Serving senior-aged patients can require a different approach, and hospitals won’t know if they’re meeting the needs of this population without a strategy that involves measuring satisfaction and quality.
Engaging these patients in the best way is a current goal for Rodney O. Tucker, MD, MMM, FAAHPM, director of the Center for Palliative and Supportive Care at the University of Alabama at Birmingham (UAB), and also chief experience officer with UAB Medicine. UAB uses the CAHPS Hospital Survey and other standard measurement tools, but in addition to measuring satisfaction, UAB is focusing on engaging patients more — and differently.
Senior-aged patients are not the same as millennials, baby boomers, or Generation X, and trying to engage them in the same way won’t be successful, he says. A 75-year-old patient, for instance, is most likely to be a consumer of illness care, while a patient in his or her 20s is probably a consumer of wellness care. UAB is analyzing its patient survey data to determine what patients 65 and older value in the healthcare experience, and how that differs from other groups. With that knowledge, UAB can better target efforts to engage those patients.
“Every improvement project we undertake now includes a look at the older population and how they engage in the healthcare system,” Tucker says. “We’re paying very close attention to the idea that their experience may be very different from someone younger. They might not need as much transitions of care, being moved from one place to another. They might need more deliberate family engagement to discuss discharge plans.”
Younger patients, on the other hand, may be more concerned with easy access to healthcare when they need it, and they certainly are savvier with technology. They will be more loyal to the healthcare provider when they can satisfy many of their healthcare needs online, and when they feel the cost of services is reasonable, since they likely are paying more out of pocket for copays, Tucker says.
“The traditional model of coming in for a physician visit so the doctor can sit down and go over lab results and discuss their health isn’t going to go over well with those younger patients,” he explains. “They’re used to making dinner reservations on OpenTable and ordering everything off of Amazon.com. Coming in to the office for a five-minute conversation seems ridiculous to them.”
Older patients may be comfortable with using technology and the Internet, but they are more likely to prefer the more traditional interactions of office visits and face-to-face conversations with the doctor, he says.
Those differences also can apply to how the hospital engages with physicians, Tucker says. A younger physician caring for a younger patient might work well because they have similar preferences and expectations, he notes, but that physician might not meet the expectations of an older patient who needs more time, more direct conversation, and more information than the younger patient. Conversely, a young patient may be frustrated if an older physician does not use email and other technology.
UAB is currently studying its provider mix and how their different age ranges affect their expectations and satisfaction. Tucker says he expects the data to lead to strategies in the near future.
The primary concern for older patients is for someone to help them understand the healthcare system, says Romilla Batra, MD, chief medical executive, SCAN Health Plan, which manages care for people 65 and over in a Medicare Advantage plan. They also are focused on having their care provided by someone credible, and they want to live in their own community for as long as possible, she says.
“Based on that information, we have started providing what we call care navigators. These are people who can guide them through the healthcare system and help them understand what their providers are doing and what they want the patient to do,” Batra says.
SCAN also pairs up senior patients who have been through the system with those who don’t have much experience, to serve as a guide and companion. In addition, the health plan provides a care transition coach for those recently discharged from the hospital. This person helps the patient understand the process after discharge and assists with practical considerations such as getting to the pharmacy or doctor’s office, Batra explains.
“Even in this age group there are different personas, with some being very involved with email and computers, and some who completely avoid that,” Batra says. “We try to meet them where they are. It’s important to know the common or more likely characteristics of people in an older age group but at the same time you have to remember that individuals may not fit that profile.”