What patients really want from healthcare

Patient Perspectives

Our new report, “What patients really want from healthcare” evaluates patient attitudes toward technology and automation. The sample was collected from March 3 through 5, 2022 and had 1,005 patient respondents. 

Key Findings

• When care is difficult to access, many patients find an alternative or forgo care.
• Sixty-one percent of respondents confessed they skipped going to the doctor in the past year because scheduling an appointment was too much of a hassle. 
• Many of healthcare’s digital offerings fall short. 63 percent of patients report their provider added some online or digital tools, but that these tools didn’t meet their expectations. 
• Patients are frustrated by healthcare’s inefficient use of time. They report spending almost twice as much time waiting as they do with their provider.
• Despite poor digital experiences, patients remain optimistic that technology can be leveraged to help. 

Why old approaches to digital engagement fail

Health systems lag behind other industries in terms of consumer experience. Historically, health systems have focused on the clinical experience as a proxy for overall patient experience. However, health systems are increasingly finding that in a competitive market, a more holistic understanding of consumer experience is essential. Every touchpoint matters.

With more options available to patients, patients are more likely than ever to switch providers if the consumer experience doesn’t measure up. 

To better understand what really matters to patients–especially in terms of their digital healthcare experience–Notable undertook a survey of a thousand patients.

Our findings point to a disconnect between what patients expect, and what providers deliver.

Health organizations have thus far answered the call to add digital engagement options with patient portals. But despite heavy investment in patient portals, utilization remains underwhelming. So, why won’t patients embrace them? 

The portal ticks a checkbox for the health organization. It is a tool that displays medical records, provides a secure way to email providers, and enables patients to complete specific tasks online. It seems like it should be a powerful engagement lever, but it fails to deliver results.

For patients, the patient portal can present additional challenges in accessing their care. To use the portal, they must download another app or remember another log-in. Once logged in, they may be able to see their clinical results, but often see no explanation or context to understand their meaning. In those cases, accessing the portal may only raise more questions — and the patient logs out again, dissatisfied.

This digital disappointment exists despite millions spent to create digital front doors at health systems. Yet, based on our original research, 63 percent of patients state these new digital or online tools do not meet their expectations. We believe it is because most investments are merely bandaids. They offer information — digital physician directories, insurance plans accepted, patient panel availability — but no way to act without staff intervention. 

Patients also expect the portal to provide online scheduling. Yet most portals do not deliver. If the portal instructs a patient to call for an appointment, then it has only added another step in the scheduling process instead of providing self-service. 

Hassles are driving your patients away

In an interview with Patrick Cawley, the CEO and VP of Health Affairs at the Medical University of South Carolina (MUSC), he stated that one of MUSC’s priorities was reducing patient hassles. “Hassles are things that the patient is bothered about when they interact with the healthcare system… Patients come for our doctors and nurses. But patients get tripped up by the front desk and by parking and all these other things... Then those [hassles] color their whole experience.”

Inspired by his candor, we asked patients whether they had skipped going to the doctor in the past year because it was “too much of a hassle to schedule an appointment.”

The result is stunning, particularly since many have already delayed appointments due to limited access during COVID. Notable’s new research shows that in the last year, 61 percent of patients have skipped going to the doctor because it was too much of a hassle to schedule an appointment. 

The traditional method — telephone-based scheduling during business hours — has been listed among patient frustrations for some time. Yet, our findings demonstrate that digital scheduling methods are failing to deliver as well. Even the addition of “smart” features such as chatbots add little value, because they redirect patients to use the telephone  when conversations exceed the chatbots’ capabilities. 

In fact, 70 percent of respondents agree that in the past year they have tried to schedule an appointment online, but were redirected to call a phone number to complete the process. 

With each added step in the process, patients are more likely to walk away. As a result, 41 percent report that they have switched providers due to a poor digital experience in the past year. Dr. Cawley invested in Notable to stem the potential loss of patients to hassles at MUSC. 

“We needed someone who could help us intelligently automate these hassles — and we have found that in Notable,” said Dr. Cawley. “If we’re easier to schedule, if [patients] know that the bill is going to be correct and done in a timely manner — they’re going to come to us. We see this as an absolute necessity in order to maintain [relationships with] the patients and families who come to us today.”

Patients are sensitive to time spent waiting

Survey respondents believe they spend an average of 28.8 minutes waiting before they can see a doctor. This is more than 10 minutes more than the reported average wait time in 2018 of 18.2 minutes. 

Survey respondents also report that, on average, they spend 16.7 minutes with their provider at their appointment — meaning they spend almost twice (1.7x) as much time waiting as they do with the doctor.

Some studies have shown that wait times impact a broad swathe of metrics beyond satisfaction — extending to confidence in the care provider and the rating of the overall quality of care.

Adding insult to injury, patients report that caregivers spend 41 percent of the visit looking at screens, not the patient. This can interfere with communication and understanding between patients and caregivers.

In open responses, 46 percent of patient answers focused on time. There were 19 mentions of the word “wait” alone (out of 155 responses). 

Some of these responses include: 

• “I dislike the waiting most of all.  It could be reduced.”
• “Get all that crap out of the way and the actual visit will be direct, quicker and spend less time at the appointment.”
• “I can spend more time talking to a doctor rather than doing paperwork.”
• “Technology could help to better automate the scheduling of my appointments and simplify the check in process and therefore potentially reduce the time I'm waiting to see the doctor.”
• “Text message if the doctor is running very late in appointments to delay my appointment by 15 or 20 minutes so I don't sit in a waiting room but arrive at a later scheduled time.”

Patients want convenience but providers are failing to deliver

Patients are trying to engage digitally, even though many of the tools available to them are insufficient. 67 percent of patients state they have used an app, website, or patient portal to get healthcare information, set up an appointment, or communicate with a doctor. Given what they can accomplish digitally with companies in other sectors, it should be no surprise that 72 percent still feel hopeful that technology can improve their experience as a patient. 

Their survey requests for technology are not, for the most part, far-fetched — apart from one written response requesting “holographic examination”, most other requests were for technologies we already have. 

Patients want technology to make it easier to access their records, schedule an appointment, and communicate with their doctor. 19 percent of responses mentioned words associated with “ease”. 5 percent of responses used the word “access”. 

They also expressed interest in monitoring their health and automatically sending updates to their doctor, and reminding them of screenings to help them detect disease earlier.

The entire process needs to be transformed

Patient desires for digital transformation span the entire care journey. They want technology to streamline the experience of healthcare, end to end. Open-ended responses provide visibility into what patients really want.

Touchless scheduling, patient registration, intake, and payment:

• “I would love to be able to book appointments online with my PCP but there is always a snag.”
• “​​Get all paperwork and everything out of the way and to let the doctor know what's going on ahead of time so he knows what to look into.”
• “Easier options for paying bills”

Virtual and asynchronous care:  

• “Not having to leave home to see a doctor.”
• “They need to follow up using text or email to track how I feel, it will be best online instead of using a phone or more visits.”

Unfettered medical record access: 

• “All important information can be accessed in one place.”
• “My records will be available to me whenever I check them online.”
• “Let me have access to my medical records and tie in my blood pressure and glucose readings to an app so it could be monitored by my doctor in the way my sleep apnea machine does.”

Based on our work with leading healthcare providers, Notable recommends organizations take three steps to accelerate their digital transformation journeys.

1. Evaluate your digital engagement status quo. Inventory what digital engagement tools are currently in use and learn how patients feel about them. Some organizations have invested extensively in an array of digital tools, but patients may still experience confusion or frustration. Other organizations have made investments in EHR-based digital tools that are hard to use and must be managed manually by staff. Collect and analyze qualitative and quantitative data on how your digital engagement tools are performing, seeking out feedback from both patients and caregivers.
2. Start by improving patient intake. A seamless patient intake process is non-negotiable for patients. While many organizations have invested in portals for intake, patients experience app fatigue and may forget usernames and passwords. Similarly, patients are frustrated by having to re-enter the same information at every visit. A remembered experience is table stakes when crafting a delightful patient experience. Finally, the intake experience should be as cohesive as possible, with patients being able to move from an appointment reminder to form completion to payment in a single digital interaction. 
3. Improve the patient and staff experience with intelligent automation. While many organizations begin by optimizing existing investments, especially the EHR, these tools may fail to satisfy patients, while also creating more work for already overwhelmed staff. Similarly, point solutions produce clunky experiences that may prompt patients to look for more convenient options. Through deep personalization and consumer-grade experiences, intelligent automation is the only solution that can provide patients with the seamless healthcare experience they expect. 

‍

Download the full report to learn more about what patients really want.