<v Jordan Cooper>Hello. Well, hello and welcome to the.</v>

<v John Lynn>Listen, uh, sorry. It's gonna be about 20 minutes. Sorry, I should.</v>

<v Jordan Cooper>Hello and welcome to Healthy Data podcast with Jordan Cooper from Inter Systems. This is a we're here today with John Lynn, the founder of Healthcare IT today and healthcare marketing community. He's also the host of the CIO Podcast Healthcare IT Today Podcast and Health IT interviews podcasts. John, thanks for joining us today.</v>

<v John Lynn>Yeah, it's great to be on the show, Jordan.</v>

<v Jordan Cooper>So I think where we're gonna start is discussion about digital front doors. We typically talk about emerging trends across the industry. You're well positioned.</v>

<v Jordan Cooper>Ohh Jim, small pots and speaking with some of the nations leading CEOs in the healthcare space. Well, I'd like to ask you is what are you hearing about digital front doors, convenient patient experiences especially now that patients are experiencing in different industry sectors for instance, same day delivery from Amazon transparency and accountability. What are you seeing when in the healthcare space with digital front doors?</v>

<v John Lynn>Yeah. So I think we've seen the industry kind of be forced to transform and there's a number of pressures that are happening right now that didn't happen before. And so as I look at it, I see that the healthcare organizations for in many regards kind of took the patients for granted. They had to either monopolies or you know, patients would just go to their insurance company and go to that organization to get their care. But as we've seen increase in high deductible plans.</v>

<v John Lynn>Patients now are choosing where do they want to go to get their care. Plus we're seeing an increase in information. Everyone can Google anything to find out about an organization, about a doctor, about whatever they wanna do for their care. They can understand what's the quality of that person using various quality scores or what's the customer service of this organization. And so that easy access to information is making it so patients have more choice and they're making different choices.</v>

<v John Lynn>In their care versus before, which was ohhh. It's the closest one. So I wanna go there, you know. Or hey, it's on my insurance so that I can go there. Right. And so I think we're seeing the patient being more proactive in who they're choosing to get care from. And now we actually have more options available to them. And as they choose their care. So those dynamics are forcing the healthcare organizations along with this increase of consumer direct to consumer care.</v>

<v John Lynn>From the Amazon one medical acquisition or from, you know, telehealth or or even from CVS and retail health, you know, Walmart, etcetera, all getting into their the healthcare as well. All of those pressures are forcing healthcare organizations to say hey, we now have to transform how we're interacting with patients. We can't take them for granted anymore and say oh, it's fine if they wait for an hour in the waiting room and then they wait for another hour in the exam room and then they're like, wow, this was the worst.</v>

<v John Lynn>Experience I've had ever. And so like they now have to say no, we need to embrace things like online self check in, you know, informing the patient of where they're at in the process and how long they're going to have to wait. You know, I I love to say that the DMV figured that out and can tell you when you're where you're at in line and how many more ahead of you like, why can't healthcare if the DMV can do it. And so I think that's what we're seeing is this kind of embrace of digital transformation on the front door and the the waiting room experience, the check-in experience.</v>

<v John Lynn>Etcetera. That before we weren't seeing because they just didn't have to.</v>

<v Jordan Cooper>So you mentioned patient satisfaction and evaluating kind of where they wanna go and how they want to receive their care. That said, there have been HEDIS patient satisfaction scores for decades that have been at least.</v>

<v Jordan Cooper>Elbow the providers. How would you say patients are? How would you say patient satisfaction is being evaluated differently and how that's affecting healthcare today?</v>

<v John Lynn>So here's the problem. I'm not sure we can evaluate the quality of a provider. I I'm. I'm not convinced that we can and I haven't seen that, but because if we could, every patient would do that. Ohh, this is the person who's gonna give me the best outcome. Let's go there, right? I mean that. Sure, there's some other dynamics. Can you afford it? Can you get there? Etcetera. But for most of us, we would say, oh, we're gonna go to the person who has the best quality scores. And so unfortunately, I haven't seen anyone that's been able to really assess.</v>

<v John Lynn>Quality property? Yeah, there's heat as scores. There's some, you know, there's some outcomes, things, but none of them really focused fully on how good is the quality of what you're providing. And so instead we use these kind of like faux scores that we could kind of think might be quality. For example, we might say, do I want to go to the Doctor Who has done five of these surgeries or do I want to go to the Doctor Who's done 5000 of these surgeries. And so it's it's kind of a fake.</v>

<v John Lynn>It representation of what the quality is, because I assume some of that's done 5000 is going to have a higher quality than someone who's done 5, and that probably plays out pretty well because you've had the experience of good and bad and that you've learned from those experiences. And so we have these faux scores like that to understand what the quality is. The other one that I think actually patients use more than anything because it's the only thing that a patient truly can evaluate.</v>

<v John Lynn>In in a office visit or for a visit to the hospital. And that is what was the customer service that was provided to me. What was the patient experience like to me? So if you go to any of the ratings and review sites for it, including Google, who is actually the behemoth of all this? If you look at any ratings or reviews there, health grades, zocdoc, et cetera, et cetera, right. If you go to those, all that patients are really evaluating is.</v>

<v John Lynn>What was the patient experience like? Did the doctor have good bedside manner? Did I enjoy the front desk experience? What was the payment like experience like and so that's what they're evaluating. But what's interesting is most patients aren't sophisticated enough to realize that. Ohh, the health grade that you got on it, right. Or the rating you received on Google really really relates to your customer service experience versus your quality experience and so in.</v>

<v John Lynn>In their mind, they may look at it and say ohh they're the highest rated. They must be a great doctor when they don't understand that really what the that rating is saying is either you know it could be two things actually they're a great doctor that provides great customer experience, who knows what they're quality is like or it could be oh, they're really good at gaming the ratings and review site, which is a kind of topic for another day.</v>

<v Jordan Cooper>So it sounds like quality of information is something that's difficult to discern for patients, and it's also difficult to evaluate quality and then tie the connection between a quality metric. For instance, it's used by CMS and outpatient prospective payment system or some sort of national quality forum quality metric and what patients are actually looking at, how, how are healthcare organizations responding to patient demands and how are they correlating?</v>

<v Jordan Cooper>How they're paid to improve quality with what patients are actually requesting and demanding in terms of the quality of care.</v>

<v John Lynn>Yeah, I I think it's a challenge, right? Because if you have an MD after your name, you have a certain expectation of quality and that that doesn't matter. If you gotta see in Med school or you got an A or, you know, whatever else it might be. And so I I think we all have a a challenging time understanding what's the quality that's being provided, for example, hey, you know, here's how I evaluate quality. I got better and you're like, OK, wait. Is that true though, right? Maybe it took you seven days to get better.</v>

<v John Lynn>And you should have gotten better in two days, so it's just really hard for a patient to be able to do it. Even doctors in different specialties often can't evaluate the quality of another doctor in another specialty because they don't know what the standards are. So how are organizations reacting to this? I mean, the reality is they have to do it because of things like readmissions. So they have penalties around readmissions. So every health system understands that, and trying to prevent readmissions.</v>

<v John Lynn>And so they're working on things like that. But I don't think they worry about the quality on that side. I think it's more about what is our brand, what do patients think of us? Do they see us as a high quality organization? And so I think they look at it more from a brand perspective and how are we, you know, sharing this brand with our patients so that they have an expectation of quality that they understand that we do care about the patients. And to be fair, most healthcare organizations do that. They really do care about the.</v>

<v John Lynn>Their patients and they wanna do what's best for their patients. So you know, there's it's pretty rare that someone's just trying to, you know, do something off and guard that isn't, you know, really at the best interest of patients. But I'd say the biggest challenge they face is that the operational minutiae that the regulations, the reimbursement requirements make it hard for a health care organization to show that they really care about the patient. And so, to me, this is actually where technology is really interesting.</v>

<v John Lynn>Is can you use technology to make the experience better for the patient and the healthcare provider staff and the clinical staff? And I think that's what is possible now with things like automation, it applying AI to automate some of the front desk experience. Why? Why does a front desk need to be there to check the patient in right like in a lot of ways it's not necessary and we we've seen that in a lot of organizations that you can automate a lot of those.</v>

<v John Lynn>Processes which creates a great patient experience and a great front desk experience, which then of course, if the patient's going back much happier because they got checked in quickly. They had a great friend and experience. Well now they're not taking it out on the nurse that's taking it out. And then the nurse doesn't get burnt out because the patient had a frustrating check-in experience, which then the doctor has to take the brunt of all that frustration.</v>

<v Jordan Cooper>To I we're talking about digital front doors. First of all, how would you define what a digital front door is?</v>

<v John Lynn>Yeah, it's a good question. And there's a lot of definitions out there and. And so I I think you know it's it's a really good question in that regard. And so some people look at it as how am I even gonna find care? So that's like the broadest interpretation is how do I know where I'm going to go for care and who's gonna make that decision? In fact, we're seeing a whole series of companies that are kind of being called care navigators or something along those lines that basically are saying should I go to the Ed? Should I go to telehealth? Should I go to my?</v>

<v John Lynn>Primary care, doctor, should I go directly to a specialist? Should I go to urgent care? Should I go to convenient care? Should I go to retail care? Should I go to like the options are so amazing right now. To be fair. Like, that's actually cool that we have this many options. But as a consumer, it's really confusing. So that could be considered the digital front door. Hey, I've got a fever and I've got this symptom. Where should I go? So that's one definition that we see happening is oh, how am I gonna determine where I should go for care and how am.</v>

<v John Lynn>That's that digital front door that you help me understand what my symptoms are, what I'm experiencing and where should I go for care? The other digital front door is more of what we talked to. I talked about previously, which is how am I going to go from? I have an appointment or I have a surgery scheduled or whatever it might be. And how am I going to start interacting with that? You know, the doctor through the check in process through, you know, the waiting room through, you know, even all the way down to the.</v>

<v John Lynn>Came in experience on the back end as well. And what does that front door look like? And then you know, which interestingly enough, the front door becomes the the back door as you start collecting payments as well. So I think that's the other experience where we're dealing with and changing which is how do I register, how do I get checked in, how do I schedule an appointment etcetera. Those are all big elements of that digital front door.</v>

<v Jordan Cooper>But with the proliferation of different care options, I guess the question is, are you actually, is it all leading to more informed choice for the patient? And then in that respect, I'd like to ask how would you compare the goals of patients compared to healthcare organizations?</v>

<v John Lynn>And.</v>

<v John Lynn>Yeah, I mean that, that's that's a hard question because you're you're right then. I mean the, the the extra options are great, but it it is challenging for patients because they don't know where to go and they don't know what to do. And so we found one principle overrides all of patients decisions which is convenience it's it's amazing how much convenience outweighs even quality care in some some regards right it's more convenient.</v>

<v John Lynn>And then we can rationalize in our head well, they both have an MD, so that it's probably about as good, right, like I can't assess quality. So I can access is it convenient and so that's to me the biggest driver of patients today and it's probably coming from these other situations that we have in retail, in Amazon, in Uber in you know like Uber eats, et cetera, right, like all of these things are become so convenient. We're saying we want that in healthcare as well.</v>

<v John Lynn>So that's the mindset of the patient's what's the mindset of the provider? Well, it really, really, really depends. If they have a monopoly, they may not care about convenience. They may still be taking the patient for granted. And you know, if you have a three month waiting list for patients to get into see you because you're a specialist and you're in such high demand, you care about convenience, maybe, right? Like maybe you do. But like, you got a three month waiting list. You're not really driven to provide convenience. So there is a disconnect, right?</v>

<v John Lynn>For many organizations where they don't understand how important convenience is to a patient and they baby don't have the need to drive to that convenience. That said, we're seeing a lot of organizations that are waking up to this fact that hey, we need to provide a convenient quality patient experience and that if I don't, that's gonna catch up with me eventually. And especially as you look at like the shift to value based care, if I don't have a relationship with the patient.</v>

<v John Lynn>Where they trust me then can I do value based care? I think that's an important question that many healthcare organizations are asking themselves and saying that starts with things like the digital front door and providing the convenient experience. So they know, hey, we do care about you as a patient because otherwise if I provide a terrible experience to you and then I come to you and say, hey, you should do this, I'm going to be a little skeptical that you're doing what's in my best interest rather than what's in your best interest.</v>

<v Jordan Cooper>So I guess if we are digital front doors making the the patient experience more convenient and is it our digital front doors bringing more patients in the door?</v>

<v John Lynn>Yeah, I I think it is for most organizations, right? I mean, sure, it's like an EHR. EHR's are great when implemented properly. When implemented poorly, they can be awful, right? Like you can create an awful experience for someone. So the same is true with the digital front door, are you? If you do it in the right way and you do the communication and the marketing that's required, which is an interesting thing, I don't think most healthcare organizations see themselves as marketing organizations, but they need to start embracing the marketing mindset.</v>

<v John Lynn>Two patients to create these experiences, right? If you do it right with the right marketing and the right education that's needed for a patient to embrace these concepts, then yeah, it can, you know, be an amazing experience for patients and it can, you know, drive them to come for even other visits like Wellness visits or follow up visits. You know, you can use this new digital front door as a way to drive behaviors that are going to benefit the patient and the organization. So.</v>

<v John Lynn>I think it goes down to how are you implementing it. You know if you implement it poorly, it's just gonna confuse patients and you're gonna get more phone calls. But if you do it well with an organization that understands the nuances of what's required to check in a patient or what's required to navigate a patient between urgent care primary care specialists and you know, or even the Edu right, like, then you can create this beautiful experience. But if you do it halfway, if you do it poorly, then it could be a terrible experience. So it all goes down.</v>

<v John Lynn>To the, you know, brass tacks of how did you implement it?</v>

<v Jordan Cooper>So John, as we approached the end of this podcast, I'd like to invite you to add some final thoughts about.</v>

<v Jordan Cooper>How our listeners, CIO's and.</v>

<v Jordan Cooper>The thought leaders in the health IT space across the United States, if they're thinking about implementing a digital door if they've already implemented it, but they're looking to get more patient engagement, what are some of the final lessons and takeaways you think they should be aware of when you're thinking about how to create a more convenient experience and a better patient experience in general at their organization?</v>

<v John Lynn>Yeah, I think the key is to to think about this really broadly. Unfortunately in tech, we like point solutions because they're a project and we can implement that project. You know, let's get rid of the clipboard in the exam room, right? Like, that feels like a cool project. Let's do digital check in and and and include that. And let's get rid of that clipboard that no one wants to fill out. Let him fill it out at home.</v>

<v John Lynn>That feels like a project to me, right? And I think that's the wrong mindset. Like that might be part of a bigger overall strategic plan is being able to replace the cupboard and that might be an element that happens within a bigger vision of what you're trying to accomplish. But if you approach it from a project standpoint, then you're going to receive results that are just congruent with that project. Whereas if you think about it more holistically and saying what should the digital.</v>

<v John Lynn>You know, front door really look like and listen to patients, ask patients what do they want to experience? What should this be? Then you're going to see a lot of other opportunities that present themselves. For example, when I replace that clipboard, what am I gonna do to or how could I leverage that new connection that I created with the patient and that new opportunity to engage them? What could I have them do? Could I have them sign up for a CCM program? Could I have them sign up for?</v>

<v John Lynn>You know something else or or you know, or even educate them about something that's important for them while they're doing the sign up process or while they're in the waiting room. You know, being, you know, educated that, hey, your third in line in the waiting room. And you know, now you guess, what you have a captive audience where you could educate them, you could engage them in something that would be useful to your organization and benefit the patient. So to me, it's like, open your gaze and stop working on projects and think more holistically about.</v>

<v John Lynn>OK, this is an opportunity to really engage the patient. How can I assure replace the clipboard and, you know, make that a more efficient process for everyone, but also capitalize on the opportunity that I haven't engaged patient with me.</v>

<v Jordan Cooper>OK. Well, that's been a conversation on the biggest driver of patients today is convenience and the best way one of the best ways to offer convenience to patients is through a digital front door. I'd like to thank John for joining us today. Again, John is the founder of Healthcare IT today and healthcare marketing community and is also the host of three podcasts the CIO Podcast, Healthcare IT Today, Podcast and Health IT interviews podcasts. John, thank you for joining us.</v>

<v John Lynn>Thanks, Jordan. There's a lot of fun.</v>