As systematic changes in US healthcare convert patients into consumers, hospitals must meet each generation's measures of quality.

Larry Stofko, Contributor

May 20, 2014

4 Min Read

The Hospital Consumer Assessment of Healthcare Providers and Systems, better known as HCAHPS (pronounced H-caps), is the national, standardized, publicly reported survey of patients' perspectives of hospital care -- an increasingly important metric as hospitals learn to treat patients more like consumers and pay more attention to consumer choice.

The HCAHPS survey, its methodology, and its results were first publicly reported in March 2008. This reporting creates incentives for hospitals to improve healthcare quality and also increases accountability by increasing transparency into hospitals' quality of care.

The survey can be a great tool, but it's fallible because a patient's perception of care quality is highly subjective. It will also vary from generation to generation. Take the Millennials (age 18-33), for instance. According to Pew Research, these "digital natives" were born with digital technologies in place including the Internet, smartphones, and social media for communications and interaction. Therefore, their expectations will most certainly be different from those of the pre-digital generations.

[Do we understand each other? Read 6 Ways To Stop Baby Boomer, Millennial Conflict.]

Boomers (ages 50-65) were born without all these great digital technologies, yet they developed them to enhance their busy lives. They are probably okay with a two-week wait for a doctor's appointment, though, since that's all they've ever known.

Not so for our demanding digital natives. This is one reason the Cleveland Clinic began to offer same-day appointments by phone or email. "We perform close to one million same-day appointments each year," said Cleveland Clinic chief experience officer Jim Merlino, MD. "This is something that is especially appealing to our Millennials."

Pew Research indicates Millennials have emerged with low levels of trust. Just 19% of Millennials say most people can be trusted, compared with 31% of Gen Xers, 37% of those from the Silent Generation (born during the Depression through World War II), and 40% of Boomers.

So how do we address this with technology? Mary Anne Graf, VP of women's services for Bon Secours Virginia Health System, says that smartphones are Millennials' lifelines to family, friends, work, and everything else. Therefore, to gain their trust, the health system leverages that lifeline with HIPAA-compliant technology.

"We recently used a 'Passions and Pains' market research app by The MomComplex for moms to communicate about the pregnancy experience. The videos, texts, and photos were used to improve and innovate prenatal care to make it more individualized, contemporary, and appropriate to the needs of today's woman and family. We found critical elements of care we are not addressing, and easy ways we can engage women earlier in pregnancy to stay healthy and help prevent complications," said Graf.

"The way office prenatal care is given in the US is often a barrier to engaging the woman in pregnancy health, with long waits for care, shuffling from station to exam room, hurried doctors, and short visits that limit questions and inhibit discussion about deeply buried concerns," added Graf.

To counter that, Bon Secours provides several great communications programs including Moms in Motion, which addresses three key values of Millennial moms: fitness, networking with other moms, and giving back to the community. This program incorporates fitness trackers like Fitbit or Jawbone UP with a custom Digifit app for the individual, providing instant feedback on these women's progress. "Bon Secours is excited to be the first in Virginia -- and one of the first in the US -- to offer these programs," said Graf. Graf is the author of The Complete Guide to Women's Health Service Line Marketing (HCPro, 2013), focused on program development and marketing for all women's psychographics, including Millennials.

Johnson & Johnson developed a Text4baby service a few years back for expectant moms. It is designed to promote maternal and child health through text messaging, another great tool for Millennials.

Realizing that each generation has different perceptions of care quality, we will need to listen to patients of each generation more closely to develop technologies that address their specific needs. I believe telehealth and mobile health solutions will be key to turning medical care into something more efficient, affordable, and competitive for all, similar to our e-commerce models.

The Innovation Institute is exploring technologies that will be beneficial to each generation. Here are some that we are excited about exploring more deeply:

  1. Telehealth and mobile health solutions

  2. Social networking

  3. Gesture control

  4. Gamification

  5. Wearable user interfaces

  6. Integration of genetic and genomic information.

Healthcare providers must look beyond Meaningful Use regulations and start asking: Is my site as useful as Amazon? Also in the Patient Engagement issue of InformationWeek Healthcare: IT executives need to stay well informed about the strengths and limitations of comparative effectiveness research. (Free registration required.)

About the Author(s)

Larry Stofko


Larry Stofko is executive vice president of The Innovation Institute and serves as chief technology officer and head of the Innovation Lab, an incubator of ideas from concept stage to commercialization.

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