Healthcare has gotten good at finishing things. Discharge instructions are handed over. Follow-ups are scheduled. Portal accounts are created. Bills go out on time. Every one of those is a verb that ends in the past tense, and every one of them is easy to count.
Yet, none of them tell you whether anything was actually resolved.
That’s the quiet problem underneath a lot of healthcare’s patient experience work right now. We can’t call it failure because it’s silent and steadier than that. It’s a system measuring activity, optimizing that activity and treating the result as good enough because nothing is visibly broke.
Why the gap persists
Throughput metrics like average length of stay or account activations win because they’re countable. They roll up cleanly into dashboards, map to staffing models and give operations teams something concrete to improve quarter over quarter. Resolution is harder. It crosses functions, it resists clean attribution and it often shows up as the absence of something — a call that didn’t need to happen, a portal message that didn’t get sent, a bill that didn’t prompt a confused phone call two weeks later.
So discharge owns discharge. Billing owns billing. The portal team owns the portal. Each function ships its piece to spec, and the patient is the only person in the system experiencing seams between them. The org chart isn’t broken. It’s producing exactly what it’s designed to produce. The problem is that what it’s designed to produce isn’t quite the thing patients need.
This is what good enough actually is. It’s not low effort or underinvestment. It’s the steady-state output of an organization succeeding at the wrong thing.
The Healthcare Payments Industry Has a Perception Problem
Healthcare payments are no longer about transactions. It’s about controlling the revenue cycle. And increasingly, that control is not sitting with ISOs.
A familiar pattern from other industries
Airlines went through a version of this with on-time performance. Once on-time arrival became the metric that mattered, schedules quietly got padded. Flight times stretched. The number improved, but the actual travel experience didn’t because the system was now optimizing for a metric that had drifted from what it was supposed to represent.
What measuring resolution would actually look like
A few questions that would change what gets reported:
- Did the question that prompted the contact get answered, or just routed? A portal message resolved on the first response is a fundamentally different metric than a portal message responded to within 24 hours. Both count as a win on the dashboard. Only one ends the interaction.
- Did the follow-up surface a new issue, or close the original one? Both are valuable, and conflating them hides the second.
- Did the bill generate a call, and did that call generate another call? Repeat contact is a resolution metric in disguise. Most systems track call volume, but very few track which calls are sequels.
None of these are exotic. They’re standard in industries that have measured customer effort for a decade. But they’re nearly absent in healthcare.
The financial argument
This is where good enough stops being a soft issue. Unresolved contacts generate repeat contacts. Repeat contacts generate staff workload that doesn’t show up as a line item because it’s distributed across functions — a nurse line call here, a billing callback there, a portal message, a rescheduled appointment, a walk-in that didn’t need to happen. The cost is real. It just isn’t aggregated anywhere, which means it isn’t managed anywhere.
Healthcare counts rework in clinical workflows. It counts readmissions. It counts denials and rebills. It doesn’t, in most systems, count the patient-facing equivalent — the rework patients themselves generate when the first interaction didn’t resolve. That’s the hidden cost. It’s hidden because the metric structure was never built to find it.
The choice
The systems that will pull ahead in the next decade are the ones that are willing to change what gets counted. Activity is the easiest thing to measure and the least useful thing to optimize. Resolution is harder, and it’s the only metric the patient actually experiences.
Good enough has been an acceptable answer for a long time because nothing visibly fails. The cost has been there the whole time. It just wasn’t on anyone’s report.
Photo: JamesBrey, Getty Images
As a Senior Experience Designer at Langrand, Mary Doeling transforms complex healthcare challenges into intuitive, human-centered experiences. Drawing from deep consumer empathy and design thinking, Mary crafts solutions that are both elegantly functional and emotionally resonant. Mary is passionate about weaving compelling stories through design and creating meaningful work that makes healthcare more human for everyone.
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