Episode Details

In most other industries, it's the customer who consumes the services and engages with the purveyor of services. In health care, not so much. Legacy health care has evolved to honor the insurance carrier as the customer or, in some cases, the fancy surgeon or other driver of revenue as the customer. Listen to the podcast with Marshall Allen for more on that front, but yeah. And here we are.

Health care should be designed so that patients get the best outcomes at a financially not-toxic price point. Otherwise, what are we doing here besides putting profit over patients?

In this health care podcast, the conversation is about PCVS, otherwise known as creating a "patient-centered value system," otherwise known as building a new OS, or operating system, for health care—one that is built around the patient and their experience. The general idea here is to rationalize the patient journey from start to finish: to create a longitudinal flow that guides a patient from here to where they need to be with a minimum of being told you need a follow-up appointment but having no idea with whom or how that's supposed to happen and when, or getting discharged with no instructions, etc.

So, PCVS … let's talk about this, how this works, real quick before we dive in with Dr. DiGioia. In a nutshell, the first step is to really, really carefully trace the patient journey from beginning—really the very, very beginning of the experience, which might start in the parking lot or with the first digital interaction or at the PCP referral—to the very last interaction, which might be after discharge from the SNF (skilled nursing facility) after their last follow-up appointment. It's figuring out what matters to the patient at each step in that journey and then documenting that flow map.

Then the next step is to compare the current patient journey, the current state, to what the team decides is the ideal patient journey.

Then the last task, which may be obvious, is to implement—for implementation teams to devise and implement action plans to get from here to there.

Here's an interesting point to ponder: We often talk about fragmentation and interoperability, and when I said these words, your brain immediately snapped to technology fragmentation and interoperability. But bear this in mind: The patient is the only commonality between all the settings of care that are using all those varied technologies. When you rationalize the patient journey, you also, to some extent, create the foundation to integrate technology.

Why a PCVS process, you might ask, if you're in charge of the P&L and regard patient centeredness as a nice to have if there's extra cash lying around? Here's why: If you're going to successfully roll out a prospective bundle, for example, to employers, you better have gone through a PCVS process. Other things, too, but being intimately aware of the patient journey and where patients fall through the cracks or get disgruntled can easily spell the difference between bundle success and failure.

This is probably also true for really almost any sort of risk-based/capitation arrangement. It's probably also true for great customer satisfaction scores. It's probably also going to become increasingly true when competing against some of these virtual-first operations that may have been built from the ground up to be sticky and engaging for patients, as well as guide them through a longitudinal journey.

For more on the WIIFM (the "what's in it for me?") if you are a provider organization and are thinking about patient-centered care, listen to one of our most popular episodes over here at Relentless Health Value—the one with Joe Selby, MD, from PCORI—on this topic.

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