Hospitals and health systems can use patient satisfaction data and carefully calculated outcome-focused metrics to both improve the patient experience and achieve the best possible health results, according to Vivian Lee, CEO of University of Utah Health Care.
Speaking at MedCity News’ CONVERGE conference in Philadelphia, Lee detailed how Utah’s biggest health system has built the tools to do this as part of a national focus on driving down healthcare costs while improving every aspect of the patient experience.
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While “patient satisfaction” can be a catch-all buzz term in healthcare these days, Lee said if done properly, it can be an important start to creating a more transparent healthcare experience for consumers. This in turn can lead to increased confidence in a given system’s physicians and the overall delivery of care.
“Patient satisfaction – those two words are kind of an oxymoron in healthcare these days,” she said.
But more than just making sure patients were satisfied with the care they are receiving, Utah Health Care also focused heavily on discovering what its operational costs are, parsing a wide range of data. Indeed, the health system as a whole has little idea, and is only learning now, the true cost structure of its own business, according to Lee.
“What we’re talking about here is the true cost. What does it actually cost for us to deliver care? We don’t really know our charges or our costs. Imagine any other business where that would happen. That’s how we are in healthcare,” she said.
First, the health system that treats over a million patients across Utah, parts of Nevada and Colorado devised a relatively simple patient satisfaction survey that was sent to every person treated, within 24 hours of being treated. It then took responses, categorized them and benchmarked them against national references. It gave patients the option of rating physicians and their experiences on a scale of one to four stars and allowed for user comments.
Before making the responses public, it shared the results privately with its physicians, which Lees said is a critical component of engaging with providers.
“We gradually made it more and more open,” she said.
Why shouldn’t we share this data with our patients in the same way Amazon or other retailer outlets would share user feedback, she reasoned. Since the comments went live earlier this year, less than 1 percent of patient reviews are deleted from the site.
Lee said physicians then bought into the concept, which spurred them to provide the best possible level of care, focused on health outcomes, and that in turn boosted the health system’s overall reputation.
“Forty-six percent of our providers are now in the top 10 percentile nationally, and 25 percent are in the top 1 percent nationally for patient satisfaction,” she said. The system worked with Press Ganey on the patient satisfaction surveys that are all digital.
With regard to measuring costs, Lee said the health system sequestered its top IT people and had them devise a number of tools to scrutinize the cost of every department within the hospital. By actually learning the true costs, a hospital can much more accurately gauge the outcome, she said.
The goal was to create a value tool using enough business data to allow leaders to see — for every patient — outcomes against cost.
“We wanted to know about everything from supply to emergency. What does a minute in the OR cost? What does a delivery cost?” Lee said.
An interface was developed that allowed a user to click on any diagnostic group and drill down into any category of patient in the entire system.
Leaders could see detailed information, which was shared with physicians who could see breakdowns in what costs what, and then ask the critical questions: why and what can we do differently?
The hospital worked with the university’s business school to analyze the costs, and collectively came up with the best possible metrics to gauge outcomes versus cost.
“The partnership with the business school was very important,” she said. “Most of us in healthcare, we don’t have that skill set.”
When this newly unearthed information was shared with physicians, they then were focusing on how they could get perfect care for patients, Lee said.
“In the relentless drive toward perfect care, costs came down significantly – about 20 percent on average. While the physicians are really engaged in quality, we see costs go down.”
Utah, she said, has seen its healthcare inflation costs increase by only 1.4 percent, compared to the national average of about 3.5 percent.
