Dr Ashish K. Jha Highlights the Importance of Patient Experience

Placing greater focus on patient experience can build trust between consumers and healthcare organizations, which important for the effectiveness of the healthcare system, said Ashish K. Jha, MD, professor of health policy at the Harvard T.H. Chan School of Public Health.

Transcript (slightly modified)

If there is empirical evidence that providers with higher patient satisfaction tend to score highly on measures of care processes and outcomes, then why is the use of patient experience as a quality metric so controversial?

So the use of patient experience as a quality measure has been controversial, I think, for a couple of reasons: One, is a lot of doctors and nurses misperceive it as being somehow a measure of satisfaction. It’s actually not patient satisfaction, it’s patient experience, and they really are different things.

The truth is that we don’t want to turn healthcare into a sort of service, the way restaurants and hotels are services. We think there is something special about healthcare. I agree, I think there is something special about healthcare. But getting the experience of individual patients, and measuring it, and focusing on that I think is a really important component of what high-quality healthcare looks like.

In your commentary for AJMC, you point out that including patient experience in value-based payment programs builds trust in the healthcare system. How will providers and health systems benefit from this increased trust?

So there are several reasons why that increased trust that comes out of focusing on patient experience will benefit both providers and patients. I mean fundamentally, as a doctor, I am in the business not just of making a diagnosis and prescribing the right treatment, but it’s really about building a partnership with the patient, ensuring that the patient takes the medications over the long run, comes back if there are complications, all of that is built on trust. And if the provider of the organization, if doctors, if hospitals, are not focused on the experience that the patients have, that trust is diminished, and the effectiveness of healthcare is substantially reduced.

You have voiced concerns about the lack of socioeconomic status (SES) adjustment in the Hospital Readmissions Reduction Program, but in the past you were against the adjustment. What are the 2 sides of the argument and what, ultimately, changed your mind?

So the fundamental misunderstanding that a lot of people have about SES adjustment—I used to have this as well—is that they think that SES adjustment means you’re giving credit to providers for providing bad care to poor people.

That’s actually not necessarily true at all. The bottom line is that if I’m a healthcare organization and I do a very bad job of providing care to poor people, and everybody around me does a much better job, SES adjustment is not going to bail me out. One of the things that I learned along the way is that fundamentally what SES adjustment is doing is it’s equalizing populations. It’s not penalizing an organization because they have more poor people.

Look, we want to penalize organizations that provide bad care to poor people. We don’t want to penalize them just for having more poor people. That’s what the readmissions penalty program does right now and what we need to do is account for SES so that everybody is on the same playing field.