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The Only Stream That Matters
I knew it was going to be a busy day. The kids had school and, right afterward, I had to pick up my 16-year-old and take him to the dentist for his six-month cleaning. Since we all know how well teenagers care for their teeth, I consider these visits essential.
But when Tyler woke up that morning, I heard groans followed by a plaintive, “My throat!”
It quickly became clear he was not going to make school or the dentist. As soon as the office opened, I called, explained the situation, and asked to reschedule.
“Let me take a look here,” the receptionist said, followed by a longer silence than I expected. “Hmm, and you said you need an appointment after 3 p.m. Hmm.”
The date I was offered was not four days hence, not four weeks, but four months. “Are you serious?” I asked. “How is that possible?”
Apparently it was quite possible—and, as I later learned, consistent with the dentist we’d been seeing for 10 years. The practice had grown so much and taken on so many new patients that rescheduling a cleaning was tantamount to canceling it for the foreseeable future. Essentially, we had to switch dentists.
I’m sure the practice didn’t intend to abandon long-standing patients, but that’s what was happening. My satisfaction hit rock bottom, even though they’d just invested in fancy tech that texted me three weeks out, two weeks out, one week out, and the day before my appointment (nothing like overkill) to make sure I showed up.
Sometimes adding tech can’t touch the underlying issue that’s destroying the value proposition for your patients or customers.
I touched on this capacity problem the other day with Melek Somai, MD, MPH, VP and Chief Technology & Product Officer at Inception Health—the innovation arm of ThedaCare–Froedtert Health—during an interview for our soon-to-be-published CHIME Fall Forum Preview. Scheduling apps, he noted, can’t solve underlying physician-capacity constraints.
I’ve been thinking about the disconnect that can arise between departmental initiatives (such as tech implementations) and patient satisfaction when we lose sight of the patient experience. Sure, we may roll out a tool that makes staff workflows easier and check the box that an app launched “successfully,” but what about the effect on patients? Do they like it? Have we tried to use it ourselves?
We all know the feeling of being confronted by tech that is anything but appealing and can’t imagine how those implementing it said, “Yeah, I love this.” Perhaps the demoed use case is so narrow that it passes with flying colors, while real life is far messier.
Businesses and health systems are segmented into departments with distinct specialties and units. That’s inevitable. Think of them as buckets. The problem for customers and patients is that they must pass between buckets in their journey, while those providing the service usually dwell within one. That’s why handoffs can be so harrowing—and so prone to service failures.
The classic example is the gap between sales and service delivery, when you hear: “He told you what? No, we don’t do that.”
Focusing on value streams exposes these gaps by walking in customers’ shoes as they move through the journey. In healthcare, pick any procedure and trace it from the first attempt to schedule an appointment to the final follow-up visit. If we stay in one bucket, we may miss the gap—the domino intended to strike its neighbor falls just short, and nothing happens.
When I think of value streams, I think of leaders who care about the enterprise beyond their purview. Two come to mind: Zafar Chaudry, MD, SVP, Chief Digital Officer & Chief AI and Information Officer at Seattle Children’s, who has said he doesn’t want IT taking more dollars from direct clinical care than it absolutely has to; and Chuck Podesta, CIO at Renown Health, who, upon arriving about four years ago, told the CFO, “IT is spending too much of the overall budget here, and we’re going to cut some of it.”
Many people tell me healthcare is in dire condition and they’re counting on technology—AI among it—to save the day. They may be right. But we must work harder to understand how new tools affect the patient experience. Doing anything less is negligent. Even in IT, let’s first do no harm.
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Thoughts on this piece? Drop me a line aguerra@healthsystemCIO.com
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