Monday, January 7, 2013

Practice Redesign and Empathy for Patients
The central tenet of design thinking, according to Kelley, isn't one of aesthetic or utility, but of empathy and human observation. "Be empathetic," Kelley explained to CBS' Charlie Rose. "Try to understand what people really value." Doing that, he says, will lay the foundation for more intuitive designs."
From Charlie Rose interview with David Kelly, founder of IDEO, a practice design firm, on CBS  60 Minutes

January 7, 2013 – Last night, as I listened on CBS’s 60 Minutes to Charlie Rose interview David Kelley,a close friend of the late Steve Jobs of Apple, I thought of how physicians might redesign their practices to attract and keep patients.  This will become increasingly important.  There are already  market signs that as health care prices rise,  patient volume drops and hospital admissions decline. 
The World According  to Kelley
According to Kelley, one can attract consumers through attractive, intuitive design products based on empathy – on what patients as human beings really want but may  ot even know what it is they want  until they see it.  Coming up with the right design, Kelley says,  depends on putting together a mix of different people from different disciplines and having them build on each others’ ideas based on empathy for consumers.   This is the kind of thinking that created the computer mouse,  the Apple Computer,  the IPod, and the various IPads now spilling off  Apple production lines.
Practice Redesign
Could physicians use the same philosophy to redesign their practices to appeal to health care consumers?   Could they somehow engage their staff and their patients, to come up with the right intuitive, empathetic  mix?
I believe they could, even though patient care is not a “product,” but a process of human interaction and anticipation of what patients are looking for.  

In my opinion, patients are looking for sympathetic understanding, quick convenient access, streamlining of the bureaucracy, grasp of risks and benefits, and, of course, affordable dependable care. 
This mix may be difficult to design, but easier to perform once put in place than one might think.
·         Concierge practices are an example of practice redesign and an appeal to patient empathy – 24 hour access,  unlimited time with the doctor, navigation through the medical maze. Breaking up concierge payments from yearly to monthly increments to make concierge practices more affordable modifies the  redesign.

·         Simplecare, a Renton-Washington practice,  breaks  payments broken into 15 minutes, 30 minutes, and 60 minute segments and gives  access to those without insurance is another example.

·         Retail clinics, whether staffed by nurse practitioners or primary care doctors, or orthopedic clinics for minor sprains and bruises ,  or cash-only urgicenters for other problems are other spin-offs of the empathy theme.
In redesigning practices, keep in mind that  it is often simple human things that count. Susan Keane Baker, MHA, is a good person to whom to talk to about patient-physician interactions. Trained as a hospital administrator, Susan is author of Managing Patient Expectations: The Art of Finding and ;Keeping Loyal Patients (Jossey-Bass, 1998, San Francisco.) Her book has been ranked #3 on’s list of 100 top sellers in the general medicine category.

Thirteen Moments of Truth, A Baker’s Dozen

Susan basically preaches this gospel to hospitals and doctors: pay attention to human details: recognize the power of word of mouth, create a strong first impression, listen closely, elicit patient feedback, educate patients, and use best practice techniques. Above all, anticipate the following 13 human moments of truth where patients form their opinions:

1. calling your organization,
2. making an appointment,
3. receiving directions,
4. meeting the receptionist,
5. waiting in reception or exam room,
6. meeting the clinician,
7. giving a history,
8. having an examination,
9. having an invasive procedure,
10. giving a lab specimen,
11. receiving discharge instructions and leaving the organization,
12. obtaining test results,
13. receiving a bill.
The Visual
Finally, there is the visual.  In his  book,  Mind Set!, John Naisbitt, author of Megatrends,  says a visual culture is taking over the world. With the changing communication mix of word and visual,  Naisbitt says the visual will dominate.   
So, think about creating a personal video of yourself and your practice for online distribution on YouTube and for display in your reception room.  Think about developing video describing the risks and benefits of  procedures you perform  to educate your patients.  These videos will reduce malpractice risks due to misunderstandings.   Think of creating websites featuring your blogs and videos featuring your beliefs and interviews with yourself.   Think of incorporating Skype interactions with patients unable to make  physical visits to your office, either because of their distance from your practice or because they are bed-ridden or disabled.

Tweet:   Practice redesign to attract and keep patients based on your empathy with their needs  are worth considering and implementing.




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