Why driving authentic value is key to improving patient experience

Patients’ key goals for care often include personal, psychological or relational factors – and that’s not how organizations typically define value-based care.

Aug 14 2411 min read

Laura Cooley, PhD

Rachel Biblow

Many initiatives have aimed to revolutionize healthcare delivery, and the transformation journey has been challenging. While the evolution towards value-based healthcare offers optimistic possibilities, reform efforts have disproportionally focused on the change of reimbursement methods.

This article is part of Open Door Policy: Bringing Patients Into Healthcare Decisions- August/September 2024 COVERstory.

The core of value-based care lies in providing high-quality care at the most affordable cost, prioritizing patient health outcomes over the quantity of services provided.

Patients, as consumers, seek transformation that provides authentic value, which prioritizes their experience and desired health outcomes, in relationship to financial concerns. To achieve authentic value, health and care leaders must focus on what matters most to patients. We must build our models that reduce burdens for organizations and care teams as they strive to deliver on the needs and expectations of patients.

This shift represents a dramatic change for health and care delivery organizations. Achieving it necessitates a dedicated investment, including building a human-centered culture, developing an integrated data strategy and leveraging relevant technological innovations.

What is authentic value-based care?

The value-based healthcare (VBC) movement was designed to transform healthcare delivery by incentivizing healthcare providers to deliver the best possible care at the lowest cost, focusing on improving the quality and efficiency of care rather than the volume of services provided. The foundational book, “Redefining Health Care: Creating Value-Based Competition on Results,” defined value by measuring patient health outcomes in relationship to cost.

Efforts toward a value-based transformation often emphasize cost, process and efficiency outcomes. While financial concerns remain critical for healthcare reform, authentic value prioritizes the experience and health outcomes that matter most to patients, with cost reduction as an ancillary effect.

Patients’ goals often include personal, psychological or relational factors. For example, a study entitled "Understanding What Matters Most to Patients in Acute Care in Seven Countries, Using the Flash Mob Study Design," asked patients what mattered most to them during the first 24 hours of acute hospital admission. Overall, their goals focused on achieving good health, returning home and receiving a diagnosis.

However, some 50 percent of patients said they do not believe their providers knew what mattered to them. Participants expressed motivations related to being with family and friends, resuming normal life, being more comfortable, taking care of others, feeling less anxious or insecure and, of course, receiving treatment.

To improve experience and health outcomes, provider organizations need to update models to measure value in ways that matter to both patients, clinical care experts and healthcare delivery organizations.

In the book “Competing Against Luck,” the authors argue that when a consumer buys a product, they aim to make progress and “get a job done.” If their goals are achieved, then they “hire” the product again and look for something else. When the framework is applied to healthcare organizations, the achievement of health outcomes creates a natural alignment around shared goals and mutual benefit for achieving them even more so, compared with other industries.

To remain competitive, healthcare leaders must communicate and work together with patients and their workforce to understand what quality care means to them, rather than making assumptions or relying on traditional, less inclusive measures.

Defining patient experience

The Agency for Healthcare Research and Quality (AHRQ) describes patient experience as the range of interactions that individuals and families have with the healthcare system, and, as such, it is an integral component of healthcare quality.

Many factors influence our healthcare experiences (Figure 1), including interactions with healthcare providers, the accessibility and convenience of care, the physical environment, and the overall emotional and psychological impact of these encounters.

Although patient experience is widely recognized as an important quality measure, definitions are often diverse and dependent on the perspective of the one creating the definition. The article, Understanding the Patient Experience: A Conceptual Framework, published by The Journal of Patient Experience, highlights the evolution of patient experience and the many definitions that persist.

Central to the understanding of patient experience is the differentiation between the terms satisfaction, experience and engagement. Often used interchangeably by healthcare professionals, Figure 2 offers a simplified explanation of the terms, based on evidence-based materials shared by AHRQ.

Experience refers to “whether something that should happen in a healthcare setting (such as clear communication with a provider) actually happened or how often it happened.”

Satisfaction, on the other hand, is about whether a patient’s expectations about a health encounter were met. Two people who receive the exact same care, but who have different expectations for how that care is supposed to be delivered, can give different satisfaction ratings because of their different expectations.”

Engagement refers to “the inclusion of patients and family members as active members of the healthcare team and collaborative partnerships with providers and provider organizations.”

The reciprocal relationship between these elements can support better health outcomes, which often translate to lower costs in a value-based arrangement.

Leveraging experience to drive authentic value

The reciprocal relationship between experience, satisfaction and engagement influences our ability to deliver authentic value. Many studies have delved into patient experience improvement efforts, aiming to focus on what matters most to patients. (Visit The Journal of Patient Experience for free access to hundreds of evidence-based articles.)

A recent VBC framework published in Academic Medicine outlined the importance of understanding the shared health needs of patients as a core strategic element. We can then advance solutions to drive and measure health outcomes, to integrate teams and to expand partnerships.

The authors advocate for a shift beyond a focus on cost or experience to instead prioritize individuals’ needs, such as capability, comfort and calm.

Capability refers to patients' ability to perform activities that define them as individuals, tracked through functional measures.

Comfort encompasses relief from physical and emotional suffering, including reducing pain and addressing anxiety and distress associated with illness.

Calm involves the ability to live normally while receiving care, free from the chaos often present in the healthcare system, particularly important for those with chronic conditions.

Improving patient experience has a wide range of aligned benefits across various aspects of health and care, including advantages for patients, clinical teams and systems (Figure 3).

Benefits for patients

Enhanced trust and partnership. When patient experience is prioritized, patients are more likely to feel valued and respected, leading to greater satisfaction and engagement with their care. This can foster trust between patients and healthcare providers, making patients more likely to follow medical advice and maintain a long-term relationship with their providers.

Improved health outcomes. Positive patient experiences often correlate with better health outcomes. For example, patients who feel their concerns are heard and addressed are more likely to follow through with treatment plans, attend follow-up appointments and engage in preventive care, all of which contribute to better health.

Reduced anxiety and stress. A supportive and responsive healthcare environment can significantly reduce the anxiety and stress that patients may feel, especially in situations involving serious or chronic conditions. This can improve overall well-being and contribute to faster recovery times.

Benefits for clinical teams

Increased engagement. Healthcare providers who work in environments that emphasize patient experience often report better satisfaction and engagement in their work.

Improved communication and relationships. Focusing on patient experience can lead to better communication between providers and patients. This enhances the patient-provider relationship, making it easier to discuss treatment options, share concerns and collaborate on care plans.

Increased well-being. By creating a more positive and supportive environment, improvements in patient experience can support greater well-being among healthcare providers. When providers see the positive effects of their efforts on patient outcomes, it can reaffirm their sense of purpose and commitment to their profession.

Benefits for healthcare systems

Enhanced reputation and competitiveness. Healthcare systems that prioritize patient experience often gain a strong reputation for quality care, which can attract more patients and skilled healthcare professionals. This enhances the system's competitiveness in the healthcare market.

Increased retention and growth. Engaged patients are more likely to return to the same healthcare system for future needs, increasing patient retention. They are also more likely to recommend the system to others, driving patient loyalty and new patient acquisition.

Better financial performance. Improved patient experience can lead to better financial performance for healthcare systems. Engaged patients are more likely to use additional services, comply with treatment regimens and avoid unnecessary hospital readmissions, all of which can reduce costs and increase revenue.

Regulatory and accreditation. Many healthcare systems are now evaluated based on patient experience metrics as part of regulatory requirements and accreditation processes. By improving patient experience, healthcare systems can more easily meet these standards and secure necessary certifications.

When we determine value with patients – not for them – efforts focus more on achieving meaningful outcomes. For healthcare organizations, this means consistently delivering on the promise to help patients reach their health goals, which builds trust, engagement and loyalty.

This approach requires organizations to continuously improve and design experiences that create high-value interactions. By doing so, organizations can foster authentic relationships and unlock new potential for achieving health outcomes.

Measuring authentic value

Patient-reported outcome measures (PROMs) are tools used to capture patients' perspectives on their health status, including symptoms, functional status and quality of life.

Patient-reported experience measures (PREMs), on the other hand, focus on patients' experiences with healthcare services, such as communication with providers, wait times and overall satisfaction with care.

A recent article on “Driving Value Through Standardized Measurement of Patient Reported Outcomes,” outlined the domains of outcomes and experience measures. PROMs often assess physical, social, emotional and cognitive function, as well as domains health literacy, side effects and adherence. PREMs often assess treatment, technology and communication experiences, as well as satisfaction and engagement.

Integrating PROMs and PREMs into clinical workflows is essential to streamline the process and minimize the burden on both patients and care teams. By embedding these measures seamlessly into routine care, consistent and reliable data collection can be ensured without adding extra steps for anyone involved. This approach not only enhances the quality of care but also fosters a more efficient and patient-centered healthcare system.

Taking steps to drive authentic value

Inspired by the strategic framework of Teisberg and colleagues, here are some initial steps toward a strategy for authentic value.

Adopt a human-centered culture by prioritizing individual health needs and goals. This approachprioritizes patient needs and preferences, while also supporting those who provide care at all levels. In their 2020 strategic framework, Teisberg and colleagues outline the need to organize healthcare around patient segments with similar needs, enabling more coordinated and efficient care. By understanding and grouping patients with common health issues, providers can tailor services to meet specific needs more effectively. A commitment to a human-centered culture must ensure ongoing training for healthcare providers on the importance of patient experience and health outcomes, and strategies to improve.

Develop an integrated data strategy and utilization plan. This can be accomplished by regularly gathering and analyzing measures, using insights to drive continuous improvement. The strategic framework by Teisberg and colleagues also emphasizes the importance of tracking health results and costs for each patient. By measuring these outcomes, healthcare providers can align care with health improvement goals and identify areas to achieve efficiency gains. This data-driven approach ensures that resources are used effectively to improve patient health. Ideally, technology enables the integration of data into electronic health records and patient portals as practical and efficient tools that impact experiences and outcomes.

Leverage technology innovations as strategic tools. For example, artificial intelligence can analyze large amounts of data to offer personalized treatment plans, leading to better patient results. It also can predict patient needs and potential health issues, enabling healthcare providers to act proactively and prevent complications. Additionally, artificial intelligence enhances communication through tools like telehealth and chatbots, making it easier for patients to access care and communicate with their providers. This leads to better overall patient experience. In addition, artificial intelligence has the potential to improve operational efficiency by streamlining administrative tasks, which reduces wait times and makes healthcare delivery more efficient.

While concerns around cost remain central to sustainability and healthcare reform, an authentic value-based model represents a human-centered approach by intentionally designing care experiences that strengthen engagement and achieve mutual benefits and outcomes.

Laura Cooley, PhD, is editor-in-chief of the Journal of Patient Experience, in which she advocates for improved health and experience outcomes through evidence-based research and practice. Rachel Biblow is a healthcare executive who relentlessly pursues better health, experience and business outcomes.

Meet the authors at The Patient Experience Symposium in Boston September 16 to 18.

Return to Open Door Policy: Bringing Patients Into Healthcare Decisions - August/September 2024 COVERstory.

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