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May 16, 2019

There’s a great video of Steve Jobs responding to an audience question that is, at a minimum, let’s just say strident. Jobs kind of ignores the aggressive nature of the query and offers a thoughtful response which is super relevant to health care. He says, “One of the things I’ve always found is that you’ve got to start with the customer experience and work backwards to the technology. You can’t start with the technology and try to figure out where you’re going to try to sell it.”

I don’t know about you, but I find this quote over-the-top relevant in health care. In health care, when we contemplate changing the workflow or integrating some technology or building some technology or whatever else we’re up to, how many times are we starting from the perspective of the patient or member? How often is the patient the “why” behind “why are we prioritizing this?”

So many have echoed this pretty much exact same message, including Joe Selby, MD, MPH, in EP225. Dr. Selby heads up PCORI, and they have validated studies showing that patient-centered care is more cost effective and has better outcomes than care that isn’t. Roy Rosin, who leads innovation at the University of Pennsylvania Medicine, put it succinctly in EP139: “Love the problem, not the solution. “Another quote I’ve heard from someone who would know is, “Companies with the business processes and practices in place to match the preferences of each individual customer will have the best chance of succeeding.”

I wonder, in the health care industry, how many meetings go on about what patients want with no patients in the meetings and no real consideration to that end. As a data point, probably twice a week I hear of a new program, product, service, device, digital something or other that has zero or only a few patients using it because only after development did anyone check with patients what they think about the thing. And then sometimes the patient gets blamed and labeled nonadherent to something they didn’t want in the first place.

Probably listeners to this particular podcast are sensitive to this issue and working within your organizations to alter this counterproductive lack of real patient experience contemplation. So let me introduce my guest today, Julie Rish. Julie is director of best practice in the office of patient experience at the Cleveland Clinic. And Julie definitely has some best practices to share about how to level up patient experience and include patient points of view. I don’t need to tell you that the Cleveland Clinic is well known to achieve some of the highest patient experience scores around, so I, for one, hung on her every word.

I met Julie, by the way, at the PanAgora CX conference this past March.

You can connect with Julie on Twitter at @julie_rish.



Julie Rish, PhD, is a clinical psychologist for the Bariatric and Metabolic Institute at the Cleveland Clinic. She graduated from Loma Linda University and completed her training at Henry Ford Health Sciences Center and the Cleveland Clinic. Presently, she is working in pre-surgical evaluation, pre- and post-surgical treatment, and clinical research in bariatric surgery. Her research interests include treatment outcomes, health behavior change, and women’s health. Currently, she is conducting collaborative research on pelvic floor disorders, binge eating intervention outcomes, the impact of past suicide attempts on bariatric outcome, and treatment outcomes in a bariatric population.

03:37 Shared decision making and why it matters.
04:58 Collaboratively coming up with a plan—how “shared decision making” might not be the best terminology.
05:43 “Because that’s who we are.”
07:12 Affecting culture and making change no matter what that culture is.
07:57 “Let’s just get to the source.”
10:38 The types of programs that the Cleveland Clinic partners with patients on.
11:10 The moment the Cleveland Clinic realized patients needed to be more involved.
13:16 How documenting the patient experience changes the patient experience.
18:40 Treating the medical bill as patient education.
21:05 What does being patient-centric actually look and feel like?
21:58 Where the Cleveland Clinic is gathering its metrics and data from.
23:49 “If I can’t communicate with you, there is a risk to the quality and the safety and the experience of this.”
26:10 “Sometimes it’s just about perception.”
27:32 How providing exceptional care is how the Cleveland Clinic draws in patients.
30:35 “What are the different lenses that we’re seeing this through?”

You can connect with Julie on Twitter at @julie_rish.

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Why you should treat the #medicalbill like an opportunity for #patienteducation. @julie_rish of @ClevelandClinic explains. #healthcare #hcmkg #digitalhealth #patientcentricity

What does being #patientcentric actually look and feel like? @julie_rish of @ClevelandClinic explains. #healthcare #hcmkg #digitalhealth #patientcentricity

Where should you be gathering #healthdata and #healthmetrics from? @julie_rish of @ClevelandClinic discusses. #healthcare #hcmkg #digitalhealth #patientcentricity

Providing exceptional care to draw in #patients. @julie_rish of @ClevelandClinic discusses. #healthcare #hcmkg #digitalhealth #patientcentricity