The Exec: Technology in Patient Engagement Is a Strategy, Not a Crutch

Rick Evans, senior VP and chief experience officer at NewYork-Presbyterian, says patient engagement and activation are crucial to health systems, and that executives need to focus on confidence rather than complacency.

No member of the healthcare C-suite has been affected more by the shift to consumer-directed care than the chief experience officer, sometimes called the chief patient experience officer.

This role was once defined as one of service excellence, and the executive was responsible for ensuring that the healthcare organization was delivering top-notch service, according to standards established by the health system. But with the rise of patient-centered care, that role has shifted radically around to focus on the delivery of care and services that meet the patient's expectations.

"We now ask ourselves if we're inspiring confidence," says Rick Evans, MA, senior vice president and chief experience officer at NewYork-Presbyterian. "Not happiness, but confidence. And with that, are we providing convenience?"

Rick Evans, senior vice president and chief experience officer, NewYork-Presbyterian. Photo courtesy NewYork-Presbyterian.

Evans has spent seven years as the CXO at NYP, but his 20-plus-year career has always been focused on how the patient interacts with the health system. He spent seven years earlier in his career as vice president of support services and patient-centered care with NYP, then moved up the I-95 corridor to Boston to spend four years as CXO at Massachusetts General Hospital before returning to the Big Apple.

To Evans, the CXO position is now all about technology and communication, though he's quick to add that it's not a technology position. His responsibilities focus on creating an overarching strategy to engage with the patient, and to work with other members of the C-suite to "facilitate good, consistent, clear, and compassionate communication" with patients.

Technology plays a large part in that strategy, and telehealth and digital health have helped to transform that platform into a real-time communication tool. Whereas patient interactions were once measured by phone calls and printed questionnaires, healthcare organizations now have at their disposal a wide range of tools to engage and evaluate ongoing relationships. This includes online surveys, messaging platforms, and other resources that allow the patient to interact on their own schedule.

"We also have a lot more data that can help us make [communications] more meaningful and move the needle [on quality of care]," Evans says.

Patient engagement, as well as the fast-rising concept of patient activation, are measured most often in HCAHPS scores, which come out of the federal HCAHPS Hospital Survey. But while that survey enables a health system to measure itself against other health systems, the precision of digital health tools enables health system executives to drill down and determine what that hospital or network is doing right and wrong in communicating with patients and meeting their needs.

"We want to ask those questions that our patients are uniquely qualified to answer," Evans points out. That, in turn, will go a long way toward creating programs and services that attract and keep patients.

"That messaging is important," he adds. "We're always looking to create that meaningful connection to give [patients] the services they need. You're not in a hotel or Disney World. You're in a hospital."

Patient engagement efforts require a healthcare executive to look both outside the health system and within. Workforce shortages can affect services, which in turn can affect the patient's healthcare experience. Staff stress and burnout can affect morale, which in turn affects the workplace, which in turn can affect what a patient experiences in that environment.

"You can not succeed as a chief experience officer if you do not understand the workflows," Evans says. "Without them we're just blowing into the wind."

And while the pandemic exacerbated those staffing issues, it also highlighted the opportunities of using telehealth to both address workforce gaps and improve access to care for patients. The ability to offer virtual care alongside in-person care, either as a supplement or a replacement, helps patients who face access challenges and who also want more convenience. By giving patients more ways of accessing care, they'll be more inclined to continue their healthcare journey with the health system.

"You're always thinking about sustainability in the patient experience," Evans says.

That said, there's always a chance that a health system will go too far in its attempts to connect with patients. Just because the technology is there to reach out to patients in real time doesn't mean it has to be used that way. CXOs need to map out a strategy that takes into account which communication channel a patient prefers, as well as how often a patient might wish to be contacted and when.

"How do we not get creepy?" Evans asks.

The goal, he says, is to position the health system as a trusted resource, one in which a patient has confidence. Hospitals—and their CXOs—must know when to reach out and how to connect, and offer resources that meet patient needs and expectations.