A worldwide study recently reported in the prestigious New England Journal of Medicine says that having – and following – a checklist can cut surgery deaths by 50% and complications by one-third!

The most dramatic gains occurred in developing countries, since many of the items on the checklist are common practice in U.S. hospitals — things like marking the spot for surgery with a bright magic marker, asking the patient their name and what they are in surgery for before administering anesthesia, counting the sponges before closing incisions, etc. All of us have heard horror stories about the occasional episode where the surgeon removes the wrong body part or leaves a small tool inside the body of a patient.

As one of the study authors, Dr. Alex Haynes of the Harvard Public School of Health, said: “Most of these things happen most of the time for most patients, but we need to make it so that all these things happen all the time for all patients, because each slip represents an opportunity for harm.” And in this new age of healthcare consumerism, these slips also represent a risk of reduced business. The proliferation of social networks and Internet data are a real and present danger for all healthcare organizations which I would think makes the checklist all that much more important.

Let’s face it – just because a doctor has done the same procedure many times before, there’s always a chance for a mess-up… they’re human. Once in a while, they may skip a critical step, or forget to do something that causes big problems downstream – is it possible that something as simple as a checklist could be the saving grace? – a critical point to consider as consumers make choices about which hospital and which doctor they will see based on quality data now readily available in our Information Age.