Encore! EP225: Why, Right Now, It Is No Longer Optional to Suck at Patient Centricity, With Joe Selby, MD, MPH, Former Executive Director of PCORI

There is a land grab going on right now, the likes of which the health care industry hasn’t seen before—at least in our generation. Spoiler alert: There’s a whole episode of Relentless Health Value coming up on the impact of the Teladoc-Livongo hookup. And that is totally relevant to the point I’m about to make.

But let me just start with a little bit of background: American patients—let’s get real here—have no more money to spend on health care every year. Really. I mean, you look to employers. The government? Who knows? But let’s just say for the purposes of this discussion that what’s going on right now is a zero-sum game—that the dollars in the system every year are the dollars in the system, and if you want to increase your revenue as any given health care stakeholder, you’ve got to take those dollars from somebody else.

Alright … now consider this: Previously, if a health system, say, were going to make a list of their competitors, they’d probably list the health system down the street, maybe the one in the next town over if there seems to be a lot of commuting. Oh, my, how we no longer live in that simple world!

Enter the pandemic and patients not only accepting but kind of digging virtual care and its convenience and its accessibility. Now consider what happened to brick-and-mortar stores who didn’t add online retailers to their list of competitive threats. Virtual entities doing chronic care management, diabetes, musculoskeletal, other population health endeavors … these are now or will soon enough be head-to-head competitors to in-person care settings.

My local health system, they may also decide to stand up to telehealth—and many of them did. But if the playing field is now in the Cloud, how’s the patient experience on their systems? Everybody accepted that, in the beginning, they were kind of buggy and calls dropped and all you could see was the doctor’s ear in a weirdly dark room or something. But six months later or a year later? Not exactly sure when patients’ patience will run out, especially when there are companies out there who built amazing virtual experiences from the ground up and who, by the way, are often hired by health plans, who, by the way, make it financially, let’s just say, attractive for patients to use those services that the plan is providing instead of the big expensive consolidated health plan that raised their rates 30-fold over the past couple of years like one of them anecdotally did.

So, you start to see why, if I were a health system or a provider executive, I’d kind of shuffle the patient centricity, design thinking, patient experience—that whole bunch—to the first tab of my spreadsheet. Patients have, at this moment, unprecedented choice; and so do their employers, nothing for nothing. As Dr. Matt Anderson told me the other day, if a health system thinks that it’s going to make the difference by doing more specialty services and expensive procedures, that might be a risky bet.

So, anyway, I thought it might be a good idea to replay my conversation with Dr. Joe Selby from early last year. Dr. Selby is the [now-retired] executive director of PCORI, otherwise known as the Patient-Centered Outcomes Research Institute. PCORI is an independent nonprofit organization in Washington, DC. Since December 2012, PCORI has funded hundreds of studies that compare health care options to learn which work best given patient circumstances and preference. So, it’s definitely good background information. Anyone driving for the best patient experience might want to have it at their fingertips.