Whether you run an outpatient orthopedic clinic or a home healthcare agency, improving patient is always a priority. There are many points along a patient engagement that have the ability to either add to or detract from a patient’s total experience in our clinic or facility. Often these “touch points” appear rather benign and harmless, but taken in totality have far reaching effects on how our patients perceive the quality and ultimate value of the care we provide.
What is a touch point? A touch point is any area that you, your clinic, or staff interact with a patient or potential patient. From the first phone call to the last treatment; from the first advertisement to the last piece of communication, these interactions make up what we refer to as the patient experience. Sometimes, we nail it. Others, we walk away wondering how the heck did that go so badly?
Some patients leave our clinics in a great mood, ready to tell everyone they know how great our clinic, services, and team are. Others leave our clinics apathetic at best —if they even complete their plan of care— without anything notable to say. They may not have had a negative experience, but they definitely didn’t experience anything to write home about either. Most of the time, this hit-or-miss we experience with patient experience results from not fully understanding where along the patient lifecycle a problem occurred. That’s what we’ll look at here.
Common Touch Points that Affect Patient Experience
As mentioned earlier, any place or area that you, your clinic, or your staff interact with a patient or potential patient is considered a touch point. Sometimes, it’s easy to see a problem along the timeline of a patient engagement and know how to fix it. In other instances, the issue may be much more nuanced and difficult to diagnose. In these situations, it helps to try and make a list of every area where a patient or potential patient may come in contact with you, your clinic, or your employees to try and narrow down the focus. Below is an abbreviated list of the most common touch points for every clinic and how they may negatively impact patient experience. Of course, you could also use surveying to find the biggest areas of frustration  and work to build a culture that values the patient experience.
Marketing & Messaging
Marketing in healthcare and therapy is a bit of a cloudy area, especially for clinicians-turned clinic owner. We spend the bulk of our professional learning and schooling on clinical application, understanding, and mastery. As a result, marketing often gets overlooked or addressed on the fly.
How we market our services and clinics —what our messaging says to potential patients— greatly impacts our patients’ perceptions, expectations, and experiences in our clinics. Care must be taken to ensure that our marketing and messaging remains consistent with our mission and actual practices in our clinics. For example, if your slogan is something like “putting patients first”, then you better make sure that the actual processes and practices at the clinic truly deliver on that promise. Does putting the patient first mean putting in place procedures that make the sign-in or check-in process more convenient for the patient or for the front office? Does the clinic go above and beyond to followup with a patient, their PCP, or other stakeholders?
Content
Another aspect to consider about messaging and marketing is what our messaging says to patients and potential patients. The content of what we communicate subtly implies things to our patients which can either adversely or positively affect their experience in our clinics. For example, as we have written about here, patients want to know what value your clinic brings to the table. Money is tight and patients don’t want to have to pay medical bills if there’s no perceived benefit for them down the line.
That’s why crafting a marketing message that conveys what you truly offer your patients is so important. Think of it like this: your clinic does not offer “therapy” to your patients. Your clinic offers a single, one-word, emotional outcome to your patients. What is it? It could be freedom (to get back to functional independence again) or it could be relief (from pain etc.). Whatever it is, you must communicate that to your patients in a way that shows you not only understand their situation, but truly care about helping them reach their goals.
Referral & On-Boarding Process
What is the process for on-boarding new patients at your clinic? This touch point generates many complaints from patients who find tedious and complex on-baording processes unnecessary at best and down-right annoying at worst. Insurance verification, PCP referrals, and the like are necessary parts of bringing new patients into our clinics. But if we’re not careful, our on-boarding process can turn an opportunity to impress into a liability for complaints and frustration.
Pre-Appointment Packets
Take pre-appointment paperwork (or as some call it: “new-pateint packets”) as an example. Everything from the format, directions, and apparent redundancies provides an opportunity to improve patient engagement and experience. Are new patients provided this paperwork in advance of their appointment, or do they spend the first 15-20 minutes of an initial appointment filling out paperwork? If the latter applies to new-patient packets or paperwork, odds are that the evaluating clinician doesn’t have adequate time to review it before the patient is sitting in front of them. I can tell you this: if there’s one thing that frustrates new patients, it’s the feeling that the clinician hasn’t taken the time to review any paperwork or history before seeing them.
Think about it. Why would you have a patient fill out an entire packet of past medical history, procedures, surgeries, etc. only to have them re-tell all of that information a few minutes later when they’re seen by a clinician? If you can change this process so that the patient fills this packet out ahead of time —even better, submitting it electronically to the clinic— and giving the clinician time to review it before they arrive, you greatly improve the experience for both the patient and clinician. The patient feels that the clinic is truly prepared and invested in their issue or dysfunction, and the clinician doesn’t feel like they’re “winging” it with every new patient. It’s a win-win.
Communication
Communicating with current patients can be difficult, especially when instances like cancellations, emergencies, or clinic closures occur with little notice. But the manner and method in which we communicate with patients opens the door for outstanding experiences. A well thought out communication strategy and method engages patients and makes them feel valued and cared for. Let’s just break down two main parts of how we communicate with patients: the method and the manner (style).
Method
One of the first decisions we make when it comes to communicating with patients is the method we choose to use. So many option exist today, and the acceleration of technology advancement means more options become available with increasing regularity. Â With so many options, selecting a communication method can be overwhelming. When selecting which method your clinic uses to communicate with patients, take into consideration patient demographics, desires, and values.
For example, if the majority of your patients are elderly, do not like using computers, and value personal interaction, then maybe moving all patient communications to a cloud-based secure messaging system isn’t the way to go.
Given the advancement in technology, it may be beneficial to adopt a blended model for communicating with patients. Some clinics I have worked with have used this method with good results. Offering patients a choice about how they receive communication from your clinic makes the patient’s feel heard and improves their experiencing by allowing them to participate in the patient-clinic relationship. As I’ve discussed here, patients want to act as partners in their healthcare programs and plans. This extended to little decisions like how they communicate with their clinics or clinicians.
Style
The style or manner in which you communicate with patients also sends subtle cues that can impact the patient experience. This applies to clinic communications like call-backs, scheduling, and the like and it also applies to in-person communication. How we say things to patients matters almost as much —if not more— than what we say.
Take for example, a patient in pain. As we have written about here, a patient’s condition or diagnosis is affected not only by the physical or biological components at play, but also psychological and social factors. When a patient describes their pain or limitations. How you reply sends subtle cues that can potentially have a negative impact on their experience in your clinic. For example, if you say to a patient: “I know this pain feels real to you.”; what the patient hears is: “but it’s not real for me.” Saying things like this to patients automatically undermines the therapeutic relationship. How will a patient trust you if they don’t think you even believe what they are saying to you? How do you think that affects their experience and engagement during treatment, throughout their plan of care, and ultimately when they leave your clinic?
Even when our communication is not face-to-face or in person, how we structure it says a lot to patients. There is always a fine line between communicating in a way that is understandable, clear, and accurate and coming across as complex, dull, and dry. Going back using emotional language here makes a big difference. What emotional outcome do you want your communication to elicit in your patients? Do you want them to feel empowered, inspired, or motivated? Structuring your communication in a way that gets the information across and engages patients is the key to using communication to improve patient experience.
Check-in Process
As you will likely discover when making your list of touch points, the front desk is a hub for patient touch points. Front office staff and receptionists are usually the first people from the clinic your patients speak with and they’re also generally the last. That’s why it’s so important to hire the right people, train them appropriately, and work to build a culture in your clinic that puts the patient first. When everyone is on the same page with patient experience and engagement, a lot of these issues can be dealt with quickly and with little drama.
Just to cover one of the many front desk touch points, let’s look at check-in procedures. When a patient comes to the clinic for an appointment, what does the check-in process look like? Are directions clear and understandable? What is the average wait time?
Some things like wait times can fluctuate, especially in cases where patients show up late, emergencies arise, or a clinician calls in for the day. Even if wait times are on the longer side, how this is communicated to the patients by front desk staff can make all the difference between a good experience, and a complaint. If a clinician is running behind, the front desk staff can inform the patient as they check-in of the delay and then take a few extra seconds to explain how the clinic values one-on-one care and works to make sure every patient receives individual attention from clinicians. Now this will fall on deaf ears if those statements aren’t backed up in practice. Patients can tell the difference between a clinic that is really trying to provide great individualized care and one that is just saying what it has to as an excuse for wait times or other inefficiencies.
Financial Obligations & Expectations
As healthcare changes, especially in the US, more and more patients are becoming more aware of the costs associated with receiving treatment. As we’ve discussed here, rising premiums, deductible, and co-pays drive patients to question whether or not receiving treatment is worth the cost.
The best way to address this concern, while also building trust with patients, is to be as open and up-front about the costs of treatment. For some clinics who have moved to a cash-based model, conversations about cost and expenses are becoming easier. For other clinics that may still be relying on third-party reimbursement and patients who are not used to paying higher costs out of pocket, it takes some practice. As a general rule, you should always try to get at least an estimated cost per visit to the patient before their first visit in the clinic.
Nothing can turn a good experience sour quite as fast as a patient being told that they owe much more than they anticipated for their visit. There is something in behavioral economics called the peak-end rule that says people’s memories of past experiences are not related to the average level of positive or negative feelings. Rather their memories are related to the extreme point and the end of that experience. So think of this: your patient comes to therapy, completes 12 sessions, and meets their goals. They are feeling great a their last appointment. Then a few days or weeks later, they get huge bill from the clinic. What do you think happens to this patient’s memory of your clinic and services? They may say something like, “Ya, the did an alright job, but they were way to expensive.” That result can be greatly reduced by being open and up-front about costs.
I’ve heard of a few clinics that will schedule an appointment with a patient, then verify their insurance to get an estimated cost. They will then call the patients back a few days before their appointment and inform them of the costs. Taking this extra step lets patients know that you’re clinic truly cares about their cost of attending treatment.
Going a step further, clinicians should be able to have discussions with patients about length of treatment programs and how that affects the cost. There were many times when I as a clinician had conversations with patients that revolved around collaboratively structuring a treatment program that would help the patient achieve their goals at the lowest cost to them. These conversations left patients feeling valued and cared for. They were more compliant with home programs and very engaged during in-clinic treatment sessions. They also left great reviews and testimonials about the clinic and how the staff really looked out for them.
Summary
At the end of the day, patient engagement and experience doesn’t so much hinge on one or two large events, but rather on the myriad of small touch points they encounter along the way. Everything from marketing, messaging, communication, and front desk operations adds up to either a positive or negative overall experience. It’s also important to understand how the peak-end rule affects patient experience of our clinics and services. At least on the bright side, improving patient engagement and experience doesn’t have to be one huge, monumental undertaking. It can be broken down and handled in small chunks. With each touch point addressed, patient experience and engagement gets improved little by little.
What have tried implementing to improve patient engagement in your clinic or organization? Share any additional resources that you found helpful in the comments below!
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