Embrace Transparency to Transform the Experience HMPS 2022.pptx
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Renown Health (Reno, NV), now ranks among the best in the country for physician communication with patients, a key indicator of overall patient satisfaction. Learn how Suzanne Hendery and Dr. Rahul Mediwala and team used transparency, group inspection, adaptation and a change in data collection methods led to significant improvements in social media reviews, patient satisfaction and CG-CAPHS scores for Renown providers.
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Embrace Transparency to Transform the Experience HMPS 2022.pptx
- 1. Embrace Transparency to Transform the Experience Karla Cardoza, MPH, CPXP, Consultant, PRC Suzanne Hendery, MS, APR, Chief Marketing & Customer Officer, Renown Health, Reno, NV (@therealhlthmktr) Andy Ibbotson, CEO, Ratings.MD Wed. May 18, 2022 9:30-10:30 am 27th Annual Healthcare Marketing & Physician Strategies Summit, Salt Lake City
- 2. Session Description; Embrace Transparency to Transform the Experience • Renown Health (Reno, NV), now ranks among the best in the country for physician communication with patients, a key indicator of overall patient satisfaction. Learn how transparency, group inspection, adaptation and a change in data collection methods led to significant improvements in social media reviews, patient satisfaction and CG-CAPHS scores for Renown providers.
- 6. What’s the Plan for Patient Experience? With clinical partners, we are making progress on the journey Today
- 7. Approach to Improving Quality; Patient Experience Step 1: Transparency
- 8. Transparency – Verified patient feedback made public • 77% of 1,100 consumers surveyed said they’d be more likely to make an appointment with a provider with real patient ratings. In 6/18, RMG began publishing ratings/comments from the “overall physician rating” question on the CG-CAHPS survey on each “Find A Provider” at renownhealth.org.
- 9. Transparency: How did patients rate RMG providers? 97.4% of the 78,440 ratings published for 189 providers are very positive at 4 or 5 stars. Overall, RMG providers rate 4.86 out of 5. 02% comments archived (1,628 not published) +: RMG providers compassion, expertise, interest - : Rushed, not listened to/eye contact, not physically examined, specify type of provider
- 10. Our Approach 1 Codify Need with Patients, Co-Create with Providers; Publish Star Ratings Online to help you own organic search for your providers, locations and specialties 2 Automatically Request Social Reviews after each patient encounter to collect reviews from actual verified patients 3 Publish Star Ratings on Your Website for your providers, locations and specialties 4 Share Ratings and Reviews with Providers to drive awareness, engagement and ongoing patient experience improvement
- 11. Transparency
- 12. of patients use online reviews to evaluate providers 94% How Patients Use Online Reviews | Software Advice 2021 Why are reviews so important?
- 15. of organic clicks go to the top four Google search results 83% Understanding Google Click through Rates | Catalyst Search Marketing Drive more search traffic to your website
- 16. Star Ratings in Google Search Results Stars increase click through rates by 150% How Rich Snippets Can Improve Your CTR | Catalyst Search Marketing
- 17. 0 1 2 3 4 5 6 7 8 9 10 Appointment Availability Accepted Insurances Clinical Expertise Ratings & Reviews What is the impact of various profile elements on conversion rates? 3X 4X 8X 9X Digital Patient Access Assessment of the Top 20 US News and World Report Hospitals | Kyruus 2021 Increase Website Conversions
- 18. Social Reviews
- 19. A mix of 20 employed primary care doctors, specialists and advanced practitioners. Before 3.90 average star rating 22 Google reviews After 4.93 average star rating 513Google reviews Google Reviews Pilot 2,232% increase in Google reviews
- 20. Online Review Generation • Automatically request Social reviews after each patient encounter. • Request reviews for your providers or the locations where patients receive care. • Avoid duplicate feedback requests to maximize response rates and reduce patient frustration. • Support for all sites that matter - Google, Facebook, Healthgrades, Vitals, WebMD, etc.
- 21. Online Review Generation • Automatically request Social reviews after each patient encounter. • Request reviews for your providers or the locations where patients receive care. • Avoid duplicate feedback requests to maximize response rates and reduce patient frustration. • Support for all sites that matter - Google, Facebook, Healthgrades, Vitals, WebMD, etc.
- 22. Before 3.0 stars 2 Google reviews
- 24. trust online reviews as much as recommendations from family and friends 84% Local Consumer Review Survey | Inc. Magazine 2020 Why are reviews so important?
- 26. Providers & Locations • Automatically request Social reviews after each patient encounter. • Request reviews for your providers or the locations where patients receive care. • Avoid duplicate feedback requests to maximize response rates and reduce patient frustration. • Support for all sites that matter - Google, Facebook, Healthgrades, Vitals, WebMD, etc.
- 29. a one star increase leads to 10.3 percent more patient appointments 10.3% The Interplay between Online Reviews and Physician Demand | NYU 2017 How do reviews impact my bottom line?
- 30. Approach to Improving Quality; Patient Experience Step 2: Inspection
- 31. RMG: Inspection via CG-CAHPS national survey New Board-Level Goal for Service, 1 Question for RMG/CIN providers Renown Medical Group Highest rating of 9 or 10 for Provider (CG-CAPHS) (Aligned with Provider compensation metric) N/A PRC Surveying begins 11/1/20 76% 80% In process, Changing from hybrid survey to CG- CAPHS with CIN membership by 11/1/20. NV ave. is based on Western state average. Entity Metric Baseline 2020 compared to NV ave Score Quarter 1 *as of 10/6/20 (July 1-Sept. 30) Score Quarter 2 Oct. 1-Dec. 31, 20) Score Quarter 3 (Jan 1-Mar. 31, 21) Score Quarter 4 Apr. 1- June 30, 21) NV ave (min goal) US ave (max goal) Beginning in mid-November, Patients you’ve seen from 10/1/20 will be asked Q 18 on national standard CG-CAHPS survey. “Using any number from 0 to 10, where “0” is the Worst Provider Possible and “10” is the “Best Provider Possible, what number would you use to rate this provider (0-10)?” National credit is given only for scores of “9” and “10.”
- 32. RMG: Outbound phone calls, bi-lingual surveyors Personal outreach to 100% of sample for each provider Interviewers are COMPASSIONATE Surveys are BRIEF Context & Quality are CONTROLLED Data are REPRESENTATIVE
- 33. RMG Reporting: Transparent, real-time data
- 34. RMG Reporting: Focus for Improvement Efforts
- 35. Click the summary to hear the patient Proprietary & Confidential Proprietary & Confidential RMG Reporting: Recognition She is awesome. When she decided to take on certain patients, she made sure to include me because she knows how I am with doctors. She’s amazing, I will never leave her side. All is outstanding. She has really helped me out with my health. Glad I have her, I feel safe.
- 37. Results: RMG & Hospitals to Board metric +6 ppt difference +7 ppt difference +1 ppt difference +7 ppt difference +4 ppts above US Ave
- 38. FY 22 BOARD MEASURE FY 22 System Measure- Patient Experience Measure Definition Metric Min (NV) Metric Max (US) FY 21 Baseline Q4 ‘21 PRC FYTD PRC Regional MC Highest rating of 9 or 10 (H-CAHPS) 66%* 72%* 63% 68% n = 467/467 69% n = 1260 YES-Definitely Recommend 70%* 72%* 68% 76% n = 467/467 75% n = 1260 South Meadows MC Highest rating of 9 or 10 (H-CAHPS) 66%* 72%* 74% 73% n = 94/94 62% n = 200 YES-Definitely Recommend 70%* 72%* 77% 84% n = 94/94 72% n = 200 Renown Med Group Highest rating of 9 or 10 (overall doctor rating, CG-CAHPS) 76% 80% 85% 85% n = 2990/2990 84% n = 8775 Hometown Health (For FY22) Highest rating of 9 or 10 (CAHPS) SPH surveyor 90 91.8 FY 21: 88.5%
- 40. Approach to Improving Quality; Patient Experience Step 3: Adaptation
- 41. 1. Transparency; patient experience scores linked to provider compensation, and everyone can see each other’s results. 2. Key Driver: Time with provider; extended from 15 minutes to 30 minute appointment times. 3. Telehealth appointments; patient satisfier through pandemic and beyond 4. MyChart usage, appointments, RX, Open Notes; vaccine jump start 5. Visitation; as soon as allowed, opened for 1 visitor and then 2 to medical appointments and hospitalized patients. 6. Leadership; poor performers were coached, some contracts ended. 6 Changes to Operations Resulting from Transparency, Inspection and Adaptation (Listening, Learning & Responding)
- 42. renown.org Pleased to answer questions! Thank you!
Editor's Notes
- Hello. My name is Dr. Rahul Mediwala and with Suzanne Hendery, we are pleased to join you today to share how we have been able to Harness and engage Patients & Providers to improve satisfaction- in the hopes that you might be able to do something similar to help patients and families at your organization. We began this new “Voice of the Patient” work with patients of Renown Medical Group- our employed medical providers last fall, and we have expanded to gathering the voices of patients of our hospitals, insurance company and CIN as well.
- Suzanne: Thank you Karla, Andy and everyone for joining us for today’s session. Here is how we will spend our time today. Through this process, we were able to demonstrate that, in aggregate, the patient satisfaction scores for our providers are now 4 points above the US average, and rank amongst the best in the country for their service. It was important and challenging work, and we’d like to share our story.
- Suzanne: We are pleased to represent Renown Health, located in Reno, NV. We are a Not-for-profit, integrated health system that serves 17 countries, both urban and rural, and we are the only Trauma Center covering 100 square miles from Sacramento, CA to Salt Lake City, UT.
- Suzanne: Like your organizations, our patients, and their family supporters are the center of all we do at Renown, and central to our mission, vision and values. Our clinicians do an amazing job caring for patients. However, when it came to “proving” that we did an excellent job with the patient experience and communications- across our medical practices and our hospitals- we did not have wonderful results to show.
- Suzanne: The work we do in enhancing our patient experience is important. It has becomes increasingly important as we build our branding efforts for Renown. Here are samples of how our brand values of Hope and Determination, and our campaign of Fight the Good Fight have been seen throughout the last year. The best test of a brand is the experience you have when you encounter it. Thousands of patients in northern Nevada make visits to our Renown Medical Group providers every year. Consistency with our brand- and having every provider and experience rated as “excellent” is key. That is why we started with a new approach to measuring the voice of our patients.
- Suzanne: Over a year ago, I had assumed a new responsibility- that of Chief Experience Officer, which was added to my Marketing & Communications role. Knowing we had to show improvement, we outlined a plan- that included; 1) establishing a goal for all leaders- at the highest level- and made it a Board goal. #2, we sought to understand our current process of Listening to the Voice of our Patients and Families; #3- Researching Best Practices, and #4, Implementing a new listening process. What we heard through Best Practice, is that if we made a switch from our traditional vendor to a new vendor, we could use a new survey and methodology to accurately report our patient experience. Today, as a result, we understanding what Patients Want Fixed, and working with leadership to resolve issues and report back to our patients and community. As communicators, this has allowed us to share the stories of how patients asked for change, and with their help and support, we were able to improve. Next, we will be designing a Service Recovery Playbook for every one of our 7,000 employees- so when things go wrong, they can immediately address and resolve them- before it becomes an official Complaint or Grievance. And, best of all, we will be working with our clinical teams and patients to create Ideal Experiences for patient segments. And then, we will do it all again- as this work never ends!
- Suzanne: With the leaders of our Renown Medical Group, we borrowed from Performance Improvement, Scrum-Agile teams. We started with…. Transparency: This means presenting the facts as is. All people involved—the customer, the CEO, individual contributors—are transparent in their day-to-day dealings with others. They all trust each other, and they have the courage to keep each other abreast of good news as well as bad news. Everyone strives and collectively collaborates for the common organizational objective, and no one has any hidden agenda.
- Suzanne: As part of being transparent, we asked our community if they would be more likely to make an appointment with a provider who posted real patient comments. In June of 2018, we began to post most patient comments from our patient satisfaction surveys on our website, so prospective patients could choose the provider best for them. We were proud to be among the 1st in the West to do so. Andy assisted us in putting this patient ratings transparency program together back in 2018.
- Suzanne: What did we see? Transparency improved performance Feedback from “real” patients gave opportunity to enhance practice Brought accurate patient ratings to the internet and website Provided overall picture of the care provided by RMG Protected providers online reputation “Own” Google Search for each provider’s name First mover advantage in market Optimized performance before move to CG-CAPHS CMS survey 6% Increase in visitor traffic to Find A Provider area on website in the first 3 months of launching Star Ratings. Now we have 91.5K visitors to website mo./22,875 wk/2,951 day. +10.75% over previous mo. Andy, can you tell us more about how we’ve updated this program in 2022?
- Suzanne: Once we had data enough data from our patients, we moved to Inspection. Inspection: Inspection in this context is not an inspection by an inspector or an auditor but an inspection by every one on Team. The team openly and transparently shows the data in order to gather valuable feedback.
- Suzanne: To that end, we have one TOP Level goal for all RMG providers that we will be reporting to the Board and senior leadership. That is the results from RMG patients for Question #18 from the CMS national standard survey for all medical group practices, it’s called “Clinician and Group Consumer Assessment of Healthcare Providers and Systems” or CG-CAHPS survey, and allows each provider to receive feedback from 50 patients per year. The question is this, “Using any number from 0 to 10, where “0” is the Worst Provider Possible, and “10” is the Best Provider Possible, what number would you use to rate this provider? 0-10. Credit is only given for scores of 9 or 10, and the percentage of 9s and 10s is in the goal. The Minimum goal we have for this fiscal year, which goes through June 30, 2021- is that 76% of our providers receive scores of 9 or 10 from patients surveyed. 76% is the average of the Western states- CA and UT, etc. who are using CG-CAPHS. The Maximum goal is 80%, which is the US average for all providers and groups scored for this question. This goal is also linked to the new provider comp plan. Participation in CG-CAPHS is not yet mandatory in NV. It is for those in ACOs, CINs and requested by most insurance companies for contracting.
- Suzanne: To help RMG providers exceed this goal for patient experience, Renown partnered to make personal outreach calls 24-72 hours after a patient visit to a random sample of patients. Surveyors call from a local phone number, are located in NE and speak both English and Spanish. They gather real-time responses from patients for RMG providers. As soon as the calls began, the data was available immediately. This new survey methodology completely replaced the paper surveys mailed to RMG patients by another national vendor. In the meantime, Renown chose to run both systems through the end of their fiscal year, to see if there was any difference in the results. Our new system provides individual and aggregate CAPHS provider performance results on a dashboard, and provides a 100% representative sample for each provider (50 per year) and a total score by practice. Karla, can you tell us more? Interviewers are real, the survey is brief- 9 minutes or less, quality is controlled and data are more representative of the excellent relationships the Renown team is creating. The new “top box” or highest score they can receive is now EXCELLENT, vs. Very Good which was the highest score on the other vendor survey. We know patients who report an EXCELLENT relationship with you, are 4x more loyal to you and are committed to following through on medical advice.
- Karla, We now provide Renown and their providers with the real-time data and they openly and transparently show the data in order to gather valuable feedback. (Data each day, Reports emailed monthly) Includes voices of “real” patients gave opportunity to enhance practice, shared at their Daily Management Huddles, and all employee CEO Town Halls. This Provides individual, team and overall picture of the care provided by the Renown Medical Group. (Review slide)
- Karla, Providers now have he real-time data and they openly and transparently show the data in order to gather valuable feedback. (Data each day, Reports emailed monthly) Includes voices of “real” patients gave opportunity to enhance practice, shared at their Daily Management Huddles, and all employee CEO Town Halls. This Provides individual, team and overall picture of the care provided by the Renown Medical Group. (Review slide)
- Karla, we are also able to share Real time, actual voices of patients with comments back to our providers. Patients share What’s outstanding and what needs to be improved. The richness of these comments are powerful, and our system allows them to be shared at meetings and emailed to staff in recognition of their efforts, or to teams working to resolve issues and improve experience. Dr. Mediwala, do you want to conclude our presentation with your results? We promised to have lots of time for questions.
- Suzanne: And, we take information from the comments over time, to see what patients celebrate, and what they want fixed, so we can fix it, and then communicate back that they’ve helped us make changes.
- Suzanne: So, let’s show you the results. This graphic at the top of this slide shows a slice of Renown’s Strategic Plan for FY20-22. Patient Experience is now one of our 7 Board Goals. The Metric has been simplified to focus on the CMS CAPHS (which stands for - Consumer Assessment of Healthcare Providers and Systems ) national survey. The Metric is now “Patients surveyed say 1) Yes, they would give the provider/hospital a highest rating of a 9 or 10 on a 10 scale, and 2) patients surveyed say they would “definitely recommend” the hospital. The minimum goal is to meet the “State Average” and maximum is to meet the US average for hospitals and medical groups. You can see that what we found, for one quarter, with splitting the discharged hospital patient sample- was significant. Can you imagine the impact better scores would have on your Value Based Purchasing through CMS? We were losing 1M annually in payments due to lower scores; Leapfrog and CMS stars? Again, this is one health care organization’s experience, and we are not sure what impact you would see. For us, in every area, the scores improved with a real time call methodology. These were our results back on 9/21; we are pleased to say that we have maintained our scores.
- Rahul- our latest measure- this quarter in fact, shows that- we ended Fiscal Year 2021 with 85% of 2990 patients rating their provider the highest- at a 9 or 10, this 85% is important, as it is the only score CMS counts for star ratings. This Fiscal Year to date, with over 8,775 patients rating their employed provider, we are at 84% rating them a 9 or 10. Very proud to maintain those high scores through a pandemic, virtual visits and all we’ve been through.
- Suzanne, thanks to these partnerships, We are now in a place where we are able to recognize our best and brightest providers, who score in the top 10% nationally for patient communications, and through a donor family, and with some of their patients, we are able to celebrate and recognize their tremendous accomplishment.
- Suzanne: The final stage of transforming the patient experience is Adaptation: Adaptation in this context is about continuous improvement, the ability to adapt based on the results of the inspection. Everyone in the organization must ask this question regularly: Are we doing better than yesterday? and improved customer and employee satisfaction.
- Suzanne: Though this process, when we did a better job listening to patients, and determined what was most important to them- we made the following changes-which further improved our scores.
- Thank you! We are pleased to answer any questions.