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The Future of the Patient Experience

Discussion on the future of patient experience, and how technology can support a healthcare provider's transformation journey.

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Peter Dorrington : Hello everybody, and I'd like to welcome you to this webinar about the future of patient experience, brought to you by KPMG. My name is Peter and I'm going to be your host for our webinar. And joining me today, we have three experts and I'm going to bring them onto the stage and ask them to introduce themselves, starting with Michael Beaty, who's the principal at KPMG. So, Mike, if you wouldn't mind, a brief introduction, please.

Mike Beaty: Thank you, Peter and good afternoon to everybody that's joining us today. Appreciate your time. I am a partner at KPMG in our healthcare practice. I lead a large portion of the consulting capability focused on providers of care and that's an evolving term these days. So excited to be with everyone today and share some of our insights. Thank you.

Peter Dorrington : Thank you very much, Mike. And next I'd like to invite Dr. Clifford Goldsmith to join us, and Clifford is the US Chief Medical Officer at Microsoft Health and Life Sciences. So, Clifford, would you mind introducing yourself?

Dr. Clifford Goldsmith: Hi Peter. Hi Mike, and very nice to be with you today. Looking forward to the discussion. I'm the US Chief Medical Office at Microsoft. Been at Microsoft 23 years. Also prior to that, founded a company and prior to that, as you can see, I'm a physician as well. One of the areas that I focus in deeply is health equity and another area is patient experience so looking forward to the discussion.

Peter Dorrington. : Yes, I am too. Thank you very much, Clifford. And last, but by no means least, I'd like to introduce Matthew Kull, Chief Information Officer at Cleveland Clinic. Welcome Matt. Would you mind doing a brief intro?

Matthew Kull: Hi Peter, great to see you. And gentlemen, it's a privilege to share the stage with you today. I'm Matt Kull. I'm the Enterprise Chief Information Officer for the Cleveland Clinic. I have responsibility for technology globally for our organization and like many are still finding our way through the journey of patient experience. Always trying to improve day after day so it's a good topic for us to talk about.

Peter Dorrington : Wonderful. Thank you, gentlemen. So, a brief moment on housekeeping and then we'll get into today's conversation. So then, it's a webinar so you don't need to worry about your cameras or microphones, but we do want you to interact if you're taking part in the live webinar. You can do that by asking questions or making comments in the comment section, and I'll try and keep an eye on that, and I'll bring that to our group to talk about as they come up.

Also, as you would expect, this webinar is being recorded and will be available to watch on demand afterwards. We'll send you instructions on how to do that shortly. But anyway, without further ado, I'd really like to start this conversation about some things very close to my heart as well. So patient experience. Yeah, expectations have changed, delivery has changed, demand has changed. But let me go first to Matt.

So, Matt. Consumers, patients today have come to expect a seamless customer or patient experience, but when we think about the healthcare setting, are patients different from consumers?

Matthew Kull: Thanks, Peter. You know, dozens of years ago, Cleveland Clinic kind of wrote the book on empathy and healthcare. Patient experience became core to what we did, and we published a video that may have gotten 40 or 50 million views about living the life in a patient's views and what they're going through. And I think that everyone across healthcare has really gotten to the place where we understand how to care for people.

We understand how to be empathetic, and we understand how to put ourselves in their shoes, in their care journey, but times have changed. We now live in the days of Netflix and Uber and Airbnb and online banking and Amazon, where I can get anything that I want by pushing an orange button and it shows up tomorrow. And it is an ever-changing consumer that is starting to really demand convenience, personalization, as well as quality. And so, I think that the kind of concepts around the empathetic partner in your care are now being kind of taken to the next level about how we meet you where you are and how you want to be met through the care channels that are most important to you.

We have to meet this problem both technically as well as operationally. Our business has to change just as fast as the technology. And so, I'm looking forward to hearing my colleagues, Mike and Clifford, on how they're looking at this from outside of the mainstay of healthcare and an integrated delivery system.

Peter Dorrington : Great. Thanks very much Matt. And yeah, I'm going to come to Clifford. Clifford, Microsoft obviously is well known for delivering a great customer experience, but is patient experience different from that customer or consumer experience?

Dr. Clifford Goldsmith : Thanks, Peter and Matt. Fully agree with you. Patients are no longer just patients. Actually, patients aren’t patients. They're members, they're customers or pharmaceutical companies. So really the bigger term to think about them is consumers. And Matt is quite right, the world has changed. I think in the pandemic particularly we saw an escalation of changes in the retail space. I'm amazed when I think back three years ago, how many Amazon boxes there are outside my door and my condominium where there 20 or 30 units.

There are just so many people using online services in different ways, but I think the point that Matt was making is really important, we can't think about this as one homogeneous consumer. These are consumers, often generational, often related to their particular generation, and that is why we need to think about it in a multichannel way. So, it's confusing sometimes. Sometimes we don't see the consumer angle of healthcare because of the different utilization by the different generations.

And so, I think it's very important for us to look at this in the desired way and outcome that consumers want to receive their care and that that means being very agile and very flexible. Having a very different environment to the one we've had in healthcare in the past. But one other thing I wanted to say is that the pandemic also made it important to have online access available in every possible way, and that is continuing. I mean, we're seeing that people want the basic things that they can do in other areas, make appointments, change appointments, reschedule something.

Those are the things that we need to be able to do quickly and agile. And finally, I want to say that I think the patient is the most underutilized member of the care team today. And that is what consumerism is all about. If the patient was given the right little bits of information that they need in the right way, that they could understand, they could become a very active participant in their own health and wellness.

Peter Dorrington : Great. Thank you very much, Clifford. And lastly, let me come to you, Mike. Same question. We’re often involved in thinking about customer experience. Patient experience, it sounds to me like it is different, but I'd love to hear your thoughts on this as well.

Mike Beaty : It's a great question and good points made by Matt and Dr. Goldsmith. I mean, our best experience anywhere is our experience everywhere today. And as we work with our clients in the healthcare industry, broadly payer provider, life sciences, and other parts of the ecosystem, we are very much looking at lessons learned in other industries over the last 25 years. Banking, retail technology, and trying to find commonalities between those industries that will help us accelerate some of the things that Clifford and Matt just described.

But we do believe that patient experience and customer experience are synonymous, and I'll talk in a few minutes about some of our vision in that space. But over the last few years, a couple key things have occurred that I think actually make all of these things achievable. If both our technical and operational strategy and discipline are aligned, meaningful use raised the overall level of technology and availability of data in the healthcare industry.

And that was a big step forward. The pandemic, as terrible as it was though, changed our thinking about how we could use technology. How quickly we could deploy technology, how quickly we could, or in an agile way, solve many of the challenges or friction points that before we were struggling with. So, it's an exciting time.

It's a challenging time, and I think there's going to be a lot of unique innovations over the next few years, but all of it should benefit both the experience of the patient as well as the clinician and administrator that are powering that experience.

Peter Dorrington. : Yeah. Thank you very much gentlemen. So, if I just repeat back a couple of things I'm hearing. I did like this point about empathy being where the patient is, but also understanding, you know, the way that they're expecting this to play out. The, you know, if it's something mundane and transactional, I want to be able to do that very quickly myself. But obviously there are times when I need to talk to a clinician. It isn't just the patient either. Of course, we have the people around them, their carers, their family that are also part of this.

So, it's, you know, I think it's a more complex and certainly more significant journey. They have some things we come to think of for customer experience. But Mike, let me come back to you then. So, clearly there's a need for improved or enhanced patient experience. So, if you had to reimagine the patient experience, what would that look like?

Mike Beaty: Well, I think we would view it through both the eyes of the patient or consumer of services and care, as well as the provider of those services. One does not work well without the other in our point of view. On the patient side, it should be intuitive, it should be frictionless. It should be aligned with our preferences and desires and clinical needs as well. On the provider side, there's a lot of opportunity to optimize their experience. And when I use the word provider, I use that broadly to mean, you know, the physician, the nurses, the other parts of the care team that are providing care.

But focusing on their experience and how their time is being used is actually a really key piece of the puzzle for the patient experience. And so, as we look through, you know, our abilities, our strategies, our journeys across the continuum, seeing things through both sets of perspectives and personas is absolutely critical to designing the experience that ultimately drives empathy to Matt's point, or drives brand recognition for an entity like the Cleveland Clinic, over time, across episodes of care, across family members, across time, as we age.

Peter Dorrington : Great. Thanks very much Mike. Yeah, and as you said, I just suddenly thought of course empathy takes at least two people. So, let me come to Matt then. Same question. So, if you had to reimagine the patient experience for the future, what would that look like to you?

Matthew Kull: We're in a period in this country, and I think globally, where people are more mobile and wellbeing is multifactorial across different stages of life. People I think have a very strong desire for a fully differentiated lifetime of care. And focusing on sick care at the end of life is not how we're going help people live better. So, I had an experience recently. I was sitting at a friend's house and his daughter came home from college and he was scrutinizing the credit card bill, and he asked her, "You know, what is this $65 to lemonade? Who spends $65 on lemonade?" And what she said was, "Oh, that's a doctor." And his comment back was, "Well, you have insurance." "I'm never going to go wait for three hours in a waiting room to see somebody because I have a sinus infection. That's crazy."

And it was kind of that pivot. Look, convenience is a really big deal at different stages of your life. At an early stage of life as you think about taking care of patients, they want fitness and nutrition and how to be mentally well. As you start to mature and you start to think about a family, that care changes. And through this period, people are likely to move states three to four times in their lifetime. And how do we provide continuity of care that gives an end of one experience, especially as we start to move into the age of delivering on the promise of personalized medicine.

It's not just a bunch of patients that have diabetes or high blood pressure anymore. Now it’s Matt, Peter, Mike and Clifford taking care of us individually. And I think that's the way we have to think about that experience. As we think about that experience, being proactive and using our digital tools to identify moments where intervention is possible so that we become a partner in care, not a fixer of care.

And the one thing, Mike, that I want to stress that you said, that it's really important for two reasons. One, as technologists, many times when we implement technology, what we're doing is we're increasing kind of the noise level of technology in the physician space. It's creating more clicks, it's creating more burden, it's creating more things that have to happen. And so, we have to be extremely cognizant of that and how we actually use automation and decision support to make a physician's life easier. To drive tools and utilities in a very user friendly fashion for that physician.

And then secondarily, that I think it’s really important, as we think about the clinician perspective of a patient's experience, we are entering a time when frankly there are not going to be enough clinicians to take care of all of the people who need care, which means we're going to have to amplify human output. And the way that we're going to do that, the only possible solution, is a tech solution. And if we don't do that, what we're doing is we're impacting patient and consumer experiences by creating additional delays to care. Barriers to get care, inequity of care, all of which I think are critically important to address.

If we're not, we must take a lifetime of a patient in its totality when we think about what this reimagined version of the patient experience is. And again, I will sound like a broken record here, but it is not entirely a technology problem. It's going to require partnership across the entire continuum from clinicians, very importantly, our nurturing staff. Operations revenue cycle as well, to make sure that we can deliver on this in a really timely way. We are a very huge, complex global organization and if we apply that, don't obstinate that to our patients, just the complexity of our physical footprint can translate into the complexity of their experience as well.

Peter Dorrington : Okay. Thanks very much, Matt. And I'm going to come to Clifford. By the way, just before we do, I just want to remind people, please do ask questions in comments. We've seen a couple come in already. So, Dr. Goldsmith, I may come to you then. If you had to reimagine the patient experience, what would that look like for you?

Dr. Clifford Goldsmith : So, I think Matt just gave an incredibly comprehensive answer to that question and with some really good examples. So, and Mike as well, talking about both sides, the provider and the patient and looking at and viewing it around the experience of the patient. I think if I said it, if I wanted to reiterate one thing that Matt said, it is that it's going to eventually be a highly personalized experience. If you look at it from a quality and technical point of view, it's going to be a precise form of medicine because of that. But it's also going to have a highly, highly personalized component everywhere.

The best thing I think I could do is give another example. Matt gave one example. I'm going to take a pop up. There's a point in the journey that everyone goes through. I always think of the journey as pre an encounter with a healthcare system or a health clinician during the encounter and after the encounter. And that's what I mean when I think of it. And all along that journey with all of its points on that continuum, there are many things we can do to impact the journey, outside the hospital, outside the health system, inside the health system.

But what the example I'm going give you is a very recent example, and it really is a stunning example to me. Coming out of the pandemic we all know about the workforce crisis that's been going on that clearly has impacted the providers significantly. Many organizations that don't have enough nurses, for example, to deliver care. One large national health system made up of many hospitals chose one hospital, and decided, this is now less than eight months ago, decided to put in a technology, but the real reason was to support the nurses.

They created virtual nurses. Now, I don't think they're the only hospital doing this. I think there are others doing this. So, what these nurses are, think of them as some hospitals in the past, called them bunker nurses, but these one, these are nurses. They ask them to still come into the hospital although they don't have to do that in the future, and they put them in a basement room. And what they did, they did hourly roundings so the point on the journey that they were impacting was the hourly nurse roundings.

They reduced the workload for the nurses in the hospital completely. But the most interesting piece of all of this is that the patients in the hospital were extremely satisfied with this rounding. The way the rounding worked, they had a monitor or a tablet or a mobile computer, whatever you need at the patient's bedside. So, the patient was communicating hardly with the nurse and the satisfaction went up. So much so that the organization, the CEO of the organization announced the success of this pilot, and they plan to implement it across all of their hospitals, and they stopped piloting it because it was so successful. That's an example of a small piece of technology. A big piece in process change that really changed.

So, I would consider, I'd think of that as changing the model from an on-prem model for nursing to a hybrid model for nursing. And they were doing things like, the way that they save time was doing simple discharges, which are a huge burden on nurses, in a much more rapid way. But the patient satisfaction went up enormously in that process.

Peter Dorrington : Brilliant. Thank you. We're going to take a couple of questions now. Thank you everybody. I can see the comments sections blowing up, so we're going to try and get through some of these. So, we will be brief. Mike, let me come to you first with the first question. And it's this, “Do you think that healthcare professionals are prepared for well-informed and educated patients trying to impact and ensure the highest level of care? For example, the physicians getting frustrated with patients referring to Dr. Google.”

Mike Beaty: Great question. And I think, Matt made a comment a moment ago about a shortage of professionals that will persist. That is true. I think we already see that. And I would submit that the experience there, Dr. Google using, the broad based technology assets available to the end consumer are a symptom of that shortage already, right? Because I can't get to a service, the wait time is long, I'm not sure exactly how to navigate the care system, so I go to what's easy, which is what we do every day when we're searching for something and you get a lot of answers back, and that is empowering the consumer with information.

Now, whether or not that is the best information, whether it is curated, whether it is right for me and my specific, you know, episode of care, it’s certainly something that needs to be debated and thought through. But a patient that understands their situation, that understands the potential risk, the potential treatment pathways, I think ultimately will enhance their experience and their ultimate outcomes. But it's something that has to be, I think, designed into the journey.

Our clinical professionals do have to understand how to deal with different levels of understanding. Back to that point about empathy. Some will have better information than others, but it's not going away. And so we have to think about operational implications and how to design that overtime and get the best out of it.

Peter Dorrington : Yeah, I think there's a really important point about the curation. I'm sure you're all aware that trust in established institutions. Even professions have been on decline since the '70s, and there's a lot of alternative advice out there. Quite a lot of it is not particularly helpful, but nonetheless, it's never going to go away as you say. Let's take the second question and then we'll move on. So, this one's for you, Matt, I think. So, if healthcare professionals are going to be in short supply, technology support may not, or does it not, address regulatory requirements. So, how would we address that if that is actually the case?

Matthew Kull : There's only one simple answer for this. It's going to take congressional and federal agency support. We are going to need to see faster pathway and support for algorithmic decision making and algorithmic device through the FDA. We are going to need to see congressional support for payment. We are going to need to seek congressional support for operating nationally as opposed to at a state level. And I think, Eric, to your question, we are about to see one of the biggest tests to see if this is actually something we can accomplish. Because right now there is an enormous push to continue or make permanent the state line regulations and state line licensure rules that were relaxed during COVID. If that passes, I think we're going to have hope to see more modernization of how we practice medicine.

Peter Dorrington : Great. Thank you very much, Matt. So let me just quickly recap a couple of things I've heard so far then. So, you know, this is a profession or a resource, which isn't always going to be in short supply. After all, we all want to live forever and in perfect health, but we don't want to pay for it. So, there's always going to be more demand than supply, and part of the solution to that is going to be technology. But not just technology. So, we do have to think about more agile ways of delivering how we scale without having to just keep increasing the number of bodies we put into the process.

And it may require some differences in the way that we think about healthcare provision. But let me come back to something specific. So, I'm going to go back to Mike again on this. So, what do providers need to do today to begin or to continue on that transformational journey, to provide a better overall patient experience? So, what are we looking to the providers to do?

Mike Beaty: Yeah, it's a good question and we could probably spend the rest of the hour on this. I'll summarize a few thoughts and then would like to hear Cliff and Matt's thoughts on this as well. But, you know, today the technology can do a lot, right? We have amazing assets available to us. We have a lot of innovation in this industry space over the last several years, but where we often find our clients needing the most help is the governance around how to invest, how to use, how to prioritize that technology deployment to actually impact the operations and the experience.

Many, many entities, both provider payer and others have, you know, worked in a legacy model that is often very siloed, right? We have an ambulatory entity and a hospital entity, or we have, you know, one type of health plan and another type of health plan, or we have a retail entity and a payer entity. There are a lot of silos in. There just are. And so, the entities that are making the most progress are the ones that are turning that governance model on its side and actually thinking across the continuum of care, across the operational disciplines to create pathways, experiences, journeys that consider the needs across the silos versus thinking in a siloed format.

That's going to be one of the biggest challenges I think for a lot of entities over the next several years to get the most out of the pretty significant investments they've already made in technology. I think the other concept here that is emerging every day is the difference between legacy technology platforms that were designed to do a thing versus platforms today that are designed to provide a capability that must be customized to your needs and wants and desires. So, think about a package platform that might have been implemented to support meaningful use based on a pretty specific set of requirements versus a platform today, for example, some of the things that Microsoft offers that can be configured and deployed based on your design, not necessarily a specification provided by somebody else.

Those are different approaches to technology, and I think there's a maturity curve there that we're still seeing many focus on.

Peter Dorrington : Great. Thank you. I'm going to actually just ask Clifford a little bit about that because you mentioned Microsoft. So, here we go. Clifford, I like this idea. It's patient centric and it's about the pathway or the journey rather than the silos. So perhaps you could just share, is that something you are seeing is behind what Microsoft is currently working on?

Dr. Clifford Goldsmith : We're seeing it a lot. We're seeing it in big institutions like the VA. Everyone is looking at how to create a framework or a platform for transformation. I think that's what's missing in our industry and we've got all the data of the patients. Those are nicely put into EMRs, and that helps us. I mean, that gives us a starting point to know how we are doing in terms of quality of care. But how we are delivering care is not part of that system, and we really do need an organizing principle for healthcare.

And I actually do believe, and Microsoft believes that it's around the patient centered journey. You could add to that the population journey as well. As part of that, doesn't mean that it doesn't have the provider, you know, as an important part of it. They play a role around the patient journey, and I think we're getting pretty close to actually having that framework encoded in what are called patient journey and service blueprints.

We're seeing them for things like hypertension. We're seeing them for opioid management. So, we're beginning to see those kinds of frameworks being used and I think that's the key, to build that. It also needs to be done in such a way that these frameworks can be shared by the big institutions like Cleveland Clinic who work this out and understand the best ways to do this so that other institutions can see where they're at today, where they could be in the future, or should be with the best practice and what they can do today. What's possible today.

It requires, just one point about that, there's one other side to the Microsoft side of the story, which I'll say something in the moment, but an important part of what we learned at Microsoft is at the organizational level, we had to change our mindset. And that's something that when Satya Nadella took over Microsoft, I've had experience for a long time under leadership at Microsoft. He brought in this idea of a growth mindset and that changed the organization. So, it was transformation from the top level, the CEO down, that changed, that allowed Microsoft to do this. I think that's what hospitals need, health systems need as well. Top-down transformation with the right culture in place.

I do want to say one other thing about Microsoft. Microsoft is a company that came out of the developer environment. We created languages, we developed coding for different coding sources, visual basic, Visual Studio, visual C++. You remember all that. One of the things that we now focus on is what we call low code or no code environments, and we built tools for other vendors that are doing the same thing. But the beauty of those tools that power users, or good users, or power users, can be developers and test concepts without having to do too much coding today.

So, technology has advanced far enough for us to do that. Other industries have benefited from that. I'd love Matt to hear what you think, but I don't think healthcare has benefited yet from the potential for making apps that will run in in various environments.

Peter Dorrington : You know, that's a really good question, I think. I'm going to come to Matt in just a second. Before I do, let me just reflect back on that. So, for many people, transformation is actually also a process of simplification. And one very simple way I look on this is every time our process becomes the patient's problem, we fail. So, we need to think about, you know, how we deliver against that. So, then let me come to Matt because I'm going to ask you specifically about that. So, Matt, then how does the clinic think about architecting the ecosystem of partners that are required to create these frictionless healthcare experiences that we're all striving for?

Matthew Kull: Thanks for that question because I think getting the foundation and the ecosystem right is really important and we've taken an approach of enablement. And what I mean by that is most of the good ideas that are not coming out of the IT shop, most of the good ideas are coming from the people who are working in the gemba, those that are on the front lines, that are bedside, that are in our patient experience team, in our patient journey team. Our nurses are a tremendous source of good ideas for how to improve workflow in the organization.

And all of those things kind of tie back in when we think about this frictionless experience. How do we make it easy for you to get from where you are, to care, and how do we make the care easy while you're in your encounter and then as well as after your encounter? So, we think about ecosystem as a set of tools and a set of partners. The partners are both internal and external. We have human factors design team that looks at every great idea to see how it can be used and how we can streamline the usage so that we're not actually including that friction. The same thing on the patient side is we think about how we're going to put a technology that's patient facing.

Is it easy to use? Is it branded? Is it consistent with our other tools that our patients use? Does it have the same wording, the same verbiage, the same reading level, the same look and feel? And all of that kind of is at the surface level of can we get it right if we have the good idea. I think the second piece of it is that we have to look at it from that patient journey perspective. When we think about technology, if we come up with a great idea around getting people to vaccinations, and I send a single parent who works all day, nine different invitations for potentially somebody that they're giving care to their children, can we bring them all at once and take care of it in a shared event?

And so that ecosystem internally requires nursing staff, clinician staff, technology staff, people who are really just focused on experience as well as feedback from our patient focus groups, so that's one aspect of it. When I think about technology partners, we look for enablers and we look for enablers that are easy to use. I have a responsibility to the organization to provide a platform, that has security, that has data, that has utility, and tools that can be used across the enterprise. And so, when I think about Microsoft as a partner or the work that we do with KPMG or any of our other partners, it's how do we build things that are consumable and how do we build things which users, or creators can do that with very little burden?

We try to find low code, no code tools. We try to find tools that are manageable, buyer end users. And we always, when a tool is introduced, we introduce training as well with it, because I think that enabling those technologies within the enterprise that people can actually use. By the way, we're going to get things done. Partner frameworks really for us comes down to a couple of things. We try to standardize on core platforms and core partners, prime partners, if you will. There's a lot of new entrants in the market and it's really difficult to make sense of many of them because they all offer very, very niche solutions.

But what is the ecosystem on which we can potentially create tools and utilities that can span multiple uses? So, when we think of a cloud provider, can we get as close to the fire data store as possible? When we think of tools for development how low code can they be? How no code can they be? How many people's hands can we get them into and train people who are not technologists to use them? And then how do they work within all of the other tools that they collaborate with? Something else that we find very important is when we're looking to new tools in the ecosystem, or new partners into the ecosystem, is how do we rationalize what we already [have]? Is there an opportunity that we've created something that does not only the new thing that we do, but something that we're already doing?

 Because as I'm sure everyone on this call knows, there is an inverse correlation between the amount of technology appetite and technical solutions available and the money to pay for them. And so, we really have to try to drive value as well. And I think all of those things, and it's, again, it's a lot of different perspectives that we have to look at in this ecosystem, but I believe that they're all really interrelated and making it affordable and easy to use, and something that provides both our clinicians and our patients equal benefit is really important.

Peter Dorrington: Brilliant. Thank you very much, Matt. This is a question for all of you, but I'll come back to you first, Matt, on this. So, this relates to what you've just said. What are some of the key considerations that organizations need to take into account across the enterprise in order to deliver on this better patient experience? So, what are some of the key things we have to keep in mind or act on?

Matthew Kull: We have to ask our patients what they want. I mean, we really do. I go back to the example of a single parent or both parents working or an environment where it's really difficult to get care. You have to think about across all of our kind of demographics and socioeconomic status of how our patients interact with us. There's a concern for some about frankly getting to a medical appointment. There's a concern for some about what time off looks like. There's childcare concerns, and we have to think about that entire ecosystem of pressures both socially and financial to really create individual situations that work for each individual consumer.

 And that's not unlike what mainstay consumer companies are doing today. Amazon has me figured out. I go to their homepage and inevitably there's always something I didn't know I had to have, and I have to buy it. And at the same time, do we know enough about our patients yet? Have we got enough depth in our CRM platform to know about our patients to know what they need? Do I know that this patient has two children who are unvaccinated who need a vaccination? Do I know that this is a person who's missed appointments before because they're transportation limited? Do I know that we have patients who are going to require their caregiver to be here at the same time, and am I communicating with both of them?

 These are the kind of things that are really about knowing who that consumer is so that you can give them an experience that fits what they need. It goes back to the very first thing I said. People, consumers, have evolved to wanting to be met exactly how they want to be met, where they want to be met, and over the channel that they want to interact with. And I think we have to provide all of those.

Peter Dorrington: Great. Thanks very much. So then, let's come to you Dr. Goldsmith. Same question, if you wouldn't mind. So, what are some of the key considerations that organizations need to take into account across their enterprise in order to deliver this better patient experience?

Dr. Clifford Goldsmith: It's, you know, Matt has said it, starting to democratize transformation, but democratizing it as I said it a little earlier, using the patient as the one of the members of their team. So, getting the data that Matt is talking about is we need to understand and engage patients. I'd say one more thing about, you know, do they want to be consumers, but they really are willing to provide the feedback as well that we need to be better to help them be better consumers. And I think we all know this, so we give a lot of feedback all the time in different ways.

Think of in our organizations, I know at Microsoft, I get surveys from everybody who does anything for me, and then using that feedback effectively. So, it's developing those insights that we are talking about in a deep, deep way to our consumers and also to our providers as consumers to how they're using the system. I imagine, in my mind, I imagine an organization, a growing and learning health system, constantly learning about its environment and constantly feeding back that to the providers and to the patient.

Peter Dorrington : Great. Thank you very much, Clifford. Lastly on this one, Mike, let me ask you the same question then. Those key considerations that organizations need to take into account in order to deliver these better patient experiences.

Mike Beaty : Yeah, I'll just offer two additional points. You know, KPMG does an extensive amount of research across industry every year around experience. What are the best brands? What are the entities driving the best experience, and what is common about those experiences? And across industry, those that think horizontally, that connect the front, middle, and back office in terms of process, in terms of technology and operational leadership drive a better experience regardless of industry type. And so, as we, you know, talk to our clients about what does transformation look and feel like. We start with that framework in mind. If you are, if you are working on the front of the entity and the contact center or the, the digital front door, what are the implications for the middle office or the supply chain or the nursing function downstream?

So, thinking in a connected way is very important. And I think the other one is an alignment comment, right? Getting your executive leadership aligned around a common set of goals before you make big technology investments, before you launch big transformations is hugely important and where that happens, the results are often much, much better. The progress, pace of play, if you will, is much, much faster, and the return on investment is significant there. So, this would be my two additional thoughts to the other great comments from Matt and Cliff.

Peter Dorrington : Okay, great. And all good comments. One of the things I was hearing there was about the importance of data. If you're going to be making data-based decisions, clearly you need data, but not just data, you need insights that you can take action upon.

Mike Beaty : Mm-hmm.

Peter Dorrington : So, I might refer to that because I think we've had a question in comments about that, but I'll come to it in a minute. So, Matt, back to you then. You mentioned this point, healthcare doesn't exist in a vacuum. There are lots of tensions both on patients, their carers and their ecosystem, but also on providers and clinicians and physicians. So, with such a list of competing priorities for healthcare systems executives, why is delivering a better patient experience the absolute imperative it seems to be. Why do we need to put that right at the top of the list? And we've got so many other things on our to-do list.

Matthew Kull: It goes back to the fact that consumers have evolved and so has our industry. Patients have choice, and convenience now will beat out brand every single time. There is no better place on the planet, in my opinion, to receive specialty care than Cleveland Clinic. That being said, if it takes weeks to get an appointment, you are likely going to call someone. That experience matters. We have, in our industry at least, we have significant amounts of non-traditional entrance to provide care in our industry. If you look at Teledoc, 50 plus million patients. If you look at Amazon and their pharmacy. If you look at what payer strategies are starting to look like about primary care. They can provide a much more streamlined, or, I don't want to say they can, they have learned to provide being technology first, a more streamlined type of care.

And I think that's terrific. And I think that that activity is going to force us to be better. And we have to be because patients have transitioned into consumer behaviors. And so that really matters. And they're going to make their decisions in part on what kind of access they can get. And I think back to an analogy that I created for a presentation, one or two hymns ago, and it think about this, okay, if you think about a hospital for a second, and let's take the word hospital off of it and turn it into airline.

Imagine an airline where you have to talk to three different people to pay for your flight. You have to call the last airline you flew on to find out where your route was to provide it to the new one, and it requires for you to sign a form and fax it to the old airline so the new airline can get it. And you have to show up to the ticket counter ahead of your flight with two CD ROMs and a stack of files. That airline would be out of business within about six minutes. Healthcare systems have to evolve for exactly the same reason.

If we don't, and we're not putting that patient experience, if we're not putting that consumer experience in the forefront, patients will make decisions that may not be in the best light of their healthcare and their wellness, but certainly will be in the light of convenience. And I want to go back to, kind of, Dr. Google. And Mike, you took that question earlier. Google's incredibly convenient and that's what we are trying to supersede is the source of information for our patients, and that's really what it is. How easily can patients get information that they need to feel better, which is really why we're all here in the first place, to help people who don't feel good, to make them feel good.

Peter Dorrington : Really important point that, Matt, you know, the patient behavior or their caregiver behavior has changed a lot to be like consumers and consumer expectation, radically different now than it was just a decade ago. But let me see if I can finish that topic off and then I'm going to squeeze in at least one more question from our audience today.

So, Mike, same question I guess then to you, because you deal with so many different organizations and types of organizations. With such a broad-spectrum list of these competing priorities for healthcare executives, why is patient experience deserving to be an absolute imperative rather than a nice to have?

Mike Beaty: Because it impacts all of the other goals at the enterprise level. It's implicated in the cost equation. It's implicated in the quality equation. You really can impact many, many goals by driving a better experience and as we move to a more value-based care world. Driving the right experience doesn't necessarily just mean that it's convenient and frictionless, but it's also designed and aligned to what I actually need to drive the right outcome. And so, by thinking about the experience as a central tenant of your goals and strategies, it will impact all of the other priorities that we know many of our health system leaders are trying to drive on a daily basis.

Peter Dorrington : Perfect. Thank you very much, Mike. So then let me squeeze in one more question and I'll just briefly ask all of you to respond to this. So, I'll start with you, Clifford, but let me ask the question first then, and it's coming this way. So, what do you think of the converging of all patient records? So, the patient owns their entire history regardless of which healthcare system or location they're in or the entirety of their history at their fingertips or attaching it to something like their Social Security number or universal record ID.

So, this concept that patients own their medical data and that, you know, I'd love to hear your thoughts about that. So, Clifford, I imagine this is something that's been at the forefront at Microsoft thinking as well, you know. So, who owns it? Is it patient's data? Is it our data? Is it healthcare provider's data?

Dr. Clifford Goldsmith : I would've, a few years ago, 10 years ago, I would've said it's the patient data, but I don't think it's an issue of ownership at this point because it's an issue of access and that's what is really needed. And it actually does require some kind of, you know, national identifier or global identifier as well to do that. So, I just think that we have to, and the law has to move in this way to give people access to the data when they need it. That’s the key you know, I just don't, you know, I don't worry about it from the ownership point of view so much.

If I could quickly comment on Mike's response, I thought it was a great response and I actually look at the previous question that you were asking about, you know, why focus on patient experience? It's the best vehicle to the Quintuple Aim. And by what there I mean, when we talk about the Quintuple Aim, it's the patient improving patient experience, will improve the quality of care, well, even if, it's because they're making a choice.

It'll improve the wellness of each individual. It will improve the provider's experience of it. It will lower the cost of care and it will do all of that from, and will improve equity of care as well. So, to me, it's the vehicle to the Quintuple Aim.

Peter Dorrington : Okay. Thank you very much, Clifford. Let's go back to Matt. Same question then for you. Is this one about ownership of data and the patient owning their entire history irrespective of who they're dealing with? What are your thoughts about that?

Matthew Kull: I think the 21st Century Cures Act actually took care of that. The other aspect of the question was Social Security Number and Social Security Number has been, by law excluded from an identifier for universal medical record. Now, there has been the emergence of TEFCA and since Epic had signed on with TEFCA, it's probably now representing something like 70% of all patient lives in this country. The last real holdout is Oracle Cerner. I think TEFCA plus the consumer directed data sharing that came as part of the 21st Century Cures Act is going to put the patient in a pseudo-ownership state of their data.

It will certainly allow direction of sharing that data and utilizing that data for self-purpose in whatever way you would want. What I do feel like is some caution, and I've started hearing a lot about this, is that hospitals, ours, and many others under IRB review and, you know, appropriate use and informed consent and everything else that's supposed to happen before this is utilized. But there's a lot of clinical research that happens. A lot of new cures are developed very quickly because of a hospital and a research facility's access to data.

And so, I think the ownership quandary is an important one, but it could have potential unintended consequences if there's not a clear sharing authority to research. Because when we talk about things like, like me too diseases, especially for often conditions that, you know, one hospital may never see, a rural hospital may never see a case, but something that we see quite frequently. Not being able to share that information and that data and the ability to provide identification, diagnosis, and cure could really decrease the quality of a lot of people's lives.

And so, it's a very good question. I think that patients should and are becoming to have a lot more say in what's happening and how they can self-utilize. But I also think that there's probably some concerns on the back end relating to research if we don't approach it very thoughtfully.

Peter Dorrington : Lovely. Thank you very much. Mike, I'll come to you for this. Your final comments on the same topic, this part about data and patient’s data. Clearly, we live in an ecosystem where they're actually having privacy and data protection rammed down their throat on TV advertising everywhere they look. So, I'd love to hear your thoughts on this.

Mike Beaty: Yeah, there's some very good comments, nuance comments there from my colleagues. So, I don't have too much more to add on that specific point other than it's a bit obvious going back to Matt's airline example, that we do need the data as consumers. Inform consumers to make better decisions and drive a better experience. But I would like to pivot to the last comment there about standard operating procedures for care and that's a big topic. So maybe we narrow that down for just a moment. I do think standard operating procedures or best practice or better practice, however you want to define it around experience is a great opportunity.

We've seen it in other industries. There's entire, you know, science around consumer experience and other industry segments. How do we think about using our data in healthcare to inform the same sorts of discipline, better practice around engagement, around experience, around benchmarks if you will. The one we really focus on is lag time. And you know, Matt made the comment about if I can't get an appointment, I will go somewhere else. And that's not just an anecdote that has statistically been proven over and over again. That if you make someone wait beyond a certain amount of time, they will go somewhere else, with high statistical confidence, they will leave you.

And so what does that mean in terms of better practice or actions we can take that others have tried and proven? And we can, you know, internalize to our operations, our culture, and our systems. I think there's huge opportunities there and we have more data to do that today than we've ever had before.

Peter Dorrington : Perfect. Thank you very much, Mike. So, I'm going to wrap up with just a couple of thoughts myself and then say what's going to happen next. So, I've been reflecting on some of the things that you've been all sharing with us. Great points, everyone, all the way through. I've learned so much and you will have noted me taking lots of notes from this.

So firstly, I did like this thing about being the empathic partner because it infers that there's a relationship there. That we understand each other. We care about the same kinds of things. And using that to be where the patient is, you know, and how they want to interact and what channel and what type of interaction they want. It also has to be simple and intuitive. So, we need to take roadblocks out of the way so that patients can access the kind of healthcare that they deserve. Now an interesting point that came up was scaling. How do we scale our healthcare resources? Because it will take technology undoubtedly, but not just technology. It might need us to rethink some of the really well-held or long established tenants that are very near and dear to healthcare professionals and actually put them into a slightly different context because the world is constantly changing.

One of the ways that it's changing is to stop thinking about silos and being patient-centric along journeys or pathways so that we are more integrated about what they expect and need, rather than about our ability to manage on control important though that is. So, we need to find a way that we can coexist with that. And one of the ways to do that is to introduce a platform and an ecosystem for delivery in this new patient experience world that she's also able to adapt and respond and ideally anticipate future demands. And we do need to deliver value in healthcare because it's a finite resource.

There will never be enough money to pay for the healthcare that everybody wants. So, we need to find the way that we can deliver the most value, the most benefit for the resources that we do have. And transformation never exists in a vacuum. There are lots of pressure, many of them competing on enterprises, on healthcare providers, thinking about, "well, you know, there's a million things I could do. How do we make sure that patient experiences at the top of that to-do list?" Because as we've heard from all three of our speakers today, it's absolutely core to delivering the transformation that we all aspire to in patient experience.

And the final thing I'd like to do is just reflect this point. It goes back to the very first question when I was talking about customer experience, consumer experience, and patient experience. They're becoming very simpler in similar things. People are getting used to living in an app world. I will use something for as long as it's useful and if it's no longer useful I'll get rid of it and try something else. But I expect instant response. I expect performance. I expect to be understood as a patient, and I think that this is the adaptation of the golden rule. What we need to do is treat patients in the way that they want to be treated, and not necessarily in the way that we think that they want to be treated.

So, we are going to need to understand them better than ever before and to be able to do that at scale and speed. So then, great webinar today. Lots and lots of important points to say. I took loads of notes. So, what we're going to do next is that KPMG will reach out to all of you. I know we didn't answer all of your questions, but we'll give you the opportunity to continue the conversation one to one where you can ask that question and talk to the experts in this field and get some of these innovative thoughts for you to bring into your organization. So, look out for that approach. As far as I'm concerned, it's one of the ways you can access some of the best brains in the business, in the field of improving patient experience. But with that said, all that really remains for me to do is to thank our three experts today.

So Dr. Goldsmith, Matthew, Michael, thank you so much. And to thank KPMG for their sponsorship. This wouldn't happen without them. Neither would it happen without the ELN doing all of the logistics and organizing in the background. But most of all, I want to thank all of you that have been on the webinar and are watching this for your attention. I hope you found it as useful as I did. And until the next time, take care now. Goodbye.

Peter: Cheerio.

Mike Beaty: Thank you.

Taking a patient centric approach to designing, delivering, and evaluating healthcare services benefits both patients and providers. Yet, day to day challenges of operations, workforce, and finances often lead to less than ideal patient experiences.

Listen as executives from Cleveland Clinic, KPMG LLP, and Microsoft discuss the future of the patient experience.

Meet the team

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Michael Beaty
Principal, Health & Government Solutions, KPMG LLP

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