Geisinger Health System made waves this past week with its announcement it will offer refunds for 'dissatisfied' surgery patients.

On the surface, it's potentially obvious to see why such a measure would seem extreme, but at the very core of the ProvenExperience program is population health and patient engagement: the cause driving the majority of healthcare organizations.

"ProvenExperience is about delivering service excellence," Chanin Wendling, director of eHealth Director, eHealth in Geisinger's Division of Applied Research and Clinical Informatics, told Healthcare IT News. "We want to make it as easy as possible for patients to provide feedback.

[See also: Geisinger's bold move: give refunds to dissatisfied patients]

"Someone can always talk to a person on the phone or by email, but with all of these technologies we have the opportunity to utilize them," she added.

In setting up the ProvenExperience app, through which patients can rate their experience, Geisinger established three impact groups – at its Danville and Wyoming Valley campuses and the practice office of Jonathan Slotkin, MD. The results were overwhelming clear: refunds weren't the most important feature of the app. Patients wanted to explain why they had a poor experience.

In fact, many patients struggled with asking for a refund, especially when the majority of their experience was pleasant, but a small incident detracted from the overall encounter. Patients strictly wanted to ensure another family didn't endure the same negative circumstance.


[See also: Geisinger making Epic, Cerner work together for population health]


After hearing these results, the refund portion was placed at the backend of the app. The sliding scale was added when patients showed difficulty in asking for a full refund, especially when the majority of the appointment was positive.

The app is currently limited to lumbar spine and bariatric surgery patients, in order to keep the focus group small. It's available in online app stores with an access code for these specific patients.

When using the app, patients are asked for reasons why their experience was poor, not to drill them, but to better understand their appointment from a patient perspective and to make improvements within the system.

"You trust us, and we put our trust in you," Wendling said. "When you ask for the amount, we go ahead and give it to you."

As Slotkin suggested to Healthcare IT News, in many cases it's easier to get satisfied service from an online vendor than to get ahold of a doctor. "They're treating customers better than we care for patients," he said.

Geisinger sees the app as a way to positively change the way patients are treated, said Slotkin.

"The goal we strive for now is to have the best customer service. So I think our patients will benefit by being treated in all of the best ways like smart consumers," he said.

When asked if ProvenExperience was financially sustainable, the answer was a resounding "yes."

"The amount of loyalty and increased patient volume engendered by this standpoint will outweigh any cost and risk," said Slotkin, noting that Geisinger, hopefully, is gaining a loyal customer base.

"Overwhelmingly, people are honest and the loyalty it grows from listening to their concerns and offering refunds for poor service, far outweighs those people that are dishonest," he said
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Right now, the project is still in pilot mode, while Geisgner researchers determine where to make improvements.

In the future, Wendling expects ProvenExperience will extend to include transparency, knowing the breakdown of payments and the copays involved with each appointment. They also hope this information can reach to all channels in their healthcare system.

"Technology makes it easier for the patients and as we receive concerns in electronic form, we can route them in different work pools to improve the system," she said.