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Do We Need “Chief Experience Officers” in PHM?

by Scott MacStravic

The concept of having a “chief experience officer” is starting to catch on in healthcare organizations (HCOs), witness the organizations such as the Cleveland Clinic that have adopted the idea. These “CEOs” do not usually sit at the same table or work in the same “C-Suite” as the chief executive officer, chief financial officer, etc. but the notion of having a person at a high level in the organization responsible for customer experiences has at least some champions. [A. Cirillo “Embracing the Philosophy of the Chief Experience Officer (Even If Your Organization Won’t” HealthLeadersMedia.com Jan 8, 2008]

The idea of having a single person “in charge” of customers’ experiences is founded on the reality that customer experience is becoming the major, often the sole competitive distinction available to many HCOs, where consumers tend to think all are of equal quality in terms of health services. The recognition is also growing that the “patient experience” includes more than what happens inside the walls between admission and discharge in a hospital, or arrival and departure from an ambulatory care facility.

Recognition that “customers” include more than patients, such as family members, especially physicians who refer or admit patients to the hospital or ambulatory facility, and payers peaked long ago, while focus on consumers is growing. And no one in most HCOs is in a position to manage the entire customer experience for any of these customers, though programs for physicians and payers are often more formally organized, with clear accountability held by somebody. [In my last position as Chief Marketing/Strategy Officer, I shared responsibility for payer relations with the CFO.]

But does having a chief experience officer make sense for HCOs that are engaged in the population health management (PHM) business? Clearly, it makes sense for such organizations to have someone accountable for relations with the employers, commercial insurers or government agencies the PHM HCO deals with, both winning new customers and keeping current ones. But does it make sense for the other “customers”, namely the individual participants in the PHM interventions that are the main source of benefit to employer, insurer, or government clients?

To answer such a question requires first a definition and description of what the “experience” is for participants, as does the same question with respect to clients. In most cases, the experience that champions of the chief experience officer are dealing with involves the processes of interaction and transactions between the seller and the buyer. But in PHM, a far more important consideration for clients will be the outcomes of such interactions and transactions, not so much the process that is involved. And even with participants, the outcomes to individuals may play a major role in determining how many participate in the first place, and how many remain participating as long as they yield benefit for themselves and the payer that is footing the bill.

This does not mean that the process elements in interactions and transactions are ignored. Any inconvenient, upsetting, disrespectful, or otherwise unpleasant interactions or transactions between the PHM HCO and its clients or participants would seriously jeopardize the relationship. But it is more often the question of what clients and participants get out of this relationship, versus the characteristics and process elements of the relationship, that make the biggest difference.

For these “new” CEOs to be successful in PHM HCOs, they will primarily have to become fully familiar with what kinds of outcomes both categories of customers expect and would welcome from their process experiences. Not only must these process experiences be satisfying in their own right, they must lead to early indications of progress, if nor success in PHM initiatives and investments. How much clients and participants have to invest, for example, in money, time, and effort, compared to how much benefit they perceive themselves as gaining, will greatly determine what they think of the experience.

PHM HCOs would be wise to initiate their own “early warning” systems to monitor what is happening as a result of their PHM efforts – how many participants show changes in: 1) knowledge/attitudes toward the health challenge each is working on; 2) behaviors that will lead the kinds of health status changes desired, or avoid the changes feared; 3) health status indicators and biometrics that reflect progress and success; and 4) what kinds of reduced use/expense for sickness care (insurers) plus workers compensation and disability expense, worker productivity and performance (employers) has been noted.

The early warning indicators can not only give clients and participants confidence that positive changes are happening, or negative ones not happening, but serve to clearly show the connection between the PHM tactics and activities and the intermediate as well as final results and economic benefit that results. It will enable PHM providers to not only describe what benefits have arisen for both types of customers, but to make a strong case that they arose specifically in response to the PHM intervention or strategy involved, rather than by chance or due to some other cause.

The new CEO in PHM will have to become or already be expert in measuring in addition to achieving the results that clients and participants are looking for. With participants, this will usually involve some objective biometrics, and some subjective perceptions, with both playing a major role in affecting satisfaction and perseverance. With clients, it will usually involve a combination of “hard” objective data from the client’s own operational databases or records, as well as new measures or estimates of productivity/performance impact on employees.

These estimates may become increasingly difficult to tie to PHM elements and measured progress, but when they occur at the same time as, and in a way that is closely correlated with early indicators, the estimates will likely be more readily accepted and deemed credible by clients. Letting any supplier measure the success of its own efforts will always generate some skepticism, but if there is clear evidence for the connection between the process experiences of participants, and their estimated as well as measured results, and a strong link between both hard and soft results, the measurement experience itself is likely to be more satisfying to clients and participants alike.

In the long run, this new CEO must also include the “E” of evidence, since unlike sickness care where recovery and rehabilitation have well-established measurement techniques, the process of tracking outcomes in PHM is in its early development phase, as far as soft data on workforce productivity and performance. Fortunately, this soft data is not only easily translatable into financial benefit measures for clients, but into personal health/life benefits for participants, through well-tested health/life quality metrics. And if chief evidence officer as well as experience, these new CEOs may easily prove their worth to their own organizations, and end up joining their peers in the “C-Suite” based on their proven importance and value.


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