CareDelivey_Bradley Kruger: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Manav Sevak:
Welcome to the Memora healthcare Delivery Podcast. Through conversations with industry leaders and innovators, we uncover ways to simplify how patients and care teams navigate complex care delivery.
Manav Sevak:
Hey, everybody, this is Manav here from Memora Health, really excited to have Brad Kruger from Advocate Aurora here as a guest today. Brad, thanks so much for coming on.
Bradley Kruger:
Thank you so much for having me. Excited to be here.
Manav Sevak:
Yeah, awesome. So, you know, you’re in a pretty interesting role, a chief experience role with Advocate Aurora, which is one that’s starting to appear in healthcare and is relatively new. So we’d love to, to maybe just get the quick introduction for the audience on the work that you do and maybe hearing a little bit about your background.
Bradley Kruger:
Thanks. Yeah, like you said, exciting times, especially as the consumer, customer piece comes into healthcare more, more and more. And how to use the voice, that voice of the customer to redesign healthcare, really redesign care pathways to better meet the needs of each and every patient, individualized and personalized care, and how do we do that effectively and efficiently across the organization each and every time. So that’s again, the challenge and the excitement, I’m lucky enough to be in the role of system vice president for patient experience again at Advocate Aurora, overseeing the experience that patients have in the clinical care arena, whether that’s virtually or, or face to face within the four, within the four walls across 26 hospitals and 500 clinics. So some of my background, yeah, it’s just an interesting path I’ve had, I think and to, and to get here but very excited to have this opportunity.
Manav Sevak:
Yeah. No, that’s, that’s wonderful. And you know, it feels as if the world of, of patient experience has never been as exciting as it is present day. And, you know, part of that is, is obviously because of new technologies that have come to life, part of it is because of regulatory changes, oart of it is because of just the state of the healthcare system in the United States. What are some of the, the really kind of interesting trends that maybe you’ve seen because you’ve obviously been in this space for a while, so what are some of the trends that you’ve taken away from how patient experience has evolved over the past several years and maybe just what makes right now so exciting?
Bradley Kruger:
And I have, not too, not to say my age at all, but 20 plus years of clinical and hospital operations behind me and have seen patient experience evolve a lot over time. Going way, way back when it was the first thing when, when we used to hand out a paper survey to patients, when they were just leaving the office along with a pre-stamped envelope and ask them to fill it out and send in. And then over time, the regulatory component for Medicare and Medicaid with the CAP surveys and payments tied to, to that and then now with all the opportunities to get really quick, fast, oftentimes frictionless feedback from patients quick and then how to rapidly, rapidly respond to each and every patient and individualized and customized way. And that’s probably one of the biggest things I’ve seen over time, is that the changes in the approach we used to do things every patient, every time, and you would hear that almost as a mantra. And especially in the hospitals, every single patient needs to have this done every single time. And then you start to say, well, that doesn’t work for every patient, every single time. In fact, groups of patients, maybe those age 65 and above or 85 and above, they need something, they need something else in order to have an excellent experience, which includes not just the experience piece, but high-quality experience and a safe experience as, as well. And then how do we measure that, the impact in real-time so we can adjust? I think in the past we used to mail out surveys then and then like a month and a half get the responses back and we would aggregate it and see where we’re doing well and opportunities. And now just with the electronic and the tech, we can make adjustments in real-time and affect the trajectory of that care pathway now. So that’s the exciting part of it, that’s speed and to be able to impact an outcome in real-time.
Manav Sevak:
Yeah, no, absolutely. And I think that that’s also like a, it’s one of the, I think that evolution is something that Memora has obviously benefited a lot from, which you and I had chatted about previously. And maybe related to that, I would love to get your perspective on, in the role that you sit in as you think about benchmarking what experience looks like for the patient, what are the big kind of metrics or milestones that you’re, you’re anchoring on, right? Are there certain, let’s say, north stars that you have in your role around, hey, here’s what we’re going to benchmark that gives us a really good sense and feel for what our patient experience actually is?
Bradley Kruger:
That’s an excellent question, and one that we’ve seen evolve. At least within Advocate Aurora Health, we’ve seen evolve a lot in the pandemic, so for our true North, we have a true north measure likelihood to recommend, and focusing on those top box. So measuring ourselves nationally against a top box score for likelihood to recommend. A lot of discussion around net promoter and at the end of the day fell on top box to align with the way that Medicare CMS looks at patient experience, especially in the Caps Survey, and then also to help us focus our resources to help to drive all of those zeros through eights, and to move them up into that nine and ten, so that’s the true north. And then what we’ve seen was a significant and this is our focus, we used to focus on a lot of the questions on the surveys, a lot, like 30 some questions, now in the pandemic we really saw that not just the key driver for livelihood to recommend is communication. In the pandemic, we saw from a safety and quality perspective that communication not just to patients but to their family members, their friends, their support team, became hyper-critical, everything from status to visitation, to go back in the pandemic and scale back visits, visitation, that communication, the traditional communication channels, really fell apart. So as an organization, we’re focusing on communication, specifically doctors and nurses listen and explain. And we’re seeing that with high communication scores, those top box, it drives all the other questions and results as well include, including helping increase safety and quality outcomes. So that communication now is the, is the focus.
Manav Sevak:
Yeah, no, that’s super, super interesting. And I’ll just, not to go down a wormhole, double click on that a little bit just because obviously it’s interesting, given the work that Memora does as well, as you think about what impacts that experience the most, obviously there are so many different places that even in your introduction you mentioned your role has oversight of experience in the walls of the clinic and the hospital, experience around payments, experience around scheduling experience or navigating an entire complex care plan or care journey, right? How do you figure out how to prioritize those, right? So where do you figure out where to start focusing all of the, let’s say, new patient experience efforts around? Are there certain ones that you have found have a greater impact than others? Is that a very, very holistic approach that you’ve taken? What’s your methodology around prioritizing and ranking those?
Bradley Kruger:
Yeah, that’s, again, great, great question. And we’ve seen that evolve too as we get more and more feedback. In the past, so what happened was a couple of years back, we switched to a electronic short, a very short electronic post-clinical survey that’s delivered through a multi, multimodal channel approach. So email, interactive voice response and text, and it will channel through a patient’s preferences until they find the one that’s in the sticks. And what we saw was a significant increase in the feedback that we were receiving and a large increase in certain populations. So we saw in using that, compared to our paper surveys, the electronic survey process, we saw a 300% increase from our persons of color. So we have a lot of new voices at the table. And what we saw was they’re telling us different things that we needed to, that we needed to improve. So what we noticed then was who wasn’t a readiness top box, which groups and looking at the patterns there across the organization, and it was very interesting to see, what we used to think was maybe it was a variable like we didn’t know ahead of time which patients were going to, if you will, score as high or score slow in patient experience. But we’re seeing these patterns, whether you’re in the South Side of Chicago or northern Wisconsin, if you are 85 and above being admitted to a, to a hospital from an emergency room, you’re pretty much going to score bottom quartile, across the board. So what, so, and knowing that, what do we need to do differently for that subset of patients and how do we utilize technology to connect all of the dots? And as we talked prior with, with, that’s where I see like Memora having that connectivity across all these different touchpoints that in the past they were, maybe not quite as connected.
Manav Sevak:
Yeah. No, absolutely. It completely makes sense. And something that we also, on our product and our care delivery teams spend a lot of time doing research on is how do you build continuity to make it so that a patient doesn’t necessarily think about every single one of those components as a distinct part of an episode? They just think of it as one continuum, where they’ve consistently had touch points, so, but, that makes a lot of sense. Maybe related to that, you know, the, and kind of tying back to, to one of the first questions that I asked you, the concept of even having roles that focus exclusively on patient experiences’ relatively new in healthcare and the amount of investment that’s happening in patient experience now is higher than it’s ever been. And related to that, I think we’ve heard from a lot of systems that it’s no surprise that healthcare doesn’t have the best experiences for their patients. And a lot of people will look to other industries kind of for inspiration on what makes for a really good consumer experience. So it’d be great to get your perspective on, on what other industries do you look to, or are there particular organizations that you look to that, that you think have really done an exceptional job around that broader concept of consumer experience that give you inspiration and work that you do at Advocate Aura?
Bradley Kruger:
I think that’s, yeah, from a tech standpoint, I would say some of those larger like the Amazons, where they sell and they remember, so they know preferences and that is not where they push the products for healthcare. How could we predictably create an experience for a patient just given their history that, that, that would be excellent to be able to implement, I would say the banking industry because of the regulatory component, you know HIPAA doesn’t cover just, just and just healthcare covers the banking industry as, as, as well. So how to gain that customer experience flow from a digital standpoint as well as the in-person coupled with the regulatory environment given that we’re, that we both need to follow HIPAA. They give me a lot of insight and airlines does as well, maybe a little bit different insight now than it was maybe a year or two ago, but still inside nonetheless on how to handle all that feedback that’s coming in quickly and be able to act on it, especially from a scheduling standpoint. And I think that that’s where we’ve seen, we can do a better opportunity in healthcare, how to use that feedback that we get from an individual and reshape their care pathway using it. And you’ve probably seen this too in your journey, it’s a push-pull between safety and consistency and individualized and personalized care. And in the past, I think healthcare felt, fell on that consistency standpoint, do the same thing for everybody. And in order to, to achieve an outcome and what we’re seeing that that doesn’t work for all patients and for and for some it actually creates unsafe episodes. And when you layer in race, ethnicity, economic status, you can see people on the tips and tails of that fall out. So how do we individualize and personalize care and build, and build that workflow?
Manav Sevak:
Yeah, absolutely. Cool. So I know that we’re, we’re coming up on time here, and maybe the one thing that would be helpful to get your perspective on is obviously you’ve been in healthcare for for quite some time and have seen the evolution that it’s gone through. And as we were chatting right before, this, one thing that you mentioned is it still feels like we’re just in the early innings of where healthcare actually needs to go and what it’s going to accomplish as an industry over the next, next couple of years, but what are the things that kind of excites you the most about where the industry is right now and excites you the most around all of the work that’s happening? Are there any really big trends that you’re noticing that, that kind of excites you every single day for the work that you do? Or are there particular initiatives even to Advocate Aurora that have gotten you really, really excited?
Bradley Kruger:
Yeah, I think that being able to quickly, so all of the new listening stations that are out there and knowing when a patient is beginning to go, if you will, a downward cycle, whether that’s with experience or from a quality safety standpoint. And then how do you adjust quickly and how to reach out to them to get them, if you will, back on track or to help them get the resources that they need for their care. I’ll just use one quick, quick example, being connected through text. If a patient’s discharged from a hospital and they were prescribed certain medications for their heart failure, in the past, hopefully somebody would call after a certain period of time, check in and, check to see how they’re doing. Now, we’re able to quickly check, did they get that scrip filled? And we’re able to monitor that. And if they did not find out why, if it’s a financial reason, well, there’s lots of resources in the community that we can help get their scrip filled, making sure that they’re taking their medication and then to monitor then their and their weight, any symptoms that may arise and try to prevent, let’s say, re and, re-admission. But that’s speed, speed and the connectivity excite me. And then also I think the move of patients are feeling more and more comfortable sharing their experiences on social media. So that’s always …. A challenge too. So how do you make sure that they’re sharing positive stories out there with the world and to monitor, and if they aren’t, how do we quickly step in and reconcile the re, and the relationship and get things back on track, so we have that ability now, in the past we didn’t.
Manav Sevak:
Yeah, absolutely. No, that’s, that’s awesome. And it’s just so fascinating to start seeing how healthcare is becoming so much more kind of intrinsically involved in all these other components of people’s lives and tools that they use. Awesome, so on that note, Brad will let you go really, really helpful perspective even for me to hear and for what it’s worth to some degree kind of preaching to the choir around a lot of the patient experience work that that you all are doing and that Memora is doing and excited to hopefully have you on again soon.
Bradley Kruger:
Yeah. Thank you again for the opportunity. Looking forward to partnering in the future.
Manav Sevak:
Thanks for listening to the Memora healthcare Delivery Podcast. For more ideas on simplifying complex care for care teams and patients, visit MemoraHealth.com.
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