In the era of technology, why doesn’t healthcare make any sense?

Ryan Grimmett, Chief of Staff, Product

Consumer technology has come a long way from the days of trekking to your local video rental store. Now, with smart TVs, you can effortlessly browse and stream the endless supply of films without concerns about availability or the hassle of physical in-store returns. 

This expectation of convenience has created a new consumer standard that has seeped into almost every facet of our life. We now enjoy customized music streaming on our phones, the ability to hail a ride from our exact location with trip price transparency, ordering groceries for delivery, paying bills while on vacation, tracking important packages, and even paying the babysitter electronically when you forgot to grab cash. While seemingly every aspect of our daily life is receiving this type of advancement, why does it still feel like healthcare is operating like our old movie rental store? 

As a healthcare solutions designer at Get Well, I am constantly thinking about the patient experience, but recently, I had the opportunity to have first-hand experience as a patient during a routine surgical procedure. My local providers are not current Get Well customers, so even as a patient I felt compelled to put my product design hat on and document my experience from the patient perspective. Despite my surgeon’s office being conveniently located within the hospital where my procedure would take place, the proximity didn’t benefit my patient experience. 

A real-life view of the “patient journey”

Pre-op Scheduling – After consulting with the surgeon, we agreed that the recommended procedure was the right course of action. They were able to get me in before year-end, so it would be advantageous for my insurance deductibles. Despite the surgeon’s office being able to schedule the tentative surgery date, they informed me that the hospital controlled the final scheduling. I was told to expect a phone call the night before and that the hospital could change the date and time as needed. Anticipating a last-minute call and potential changes, organizing work, transportation, and post-surgery support became a challenge. Luckily, my planned surgery date remained unchanged, however and I was able to report for the procedure that morning.

Pre-Op Insurance & Billing – “What is this going to cost?”, The unnerving question that almost always follows any healthcare interaction. Now try asking that five times as there isn’t one entity billing for services. Below illustrates the myriad of factors that went into understanding billing for my one procedure:

  • Hospital – Completed a pre-authorization for my insurance with an estimate on the fees related to my hospital stay. The hospital then wanted to collect a large upfront deposit prior to any services actually being rendered.
  • Surgeon’s Office – No estimate provided upon request. Office staff only provided me with surgical and diagnosis codes, something the average person outside of healthcare would have no idea how to interpret. I had to additionally call my insurance provider to make sure these codes would be covered and to fully understand the estimated cost relative to my deductible.
  • Anesthesia –  While the anesthesiologist works at the hospital, they are part of independent provider groups and it’s highly likely you will get a separate charge for their service, even though the medicine they use will be billed from the hospital. 
  • Pharmacy – A prescription is ordered and you show up to pay whatever portion your insurance doesn’t cover, period.
  • Pathologist – While common for surgeries, I had no idea that a tissue sample would be extracted and sent off to a pathology group. I only learned this when I received a surprise bill in the mail months later.

Only two of the five billing charges were from recognized organizations. Putting this into the consumer perspective, imagine if you received separate bills for cleaning, TV usage, electricity, internet, and laundry from a recent hotel stay. It seems counter-intuitive when applied to any other consumer industry yet in healthcare it’s standard practice.

Day of surgery – With the insurance confusion out of the way, surely the hospital experience would be more straightforward? Wrong. Here’s what  I experienced the day of my surgery: 

  •  9:30 AM – Registration
  • 10:00 AM – Changed into gown and in room
  • 10:15 AM – Finished vitals check and IV setup, told I was second on the schedule for surgery

My room was equipped with a basic TV controlled by the pillow speaker, and a whiteboard that only contained the name of the nurse and some basic vitals from when I first checked in. There was no signage information about guest Wi-Fi, or my care plan or care team for the day.

  • 12:35 PM – First check-in from a nurse. This nurse was not my original nurse and it was unclear if she was taking over. I was informed that the surgeon was running behind on the first procedure,but no ETA was provided.
  • 1:05 PM – An OR nurse (different from the previous nurses) checked on me.
  • 1:10 PM – The Surgeon & Anesthesiologist checked in and prepped for surgery.
  • 4:30 PM – I went into post-operation recovery.

The in-room experience at the hospital was a far cry from the standard – non-healthcare-  consumer digital examples from above. The lack of expectation, orientation, or any communication channels left me feeling more like a prisoner than a customer. I ended up having to fill in the gaps through my own personal technology, leveraging my phone for content, work emails, and chat, and even coordination with my wife for both transportation adjustments and food because of the huge delay in what the day was supposed to look like. What stands out as most frustrating was that these environments are not devoid of technology; hospitals have some of the most state-of-the-art technology imaginable. It just wasn’t leveraged for the patient experience and as a patient, the gap was palpable.

Post-Op Pharmacy
– Picking up prescriptions should be quite simple. You show up at the pharmacy, they look you up, and you pay for whatever the clinician sent over. Imagine my surprise when I opened the bag for what was supposed to be a 5-day antibiotics course, and instead I had a whopping 75-day supply! After a quick call to the surgical practice’s nurse line, they confirmed indeed that this was a typo and provided adjusted guidance to simply take 5 days of the supplied medicine. Although a relatively cheap drug, 75 days of anything adds-up and, over 4 months later, despite coordinating with the surgical office to refund overpaid fees, this is still not resolved.

I’m left with the question why? Why is it that healthcare has become the last adopter of the modern consumer experience that we have come to expect from every other industry? We can’t hide behind excuses about security or privacy when other sectors like banking and finance have streamlined into effective consumer experiences while safeguarding data and access- and without compromising on the experience. 

At Get Well, our mission is in our name. We don’t simply aspire to design digital technology to improve the healthcare experience, we require it. My personal experience shone a light on the problem I am trying to solve in my professional life, and it will take more than one digital health innovator to move the needle for reversing this trend within healthcare. By prioritizing the race to the bottom for cost savings in the short-term, we are losing patients and consumers by refusing to raise the bar of experience.  

This is why Get Well focuses on the end-to-end journey of a patient, and navigating them with empathy and action. Our founder created Get Well to reduce the confusion and isolation that patients feel. Learn more about how we are tackling this across the entire care continuum here.