Posted: 13 Apr. 2021 10 min. read

Help! I’m stuck in the virtual waiting room…again: Here’s why digital investments alone won’t improve the patient experience

By Wendy Gerhardt, senior manager, Deloitte Center for Health Solutions, Deloitte Services LP

A few months ago, I was sitting on the couch with my 7-year-old. Together, we stared at the blank screen of my laptop and waited for the doctor to begin our virtual visit. At the end of our last in-person visit (shortly after COVID-19 had been declared a pandemic) the staff suggested virtual visits for the future. While this option meant we wouldn’t have to spend three hours driving, parking, and waiting to see his specialist, it didn’t dramatically improve our experience. For instance, we still wound up spending 30 minutes waiting for the doctor to appear (albeit we were in our living room rather than a waiting room). We had no idea how long we would need to wait…or even if we were still connected to the doctor’s office. Our experience could have been greatly improved if the administrative staff had just sent us an email or text when the doctor was ready; then we could have logged into a virtual-visit app. This strategy respects the patient’s time and creates a more thoughtful and convenient experience.

Prior to the pandemic, health systems and doctor offices had little incentive to make virtual visits—or other consumer-facing technology tools—available to their patients. My son’s doctor’s office says a virtual option has always been available. However, they never promoted it or even told me about it. When they started promoting their virtual option, they still ran it like a regular clinic day where the doctor would go patient to patient, be overbooked, and usually run behind. Even tools like online scheduling and online bill pay are not pervasive or seamless. It’s not surprising. The health care sector has traditionally lagged behind other consumer-facing sectors when it comes to the use of digital technology to improve the user experience.

The Deloitte Center for Health Solutions recently interviewed 10 technology, digital, and marketing executives from major health systems to understand how health systems are approaching consumer-facing technology. While our interviewees said their organizations want to improve the consumer experience for their patients—and have been making substantial investments in digital technology—they are often just digitizing antiquated analog processes. This includes everything from how we fill out paperwork (usually multiple times on a clip board) to how we pay bills (rarely without manually entering a code from the paper bill).

According to our research, digital maturity can vary widely by health system. Some of the people we interviewed told us that their organizations began investing in digital consumer experiences well before the pandemic and have since accelerated their investments. Other health systems were further behind. All respondents agreed that both digital transformation and the consumer experience should be top organizational priorities.

Digital technology has tremendous potential to improve the patient experience, but it also has the potential to add a new layer to an already frustrating process. Health-system leaders should design their processes with the end user in mind. Many health systems and medical groups now tout online bill-payment options and online appointment scheduling.  Consider these three examples:

  1. Online bill payments: One medical system we use recently began promoting its online bill-payment capabilities. However, their system is far from seamless and is not connected to my patient portal. I still have to key in information from a paper bill and enter my credit card number. A couple weeks after making an online bill payment, I received a paper bill in the mail. I thought maybe my payment hadn’t gone through. The only way to confirm the transaction was to go into my bank’s website to see the transaction—something I couldn’t do through the medical system’s consumer portal. I then had to call the health system’s financial services customer-support number to understand why they sent a second bill. It turned out the second bill was a duplicate that was mailed before I had made the online payment. Sending bills to patients through online portals—or allowing them to enter brief identifying information that is not linked to a paper bill and connects to a payment history—could help simplify the payment process and create a digital record of the transaction. 
  2. Online scheduling: Another health system told us that we could now schedule our appointments online. This was exciting because scheduling appointments over the phone can be frustrating. The scheduling staff usually works 9am-4pm, and I rarely have time during my workday to spend 10 or 15 minutes talking with a scheduler. Unfortunately, I quickly discovered there was nothing digital about the new online scheduling button. Our health system, like many others, uses an electronic worklist, which is part of the electronic medical record (EMR) system. The process triggers an order to someone in a call center who then calls to schedule the appointment.
  3. Data sharing: Due to my son’s condition, he has seen a developmental specialist, gastroenterologist, physical therapist, occupational therapist, and cognitive behavioral therapist. We also regularly see our pediatrician. During the initial visit with each of these clinicians, I was handed a clipboard and asked to fill out a paper form detailing my son’s medical history. He has a lengthy and complicated medical history, so it is important that I include detailed information on each form. When I asked whether they could get his history from one of the other offices (which I had recently filled out and included the exact same information), I was simply told the paperwork is required. These clinicians are all part of the same health system and they have their EMR linked to an app on my smartphone. These medical offices didn’t have the ability—through the app or even internally—to share my son’s information and upload it into their separate documentation system screens. (Don’t even get me started on how the first 15 minutes of each appointment was then spent on the same questions that I had already meticulously detailed in the paperwork.) 

New entrants could reshape the patient experience…and incumbents

Most of the people we interviewed said they recognize that their patients often run up against multiple points of friction. While health systems typically haven’t focused much on patient experiences, there is agreement that this issue is becoming increasingly important.  As these organizations try to smooth out these friction points, a growing number of consumer-focused, tech-savvy companies are already offering a truly digital, consumer-friendly experience for patients. Some of these groups, which are not tied to outdated legacy systems, offer seamless virtual visits and scheduling. And they are beginning to expand beyond basic health services. This is forcing some consumers to choose convenience over loyalty to their established doctor-patient relationships.

Health systems that offer their patients superior experience—before, during, and after services are provided—will likely be better positioned to retain and attract patients. As we move closer to a value-based payment system—or a future where consumers are more empowered—hospitals, health systems, and physician practices will need to retain their customers and add new ones. Unless they can smooth out some of the existing friction points with digital technology, they could start to lose customers to newer and more tech-savvy competitors that can offer a better patient experience. 

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Wendy Gerhardt

Wendy Gerhardt

Research leader

Wendy Gerhardt, Deloitte Services LP, is a research leader with the Deloitte Center for Health Solutions. She is responsible for conducting research to inform health care system stakeholders about emerging trends, challenges, and opportunities. Prior to joining Deloitte, Gerhardt held multiple roles in strategy/planning for a health system and research for health care industry information solutions. She holds a BBA from the University of Michigan and an MA in health policy from Northwestern University. She is based in Detroit.