Health systems seek out patient feedback to improve telehealth platform


The pressure is on for health systems to create digital experiences patients will enjoy or risk losing out on revenue. In the digital age, consumers have high expectations of what these platforms should be like. “Systems are no longer just competing with other health systems in their region, they are competing with the experiences people have in their daily lives from other brands—that is the bar,” Kalis said. “When those experiences are cumbersome, that can lead to choosing one provider over another … and in the most extreme case, even switching providers.”

Telehealth’s increased popularity has prompted Stanford Health Care to totally rethink how it is assessing patients’ experience with the platform. The California system now does about 62,000 telehealth visits a month, up from about a 1,000 a month before COVID-19.

Now that volumes have stabilized and are staying strong, Alpa Vyas, vice president for patient experience at Stanford, said leadership saw an opportunity to reflect on lessons learned during the growth period and ways to improve patient experience.

Stanford asked more than 50 patients and some physicians who have experienced video visits for feedback on what didn’t work and what types of questions should be included on a telehealth survey. The result is a new survey that is more flexible and specific to the Stanford experience, said Mysti Smith-Bentley, executive director for service excellence at Stanford.

The previous survey was static and limited how much valuable intel it was gathering, she said, because questions weren’t changed frequently and weren’t specific to Stanford.

The new survey, launched at the end of June, asks about pre-visit scheduling and instructions; connecting to the visit; wait times; visual and audio communication with the provider; and post-visit planning. There is also a section for patients to provide comments about the visit overall and the provider.

Smith-Bentley said Stanford plans to remove items when it appears an issue has been addressed and then add new items with more recent concerns.

“Even now if we see that 95% to 99% of patients tell us something isn’t a problem, we should ask something that is more relevant so we can continue to improve,” she said.

The survey’s response rate is about 25%, which is higher than for Stanford’s inpatient surveys. The survey shows up in the patient portal immediately after the physician ends the visit.

An early insight so far from the survey is that the effectiveness of physician communication determines how patients perceive the overall visit. Smith-Bentley said if patients don’t give the question regarding physician communication a high score, the overall rating of the visit drops by 30%.

“People value the (relationship with their provider) immensely, regardless of how they interact with them,” Vyas said.

In response to this finding, Stanford will begin training providers in communication skills during telehealth visits. The system is developing the content now, with the training available in early 2021.

“We are digging into a lot of the data but that was one early insight that we are taking action on immediately,” Smith-Bentley said.

Health system digital leaders say the ability to get data from the patient experience surveys immediately is key to improving telehealth platforms.

Since COVID-19, North Carolina-based Novant Health has added icons to its patient portal indicating if a visit will be done over video, phone or in-person, in response to feedback from patients in surveys that they were confused about what kind of visit they were having. Additionally, Novant has changed instructions on how to access virtual visits, creating detailed step-by-step guides as well as videos on its website demonstrating how they’re done.

“All (the changes) came from patient feedback,” said Dr. Hank Capps, Novant’s chief digital health and engagement officer.

The real-time feedback is possible because Novant has created its own survey, Capps added.

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