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The history of Patient experience

Missed and late medical appointments have become a growing concern within the healthcare industry. As populations grow and we start to live longer, the effect of missing appointments has already begun to disrupt healthcare operations.

Not all missed appointments are caused by the changes in population; however, they are more personal to the patient, as seen in this Harvard Business Review blog.

What is patient experience?

Defined by the Agency for Healthcare Research and Quality, patient experiences are “…aspects of healthcare delivery that patients value highly when they seek and receive care, such as getting timely appointments, easy access to information, and good communication…” however when originally defined by the NHS in 2011 patient experience falls into eight categories:

  • Respect for patient values, preferences, and needs.
  • Coordination and integration of care.
  • Information, communication, and education
  • Physical comfort including pain management.
  • Emotional support for clinical fears regarding the patient and their family.
  • Involvement of family and friends
  • Transition and continuity between locations and types of care
  • Access to care including the waiting times and time between admission

Keeping these definitions in mind, not much has changed regarding the experience of healthcare venues. However, an individual patient experience has more to it than just the appointment itself. Every step of getting to the location, finding their way around, and then locating the correct exit is a part of their experience.

These external factors contribute to the increased amount of missed appointments, and heavy losses in revenue.

Around $150bn is lost each year due to missed appointments, and $200 per missed slot for individual physicians. 
This amount of revenue lost further affects healthcare providers’ ability to pay staff wages and available funding for medical equipment.

What has changed? A patient experience timeline

The healthcare industry has become increasingly competitive in trying to deliver the best patient experience possible, in some countries the reasons differ, however it’s clear that in order for healthcare venues to survive, they need patients to turn up.

1990’s & 2000’s

During the 1990’s the idea of being able to understand patient experience became very popular, and a widely agreed concept to review the quality of care being provided. The issue at the time however was there were no existing attributes as to what contributed to a patient experience.

In 1995 the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program was created as a method to survey patients about their experiences. “CAHPS surveys do not ask patients how satisfied they were with their care; rather, they ask patients to report on the aspects of their experiences that are important to them” – AHRQ

With little understanding over how to accurately collect and action patient experience insights, the ’90s and naughties primarily focussed on developing surveys like CAHPS.


The standard of using surveys to understand patient experiences doesn’t change but improves. During the 2000s advancements in technology-enabled healthcare providers to conduct survey outreach through SMS.

Additionally, surveys could be filled online on handheld devices, at healthcare kiosks for real-time feedback for example during a patient’s discharge. Further insights were given directly by members of staff with complaints and compliments from their patients.

During this time, the methods for collecting patient feedback were scrutinized based on whether patients were able to provide credible insights, making it harder for venues to have actionable feedback and improve on the issues mentioned.

2020’s so far

During the Covid pandemic, the understanding of patient experiences went out the window, similarly, with reviews for other industries, the world became a different place. Overwhelmed hospitals and medical practices were left with no choice but to try and find ways to better manage the influx of patients and their expectations.

A blog by engineering company HDR provides insight into the methods used by healthcare providers when attempting to diminish patient anxieties. The main strategies for this are as follows:

The streamlining of operations – Reduced patient contact and density would allow healthcare venues to make patients feel more comfortable in the hospital environment.

Providing clear and concise communication – By having a clear method of communicating with patients, healthcare providers allow recipients to have a greater amount of insight into their appointment. This means that healthcare providers have an improved method of managing expectations.

Including outdoor spaces – By utilizing outdoor spaces it becomes easier to control and communicate social distancing practices to patients, a further step taken to remove the stress caused by the pandemic.

What’s next for the patient experience?

Innovation within the healthcare sector is now soaring, not out of interest, but choice. The needs of the consumer mindset are becoming more common within healthcare and as a result, venues must drive digital solutions that best fit the needs and behaviors of multiple groups and demographics.

For a lot of patients and visitors, navigating to, from, and between large healthcare venues is causing stress, so navigation advancements like Purple’s wayfinding are being sought. For the aging population, telehealth and at-home care would be best suited to resolving their anxieties of travel or inability to travel due to poor health. A similar situation can be applied to adults that have to work around their children.

Check out our interview with University Health’s, Kip Lee to see how Purple’s Wayfinding is already changing healthcare – Improve patient experience through healthcare digitalization

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