Before I studied to become an architect, I was a men’s wear buyer with a department store, and I had a particular affinity for shoes. While my two callings may seem wildly unrelated, there are similarities. You have to be intensely user-focused—able to almost walk in someone else’s shoes—to be successful at either merchandising or architecture, and perhaps no more so than in the design of health care facilities and spaces. In my estimation, the world of health care could learn a thing or two from a great shopping experience. The right teacher: Zappos.
Extreme customer service—delivering happiness— is what Zappos is all about and what should be the foundation of health care delivery. While I’m not the only one who has made the connection (the American Health Care Association invited Zappos CEO Tony Hsieh to speak at its convention a few years ago), I believe this notion that patients are customers, first and foremost, needs to be shouted from the mountaintop yet again. With the Affordable Care Act now in place and making health care services more transparent and “shop-able,” We The Patients are empowered more than ever to include customer service—happiness—in our health care decisions. Retail health providers such as Walgreens and CVS get it. They deliver the joy of expedience, along with that flu shot and a whole host of other basic medical services. Traditional providers likewise need to figure out the experience factor. Here’s what Zappos knows and does well and what could be designed into a visit to the doctor or hospital in the not so distant future:
When asked what was most important to them when seeking urgent care for an illness such as the flu (and assuming their usual provider was not available), consumers ranked a guaranteed wait time of no more than 30 minutes (and that’s without an appointment) first on the list, according to a survey from The Advisory Board Company. A free visit ranked fourth. Convenience/speed trumped even a freebie. While the survey narrative acknowledged that the ranking may, indeed, be different if people were choosing a provider for chronic care, it also noted that that many people who have a good experience with a visit for something episodic like the flu, will return to that same provider for other kinds of care. Zappos gets the importance of speed and convenience. So does Walgreens. The latter reaches 8 million people a day with multichannel access that includes several convenient apps that do things like tell people their prescription is ready, let them schedule clinic appointments, etc. And it’s capable of reaching people on their own terms, on their cellphones and devices, within the confines of their busy day.
A number of doctors and health care networks have already introduced Web-based systems for communicating easily with patients. But why couldn’t they delve even further into the realm of power convenience? Why couldn’t doctors offer patients an ongoing relationship that happens through multiple modes of connectivity—some physical, some virtual. To do the latter, doctors could harness the “Internet of Things” so that a patient’s (smart, Internet-connected) pill container or blood pressure monitor or heart monitor or bathroom scale does the talking, allowing basic check-ins to happen organically and to better inform their in-person visits with the doctor.
Happiness is knowing that your Zappos box will arrive in a few days and, likely, the very next day. Happiness is going to the doctor’s office and, if not knowing exactly when the doc will get to you, knowing you’re not going to be forced to sit in a cramped, germy waiting room while that process unfolds. Certainly, all trips to the doctor need not require an expedition to a big medical center. Why can’t certain types of medical services be available closer to you and with a completely different kind of sensory experience? In Nashville, Vanderbilt University Medical Center moved a number of its clinics that didn’t require a physical connection to the hospital (e.g. women’s imaging, sports medicine, adolescent medicine, medical infusion, pediatric allergy) to the top floor of a struggling mall (about five miles outside of downtown), thereby activating the mall and providing patients a chance to window shop, get a cup of coffee, and wait in spaces other than the medical/doctor’s office. Touch-screen kiosks allow patients to check in faster; a pager system allows them to roam once they’re signed in.
Delivering happiness starts with empathy for the individual. One of my colleagues who was getting married, got a bouquet of flowers from “your friends at Zappos.” She had ordered multiple pairs of wedding shoes and had talked to a call center agent to get help with the multiple returns. He took it upon himself to find a local florist in her area and have the congratulatory flowers sent over. In the world of health care, faith-based health systems do this kind of keen focus on the individual best, typically better than larger academic medical centers where research is the preoccupation. That same colleague talks with great emotion about her out-patient surgery at a Catholic hospital in Chicago where she was wished a “blessed day” and from which she received a get well card a week after her surgery, signed by her entire “care staff.”
With similar micro-devotion to the patient, all sorts of health care facilities are revamping their wayfinding systems (and using strategies seen at airports and shopping malls including interactive talking kiosks, according to the Wall Street Journal) to make it quicker and easier for people chart their course through what can be large and complicated buildings. Others, including Advocate Health Systems, which is faith based, have embarked on large-scale renovations of their exterior signage and graphics to improve people’s experience before they even get in the door. And still others are working to create facilities whose very design supports healing. The new Tulsa Cancer Institute, for instance, uses nature as a healing element of its design. The building is organized around a central garden that merges indoors and out and gives both patients and families a very different sort of waiting room and/or view during treatment. With all facets of health care now looking for a competitive edge, this idea of being truly patient-focused is likely to gain momentum and touch both the physical design of the facility and the process for being treated.
Zappos’ shoppers get to compare the shoes they desire with other comparable styles, all prices clearly presented—and they don’t have to work to get it. This relevant “data” automatically pops up on a shopper’s computer screen. Shoppers also get to read customer reviews of said shoes and often can view a video of a real person (a Zappos employee) wearing them. Dovetailing with all that transparency is friendly customer service delivered in either real time or through virtual communication to give shoppers a shopping experience that feels good. Health care needs to add that kind of clarity to the experience it delivers to patients. Again, the retail clinics get it. At Walgreens, for instance, there is a price menu that lays out the cost for each of its clinic services (i.e. chickenpox vaccine, annual school physical, ear wax removal). Given the new focus on making health care more affordable and costs more transparent, all of which is giving rise to a more informed consumer-patient, general practitioners, in particular, will need to eliminate the shroud of secrecy/confusion that has long accompanied a trip to the doctor’s office. Price lists, right there and available on demand and even electronically, are likely to be an addition to the doctor’s office “décor.”