The Virtual Care Bill of Patients’ Rights

When I first entered healthcare in the year 2000, I did so in the hallowed halls of the Mayo Clinic, where the spirits of the Mayo brothers, Will and Charlie, and their father, William Worrall, where still setting the tone: “The needs of the patients are the only needs to be considered”, translated into modern, snappy language as: “The needs of the patients come first.”

Which makes sense, since despite the status that clinicians enjoy, it is, like in any other service industry, first and foremost about the customer, the patient.

Yet it is the exception, not the norm, that healthcare leaders and operations staff think about the experience from the patient’s perspective. True, there is a focus on privacy and confidentiality. Or a focus on marketing efforts to make the patients aware of services provided.

But what about the patient experience? What about the rights, as a patient, a public commitment to state (and live up to) what patients should expect from their healthcare experience — not just in terms of “no harm” and “no medical errors”, but in terms of the service experience?

In my observation, that is where healthcare still has a lot to learn: to design systems and processes that improve the experience of seeking and receiving care.

So, does your organization have a Bill of Patient Rights for Virtual Care?

A Physician’s Bill of Telemedicine Rights

A few years back, in the midst of the Covid-19 health crisis, I shared some key concepts on how to rethink the design of virtual care services to ensure the lasting lasting buy-in into telehealth by clinicians. I described a “Happy Day Scenario” of what the ideal telehealth visit should look and feel like from a physician’s perspective.

In addition, the article also described a “Physician Bill of Telehealth Rights” that covered rights regarding the workflow, the technology, training & support, continuous improvement and pay. You can also download a printable PDF version of the article.

Serving the Needs of the Modern Healthcare Consumer

Many customer-service focused organizations, such as the hospitality industry, the in-person entertainment industry (think: Disney), or even retail do a superb job in putting themselves into the mind of their target customers.

What are their needs? What are their desires? What needs may they not be aware of (latent needs)? What are customer “delighters” and what are the “distractors” that take away from a satisfying experience?

Healthcare, however, is, for the most part, still quite different. Many, especially in “traditional” healthcare settings are taking the “showing up” of patients for granted. The industry as a whole has a hard time wrapping its mind around having to woo and win patients as customers — which explains some of the successes of innovative healthcare clinics that have sprung up all over the country.

In my observation and analysis, this stems mostly from the 150, 100 year old model of very limited access to qualified medical professionals. Medicine, for a long time, was “magic” using processes and machinery and tinctures that, as time progressed, showed increasingly positive outcomes. Patients showing up at the physician’s doorstep (or summoning a physician for a house call) were simply in awe of what the physician was able to do for them as patients or their loved ones.

The attitude toward physicians was for the longest time one of deference, one of great respect and gratitude.

A Trojan Horse to Sneakily Improve Care Delivery

The modern times, however, have changed that.

As modern healthcare consumers we have access to Dr. Google, Facebook groups, Reddits and YouTube.

Many aspects of medicine have lost their mystery to us patients.

Ever since I started implementing telehealth in 2008, I secretly used the rollout of telehealth as an “excuse” to redesign the delivery of healthcare — a kind of Trojan Horse. Virtual care for me is about empowering clinicians and staff to “enable the delivery or extraordinary care”. Excellent telehealth is optimized for clinicians and for patients alike. For their experience and for the clinical outcomes.

As we are rethinking all aspects of care delivery in a remote environment, we have a unique opportunity to do it differently. And developing, declaring, and delivering on a “Patient’s Bill of Rights” for Virtual Care is an excellent starting point.

Patient Bill of Rights for Virtual Care

So what would a sample bill of rights look like? Here’s an example you can use as a starting point to develop your own.

As a patient receiving virtual care:

§1 You have the right to be adequately prepared for your virtual care visit. This includes assistance with the technology, with connectivity, and with the processes for preparing for the virtual care visit.

§2 You have the right for a medically appropriate pre-visit process, that ensures that all the pertinent information (e.g., your primary health concern (no, it’s not a “chief complaint”), your vital signs, your current medication, etc.) are captured and shared with your physician.

§3 You have the right for the clinician to give you their undivided attention, be properly trained in the use of the technology, and to present with a highly professional appearance, an appropriate background with no background noise, reliable technology, etc.

§4 You have the right to be adequately taken care of after the visit, including the receipt of a visit summary and support with filling medications, scheduling follow up appointments, scheduling referral appointments, or assistance with scheduling lab tests.

§5 You have the right to upfront transparency of cost, i.e., clarity on deductibles or out of pocket expenses prior to scheduling your appointment.

Most of these rights should resonate with your organization and most likely were addressed quite appropriately in an in-person environment. Somehow some organizations, though, may have lost sight of these promises when they added a virtual care delivery modality.

Implementing the Bill of Patient Rights

Telehealth is definitely here to stay and here to grow and if you don’t offer a great experience, dozens of virtual competitors are targeting “your” patients to offer a more convenient, more pleasant experience.

To make the necessary changes in your processes, policies, and technology, you must undertake the following steps:

1. Design all workflows (the 7 Thworfs) to optimize the patient experience for satisfying the patient’s rights.

2. Select and configure all technologies to meet the needs of the patients, especially around connectivity and ease of use.

3. Provide appropriate and adequate support for patients, e.g., by using a Telehealth TechCheck and a TeleRooming process.

4. Continuously improve the service by periodically collecting and acting on patients’ feedback.

5. Co-design the experience with patients, and do not hesitate to iterate the processes multiple times, based on feedback and patient focus groups.

It is important to remember, though, that while focusing on the patient experience is necessary, it is not sufficient by itself. The primary driver of patient satisfaction is, surprisingly, not the technology or the workflows.

The primary driver for patient satisfaction is how the clinician conducted the visit. Thus investing in clinician satisfaction first is critical to achieve high patient satisfaction.

For a copy of our Virtual Care Bills of Rights for Physicians and Patients (including a downloadable PDF), check out the expansive resources section on our website.

You’re invited to Telehealth T-Time: A Community for Telehealth Enthusiasts. Three pragmatic sessions with insights from your Telehealth peers at this free event every third Thursday. Register for free now.