The Mayo Clinic experience

Patient experience for Mayo Clinic, the number one hospital in the world, is driven by front-line employees, as discussed by the Assistant Medical Director of Patient Experience, Dr Thomas G Howell Jr.

Joe Rath, a prostate cancer patient at Mayo Clinic, compares his hospital stay to a full-service treatment as if he’s in a resort. From parking attendants, cleaning staff, nurses, and doctors, everyone in Mayo Clinic gave Rath an unforgettable experience that assures and comforts him as a patient.

The “Mayo experience” – this is how patients at Mayo Clinic refer to their hospital trips and what makes them return to the hospital, remember it with fondness, and recommend it to others.

Mayo Clinic’s  Office of Patient Experience is comprised of five service lines: service recovery to redeem a patient who was previously dissuaded, improvement to address the weak points in the current system, research to support the improvements, training and education for staff, and customer relationship management to nurture relationships with existing patients and develop new ones.

We recognize that patient experience really lies with our front-line employees, Dr Thomas Howell, Assistant Medical Director of Patient Experience at Mayo Clinic tells Hospital Insights Asia. Just like how your assessment of a restaurant depends not only on the food but also on how the staff greeted you and addressed your concerns, patients rate their care experience based on how the doctors, nurses, and nonclinical staff treated them throughout their stay.

In line with its goal to constantly enhance its patient experience, Mayo Clinic supports its employees “to unleash their creative potential and manage improvement as well as service recovery at the front line”, says Dr Howell. Formal training, new employee orientation, and brief training are just a few programs aimed at helping the employees support the Mayo experience.

Another key strategy used by Dr Howell and his team is using the SBAR (Situation, Background, Assessment, and Recommendation) model of communication and including an “e” in the assessment part. The “e” is to acknowledge the experience impact of any proposed changes to both staff and patients. After all, engaged employees can reflect satisfaction on how they deal with patients.

Sometimes, though, the toll of work stresses and other competing interests can obstruct the priority of giving excellent patient experience. Dr Howell finds that trying to keep the goal at the forefront of employees’ minds is a challenge in keeping the highest standard in care experience. Added to this, Mayo Clinic finds that managing complicated patient itineraries, for a huge hospital that takes on highly complex patients, can be a pain point that interferes with a seamless patient experience.

Yet, with the advent of COVID-19, Mayo Clinic finds that people can adjust really quickly. Employees who understand what the hospital believes in can be highly resourceful and creative. Likewise, the staff have received the necessary preparation and training on what to do in a pandemic from the hospital’s approach in responding to H1N1 influenza in 2009. Diane Baier, a patient who recently had surgery at Mayo Clinic, was all praise at how the staff assisted her throughout the procedure so she managed to feel calm despite the threat of the virus.

In essence, the first step in improving your hospital’s experience, according to Dr Howell, is starting with the big “Why”: Why do you care about patient experience? Why are you in healthcare?

These questions must be answered both by the organization and the employees, and connected to the values upheld by your hospital and the individuals who work for you. If you care for your patients and your employees share in the belief, patient experience can be raised.

How Medistra improved patient experience

Dr Dini Handayani, Chief Executive Officer of Medistra Hospital, unlocks an effective process for improving patient experience.

We have been told countless times that customers always come first. In the same way, the real experience occurs, especially in healthcare. As patients, we choose a hospital that prioritises our wants and needs. In other words, we consider the patient experience it offers as we build loyalty to a doctor or a hospital that has met our criteria.

Hospitals today are quickly embracing the benefits of excellent care experience for patients. For Medistra Hospital, getting this done starts with identifying the most problematic area in the entire patient experience.

In an interview with Hospital Insights Asia, Medistra Hospital’s CEO Dr Dini Handayani shares how patients value consultation time and quality in rating their overall hospital experience. In its campaign to become the patients’ “real partner” in healthcare, the hospital collects data using the Voice of the Customer methodology.

Data collected from February 2020 reveal that the most important aspect of patient experience concerns meeting with doctors.

Firstly, patients want more time to consult with doctors. They want to explain their health condition and have all the information for treatment options, care plan and follow-up, as well as education for their specific diagnosis. BMJ discovers that patients want to spend more time with a doctor so they can explain what they came for and so the doctor can really make them understand what is going on with their health.

Unsurprisingly, Siloam Hospitals Group finds the same feedback in their teleconsultation services. Their patients appreciate that they are “now able to spend more time with the doctor” and “get 15 minutes or so with the doctor’s full attention”, says Siloam’s CIO Ryanto Marino Tedjomulja.

Secondly, patients value timeliness in medical appointments. This is why Medistra Hospital asks about the waiting time of patients when they go for consultations as this can be a highly important factor for most clients. Also, patients appreciate a swift response time during emergencies. As much as possible, they want to schedule doctor appointments in just a few hours, especially if they are really unwell.

Lastly, patients look at the quality of consultation, especially the information provided by the doctors. Besides the minutes’ count, patients want satisfying content in consulting with doctors. A study finds that these two factors are related in a way — patients can feel that the consultation is short because of the quality of content shared by the doctor.

Knowing the above pain points for their patients allows Medistra Hospital to consistently innovate its processes. They look at the data as actual ratings of their services from their patients. For Dr Handayani, patient experience is “a very 360 degree or a very robust improvement process” that goes beyond achieving patient satisfaction and asking yes or no questions.

As such, they send collected data to all concerned departments so the latter can take necessary steps to strengthen the weak points in their respective systems. So far, the majority of the improvements done by Medistra Hospital are related to system and re-design process, Dr Handayani remarks.

More than improving patient experience, dealing with the pain points is also about securing a loyal patient base. Patients regard such areas as most important in their hospital experience, hence, the same areas are what they look at when choosing which hospital to get treatment from. Research proves that “patient experience is five times more likely to influence brand loyalty than other marketing strategies”. Normally, patients return to a clinic that meets their expectation during the first visit. As Dr Handayani puts it, “a great patient experience makes your hospital the patient’s first choice”. 

Accordingly, an extraordinary patient experience helps attract new patients as the loyal ones will recommend the hospital. When searching for a hospital, patients often ask for a referral or look at patient ratings and reviews online. If a patient is happy with the experience he got from your hospital, he will most likely recommend the hospital to friends who can be your new clients.

Hospitals that acknowledge patient experience as the “most salient point in the hospital industry” can uphold quality. Dr Handayani points out that it is about “knowing what really happened with patients during their treatment and stay in the hospital”. In approaching patient experience, hospital accreditation does not even matter. A KARS and JCI surveyor, Dr Handayani thinks that there is no limit to a hospital’s capability to provide high-quality healthcare services. In fact, focus on advancing patient experience will certainly enhance the quality level of service for both locally or internationally accredited hospital.

Essentially, first-rate patient experience builds competitiveness. As Dr Handayani puts it, “It is not just about the equipment or resources in your hospital; in the end, it is really about how you deal with patients and have them as your real partner”.

3 tips for patient experience from St. Luke’s Medical Center

Interview with Joyce K. Nazario, Assistant Vice President and Head, Patient Experience Group, St. Luke’s Medical Center, the Philippines.

Empowerment, access, and compassion. This is Joyce K Nazario’s formula for exceptional patient experience, she tells Hospital Insights Asia.

Nazario, the Assistant Vice President and Head of the Patient Experience Group of St. Luke’s Medical Center in Quezon City, the Philippines, notes how patients these days have come to expect a certain level of customer service just as much as they expect high quality care. “They want excellent service, too, which means—among other things—care delivered with more ease, convenience, and choice,” Nazario notes.

Hospital leaders need to realise that patient experience can have a very real impact on a hospital’s future. As Nazario puts it, “the sustainability of a healthcare organisation is in its loyal patients and their power to recommend us”. She reveals St. Luke’s patient experience philosophy in this exclusive interview.

The vision

The rise of “healthcare consumerism”, as the phenomenon is called, requires healthcare providers to constantly innovate, according to a 2019 Becker’s Hospital Review article. But tech is only half of the picture. The devil is in the details, according to Nazario, and in her experience, it takes three key elements.

First and foremost, hospitals need to empower and engage patients and their families from the outset, Nazario says. At St. Luke’s, all communication with the patients have a feedback loop. “At all points of the journey, the processes, options, and possible outcomes are explained and are acknowledged in a way that the patient and family understand,” she explains.

This goes a long way in building a relationship between hospital and patient, and helps to prevent any communication breakdowns. Clinicians are also able to engage their patients better on treatment choices available to them, Nazario explains.

Second, hospitals can boost patient experience by improving access to healthcare services. At St. Luke’s, this takes the form of value-based care that is “within the financial capacity of the patient”, says Nazario. Good communication is the foundation for this: “There will be provider-patient relationship discussions on the financial capacity of each family, understanding the resources available, and guiding the family through costs,” she adds.

The end goal here is to ensure that patients that need frequent procedures receive affordable care packages that provide the best quality care possible. Meanwhile, for those with chronic and catastrophic illnesses, Nazario hopes to ensure that “throughout the journey, the patient and family retain the level of financial capability they had on Day 1”. By bundling payments, healthcare systems can “control out of pocket payments as well as government spending”, she points out.

Finally, it is key for hospitals to focus on the little things. Small comforts and thoughtful touches matter most to the patient when they are at their most vulnerable. “It’s the little things they remember. A very comfy blanket, a small aromatherapy inhaler, having someone to talk through their fears. These things stick with our patients,” Nazario points out.

There are several ways that the hospital crafts a welcoming environment for patients. The hospital has spaces where healthcare discussions can be had in a private and confidential setting, for instance, Nazario says. The priority should be making sure that “patients and their families feel our compassion, and that their dignity and privacy are respected during their whole time with us”.

It is also important to respect patients’ religious preferences. Muslim patients receive halal food, and if they are female, will be assigned a female bedside nurse in keeping with Muslim religious requirements, according to Nazario.

“We understand every patient’s journey is unique,” she continues. “We want to deliver excellent clinical outcomes by creating efficiencies in our processes, while also leaving room to make sure we address each patient’s individual needs.”

Patient experience in the Philippines

Nazario goes on to share her key takeaways from her role. The Universal Health Care Law (UHC) was passed in 2019 by the government, at a crucial time for the country’s healthcare system. Here is some context: out-of-pocket expenses made up 54 percent of the country’s 2016 healthcare spending, according to a report by the World Health Organization.

Filipinos carry the biggest burden when their loved ones seek treatment. They therefore only consult a doctor when their illnesses are at their worst, the report said.

What does this mean for patient experience leads in the Philippines? “If a future iteration of the UHC is similar to the US model, which takes into consideration patient experience scores when reimbursing healthcare spending, patient experience scores will have a financial impact on healthcare institutions—especially in the private sector,” Nazario says.

And to create a culture of great patient experience, change the “tone at the top”, Nazario says. This helps with buy-in across the entire hospital. “Our President and CEO always says “Great Patient Experience” in his conversations with the organisation,” she explains.

Equally, a great employee experience is foundational for a great patient experience. To reduce the burden of administrative work on clinicians, St. Luke’s is currently rolling out an Electronic Medical Records system that will connect its two sites.

This lets doctors spend more time with patients, instead of on paperwork. “This will be the only full-scale EMR in the Philippines to date,” Nazario adds.

Ultimately, as Nazario concludes, the hospital has kept its focus on patient experience constant throughout the years “by keeping our ear to the ground and making sure we set our patients’ needs as our guides”. This is particularly relevant in the current climate, even as hospitals and healthcare systems have had to pivot to address the needs of COVID-19. “A realignment of both priorities and policies is necessary after this crisis passes,” Nazario concludes.

Patient experience for a global market – how Bumrungrad does it

Dr Chatchai Arthur Yachantha, Division Director for Patient Experience & Engagement Services, shares his insights.

The setting within a hospital is everything. It can help to make international patients feel relaxed as they are at home, especially if they have travelled a long way. Dr Chatchai Arthur Yachantha, Division Director for Patient Experience & Engagement Services at Bumrungrad International Hospital, shares how the hospital “shapes better experiences” for patients, depending on their geographical and cultural origins.

“Most of the time, patients usually feel welcomed as they feel they are at a hotel that has an expert medical team and it is our mission to create such an experience and maintain them with comfort,” says Dr Yachantha. Bumrungrad is renowned in Thailand as being a key medical tourism player and the first hospital to be accredited by Global Healthcare Accreditation outside of the United States.

For instance, apart on the focus on regional patients in CLMV, Thailand welcomes tens of thousands of medical tourists from the United Arab Emirates. At Bumrungrad, trained medical interpreters who have previously lived in Arabic countries are on hand 24/7 to assist them. The hospital creates an environment based on Arabic patients’ preferences; there are interpreters on hand; and they are served Arabic beverages, Dr Yachantha explains.

“Anything around the patient’s ecosystems – we take care of their relatives, the scenery, specific wards, anything that applies to their cultures. This is to comfort them as they have travelled along the way from distance,” he says. “Our thought is simple: we understand how their journey begins, and we support the best way to make them feel better while receiving treatment and aid them in the fastest recovery possible before returning home.”

“Remote cultural support” is important for them too, Dr Yachantha stresses. For medical tourists, it is key to have constant communication even before they set foot in Thailand. This means that “the feeling of service provision has to last for several days”. Physicians and care teams work with remote medical interpreters to communicate with the patient to ensure good understanding, and this is provided free-of-charge to ensure the continuum of care, he continues.

The little thoughtful touches add to the entire experience, according to Dr Yachantha. The hospital also keeps touch over Customer Satisfaction Surveys, mobile apps such as WhatsApp, and telemedicine, ensuring a seamless experience. Each patient is assigned “personal helpers” who support them and their families on a daily basis; and they are greeted with welcome cards and health gifts when they get to their wards.

One way that the hospital keeps innovating is to learn from other global and regional medical tourism players, such as Mayo Clinic, Vinmec Group, Parkway Pantai, and Raffles Medical Centre, he goes on to say. At the same time, Bumrungrad conducts service design workshops with multidisciplinary experts who works with patients “to understand how they currently deploy the service, what are their basic background, what will happen to the patient, what have been communicated to patient, and what experience they expect”, Dr Yachantha remarks.

Exercises like these are useful for identifying pain points of the patient’s journey from their home countries to the hospital. Hospital staff work in teams, roleplaying as patients and problem solvers, to determine how best to serve international patients’ needs.

These various elements are woven together to shape how the patient interacts with the hospital at every step, ensuring that they feel supported when they are most vulnerable. Ultimately, it is crucial to engage patients as much as possible, Dr Yachantha concludes.

Exclusive: Interview with the MD of Bundamedik Hospital, Indonesia

Nurhadi Yudiyantho discusses how the hospital does market mapping to understand the needs of patients.

“There are lots of challenges in Indonesian healthcare, but we know that the challenges can make us stronger,” says Nurhadi Yudiyantho, the Managing Director of Bundamedik Hospital, a large private hospital in Jakarta.

For hospital leaders like him, market mapping is important to understand the needs of patients and the demand for healthcare, and design services based on that, he tells Hospital Insights Asia. Bundamedik Healthcare System, the group which owns the hospital, has plans to expand their network of hospitals and fertility clinics over the next few years. Niche market studies help the group to determine the types of clinics or centres of excellence they need to provide, Yudiyantho explains.

The Indonesian market has “dynamic” healthcare needs as purchasing power increases, Dr Ivan R Sini, a renowned gynaecologist and a commissioner at Bundamedik Hospital, said recently. “We used to see the Indonesian healthcare market as segmented, with the market having limited capacity to purchase good quality healthcare products. But recently the buying capacity has increased rapidly,” he was quoted by e27 as saying. “Healthcare has become a primary need.”

Hospitals such as Bundamedik are making the choice to cater to this growing middle class. It is more challenging to serve the universal healthcare group of patients, Yudiyantho admits, as “it is a very small margin, since the return of investment will take longer – almost ten years.”

Bundamedik Hospital limits the number of beds so they can provide better care, Yudiyantho adds. Instead of a few hundred beds, Bundamedik caps the number at 150. “It means that we can deliver more, focus on the patient needs, better facilities, better standard procedures from our doctors and services,” he remarks on the sidelines of the Clinical Effectiveness CEO Summit in Jakarta in August 2019.

It means that we can deliver more, focus on the patient needs, better facilities, better standard procedures from our doctors and services.

This helps the hospital to reduce medical errors as well. “What we can see from the CEO of Wolters Kluwer Health, is that lots of medication is basically unnecessary to give to the patient – about 20 or 30 percent of patients can be affected,” he notes, referring to a keynote presentation by Dr Denise Basow earlier that day. With fewer patients, doctors can be more careful with decision making at point of care.

The hospital attracts patients from elsewhere in the region, which is why it also operates two hotels for medical tourists. These patients come from other parts of Indonesia, such as East Java, Bali, and Kalimantan. “They get the treatment in our hospital and then a hotel stay,” Yudiyantho explains.

Research is a priority for the Bundamedik group, which operates Indonesia’s largest network of IVF clinics with 45 percent market share. IVF and genomics are two research areas of interest, according to Yudiyantho. “We put it back again, all the reports into the research and science. This is how we improve our services, how we improve our quality.”

In 2015, Bunda Medical Centre in Padang, West Sumatra partnered with Philips to address the problem of maternal mortality by testing a mobile obstetrics monitoring solution. This app allowed midwives to build a health profile of pregnant women by collecting data from physical examinations, tests, local nursing clinics and even patients’ homes.

As the Bundamedik group expands its network, the pressure is on leaders to “make sure that we can still deliver a good quality outcome for our patients,” Yudiyantho concludes. “That is most important.”

Exclusive: How good hospital design makes all the difference in Vietnam

Interview with Tan Seang Teak, Group Chief Operating Officer of Hoan My Medical Corporation.

“When we have good design and a good system, the doctors can focus their time on taking care of patients,” says Tan Seang Teak, Group Chief Operating Officer of Hoan My Medical Corporation, Vietnam’s largest private healthcare network.

A well-designed hospital can make a difference by helping patients feel more welcome, and creating a better environment for clinicians and staff, Tan tells Hospital Insights Asia. His work focuses on “how a hospital can be built to be more efficient, with better safety and also providing patients with better experience and quality of care”.

In establishing a new hospital, “the first thing is making sure that the design is right, that it follows international criteria, infection control, workflow”, Tan explains. “If from step one, the hospital is not designed properly, we are compromising a lot of infection control and safety procedures.”

“If from step one, the hospital is not designed properly, we are compromising a lot of infection control and safety procedures.”

A more welcoming space helps healing

A simple example of bad hospital design is a long registration counter where nurses are one side and patients are on the other. “You have something like a Great Wall of China separating patients and healthcare providers,” Tan notes. Counters can be designed to encourage interaction between both sides, which can “actually enhance the quality of care”.

This concept extends to the rest of the hospital environment as well – for instance, moving away from the tradition where “everything is white”, Tan suggests. “When you are in an environment that is more friendly, and more homely, you tend to interact with each other more warmly,” he says.

It is simply about understanding human behaviour, he remarks – a more welcoming environment can help doctors and nurses to work better together. Friendly and effective design plays a key role in patient-centred design, Tan notes.

Vogue Australia recently reported on a new wing in a hospital in Victoria that was designed with patients’ recovery and comfort in mind. Architects used natural wood panelling in wards, hid equipment out of sight, gave rooms green views. “We wanted to ensure new levels of dignity, comfort and safety,” the architecture studio director was quoted as saying. The team also worked with hospital staff to design medical workspaces that were highly functional, yet soothing.

Letting doctors do what they do best

Good hospital design is just one aspect of the whole. It is also important to introduce strict standard operating procedures, and at the same time, relieve clinicians of the burden of administrative work, Tan continues.

Many hospitals today are relying on outsourcing non-clinical services, such as facilities management, lab services, and supply chain, he explains. “I think this is a trend that is moving forward; a lot of hospitals will need to do that.”

This way, doctors do not need to worry about administrative duties, and will be able to devote themselves to what they do best – providing high quality care. Service providers can support hospital administrators in running some of the hospital operations, so that the administrators can focus on recruiting and training doctors. “They can bring the economy of scale, as well as the economy of skills with new techniques and procedures to take a hospital run more efficiently,” says Tan.

On a broader level, healthcare ecosystems as a whole have much to learn from other industries. Fast moving consumer goods companies have been using consumer behaviour techniques, analytics and digital marketing for years now. But all these methods are still new to healthcare, Tan says. “It is now beginning to be adopted in terms of analysis of patients’ behaviour, as well as their satisfaction.”

Perhaps one day, hospitals will not be perceived as cold, sterile, unfeeling spaces any longer. There is an opportunity for new hospitals to be built to encourage interaction, collaboration and healing.

Exclusive Interview: Liz Dantes, President, Manila Doctors Hospital

This hospital in Manila is focusing on retaining healthcare workers and improving nurses’ interactions with patients.

Manila Doctors Hospital is a training hospital in metro Manila. Hospital Insights Asia speaks to Liz Dantes, President of Manila Doctors Hospital, on the challenges she is facing right now, and how she is transforming patient experience, human development, and facilities upgrading, among others.

What are the challenges that you are facing right now?

In the Philippines there is now a concern that a lot of our trained nurses are moving out of the country, as there are more financial benefits and better salaries in foreign countries. There is difficulty in retaining these medical personnel and get them to stay in the hospital for longer. Even accountants are difficult to find because most of them are moving out to Singapore, Dubai, Canada or Australia!

We are doing a lot of talent retention programmes in order to make them stay. One of our primary goals when I became President was human and organisational development.

For us, there is continuous training among our nurses of both soft and hard skills, and continuous improvement of the facility. We are conducting human development programmes to retain them.

How are you equipping your nurses to serve patients better?

The nurses will always have their own training programmes in terms of better customer care and patient-centric experience. We need the patient to have a very good experience in the hospital. It’s not just curing them or looking after them; they really need some extra effort in making sure that these patients’ needs are understood, and addressed immediately.

Because patients don’t feel comfortable sometimes, they expect extra attention. So we tell our staff to be very careful in terms of how they relate to them, how they would conduct themselves. Put a smile on their face when they are meeting with these patients.

When you see others come into your room with a happy face, for the patient, they feel a lot better, rather than you see a nurse coming in with a long face. These are very simple things that we tell them. I think it is doing a lot of good for our nurses.

We are also training our back office and the support teams at the same time. We need a lot of efficiencies in the hospital to run it effectively in order to save costs, in order to reduce turn-around time in preparing and issuing medical results.

I am doing it, doctors are doing it, all of the managers and officers throughout the hospital, are really putting in the best effort in order to introduce efficiencies in the hospital processes. So it’s different continuous improvements across the hospital right now.

How do you ensure consistent standards and quality of patient care?

It is a concern of all of our doctors as well. I think it’s a continuous process of improvement.

Newly graduated medical students are always under a mentorship programme. And we make sure that all of them are properly trained in handling patients. With our nurses, as I mentioned, they will always undergo trainings, seminars or conferences before being deployed at the bedside. Patient safety is the core of the institute.

It can be a month of training before they are deployed, and when deployed, they’re under constant supervision of our nurse managers or supervisors. This helps make sure that the health of our patients is well taken care of.

Aside from that, we are expanding our services and adding more private rooms for patients. These are no ordinary rooms: they have the view of the city, Manila Bay and the surrounding greenery. We’re very excited about this, and hope that it would be part of the healing process.

We hope that the rooms will give patients the feeling that they’re not actually in a hospital. Of course, a lot of hospitals are doing this, but it is a definitely a step forward in terms of patient care.

What are some current healthcare trends to watch?

In the Philippines, even in Asia, a lot of hospitals have started putting up their cancer centres. Cancer is the third highest cause of death in the Philippines.

We have inaugurated our cancer centre with top of the line therapy machines. It offers a very holistic multidisciplinary treatment for our cancer patients, including their families.

We feel that it is one way of being part of the larger community, looking at the treatment of cancer very seriously.

Exclusive Interview: Dr Paul Brigino, COO, Our Lady of Caysasay Medical Center, the Philippines

How this Philippine private hospital is putting patient experience first.

Our Lady of Caysasay Medical Center is a multi-specialty hospital in Batangas, the Philippines. Hospital Insights Asia speaks to Chief Operations Officer Dr Paul Brigino on how he is making processes more efficient for the comfort and convenience of the patients.

What is your vision for the hospital this year?

This year the vision is to become a model hospital in the country, in terms of quality operations and services that we can give to the community. At the same time, we are continuously trying to improve our patient care in terms of hospital operations, innovation, and making things more efficient.

How have you made patient experience a priority in your hospital?

Role playing is very important to me right now, especially for the nursing service – in every step, every procedure of each and every transaction, in every department. Because I want to make sure that what we do meets the expectations of each patient.

We also have a total quality manager to see to it that every procedure have been performed in a very set way. It is not only on the outpatient basis but also patients being admitted in hospital. There will never be discrepancies in any of the tasks carried out for the patient.

And in the nursing service every morning, we make sure that the task given to each and every person on duty must be listed. We have what we call an Accountability Board, with tasks for the day and how they should be executed. We have been using this system for over a year now.

Once a task is done, we make sure that it is marked as completed before the nurse finishes their shift – even in the ancillary department, like the medics and pharmacists. That is the only way that we can make patient experience very possible for us.

What are the challenges that you are facing today?

I am focusing now on streamlining and strengthening business processes and policies for patient-doctor; management-doctor; and hospital-client relationships. We are looking at doing this for each and every department of the hospital to improve our patients’ comfort and convenience, making things easy and comfortable for them.

Similarly, we want to make our transactions more efficient so that patients will not experience delays in receiving documents or information.

Another challenge is to support our doctors so that they can efficiently manage and treat their patients at the right time, in the right place, at the right moment. And we still have to enhance our business processes based on the quality standards that the hospital should perform.

Another challenge is to support our doctors so that they can efficiently manage and treat their patients at the right time, in the right place, at the right moment.

How are you using technology to improve patient experience?

What we want to have right now is convenience in terms of booking doctor appointments. Doctors will have convenience in giving orders to the patient, and the patient will know the treatment allotted for them.

I want to develop something that will make our clients reachable even outside the hospital by enhancing our technology, most especially for the doctors and their respective patients.

All our ancillary services are using automated machines, which make it easier for us to transact with our patients. There is lesser time that has been spent delivering healthcare services on the administrative side. What’s more, the operational expense is much lesser compared to previous years.

I hope to empower all employees to share and contribute how we can make things very easy for our clients, young and old alike.

What else are you working on that you are excited about?

We are using social media to reach out to the community, from the schools to households. It is not enough for me just to be curative. For me, prevention is much more important.

That’s why there are teams in the hospital that visits schools and communities to run wellness education programmes. As long as there is a healthy community, there will be a healthy economy.

I also hope to implement the MEN framework in my hospital – it stands for Motivation, Equipping and Nurturing. Soon enough, we can offer a One Stop Shop package of quality healthcare, both for the management, and the end user. That is the totality of what the care delivery system is about.

Exclusive Interview: KK Women’s and Children’s Hospital, Singapore

Dr Dirk de Korne, Deputy Director of Medical Innovation and Care Transformation, on his vision for digital transformation and reinvention.

KK Women’s and Children’s Hospital is a 830-bed hospital and tertiary referral centre in Singapore, specialising in obstetrics, gynaecology, paediatrics and neonatology. Hospital Insights Asia speaks to Dr Dirk de Korne, Deputy Director of Medical Innovation and Care Transformation, on the value of innovation, exciting projects in the pipeline, and the importance of collaboration.

What projects are you most excited about this year?

We are currently running many exciting projects related to digital transformation. Some of them are focused on digital tracking and tracing of our operations. These projects include the use of smart sensors in the hospital to improve quality and efficiency. They give us real-time information about process times and performance.

Other projects include video consultations, which allow the patient to remotely consult their healthcare professionals from the comforts of home. We have also developed chatbots with locally validated medical information, which are available to patients 24/7. And this year, we hope to set important next steps in our computer vision journey and finalise a number of proof-of-concepts involving artificial intelligence, blockchain, cloud, and data.

The future of healthcare, as with many other industries, lies in digital transformation. Without reinventing ourselves, we will face increasing constraints such as manpower, in taking care of the rise in chronic conditions and meeting the aging population’s healthcare needs.

How are you driving innovation in the hospital to improve safety and efficiency?

Innovation does not exist in a box, and every individual in the hospital is a potential innovator. We believe that every one of our staff can improve our day-to-day operations and ways of working – and that aspiration is palpable across our teams and departments.

Our Medical Innovation and Care Transformation team is on hand to help make these aspirations a reality. The team provides a bridge to equip our healthcare staff with the necessary skills and tools.

Innovation could take the form of collaboration and co-creation with companies, including multinational corporations and start-ups. We also have ongoing working relationships and partnerships with several universities and schools, and look forward to more collaborations in the future.

As an Academic Medical Centre, we not only focus on delivering the best medical care possible, but also look into care transformation using the latest medical innovations and technology. For example, we partnered with Amazon Web Services in a hackathon. We invited local students to use AWS cloud tools to develop solutions that complement and strengthen our usual approach and processes to address key healthcare issues.

What technologies and tools most interest you currently?

Innovation is much more than just technologies and tools, but when it comes to the current fields of interest, I think they could be summarised as ‘ABCD’. In healthcare, we traditionally relate ‘ABCD’ to airway, breathing, circulation and disability. Recently, the same acronym has been used to denote artificial intelligence, blockchain, cloud, and data.

Will these be the vital signs of our future healthcare? Or is it all just buzz and hype?

Will these be the vital signs of our future healthcare? Or is it all just buzz and hype? We probably do not know its full content or potential as yet. But all four areas are definitely of great current interest – particularly visual analytics, where optical sensors or cameras help to drive excellence and efficiency.

Real-time notification using technology will make healthcare more effective as it reduces the need for registration and time-stamping work, while enabling behavioural change. Currently, in many daily practices, we are still doing manual tasks such as collecting data and tabulating reports. Real-time notification could change that almost dramatically.

It is important to note that innovation will only be of value if it translates into improved patient care, or if it increases joy in the workplace and boosts employee satisfaction. We will simply not be able to deliver the healthcare of tomorrow if we continue using yesterday’s paradigms.

Exclusive Interview: Chief Business Transformation Officer, Bumrungrad Hospital

David Boucher shares his transformation vision for the year, and how the hospital is using robotics to cut waiting times.

Bumrungrad International Hospital is a private multiple-specialty 580-bed hospital in central Bangkok, Thailand. It is known for being a key player in medical tourism in the region. Hospital Insights Asia speaks to Chief Business Transformation Officer David Boucher on how robotics is being used in spine surgeries and to cut waiting times, and efforts at closing the gap between care teams and patients.

What is your vision for Bumrungrad this year, and what role does technology play in that?

My vision for 2019 is to really support the overall hospital vision, which is to provide world class holistic healthcare with innovation, and improve customer stickiness. One of my personal visions is to continue to support the excellent doctors, nurses and other caregivers that we have – the actual folks that are hands on – as they offer a safe service to our patients.

At a high level, I will continue to support our shift to robotics, everything from prostate surgery to joint care, or makoplasty with robots. Those are some of the things we are doing in the pharmacy and lab with robotics and of course, with artificial intelligence as well.

Key to my role here is to really accelerate our pivot to become much more consumer-focused, to really respond to the whole Insta-culture, the on-demand culture in the world in which we all live now.

How are you using robotics in the management of the hospital and making things more efficient?

On the surgical side, we have a centre of excellence for robotic spine surgery. We also use 3D monitoring – it really helps to reduce the surgery time and the patient’s blood loss while encouraging a fast recovery. Most patients are walking after spine surgery practically right away. And they’re in the hospital for nine to 12 hours, and then they’re on their way. That helps us to provide safer medical surgical care, but again, lower anaesthesia time and blood loss and that is better for the patient.

Secondly, I believe Bumrungrad was one of the first hospitals in the world – certainly one of the first in Asia – to have a fully robotic inpatient pharmacy. Everything is bar coded, the meds and everything else. It’s helped us to really lower our medication error rate and of course reduce the whole throughput time.

On that note, one of the couple areas we hope to improve is that outpatient pharmacy patients do complain about how long they have to wait to get their meds. By 2020, we will be implementing a fully robotic outpatient pharmacy, which I believe will be the first in the world.

The intent of that really is not only to maintain a very low error rate but also to really cut the time that our patients have to wait. It could reduce waiting time by well over 65%. That really helps to get patients on their way to where they need to go.

How are you using technology to improve patient experience?

One of those things I recognised when I started last year in July is that none of the hospitals in Thailand were involved in telemedicine when increasingly, the 3G and 4G networks are great, and 5G is coming.

We will launch in the very near future a mobile app that will include telemedicine. Bumrungrad has made a significant investment in a company called Doctor Raksa, the leader of telemedicine here in Thailand.

The app will start with telemedicine function, which will be live by the end of April. The functions will morph in an iterative fashion to include online appointments so that consumers can make their appointments online; retail pharmacy; and then over the next few months and years, we will continue to add functions. And we are in the process of integrating the mobile app with our EMR system so that our telehealth physicians will have access to key points in the patient’s history.

For our foreign patients, we have already launched a programme where we do second opinions through telehealth. Specifically with a clinic that we own in Yangon, Myanmar. We started that about a month ago. That allows, for instance, our orthopedic surgeons here to actually talk to and work with the patient before they get on a plane to come here. There is no point people having to get on planes and coming here, if they don’t really need to.

One of the other things from a patient service perspective is that we have worked on reducing our lag time for patients making appointments. As of today, we are completing probably about 70% of all of our patient appointments requested through email or telephone within about four hours. For us, that’s a dramatic improvement over the last quarter.

Another thing I am hoping to lead this year is the ability for our patients to make near real time on-demand patient appointments, right through our app.That is certainly where we aspire to go.

How you are improving the patient-doctor relationship, and what sorts of tools are you using there?

We are keen on being able to use data from patient wearables and implantables. I can’t expand a whole lot just yet, but we will start with one or two particular disease states. At a high level, potentially, our kidney centre of excellence.

For diabetics, certain devices such as home monitors, bathroom scales, blood pressure cuffs, could potentially feed data directly into our patient portal. Both the patient and the attending physician and nephrologist can access that data as well.

It’s about convenience for the patient. In this particular case, the patient doesn’t necessarily have to deal with Bangkok traffic to get here. But it will also allow us to think long term, with a physician and health coaches, to help that patient avoid a diabetic coma and issues around that.

Finally, where would you recommend for lunch in your home city, or anywhere in the world?

I’m a runner and run every day; my number one lunch recommendation would be a hot dog at Boston’s Fenway Park.

Image from Bumrungrad International Hospital Facebook page