GlassHospital

Demystifying Medicine One Week at a Time

CXO

A classmate of mine was recently given a job title I’d never heard of:  CXO.

He’s been made the Chief Experience Officer at a large Midwestern medical center–one of the ones that’s been touted in the health care reform debate as a paragon of effective care delivered in an efficient and [somewhat] cost-conscious manner.

I’d seen the announcement about his promotion, and didn’t really understand what it meant. So I contacted him, and this is what he emailed back:

I was appointed to this role in July.  I report to the CEO.  We have the highest level commitment to patient experience.  I get all of the resources I need.  [The CEO] has made employee satisfaction / engagement, and patient experience the two highest institutional priorities.  These two issues are linked completely.  Can’t have satisfied patients without satisfied employees!

I am partnered with the Executive Chief Nursing Officer and together we run the office of patient experience.  ~65 employees.  We realized that it is really about the Docs and nurses.  [She] and I have adopted our Chief Human Resources person as the third wheel of patient experience – because of the engagement / satisfaction component.  Our department includes a variety of programs.  We have an executive director who runs the operations.  As CXO I sit on the executive team and too many committees to name.

Hang on a second.  Let me pick up my jaw.

My old classmate has sixty-five employees in an “office of patient experience.”   This tells you a couple of things:

1. The medical center that he works at is sizable and has ample resources.

2. They take customer (patient) satisfaction very seriously (and couple it with employee happiness, interestingly).  Hmmm….

Being the CXO means that my friend has become the face of his organization for all patients and their experiences at his medical center.  Since in his role the buck stops with him, he’s fully empowered to make change.  No doubt it helps to have direct access to the CEO, whose vision helped my friend attain his position.

This CXO role got me wondering:  How can I get sixty-five employees to do my bidding?

Actually, what I’m really wondering is what the consequences of such an office are. What if we were fully empowered to serve our patients the best way we knew how?  Or still yet, in ways we’ve not yet even conceived of?

Here’s what I came up with; I’d love to hear your ideas:

1.  Scheduling that works.

When patients call to see their doctor, being told that my next available appointment is in 8 weeks is not helpful.  Patients should be able to see the template online and pick a spot, just like a seat on an airplane.

2.  Transparency.

Instead of being told, “The doctor will be right with you,” which could mean anything from now until 30 minutes, let’s have some honesty or at least give patients more accurate information.  Restaurants can do this.

3.  Prices.

This is an easy whipping-boy for lots of health reformers and pundits. But what other industry would survive where the service providers (doctors) have no clue about the real world prices of the tests and products they’re recommending? Believe me, I’ve asked, and the runaround I get on this one is amazing.  So it’s not my fault, entirely.

4.  Products & Services.

Why do we treat the medical record like some ancient biblical text? “You want a copy of your records?  That’ll be 20 cents/page, take 5 business days and require you to stand on a stack of holy bibles to prove your identity.”

I understand the need for patient confidentiality, but our system is corrupted:  I’m as guilty of this as any doc.  Our records are to please the dictates of billing/coding and quality assurance.  They’re usually at least somewhat in gibberish, and we almost never give the patient a copy of what we just did with them.

Wouldn’t it be nice to have a printout of our consult?  Results of your tests? Doctors have gotten better about giving out lab results, to be sure, but shouldn’t you be able to somehow get online and check your own results and then contact us with your questions?  Or at least be able to access them once the doctor has ‘reviewed’ them?

*                    *                    *                    *                    *

I’d like to look at this post as the start of a wish list for 21st century medicine. From your keyboard to my ears.  Or screen.  Or eyes.  I have a lot more ideas, but I hope this gets the ball rolling.

That picture, by the way, is not my friend the CXO, in case you’re wondering.  It’s a maitre d’ from Paris–my idea of someone who knows how to enhance his customer’s experience.

5 Comments

  1. Great articles. Love this website. Can’t wait to share with my friends.

  2. I’ve never understood why ALL patient records are treated as anything but the property of the patient. Other professionals (law and accounting, for instance) treat their clients’ records as the clients’ property, and automatically provide them with copies. Note how much easier it would be to switch doctors if patients had all their records. And, working backwards up your list, if patients knew something about price before going to the doctor and receiving services, and if they actually had to pay out of pocket for some portion of the services, they might actually want to switch (or at least shop around). Finally, if patients could more easily switch and were shopping around, that might actually encourage doctors to get closer to seeing patients at appointment times, and also to give patients greater control over scheduling. A lawyer who concealed fees until billing and failed to keep appointments and was generally unreachable to clients wouldn’t last a week in business. In short, I’m all for making the patient “experience” better, but it’s hard to imagine any meaningful improvement without structural changes that shift power to patients.

    • glasshospital

      February 7, 2010 at 10:10 pm

      As long as we hold records hostage, it makes the energy of activation for switching all the higher. Of course, third party insurance dictates which docs are in network, and which are not–which also makes changing that much riskier. Seems like a practice that got out in front and provided records to their patients and at least some transparency about costs could use that to stake out a better ‘market position.’ Not that anyone where I work feels incentivized in that direction.

      Thanks for your comments.

  3. fantastic! now, to export that idea further. i just finished an 18-month medical odyssey with my second child (started at 2 months of age). the children’s hospital here has it’s lovely points, and some gaping holes on the “experience” side of things. i’m tempted to forward this piece to them! actually, i’m meeting with their COO next week to discuss process improvements for kiddos like mine; we’ll see how far we get. kudos to your friend. the fact that he has responsibility coupled with resources and *power to act* is key. the family relations staff here has to hear everything but they can’t make decisions that could actually change things.

    nice blog (got here by way of your comment in the NYT).

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