“Aha!” Moments are in Your Patients’ Words (If You Know How to Look)

07.06.2017 • Senem Guney, PhD, CPXP

iStock-513376890.jpgEarly adopters make or break a
technology innovation. 

Early adopters in healthcare are very rare individuals who take a leap of faith in an industry that acts (for good reason) only on solid evidence - when there is only a handful of solid evidence on the ROI for your “disruptive” technology.

When you do find an early adopter who is willing to take that leap of faith with your technology, you become obsessed with showing how it enables your user(s) to improve the quality or reduce the cost of care delivery - or ideally do both at the same time. When you get to that proof point either through quantitative metrics or use cases or even both, it’s a glorious moment for all involved.

NarrativeDx experienced that moment within six months into one of our very first implementations. Our early adopter was the department head of the rehabilitation center for a hospital network in a very large metropolitan area in the Northeastern U.S. The “Aha!” moment came about when he used evidence from the NarrativeDx comment analysis in a performance review with one of his physicians (we were later able to show our significant ROI in numbers as well as through multiple use cases that showed the context behind the numbers).

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Note: The above comment is a mock-up of the original comment from our early platform.

This particular rehabilitation center has been ranked one of the top ten in the country since 1989, which was the first year for U.S. News & World Report’s annual “Best Hospital” rankings. Only the best of the best in rehabilitative medicine work at this center. The department head shared with us in one of our pre-implementation conversations that his physicians were fiercely competitive individuals, and he was looking forward to their responses to our analysis of their patients’ comments about the care they delivered.

Shortly into our implementation, the department head began to share with his physicians the charts from our dashboard that compared the number of positive versus negative comments for each physician. He also showed each physician the chart that displayed the percentage distribution for the major themes out of all the comments from their own patients. Our visualizations have improved in the years since. However, we've kept the charts about doctor communication pretty close to the original versions because of the successful use cases we built with this early adopter. The images below show these charts from our current dashboards:

chart (18)-1.jpeg chart (17).jpeg

The department head knew that one of his physicians was double-booking 15-minute slots with patients. The physician’s scores from check-box questions about patient experience were not the worst in the group, so the physician insisted that this scheduling practice helped efficiency (which was an important measure for quality in this practice) without necessarily hurting the patient experience.

However, the number of negative comments from this physician’s patients (in comparison to the count for the other physicians) told a different story. Besides the sheer number of negative comments, major themes like “Professionalism” and “Efficiency” from these negative comments showed up as big slices on a pie chart. With a click on our dashboard, the department head could show this physician 1) the significantly higher number of negative comments from his patients in comparison to the number of negative comments his peers received from their patients and 2) the fact that his patients, when given the opportunity to talk about their experience in their own words, did describe his scheduling practice as unprofessional and disrespectful of the patient’s time.

Physicians respond very well to evidence. Our successful implementation at this rehabilitation center significantly helped the leadership team evaluate and improve their physicians’ performance based on qualitative evidence from patients. With NarrativeDx, they were able to see that data and measurement in patient experience were not limited to scores from structured survey questions but included their patients’ own words about care experiences. When these words were “added up,” just like numbers, and were displayed as trends over time, they painted a much more complete and accurate picture of patient experience.

By now, you can probably guess how that performance review ended with the physician who was double-booking 15-minute slots. The department head told them, “these comments will have to change for the better in six months or we will have to end your contract with us.”  

There was no more arguing against the evidence that this change was necessary for the rehab center to maintain its standing in its community and among its peer institutions.

This incident was not only a significant use case for the ROI of implementing NarrativeDx at this rehabilitation center, but it was also one of the first public validations of the mission we undertook to help providers hear the voice of their patients. Patients’ perspectives on the care they receive matter, and patients can best express their perspectives in their own words.

When you bring the capability to turn patients’ words into evidence, the insights you get resonate with clinicians. We built NarrativeDx for providers to act on this evidence and become continuously better at providing patient-centered care with excellent experiences.

Need more qualitative evidence beyond HCAHPS scores to create these kinds of "Aha!" moments for your hospital or clinic? 

I'd love to help you collect and visualize comments from your patients. Please feel free to connect with me on LinkedIn, or email me: Senem (at) narrativedx.com

Senem Guney, PhD, CPXP is the Founder and Chief Experience Officer at NarrativeDx. Follow Senem on Twitter.


Senem Guney, PhD, CPXP

Senem Guney, PhD, CPXP

Founder and Chief Patient Experience Officer, NarrativeDx

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