What Can the Casino Industry Teach Healthcare about Patient Experience?

Posted on October 4, 2018 I Written By

The following is a guest blog post by Spencer Kubo MD, Chief Medical Officer at CareCognitics.

Two of the hottest topics in medicine today are patient engagement and patient experience.  It is well accepted that patients who are engaged in their medical care have better outcomes, compared to patients who “passively” receive instructions, likely due to variable adherence to doctor recommendations.  It is also becoming increasingly clear that patients who have better experiences with medical contacts will have higher levels of patient engagement. But the medical community has been slow to identify, measure, and implement the specific steps that would enhance patient levels of engagement and experience.

This lack of momentum within the medical community is not surprising to some since “traditional” interactions with medicine are now often viewed by patients as paternalistic.  Indeed, many practitioners within the medical community have trouble adopting the term “customer” and still favor the use of “patient,” viewing medical interactions as inherently different from consumer interactions.

These challenges have caused doctors and health care administrators to look outside of the medical community for better ways to improve the patient experience and engagement.  The CareCognitics team spoke to a Product Manager at Nordstrom, a company with legendary customer service and loyalty, who noted, “The most important factor in making the customer feel special is to create the sense that the sale or interaction was special to both the sales associate AND the customer.”  And in many instances, doing this creates no additional cost to Nordstrom; the very basic rules of respect and personable service are all that are needed.

In our work at CareCognitics, we’ve seen success with improving patient experience and engagement using a similar focus on making the patient feel special.  CareCognitics is a digital health company founded in 2016 that leverages casino and hospitality loyalty principles, along with data science, to improve the patient experience.  Sunny Tara and Vishal Argawal, co-founders of CareCognitics, shared some of the “secret sauce” that is already helping five clinics in Nevada and California: “We started small and focused our efforts on chronic care management, especially since these activities were well supported by chronic care management code CPT 99490 and therefore brought in additional revenue for each clinic.” Here are just a couple of the ways that Tara and Argawal were able to ameliorate patient experiences by leveraging the best practices of the hospitality industry.

Make the conversation two-way: Traditional communication with patients, outside of in-person doctor’s visits, usually occurs via phone and is restricted to business hours.  CareCognitics developed a HIPAA compliant digital platform so that patients could engage in a dialogue with the medical team using a format that was convenient to the patient’s schedule and not confined to office hours.  Tara also commented, “We were also pleasantly surprised to break many myths about digital literacy in the Medicare population – over 70% of patients were responding to texts and emails.”  People loved having a “conversation” and felt the platform provided a much more interactive experience with the doctor’s office. “Our success is not defined by the technology we use, but rather by personalized content that is delivered to the patient every month, that reinforces the feeling that their doctor cares about their well-being.  We use technology and digital channels to strengthen the patient-physician relationship and provide personalized care at scale,” Tara explained.

Offer encouragement and a personal touch: “Let’s face it – completing tests as part of a chronic care management (e.g. flu shots and mammograms) is not very exciting,” says Agarwal.  Each time a patient completes a test, CareCognitics sends a congratulatory note and a message on the importance of the test (e.g. dramatically reducing the chances of suffering from flu symptoms.)  And each message is branded to the physician office (rather than a 3rd party), so the patient feels the communication is with the doctor’s staff.

In addition, CareCognitics supplies a “Care Ally,” a Certified Medical Assistant (CMA) who can respond to requests for additional details, schedule changes, etc., on behalf of the physician’s office, further enhancing the personal VIP touch, similar to a VIP host in the casino industry.  All patients who enroll in the program get instant benefits like “VIP phone” access (a special priority access phone line that physician offices aren’t responsible to run), next day appointments, and interactive personalized care.

All these perks help to reinforce the relationship between the patient/customer and the physician’s office.  The patient feels “special” because there is a pervasive sense of being uniquely cared about by doctors. Many of these principles of VIP service overlap with the principles of concierge medicine, but in this program, there is no large monthly fee to the patient!  All the patient has to do is be an active participant in his or her own healthcare.

Hey, let’s not forget about the docs!

Yes, the focus of all these activities is on the patient, but physician acceptance is critical for the program to be sustainable and incorporated as an essential feature of medical treatment, and not just a fancy add-on. Physicians’ feedback has pointed out at least 4 features of this chronic care management program which are particularly attractive to physicians: engaging dialogue with patients, natively documents in the EMR, improved PQRS scores, and incremental revenue. 

According to Dr. Cliff Molin, a family practitioner with PHG, physicians like the fact that patients are engaging in a dialogue with representatives of the physician practice, without taking time out away from the daily workings of the practice. The key elements of interaction are embedded into the EMR, so physicians can oversee the progress without having to access a different website. Because the program encourages completion of positive health behaviors, all the practices are reporting improved results on PQRS quality reports.  And finally, the program has brought in incremental revenue since all the care coordination activities are reimbursed by CMS at ~$42 pmpm.

Carecognitics improves physician’s ability to compete with large health systems and provide excellent care while improving payment for the work they do. Technology is leveling the playing field in improving patient care without increasing costs for physician practices.

Note: John Lynn, Founder of Healthcare Scene, is an advisor to CareCognitics.