Outside-In Approach to Design and ROI of Patient Experiences


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Doug Dietz, principal designer for GE Healthcare, was proud of his new scanner (MRI machine) that he designed. Like a self-described proud papa, he went to visit it at the hospital.  It was this visit that would change his life and would teach him a profound lesson.

The scanner worked fine. Everything was functioning properly and just as it had been designed to do.  But then he saw a patient, a seven-year-old girl with a tear streaked face, who was utterly terrified by the hulking, uninviting machine. He was particularly moved by the expression on the faces of the parents, essentially saying: “How are we going to get her through this?”. Doug says that he then looked behind the family as they were entering the MRI room and when he bent he saw the room through the eyes of that child. And this time it had a very different look. He notices a warning sign of the wall with an exclamation mark, yellow and black tape as an accident scene, the flooring looks bleached; the room looks dark with flickering fluorescent lights. These are what we would call subconscious clues. Normally customers may either not mention anything about those or they may say something like “looked bad”, so then you need to ask them “what made it look bad” to get to this level of detail. It’s like peeling an onion …

Next Doug spoke with the physicians. He found that about 80% of the kids had to be sedated in order to have a scan with the machine Doug designed. This was shocking for Doug. When he visited other MRI rooms he found other subconscious clues like cabinets that remind kids of dentists (not a good thing), the terrible noise from the scanner etc.

But out of failure, when applied correctly, comes knowledge, and Dietz soon learned an important tenet we believe here at Beyond Philosophy: When you design experiences from an outside in perspective and when you are aware of the feeling and senses that you want to stimulate, good things happen.

Dietz went in and designed an experience to appeal to children and overcome the feeling of “fear”. He and his team created “the adventure series”. Before the child goes to the scanner room, it will be told that it’s about to go on an adventure. Doug’s team then redecorated the room so it looks like the kid is about to step into a “canoe” and to be careful not to “rock the boat” and if it stayed still it may even see fish jumping on top of the boat. The design also made use of other human senses e.g. smell and sound. They injected water and lavender smells in the room and as they had painted a waterfall on the wall they played the distant soft sound of water running which we all know is calming. In a word they designed a complete experience.

This extraordinary story shows us the value of looking at the experience from an outside-in perspective – through customers’ eyes. We call this concept Customer Mirrors (i.e. acting as customers, looking at things through customer’s eyes) and find that this exercise is a critical step for most organizations that want to 1) engage senior leaders and 2) enhance their customer (or patient) experience. When we conduct Customer Mirrors we use an “experience psychology” checklist that we have developed to make us pay attention to the little things and subconscious clues in the experience.  Once you have identified the real problem from customer’s perspective you are into solution mode. Our method for designing an emotionally engaging customer experience – Moment Mapping uses, just like Doug, the collective brain to ideate what the new experience should look like.

And here is the best part. Many people think that good Customer Experience costs a lot of money but the reality is that when you address the right area the benefits always outweigh the costs. In this case the new scanner rooms designed from the outside in with children in mind were a huge success, improving patient satisfaction by 92%. Also it decreased the amount of children who needed sedation in order to be scanned from 80% down to less than 1% at one hospital. The better MRI Scan experience in this case reduces the need for extra physicians (whose time is expensive) needed to sedate the kids, and increases the utilization rate of the expensive scanner (i.e. you can get more patients through it in a day). All this also meant less waiting time for other sick patients.

If you listen to the story (link provided below) you’ll see that one of the byproducts was also better employee engagement.  Taking proper care of children makes the MRI technicians happy as well and in addition parents will talk about it. They will refer other parents to the scanner. In turn, the hospital will book more patients to use this great new scanner. Now the “cost” of a scanner feels more like an “investment” and the hospital wants to consider new ways to work with GE.

If you want to hear the story directly from Dietz, please watch this touching and impactful video:

And whilst this is a wonderful and moving story the principle behind it could be applied to any experience design. For example back in 2006 we worked with a healthcare system in Texas (11+ hospitals with 20,000+ employees).  By walking the experience in patients’ (customer’s) shoes and observing patients when being the patient was not actually possible we were able to get their perspective of the experience and get an insight of the more subtle clues that make them feel certain way. This is what Stanford d.school describes as “empathize” – the first step in the design process. We then re-designed the inpatient and outpatient Cancer, Heart & Lung and Emergency Room experiences. As a result patient satisfaction improved from the 78th percentile to the 95th percentile; outmigration was reduced by 25%. This meant an additional revenue for the hospital in excess of $10m as in the US Patient Satisfaction drives a large percentage of government sponsored reimbursement for hospitals. This reimbursement is crucial for hospitals to recoup the cost of care to indigent population s for which they are required to provide service for

Here is another true story, but with a very different ending to show how much opportunity is just out there waiting to be grasped. This one is at a top 5 US hospital.

‘A cancer patient between treatments who is experiencing the after effects of chemo calls the hospital to schedule a follow up exam.  She spends almost three hours on the phone.  She told me that because of that one event she will never recommend that hospital to anyone.”

Healthcare may argue that they are not in business for the money.  While that may be true, they are not in business if there is no money.  So let’s talk about dollars.

One study concluded that each time someone contacts a hospital the potential revenue in play is $7,000.  Provide a good experience during that contact you keep the money.  Provide a bad one and some other hospital gets the $7,000.

Now $7,000 isn’t likely to make a huge difference to most hospitals. However, consider this: The average lifetime value of a patient is between $180,000 and $250,000. The average lifetime value of a person who chooses a hospital other than yours is zero.

My point is clear.  The cost of poor experience is low patient retention and very low referrals. And the loss of those referrals is pretty detrimental to the longevity of your healthcare institution.

Dietz’s testimonial and the cancer patient account show us the importance of considering the experience that your customers have, through their eyes. Now in many ways, patients are different than customers. For one thing, they usually didn’t choose to be there. But for the healthcare industry, there are enough similarities between patients and customers that it is important to consider the importance of patient satisfaction when you design a patient experience. As you can see, the results can be either catastrophic or heroic.

How do you approach the design of experiences in your organization?

Republished with author's permission from original post.

Zhecho Dobrev
Zhecho Dobrev is a Senior Consultant at Beyond Philosophy with 7 years of management consultancy experience and more than10,000 hours devoted to becoming an expert in customer experience management. He has worked with a wide range of sectors and countries. Some of his clients includeCaterpillar, FedEx, American Express, Heineken, Michelin etc. Zhecho's expertise includes conducting customer research on what drives customer behavior, journey mapping, customer complaints, measurement, training and more. He holds an MBA and Master's degree in International Relations.


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