FASTER HORSES Asking the Right Question to Get the Answers that Matter

In the 1960’s movie Five Easy Pieces, Jack Nicholson orders an omelet with a side of plain wheat toast in a diner. When informed that wheat toast is not an available side, Nicholson amends his order to include a chicken salad sandwich on wheat toast, no mayonnaise, no butter, no lettuce and hold the chicken to get the plain wheat toast he wants without breaking the rules against substitutions and sides.

The effort ends badly, with the waitress throwing Nicholson out of the diner.?

While people rarely get thrown out of hospitals for complaining about service or asking for something not on the menu, historically, the U.S. health care experience is something Nicholson’s character might recognize!

Things are changing, though.

New rules link reimbursement to patient satisfaction. Science affirms that patient experience is an important factor in the healing process. Increasingly, health systems claim service innovation as a core marketing differentiator.

This focus on experience has spawned a legion of service innovation efforts. Most ask “how are we doing” compared to competitor satisfaction scores. Health care is, after all, an industry of imitators. However, approaching innovation by imitating the best of what someone else has already done leaves little room to imagine and respond to emerging consumer preferences.??

Faster Horses

There is a quote attributed to Henry Ford that “if I had asked people what they wanted, they would have said faster horses”. The quote is a staple of experience design consultants.?? In fact, there is little evidence that Henry Ford ever made the statement.

As illustrated by Erik Flowers, Principal Service Experience Designer at Intuit, the Henry Ford quote highlights the challenge of asking the wrong question when thinking about experience. Speed was the not the problem Ford was solving. There was no clamor for faster horses.

Ford’s innovation was not the car – someone else had already invented that – but the assembly line which made the car accessible for average Americans. By rethinking production, distribution, and financing Ford rewrote American history. None of it had to do with speed.

Shorter Waits

In a Harvard Business Review article,?The Secret to True Service Innovation, Lance Bettencourt argues that the correct prompt for service innovation is not “how are we doing”. Instead, Bettencourt argues the better starting point is “how is the customer doing”.[1]

Consider the hospital or physician office waiting room. A health system identified the waiting room as a major dis-satisfier. Leadership engaged a consultant to assess the problem and invested in flat screen televisions, Wi-Fi access, private workstations, and a Starbucks coffee kiosk. Gone were outdated side chairs, second-hand magazines and day-old coffee in Styrofoam cups.

When the renovation was complete the experience was improved. For the question “how is the hospital doing”, the answer was “better” based on anecdotal patient feedback. Yet, survey data showed the underlying problem was not resolved! People were not seeking a better wait. They didn’t like waiting at all and more amenities did not change that fact.

By starting with the question “how are we doing”, the health system started down a path to make for a better wait. At that, they succeeded. Had they asked customers “how are?you?doing” the answer might have led to a solution set to eliminate the “door to doctor” wait. Choosing the path they did, the system left the core service problem unresolved and created no durable competitive advantage, especially as competitors made the same “better wait” investments in their own facilities.

Parking or Transportation

Consider transportation. Getting to a medical appointment is a challenge for many people, especially those dependent upon public transportation. Even those with a car are challenged by traffic, limited parking, or the losing their car in a parking ramp.

One hospital system, confronted with data showing significant patient frustration over a bad parking situation invested in a new ramp. A competitor facing the same challenge invested in a partnership with a ride-hailing service to enable door-to-door patient transportation.

The former solution was an answer driven by the question how might the hospital do better what it already does –provide spaces for people to park. The latter ride-hailing solution was driven by an understanding that the customer goal was not a parking spot but getting door-to-doctor to make an appointment.

What Problem Are You Solving For?

My point of view is that service innovation must start with clear understanding of what matters most to customers. Henry Ford understood his customers need access to affordable cars, not faster horses. What problems are you solving for in your service innovation efforts? And critically, have you considered the business structure as well as the operating model as variables that impact how far and fast you can go with change?

?

[1] The Secret to True Service Innovation by Lance A. Bettencourt, Stephen W Brown, Nancy J. Sirianni