For one health system, improving the experience for pediatric patients meant decorating its imaging department as a camping experience, providing children with a backpack of supplies, and dressing their imaging professionals to match the theme.


March 14—After years of work, a designer of MRI machines at General Electric was excited to see his cutting edge creation implemented at a hospital. But his excitement turned to disappointment when one of the first patients, a six-year-old girl, shrank away from the machine in fear. Her pediatrician picked up the phone to call anesthesiology to administer a sedative so the girl would lie still for the images.

The experience spurred the designer to search for way to make technology that is necessary for patient care more caring to patients.

Santosh Mohan, head of 'More Disruptions, Please' Labs at athenahealth, a cloud-based electronic health record company, recently told the anecdote at HIMSS 2018 to illustrate how poor design can negatively affect patient care.

“Are we making the healthcare experience easier for patients, or are we making it harder?" Mohan said.

Much of the time, the experience is harder for the patient because hospitals and other medical settings are designed around regulations rather than the care experience, Mohan said.

More than 80 percent of pediatric patients receive anesthesia when they get an MRI. To reduce that number, Children's Hospital of Pittsburg UPMC collaborated with GE and the Betty Brinn Children's Museum in Milwaukee to redesign the pediatric MRI experience with children’s perspectives at the forefront.

The final result is “Adventure Rooms." Characters guide children through the imaging experience, with rooms and the MRI machines decorated in themes such as safari camping and a nuclear submarine. For the camping experience, children receive a backpack filled with supplies and toys and imaging professionals wear camping hats.

The adventure rooms incorporate music and other distractions to reduce anxiety and the need for anesthetics in children imaged at the facility. The result was near elimination of anesthetics for pediatric imaging at UPMC, said Rasu Shrestha, MD, chief innovation officer at UPMC.

“The problem today is the technology we've created for patients is not focused on them,” Shrestha said. "We are challenging the status quo."

Connect and Empathize

The challenge is to not just make the patient care experience at hospitals tolerable, but delightful, he said. Shrestha and Mohan recognized that this is a radical concept. But it is one they believe is necessary in today's consumer-driven environment.

“This is a dialogue we need to have,” Shrestha said. “User experience is not about iconography and color palettes. It is about making sure you do what you set out to do as care providers: to connect and to empathize."

The patient experience matters more now than ever to hospitals’ financial health. Consumers are taking on more financial risk in their health care as employers cost-shift premiums and co-payments to them, and others purchase insurance on individual marketplaces. Thanks to Google Search and the rise of smartphones, patients come into appointments armed with information about their own health and possible treatments. Consumer-driven care is expected to accelerate as patient medical records become more portable and accessible to patients, Shrestha said.

Since 2012, the Centers for Medicare & Medicaid Services has incorporated patient experience from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results into value-based incentive payments to hospitals.

Patient satisfaction also is linked to health outcomes. Patients who feel disrespected are less likely to take prescribed medications, according to one study cited by Shrestha and Mohan. Twenty-five percent of patients who reported feeling disrespected by their care provider did not adhere to their medication regimen, compared to 13 percent of patients who felt respected by their providers. Patients who do not feel respected also are 10 percent more likely to have uncontrolled diabetes than patients who feel respected, they said.

Start with Empathy

Designing for patients rather than institutions starts with empathy, said Shrestha. Empathy fuels connection while sympathy fuels disconnection, he explained. Human-centered design principals take empathy and incorporate it into final products.

“We need to see through their eyes what patients' struggles are to be able to create better experiences for them,” said Mohan. “It's important to go out in front of them and to speak to them."

One example is patient portals. Some require multiple entry points, multiple passwords, and complicated sign-on processes, Mohan said. That diminishes what could be a positive opportunity for providers to connect with patients.

Shifting design thinking in health care is difficult because it is a highly regulated environment. But as the pediatric MRI machine example suggests, it is possible with the right principles and mindset.

Athenahealth created a digital, paperless check-in process that has reduced patient-to-door time and improved front-office productivity. The system uses mobile and wireless technology and mobile credit card payments. Health care providers can “move from design for regulation to design for empowerment,” said Shrestha of UPMC.

Layering on personalized care experiences using mobile technology can boost patient satisfaction and engagement, Shrestha said.

Dignity Health, based in San Francisco, partnered with a digital health company that delivers personalized service tools and analytics to drive engagement with expectant mothers. This approach included texts and emails and virtual support during perinatal care. The result was a boost in HCAHPS scores and 6 percent overall year-over-year increase in deliveries. The system saved 1,000 clinical team member hours in one year, a $50,000 savings, according to a case study presented by Shrestha and Mohan.

“You drive the change in behavior by influencing attitudes,” said Mohan. “You influence attitudes by changing the experience. You change the experience by listening to the patients.”


Rebecca Vesely is a freelance writer based in San Francisco. Follow Rebecca on Twitter @rebvesely

Publication Date: Thursday, March 15, 2018