Paul Roscoe is co-founder and CEO of Docent Health of Boston, MA.
Tell me about yourself and the company.
I’ve been in healthcare my whole career. I’ve had the privilege of working with some amazing teams over the past 25 years at Sentillion, the Advisory Board, and Crimson.
I’ve been very privileged now to work with an equally amazing team of folks here at Docent Health solving a problem that is a top priority for most, if not all, health system CEOs. Which is, how do you think about the patient experience in dramatically different ways and more compelling ways than we’ve seen to date?
If you think about other industries that have done an amazing job of redefining the experience their customers have when they’re engaging them, healthcare has a lot to gain and learn. That’s why we created Docent Health — to be able to think about a completely new approach to experience for patients as they go through their healthcare journeys.
What do your patient liaison folks — your docents — actually do? How do they integrate with the traditional healthcare team?
There are two parts to the story. One is the use of technology to fill a gap that exists today between the electronic medical record — which has a very good, rich, clinical representation of the patient — and maybe the CRM, which has a more sales and marketing orientation of the patient. There’s this gap between the two, which is providing a rich profile on the patient as a human being.
What are their concerns? What are their anxieties? What are their preferences? Building out a rich profile so we can understand previous experiences and then personalize an experience to them.
It feels like health systems are treating patients as a stranger every time they interact with them. There’s a lot of opportunity to capture this information and make sure we’re personalizing the experience.
There’s a large role for technology, but we felt that there was also a bit of a service gap in terms of how you then engage with a patient. Clinicians are extremely busy, focused on top of license. There’s an opportunity to partner with those caregivers to deliver a new service approach. In our business, that is through a service function that we call the docent program.
Docents are empathetic, hospitality-trained, customer service-oriented people coming out of healthcare. They may have been nurses who don’t want to nurse, or they’ve come from hospitality or other customer service industries. They provide a bridge in many ways between the patient and the caregiver. They act as a guide. They set expectations.
They are providing service touches throughout the journey. Not just in an inpatient setting. That’s obviously the logical one, but we’re now engaging with patients throughout they’re journey.
One of our health systems is focused on maternity. If you think about the journey for a mother, her inpatient stay is only two or three days, but there’s all this time before and sometime afterwards where we can be engaging with them to understand what they want from their experience. That’s the role of the docent.
When hospitals get docents involved, is there resentment or conflict with staff who are accustomed to being the only connection to the patient?
I’m not sure I would frame it as resentment, but certainly there are logical and understandable concerns that one must initially overcome. Clinicians feel they have a sense of responsibility for the patient and they’re bringing on a new resource. You almost have to earn your stripes.
One of the things we do at Docent Health is to very much focus initially on that relationship between the docent and the caregiver. What we’re already starting to see from the work that we’ve done with our customers is that there’s a lift in staff engagement. Clinicians have joined healthcare, on the whole, to deliver great care. Many of them have become somewhat disenfranchised because they’re not able to provide the amount of time on an individual patient basis.
The docents now are building relationships with patients in more meaningful ways. Perhaps earlier on in their journey, starting to capture this picture of what’s important to patients. Then sharing it with the caregiver, so that when the caregiver does interact with that patient, it’s not generic — it’s personalized to things that are relevant for that patient.
Our belief is that for experience to be successful, it must meet two tests. It’s got to be a better experience for patients — make them feel like they want to come back, make them feel loyal. It also absolutely has to be a great experience and have lift for the staff, because at the end of the day, it’s a complete, total experience.
One view would be that we don’t have ways to capture the necessary non-clinical information, while the other would be that clinicians don’t have the time or maybe even the ability to do something with it even if we did. Does the docent make the process less laborious than reading a lengthy, free-text narrative at the right time in the process?
It’s a good observation. The logical technology solve to this might have been to say, "We’re capturing all this information about what’s important to a patient. Why don’t we just push that up into the electronic medical record?" The reality is that clinicians are already at their breaking point sometimes on the use of EMR, so putting more data in there and flagging it wouldn’t necessary be the solve.
We’re engineering processes where the docents — on a daily, maybe even more frequent basis than that — are huddling with clinicians, and at the right, appropriate time, delivering information that might be relevant for that particular patient. We operate in the nursing huddles. We participate in the rounding meetings.
Rounding is an interesting concept in a hospital. It’s like the general manager of a hotel randomly knocking on four or five doors saying, "How are we doing?" What we’re able to do with the docent program integrated with the caregivers is have rounding that is more personalized and adaptive to the issues the patients are facing rather than generic. That’s an example of a process where we’ve integrated the docents into that rounding so that we can provide a lot more lift and a lot more information that’s relevant to the patient.
What incentive do health systems have to get to know their patients better?
It comes back at the end of the day to whether you are in a fee-for-service world or a risk-sharing world. Health systems are waking up to the realization that they haven’t done a lot of work in terms of building a relationship with a patient, a relationship that takes their brand and makes it much more personal to that patient. Consumers are paying more for their healthcare then they’ve ever done before, having more choice, and going to different venues to make that choice. They don’t go to the common channels that health systems might like around cost and quality. They’re going to Yelp. They’re going to other social media resources.
The final frontier for a health system to build a relationship is not just about clinical outcomes. That’s a much more of a level playing field these days. It’s about experience. If you look at outside of healthcare, great brands have created an experience around their products and services. Product and service, in many ways, is somewhat incidental to the experience they can wrap around. Their belief — and there’s proof — is that that experience creates a relationship, and the relationship equates to retention, loyalty, and maybe in a more advanced state, advocacy.
Health systems are realizing that consumers have choice and are paying more for their healthcare. There are new entrants to healthcare coming up — urgent care clinics and retail medicine — that don’t have the same baggage as the health system. They’ve figured out how to get an appointment quickly. They’ve figured out what customer service is.
Health systems are increasingly concerned about those.They are realizing that experience is almost an untapped asset. If they do it well, it creates this relationship with a patient that’s great for both the mission and the business.
Is data-driven empathy an oxymoron?
Data-driven empathy? [laughs] When you think about the tech-enabled service model that we’ve deployed at Docent Health, they go hand in hand. You can’t have one without the other.
Just data for data’s sake but not empathetically driving an interaction comes across as clinical and vanilla in many cases. Empathy itself — just being touchy-feely without knowing what the right actions are and using the data to direct those actions — also doesn’t necessarily solve the problem and doesn’t scale. Our view is that you need both.
I go to health system CEOs and say, "If you had $20 million to improve your experience, where would you start?" There’s a lack of data to figure out what things make a difference to a patient that you should be focused on. We’re hoping to provide much more data inside our platform to help guide those.
The empathetic service model is as important as the data. I would point out that our way of doing it through our docents may not be the right answer for everyone. There are some health systems out there that have already invested in this, both culturally and in terms of resources. For that customer, the technology that we provide might be the most important for them as opposed to the technology and the service.
What kinds of patient information that you collect are most often relevant yet missed by hospitals?
Let’s take the journey of a middle-aged knee replacement patient who has been to that hospital in the past. We can craft an experience for that patient that combines things we know about him individually and preferences of perhaps other patients who have been through similar processes and similar procedures before. There’s a segmentation set of activities that will allow us to tailor this experience. We can look at past experiences and what worked, what didn’t. Whether there were previous service recovery moments in a past experience that we can learn from.
Did he have a good experience with anesthesia in the past? Has he expressed any specific concerns or fears that we want to be able to capture? Do we know of any specific sport that he participates in and he’s anxious to get back to, so we can anticipate his questions and perhaps his needs around physical therapy?
Based on all this data, the journey we could prescribe could include interactions. Pre-surgery discussion of how he’s going to get his knee ready to go back and play his tennis championship in three months because that’s what he’s so focused on. Suggestions for physical therapy near his house that are focused on that.
For us, it’s about taking a personalized approach, but combining that with data we’re capturing on like patients in similar cohorts. Then combining that with data science that says, "We’ve done 10,000 of these journeys for this type of patient before. What we’ve noticed is that if we deliver an experience in this way with these steps — some of them digital, some of them human — the likelihood of a great experience is Y."
Do you have any final thoughts?
For me, after being in healthcare for so many years, it’s invigorating and a thrilling time to be in the patient experience space. The beauty of it, in many ways, is that there’s already a playbook in front of us. Restaurants, hotels, airlines, and other industries have been rethinking customer journeys over the last 20 years or so. There’s been a term for that — the experience economy. It’s been a well-known economic industry that’s been created through these experiences. In many ways, they had no choice but to innovate and to evolve.
Now healthcare has this same opportunity. It’s an extremely exciting time to be able to use my experience in healthcare and that of my team to fuse that with these learnings, best practices, and approaches that have worked in other industries.
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