‍Ilona: Hello, in today's episode we continue the topic of patient experience. So if this is something that interests you, I invite you to listen to this episode. And our hospitality will be Adriana Przechlowska, which has been working for many years PX design, or patient experience. I invite you.

‍

Hello!

‍

Adriana: Hello, Ilona.

‍

‍

PX — what is patient experience design?

‍

Ilona: In preparation for our conversation, we mentioned that designing patient experiences, as well as Designing for patients is a relatively young field. I mean not only Poland, but also the whole world.

‍

This is not something we have been doing as UX designers or experience designers for a long time. This is a young field, so I would like us to start our conversation with a definition. We want our listeners and viewers to understand What exactly is CX or UX design for patients.

‍

Adriana: From the perspective of the organization, it is simply to plan all the events that to take place or to be avoided at the individual points of contact. They should be repeatable and measurable. Whether we are talking about PX or CX, the assumption is similar.

‍

From the point of view of the patient or client, this is not the sum of all experiences, but rather the difference. The client or patient has his or her Assumptions, Imaginations and Expectations, and the purchase of a service or product is simply their verification. Then the question arises whether the result is positive or negative.

‍

Ilona: A beautiful definition of experience — It's all about emotions.

‍

Adriana: Exactly, It's about emotions and an individual perspective.. This, of course, is difficult to understand from a business point of view. If you don't set it up well and explain it, it's hard to talk about it.

‍

How to deliver these emotions? It is formed special platforms, entire processes and standards. It's about what's going to happen and what's not, and each of these planned actions is supposed to create a specific impression.

‍

‍

Effortless — the most important thing for patients

‍

Later, this impression is of course measured, for example by a satisfaction survey. However, I think that in the case of patient experience we should talk more about effortless.

‍

While in the case of clients we can talk about satisfaction, the patient often avoids the experience, does not want this service, often has no choice, cannot give up. Therefore, we should focus more on Ease of collaboration.

‍

Ilona: I would put it in such a formulation — to help, not to disturb.

‍

Adriana: Exactly.

‍

IlonaPatient experience is to help, not to disturb.

‍

Adriana: How we feel bad, and the patient is rather in a reduced psychophysical condition I don't need any additional incentives.

‍

Ilona: I have a story about it. I don't know if I was telling you this when we were talking...

‍

AdrianaYou told a story, yes.

‍

Ilona: How did I call the doctor, how did I have a fever?

‍

Adriana: This is precisely this effortlessness, you just wanted to settle your case as soon as possible and did not have the strength for additional questions, explanations, going through the app, yelling, choices, and so dalej.

‍

There are no more resources for this authentically, so when we think about the patient's experience, effortless is the basis, which also translates into quality.

‍

‍

Patient satisfaction

‍

Ilona: Yes, that is very accurate, what you say. And what we also told ourselves before is that this field is young and there are no established rules yet. It's not even about the rules, because these user experience or customer experience principles exist, but they apply to other industries.

‍

Here our persona is very precise, we have a lot of different personas for whom we design. I would say no persona, this environment is very narrow. It's about medical products and services, that is, something related to health. Of course, there is a section of aesthetic medicine where we want to improve something, feel better...

‍

Adriana: This is all the more the customer.

‍

Ilona: Then we can talk about satisfaction, that would be a good word. But when we are dealing with a disease entity, it is actually better to say that someone is satisfied.

‍

Although this word is quite capacious - my case was just taken care of and I did not have unnecessary nerves. So helping not to disturb us is what sums up this definition of patient experience.

‍

‍

Patient experience in Poland vs USA/UK

‍

Ilona: We also talked about the differences in approach between the Polish market and the foreign market. You were educated abroad, so I would like you to share your perspective on what patient experience looks like in the UK, the USA, and in our country.

‍

Adriana: We are on the right track, a lot has already happened. It is controversial because it was created. the law on quality in health care, which pays attention to the satisfaction and quality of patient service. It takes time.

‍

In the United States, patient satisfaction has been measured since the mid-1990s. These were the beginnings, and in the UK even longer. They had just 25 years to test, correct. They know exactly what they are measuring.

‍

There are more than 300 indicators in the United States, so they go into it in great detail. The main difference, comparing these two markets (UK and US) to ours, is linking patient satisfaction with the financing of facilities and products.

‍

Ilona: A very interesting measure.

‍

Adriana: In the States, for example, applications that deal with managing their well-being in the case of people with ADHD, are prescribed by prescription. This applies not only to the measurement of satisfaction in hospitals, although there is a lot of emphasis on it, but also for digital products.

‍

Therefore, managers really attach great importance to patient satisfaction and everyone is working on it. For us, it will probably take a while before a similar approach develops. In addition to the fact that satisfaction is linked to financing...

‍

Ilona: With the financing of the facility, right?

‍

Adriana: Yes, but also with a refund for example of an application.

‍

Ilona: I like what you say, because health, despite the fact that we sell it as a service, should not be measured only by conversion, that is How much do we earn per patient?. This could lead to a pathology in which, instead of curing the patient, we would treat him longer.

‍

Meanwhile, if the measure of success is patient satisfaction, not how much they spend with us and how many times they return, it completely changes our point of view and we focus on what really matters — improving the health and well-being of patients. All these products or apps are supposed to improve our well-being and improve our quality of life

‍

Adriana: This is also measured. Ta quality of life after using the service whether the product is also counted. therefore, how quickly we recover, how quickly we return to the labor market, how quickly we return to sports activities - all these are indicators of whether a given product or service actually worked.

‍

Ilona: Yes, and you say that in Poland we are at this stage, we count the returnability, as in the online store?

‍

‍

Patient Loyalty

‍

Adriana: We measure loyalty. I don't like the phrase “loyalty.” And in general, patient loyalty sounds strange, because the goal should be to cure the patient and the commands, that is, opinions that we share. but We are more focused on loyalty.

‍

Ilona: But in beautiful words we talk about it...

‍

Adriana: Well, yes, but that's just the way it is. Well, we measure this NPS and later we look at whether he recommended, and if he came back, yes. But there is another dimension that differentiates us from the West. Namely, there these results are published.

‍

Facilities and product owners are required to publish satisfaction scores on a regular basis, which means that Products and services are becoming more transparent. They are measured in the same way, and the tests are repeated at the same time, which gives an obvious benefit to the patient, because he has the opportunity to compare services and products in the medical market.

‍

It is very difficult because Patients often do not have the right knowledge. There are also various alt-med-style distortions that do not facilitate the factual and substantive approach to the comparison of services, and therefore at a time when...

‍

‍

What is alt-med?

‍

Ilona: Can you explain what is alt-med?

‍

Adriana: These are all alternative approaches to treatment, that is, those that are not based on scientific research.

‍

Ilona: Conventional versus, say, alternative medicine?

‍

Adriana: Yes, only “alt-med” is a rather pejorative term. At the moment when state and government institutions have their hands on it — and in the United States we have an FDA institution that guarantees the correctness of the operation, the legality of the research, etc. — it gives the patient an advantage because he can make the best choice about the product or service based on reliable information.

‍

Ilona: On our current state of knowledge, because it is known that medicine is evolving. We discover new things, we learn new things. Recommendations may vary, but for the moment the patient is able to make the best decision for himself, thanks to these tools.

‍

‍

Patient satisfaction surveys in Poland

‍

Adriana: Yes, it has tools. We are slowly moving in that direction. Such studies are conducted. presently in Poland there is an organization Center for Measures and Quality, which this year has already examined about 100,000 patients in a standardized, repeatable way.

‍

About 250 hospitals have joined this study, so you can already compare something. They study there communication, nutrition, organization, nursing care, pain management, well, and there are many of these indicators that can be compared one to one within these 250 hospitals.

‍

So if you are looking for some kind of treatment, then this is a good source to say: “OK, however, I will not use the treatments in Warsaw, only in Wroclaw”.

‍

‍

Experience Design

patient online and offline

‍

Ilona: Great, the very good thing is that we are starting to do this, we start measuring and giving patients tools, and in a way also Power and Decision-Making concerning their state of health.

‍

In our conversation, you mentioned something else that I really liked and I wanted to come back to it. You used the term that the patient's experience is such a “two-headed dragon”, which I liked terribly.

‍

And we were talking about the fact that what happens online is just as important as what happens offline. Now you told me about the second aspect of this two-headed dragon.

‍

Adriana: Well, because to deliver a good experience, we need both management, administrative and medical staff. All this needs to be connected, because these groups can have different interests, and they often do. So this is a long and painstaking job, so strategic.

‍

We need to figure out what we're going to do, What experiences do we want to provide, at which point of contact, and what experiences we want to avoid. And in the end we have a patient who expects something to happen to him or something not to happen to him. And he decides if this is the difference or if it is the sum of his experiences.

‍

Ilona: When you think about this patient experience — offline, online, at the facility, at home — it's not about the patient spending time on the app and having fun, like on Instagram. The point is, to get his case done quickly.

‍

‍

Problems on the way to a good PX

‍

Ilona: I wonder what pitfalls might lie in the design of the patient experience if we forget all this context — offline, online, in hospital, in the facility, at home. What can go wrong?

‍

Adriana: As the classic used to say, everything can go wrong. At the beginning, I think the basis, which we also talked about at our last meeting, is that health care, no matter what channel or tool, based on safety and quality.

‍

Now, depending on who is talking about safety and quality, these will be slightly different definitions. The doctor will define it differently, because his duty is providing the best possible service and assistance to the patient, but he also bears legal responsibility for his actions.

‍

In the case of non-medical staff, they also work for safety and quality, because this is where it comes into play management of documentation, information flow, queuing patients and making sure everything works, making things happen.

‍

From the point of view of the patient, it is simply about his health and good functioning, so he will judge it rather emotionally, because not substantively - he is not a doctor and does not have such knowledge. The more difficult his condition will be, the more emotions will appear.

‍

The key is probably to define at the beginning what quality we want to deliver, keeping in mind the very the broad context of the person we are talking about. Because it will not only be doctors, nurses, the facility and the environment or the product, but also, for example, caregivers.

‍

Or when the patient is the child and the decision maker is the parent, then we have not one persona, but two basic personas — the child and the parent, and we have to meet slightly different expectations. We need at the beginning perform very reliable research workto understand these needs.

‍

‍

Optimizing the patient path — research

‍

Ilona: What pitfalls await us in this first research step?

‍

Adriana: Failure to recognize psychological needs, that is, what the child's service should look like in the presence of a caregiver. It is possible to focus exclusively on the caregiver and leave the child emotionally unattended, not to take care of comfort, good emotions and cooperation.

‍

It can also be the other way around: the guardian can be omitted, which often happens with elderly patients, seniors who enter the office or use services for which they need an accompanying person.

‍

You can simply forget the needs of one of the parties, and then complications begin. You can create the most beautiful interface that can be simple to use, but...

‍

Ilona: Even the experience in the institution itself, because it is also interesting if we have these two people and we know that there is a person who comes with a guardian — The question of age is not important here.

‍

We know then that we have two actors who come to the reception or fill out the paperwork. We must take into account that They are two people, not one. This can be neglected in both the digital product and the digital service.

‍

Adriana: Yes, because digital skills are also at stake. One “actor,” as you nicely called it, will be fluent in digital devicesand for the other it will be natural. The other may have vision problems and will not be able to use the application smoothly. They may also have difficulty filling out forms if the print is too small.

‍

Ilona: Without the possibility of magnification. And this is a simple thing...

‍

Adriana: All these things are simple. Only the worst is to make a mistake in assumptions, precisely in this person. If we do not take care of all the details at the beginning, then it will be difficult to fix it later. Of course, it is known that it is probably impossible to take care of everything at once, but in subsequent iterations, this can be improved.

‍

Honest work at the beginning is crucial. The point is that Put yourself in the patient's shoes, as they say in PX or UX. Sometimes the eyes open wide when it turns out what we have forgotten, and it is so obvious. Like the enlargement of the text you just said.

‍

‍

Wrong assumptions — case study

‍

Ilona: Yes, an interesting story comes to mind that our PM Dorota told us some time ago. She was hospitalized with a shoulder injury and told about her experience. There were televisions, for which it was necessary pay with Blik.

Many people who were not familiar with this technology did not even know what BLIK was, so they did not have the opportunity to pass the time by watching TV. They had to look for younger peoplethat could help them handle it.

‍

It's interesting how designers may have thought this was a brilliant idea. Sitting in the workshop room, they thought: “Let's give them the opportunity to pay with BLIK, it will be effortless!”. It turns out that this is practically impossible to do because of this Digital Barrier.

‍

Adriana: It's good shows the difference between patient and client. In the case of organizations that offer universal, non-health-related products, you can say, “We cut off those who do not support BLIK”, because it is known that we are moving forward with technology and consumer groups are changing.

‍

Ilona: Paying bills is a cool example. Everyone has to do this, and yet these ways are different. All the time, holding on to this Analogies to the method of payment, someone will pay with BLIK, and someone will go to the post office and fill out a form.

‍

Adriana: Exactly, these two possibilities should be available. In this case, we are dealing with patients, not customers. Their first need is not to watch TV, but it can significantly improve the quality of their stay in the hospital.

Again, we return to quality: it seems that a banal step affects the assessment of the quality of care. Does the possibility of paying with BLIK for television affect the doctor's assessment of the quality of treatment?

‍

Ilona: Or cure the patient... Totally does not affect. But for this How will I feel in this hospital, it affects a lot. And it also affects whether if I get another referral, I will gladly go to the hospital.

‍

Of course, no one is likely to go willingly, but will I at least have the conviction that it is okay, or will I think again about that unpleasant experience that happened to me last time?

‍

Adriana: This is exclusion quite simply. It would seem trivial, however, if we thought about it more deeply. It is simply an exclusion.. It also takes into account how our society looks. And it is known that we get sick with age, so there are rather more elderly people in the hospital than younger ones.

‍

‍

What is the patient willing to pay for?

‍

Ilona: Okay, back to my question about the pitfalls that lie in wait for us, designers, in terms of CX, or customer experience, and UX, that is, user experience.

We discussed the problems at the very beginning, wrong assumptions, which we have, and problems related to the recipient, that is, with a person who is not fully defined. The next is research problems — often lack of research or recognition of the environment. What else can come up?

‍

Adriana: A study by Deloitte in 2023 comes to mind. It was not strictly about health care, but covered all industries. Deloitte also asked in Poland, what experiences customers were willing to pay for in 2023.

‍

Poles unanimously stated that they were paying for it to be easy, fast and comfortable. That's why they open their wallets. On the other hand, they do not like it when their complaints, complaints or attempts to contact you are difficult. This is extremely irritating to us.

‍

I think it fits in well with health care as well. Patient care does not end at the time of the visit or the application — it continues. Bad the final impression can erase all positive experiencesthat have happened before.

‍

The loss of such a patient is already irreparable, so you need to think about these “tips”, about what happens after visits, after using the service or purchasing a product. The final impression is very important.

‍

Ilona: Okay, so the pitfalls lie in wait for us practically along the entire path of patient experience planning. If I were to draw a conclusion from what you said, then the owners of medical services or medical products must very well reflect on assumptions.

‍

They also need to be aware at all times, somewhere in the back of their heads, of the problems and challenges that our personas, that is, people who use our products, face.

‍

‍

Unique value for the patient — case study

‍

Adriana: I can tell you about my case. I will not mention the name of the company, but one of the companies with a very modern approach to health care that I had an account with, for a while She invited me for a diagnosis., reminded me of her, which I liked a lot.

‍

I don't know why, but at some point the company stopped doing it and I have to say that I feel the profession. For me, it was a relief to have someone remember that I should perform once in a while diagnostic tests for their own safety and prevention. It seems like nothing big happened, but the contact broke down and I regret it very much.

‍

Ilona: Okay. From a business perspective, the company She had a unique value proposition.And, something that set her apart. I don't know why, they stopped doing it. It probably seems to them that no one noticed, and you now have a sense of profession in some way.

‍

Adriana: I simply miss these values.

‍

‍

Patient Expectations in Healthcare

‍

Ilona: You are missing something that was important.

‍

And tell me more about the patients themselves. If we could focus on their expectations. We talked a little bit about mapping the path, about what could go wrong, but What are the expectations of patients? What are they ready for and what are they not ready for in health care?

‍

Adriana: Expectations for health care are fairly consistent. There have been many reports on the subject, starting in 2019 and regardless of the age group, the expectations coincide: easy access to services, short queues, easy contact, reliable, professional, substantive doctor, fast pace of recovery.

‍

Differences arise when we talk about speed of implementation and tolerance for errorsthat a product or medical facility commits. This is a characteristic common to many industries: the younger we are, the less we forgive and the more strict we are in our evaluations. The more we pay for services, the greater our requirements.

‍

Baby Boomers Are the Most Forgiving, and the lower we descend in age, the less there is forgiveness and patience. Younger generations also have high expectations about explaining what will happen next. We don't like to be surprised, we want predictability. This is due to the pace of life, the amount of duties, the planning of the working day or study.

‍

Surprising us, lack of information, lack of contact and unpredictability affect quality. Therefore, planning communication at every step is crucial.

‍

Of course, you can't overwhelm the patient with an excessive amount of messages, but predictability is very important, because it consists of a sense of quality. If we know what will happen or know the reasons why something will not happen, we are more likely to forgive it.

‍

‍

Chatbot as a doctor

‍

Ilona: And are there any elements or parts of medical services that we are not ready for to be digitized, or maybe we want them to be implemented in a traditional way? Do you see such a thing among patients?

‍

Adriana: I think the opposite is true. As a nation We love technological innovations and we adapt them very quickly, faster than our European neighbors. Proof of this is the last case...

‍

I will not mention the name of this website, because it is difficult to determine who owns it and who created it. From a technical point of view, however, it looked like pulling medical data.

‍

Ilona: What was this site all about?

‍

Adriana: On the fact that you buy a subscription. There were several subscription plans available. You log in to the platform, upload your medical records: extracts, research results, opinions, literally everything you have about yourself.

The platform in theory should give you a diagnosis, give a description of what to do next, recommend treatment, etc. The problem was that there was no doctor or medical specialist on the other side. It was just a chatbot.

‍

Ilona: ChatGPT was our doctor.

‍

Adriana: Yes, but this ChatGPT, is not yet at the stage to be able to perform such tasks. Moreover, diagnoses should always be Permeated through the eye of a doctor. Interestingly, people liked this solution because it was simple and effortless.

‍

It was enough to pay 50 zł, maybe 70 zł for a higher plan, load the data and get a quick response. However, it was clearly stated in the regulations that the portal does not take responsibility for anything.

‍

‍

Do Poles like technical innovations?

‍

This was not medical advice, and the feedback was in no way binding. Nevertheless, it can be seen that people like novelties. We like to chat with chat bots. We even agree to talk to this bot instead of, for example, the doctor, as long as he was controlled and substantive. We have a lot of openness, I would say, to risk.

‍

Ilona: This is very interesting, because I recently talked to people designing chatbots who said that we have Overwhelming conversations with machines. When I call the hotline, I often talk to a machine that does not understand what I am saying.

‍

It boils down to what you said earlier — lack of patience and a low threshold for forgiveness of mistakes. If the chatbot makes a mistake several times and I have to repeat because he does not understand my case, then I can actually get discouraged quickly.

‍

On the one hand, we want fast service, even at night, but on the other hand we get annoyed when the bot does not give a good diagnosis or answer.

‍

‍

Give the patient a choice

‍

Adriana: If we talk about the same research and experiences, I associate that we like chatbots, as long as we have the option to choose. When I get tired of talking to a bot or when he writes nonsense, I want to be able to switch to a conversation with a human. In general, as long as the chatbot works well, it is fine.

‍

Ilona: It's nice to loop around, referring to the psychology that connects with UX. Similarly, taxi ordering apps work. We do not care so much whether the taxi will arrive in a minute, in five or ten. It is more important that we know exactly when it will arrive.

‍

Predictability is key. There are certain UX principles that stem from psychology and help us design good patient experiences, or more broadly, user experiences. Knowing these principles and being able to use them, we can minimize errors and better respond to the patient's expectations.

‍

‍

Quality and safety at PX

‍

Adriana: Or fall for good leads.

‍

Ilona: What does this mean for you?

‍

Adriana: That means asking the right questions. Sometimes a well-asked question can completely change the direction of our actions and make it worthwhile to explore other aspects, add something or omit something. This is the research — well asked questions and a solid foundation on which we want to build later.

‍

Ilona: You said something interesting that stuck in my head, that regardless of who we address a product to in our medical industry — whether it's medical staff, patients, or administration — there is a common part related to Quality and safety.

‍

I wonder how these different groups understand quality and safety. What such a product for doctors and medical personnel must contain for me as, say, a nurse, registrar or registrar, felt safe and thought this product was good?

‍

Adriana: The basis is storage and processing of data. When it comes to the common denominator in quality for these three groups, a properly designed interface and processes that minimize the number of activities to be performed are key. This allows you to make the most of the time for contact with the patient.

‍

Visits usually last about 10 minutes, although they often last up to 20 minutes or more, depending on health needs and the need to make a good diagnosis. The software or application that the staff uses plays a huge role here. If the application requires a lot of actions, clicking through and searching for data, then precious time is lost.

‍

I know an example of one of the systems for managing a doctor's office, in which, if you want to go back to the data of a previous visit, you need to log out and log in againbecause such functionality simply does not exist. This will probably be added in future versions, but currently this functionality is not available.

‍

‍

Time to weigh in gold

‍

The common denominator in terms of quality is therefore time. Time is valuable for both the doctor and the patient. The doctor, having more time, can focus on the patient, listen to how the patient says, pay attention to the tone of voice, body language, which is important for making an accurate diagnosis. If the doctor focuses only on the screen, diagnostics can be somewhat depleted.

‍

Ilona: And from the perspective of the patient on the other side?

‍

Adriana: From the patient's perspective, time spent on service and establishing relationships is equally important. Patients are not able to assess the merits. As in other professions, doctors also differ — one is more contactable, the other less.

‍

However, this is not necessarily affects their substantive competence. Technology can help you build a relationship with your doctor because it gives you more time for real contact.

‍

‍

Are Patients Lying — The Future of Medical Databases

‍

Ilona: And tell me how you would relate to the statement that patients lie. This is a strong statement.

‍

Adriana: This is a strong statement. They lie, they confabulate, they don't confess.

‍

Ilona: My point is that a complete and accurate medical history of a patient is difficult to obtain. I used strong wording to say that patients lie, but in reality it is often the case that patients do not admit everything or They don't remember all the details.

‍

When a patient has to repeatedly repeat his medical history with each subsequent doctor, he may simply not remember all the results of examinations or health events. Automatically his medical history becomes incomplete, which provides less information to the doctor and can affect the making of an accurate diagnosis.

‍

Adriana: Yes, maybe one that matches the information he collected.

‍

Ilona: So we lack a central place where all the medical data would be collected, or at least something like an online patient file. But here we come back to the issue of data security that you mentioned, which is again quality and security — the two common, desirable elements in medical products.

‍

I'll go back to the page you mentioned earlier. Theoretically, you could load your medical records there and there could be a function that simply I keep this data, regardless of the diagnosis.

‍

‍

Patient data security

‍

However, the question remains: Who owns this data? Are they safe? Will they not be captured or deleted? What guarantee do I have as a patient that no one will misuse this data? And at the same time, I would like to go to the appointment and not waste the time you were talking about, giving the doctor as much information as possible.

‍

Adriana: Indeed, solid heads are working on this problem, but so far no ideal solution has been found. It is also a matter of regulation at the level of the European Union, since data is not processed only in one country.

‍

After all, people travel, and our insurance works not only in Poland, but also abroad. The exchange of data should therefore cover different countries. It seems to me that at the moment a certain solution is the application IKP, where you can share your medical data: medical history, test results, prescriptions and medications you take, including doses.

‍

You can share this information with your pharmacist, doctor, nurse, midwife, and even family and friends. You decide who you share your data with. This is the current solution, but data security in the GDP is also a concern.

‍

I remember a case a year ago when previous health minister revealed some patient data about the medications taken. That is why the issue of data security is crucial here.

‍

Ilona: Yes, but today we will not solve it and we do not know what the future of the security of our medical data will look like. I wish you and all patients, however, that there will be a central place where data is stored securely, so that we do not have to worry about completing our medical file.

‍

With this somewhat optimistic and forward-looking touch, thank you very much for today's conversation.

‍

Adriana: And I thank you for the invitation. I am very happy that the patient experience is reaching wider waters and starting to talk about it very openly. Thank you very much.

‍