Welcome to the Healthcare CEO podcast. Join us as Daniel Fernandez, healthcare leader and patient experience advocate, leads dynamic one-on-one discussions with healthcare executives, consultants, and other industry experts. Listen in as they share actionable insights and unique perspectives in the day in the life of a healthcare CEO.
*The following has been adapted from our full-length interview, which can be found here.
Meet Ingrid Lindberg
Ingrid Lindberg has more than 20 years of experience in the healthcare industry. She’s also the first person to ever have the title of Customer Experience Officer (CXO) — a role she holds at Cigna. She’s also a healthcare, brand, marketing, business, management and HR consultant, keynote speaker at conferences, and co-founder of aubreyAnswers.
Becoming a Customer Experience Officer
Daniel Fernandez (DF): How did you become the first CXO. What does that story look like, and how do you ultimately become a big, badass CXO?
Ingrid Lindberg (IL): Ok, so there’s like the four-hour version, but I’ll give you the short one. I walked into a CIO’s office in 1997 when we were building a tool for people to trade online. We were taking financial services online. And I said: “Hey, I think we can do this better.” And he said: “Are you a UX designer?” And I said: “No. What is that?” And then he sent me to school, I got to learn a bunch of stuff about how to design things between humans and computers, and people started saying: “Hey, if you know how to figure out the best way for people to talk to a computer, you can probably write a letter, and I bet you have some ideas about how someone should answer the phone.” So I kept adding channels and got known for doing some pretty designs and products and financial services in healthcare. And then, in 2007, the CEO of Cigna, David Cordani, called me and said; “Hey, I’d like to give you this job. I’d like you to be a Customer Experience Officer.” And I’ll never forget, I thought “I don’t know what that means. I should look it up on LinkedIn. So I went to LinkedIn and typed in ‘Customer Experience Officer’ and there were no results.
So then I typed customer experience and there were two results. Today, there are about 16.5 million. That’s between November 2007 and today.
DF: So you’re the OG.
IL: I get OG a lot when I’m walking up on stages. I tend to wear a lot of skulls and a lot of black stuff, so, you know, the OG works, too.
DF: In over 20 years, so much must have changed. Are there any things that have stood out? Moved experience forward? Catalysts for changes?
IL: There’s a lot of stuff that’s happened. In healthcare — if you read anything about me on LinkedIn, you know that I always say this, and people either love it or hate it. I built the first health savings account. So I introduced to the US the idea of consumer behavior in healthcare. We did that in the late ‘90s/early ‘00s. What that did, was it really made people start paying attention to what was happening within a service that they hadn’t been paying attention to up to that point. So now I had to open my wallet and I had to pay for things — which meant I had a much higher expectation level, and I think if I had to pinpoint one thing in how consumers really interact with healthcare in the US in the last 20 years, it’s probably the advent of that; because that made people think about it as a service and a good for the first time.
Highlighting the Humanity in the Healthcare Industry
DF: Which makes perfect sense. You’ve worked with so many clients. Are there any stories that still resonate with you today?
IL: There are things like, I was working with a large insurance company that had 65 thousand customers across the globe — in thirty-something countries. It was amazing because the intent was always so good. And what was crazy was that they weren’t available to help people, so it was hard to do business with them. We did a lot of work to make doing business with them easier. How do you take years and years of processing procedures — a lot of which was required — and remove it so that you could serve people better?
The one that always makes my eyes kind of water a little bit, though, is when I did some work with a children’s hospital several years ago. One of the things we figured out was that they were getting sued an awful lot. And one of the reasons is that when doctors were trying to resuscitate children, they would make parents leave the room. It brings tears to my eyes today. And we said, let parents stay, because the heroics that happen in those moments is not something we should shield people from. The outcome was parents actually seeing what really happens and how hard people will try. And I think that’s kind of a great frame for healthcare. We’ve traditionally done so much trying to hide stuff — even sometimes for the right reasons — but when you open it up, people can be really responsive to how decisions are being made. You just have to be a lot cleaner about it. I love that one, and they still do that, by the way. They still allow parents in the room.
DF: I believe in that transparency. Earlier in my career, I worked in a trauma room, and when a kid passed, there wasn’t a dry eye in the room. Or if the kid was struggling or hurt, everyone wept, and it’s ok.
IL: It’s human. And healthcare, specifically, we’ve created this space between the people we serve and the people serving — healthcare professionals, insurers — but they’re people. The more we open up to the world that we’re all messy mortals, that we’re all human, the better the entire ecosystem works.
Redesigning Processes for a Better Patient Experience
DF: Do you think that there are a lot of organizations out there that may have the proper intent but the wrong execution?
IL: All over the place. One of the things we do whenever we’re working with a new healthcare system is we run what I call the Stupid Role contest. We walk in and we say, “Ok, we want to change how we serve people. And our question is, what stands in your way of delivering outstanding care?” And I will tell you, the number of roles that we can find in any entity — and it’s instantaneous. There are so many roles. And they were put in place for the right reasons. But the time has come to readdress. There’s a lot of great intent, but there are spots for change.
How COVID Changed the Healthcare Landscape
DF: Healthcare in general is typically on the lagging side when it comes to technology. But now healthcare organizations are implementing so much right now, like telehealth. Do you think there are potential barriers created as they move into this technological world — in how it impacts the patient experience in general?
IL: I was a part of the team at Cigna when we implemented virtual house calls — which was telehealth — back in 2007. So, telehealth has been around for a long time. Teledoc was launched in 2005. So we have 15 years of this. But only about 11% of people had actually experienced telehealth in 2019. By April of this year, it went up to 46%. Talk about movement. We all know why it’s happened. Whether it’s happening through your iPhone or any other platform — your telephone — it’s telehealth. It’s out of the gate. I don’t have to go to the doctor’s office, I don’t have to wait. I have more time with you. Consumers get more time at a telehealth appointment than they do in person. Isn’t that crazy?
There was a stat that came out not that long ago. Before COVID, telehealth was a $20 billion industry. After COVID, it’s gonna be a $250 billion industry. And that’s assuming that only 20% of Medicare and Medicaid and in-house commercial stuff stays. This isn’t anything crazy. It’s some chronic disease management. It’s here. We have a lot to do to clean it up and legislation is going to be key. There were a lot of states that didn’t allow telehealth for certain things. We have to start over again and think about — look, we figured out it works pretty darn well.
DF: It’s no longer a fad. It’s here to stay.
IL: It’s here. It’s totally here. And consumers like it — across all demographics. We’ve done a ton of research, and what we’re seeing is that consumers across all generations would do it again. If the call is over five minutes and it’s video, satisfaction is higher. If you let me speak for 35 seconds without interrupting to let me tell you my story, satisfaction is higher. And if you make eye contact with the camera, satisfaction is higher. Those three things. That’s it. It’s not hard!
DF: No, it’s not! I’m really excited about the future. Pre-COVID, I would walk into a doctor’s office and they would give me a pen and a pencil to fill out paperwork. And they would tell me to fill out half of it with the pen and the other half with the pencil. And I was confused — and I consider myself somewhat intelligent! What is the average person thinking when they come in and are presented with a pen and a pencil? I mean, some of these changes have been a long time coming.
IL: For sure. And the fact that we’ve had to fill out the same forms — we’ve talked about this for years. And we’ve had to fill out the same forms for how many years? I remember when Phreesia had first hit the market, back in 2009-2010, and they had that iPad in a yellow case, and they were supposed to take away all of the hard check-in stuff. And they did a great job with a lot of that, but my gosh, how many times in the past couple of years did you have to fill out a form in paper that was clearly mimeographed?
Working on the Healthcare Employee Experience
DF: Let’s talk about employees. For them, the experience is changing. More people are moving to a remote work environment. How do we maintain engagement during these times?
IL: These crazy times we are now in, right? There are some great things about this. I did a great webinar not that long ago with a lot of physicians. One of my panelists was a primary care practice owner and an urgent care practice owner — up in a mountain in New York — and he has a hard time hiring people. He was talking about how he still needs people in person at the urgent care, but in primary care, he’s working 50% through telehealth and 50% in-patient visit. So we started talking about the employee side of it. He said it’s hard because you don’t get to see your team. I challenged him — and this is the advice I give every team leader — I have a standup every single morning with my entire team. And we do it over coffee, at the exact time every day. You are not required to do it, but most people show up. It’s about 15 minutes and it’s just a touchpoint that reminds us all that we’re on the same team. That’s number one.
Number two is that we need to communicate more than you have ever communicated in your life. I so often say I don’t have answers. I don’t know when we’ll go back into the office. I don’t know these things. But the level of transparency I’m bringing to my team is crazy high.
Last but not least, I do a lot of one-on-one touching base because if you ask your team how they’re doing in a staff call, you’ll get the exact same answer from everybody — I’m doing ok. There’s something about being able to really read body language and faces that we hadn’t had to use before. You can see it on someone, even if they’re smiling. I solve that by doing a lot of one-on-one outreaches and touches.
DF: I love that. I love the one-on-one aspect. Because in a group setting, everyone will do what everyone else is doing. But in a one-on-one environment, you can check on their mental health, because a lot of people are struggling today.
IL: We all are. We all are. That’s one of those things. We talk an awful lot about how a lot of people are struggling. We encourage people to say I’m struggling. I had a bad day. I had a bad week. That just happens. That opens up a whole different level of relationship with your team.
DF: I think there’s a lot that someone listening to this can learn from that — especially a CEO or a physician. Personally, for a long time, it felt as if the physicians have always created this facade, not wanting to show vulnerability. But there’s this other side where they show it and people support it and go to battle with them.
Remote Working is Here to Stay
DF: From online shopping to videoconferencing, it seems like behaviors are shifting because of everything we’re experiencing right now. Do you agree?
IL: I’m so torn on this. It depends on what day you ask me. I do a lot of work with CEOs about what the future looks like. Back in March, we did a summit where we talked about going back to work. Back then, I said that I don’t think that the average white-collar worker will ever go back into an office. I’m not sure what we’re going to look like, but I know that we’re going to look different than we looked before. There’s no going back. The freedom, the Zoom towns that are popping up all over the US. People saying I don’t have to pay this much money to live in New York or San Francisco. I can go work in this tiny little town in the Adirondacks. And they’re happening everywhere. They’re called Zoom Towns. Now I can work from anywhere! This whole piece around what can be delivered instantaneously and how easy it is. A lot is going to shift in how we show up. I think that when we can walk out again, I’m a firm believer in humanity. I think that people are so desperate for each other and for connection, that the level of connectivity people are going to expect from one another is going to hit a level we haven’t seen yet. Think about how to best insert humanity into the situation we’re in right now, because it’ll be different next week. If you keep asking yourself that question, we’ll end up in a good place.
DF: There were so many misconceptions about working remotely. That people would be less productive at home — but that’s been proven wrong already. People are more productive. That’s a good thing to ponder: How will things look like when we return, or if we return to office spaces?
IL: And that flip side of having so many people at home — one of the things we were talking about is that we’ve had human resources departments and experts for years trying to help people to have a work/life balance, to save people from work. We now have to start thinking about how to create spaces to teach people how to walk away from home. Because now home is everything. It will be a curious future for us.
Shifting the Focus During COVID and BeyondDF: We shouldn’t all be locked up all day, every day. Let me ask you this. What should CEOs be most focused on right now during all of this?
IL: I’m a firm believer — I’ve spent my career in customer experience — when I think about CEOs specifically in healthcare, we know that 33% of consumers would’ve switched doctors in a heartbeat for a better experience pre-COVID. That number is going to increase. Think about the things people are going to focus on. People are switching for experience. And experience is ease — how easy it is to do business with you — how helpful were you to me? And how enjoyable was our interaction? If there’s anything CEO’s should be focused on right now, enjoyability could be a whole other chat. But ease and helpfulness, if you’re not tackling those to things right now, you’re going to lose people that you serve, because they’re going to go someone who’s figured out an easier way to be easier to do business with, even in this telehealth age and more helpful with a video camera.
DF: That’s a powerful message and it needs to resonate with everyone who’s listening to this right now.
IL: Ease, helpfulness, and enjoyability — those are the drivers. I’ve been doing this for a long time, and nobody has been able to disprove it. Those are the three drivers.
Making Things Easy for Patients
DF: Your passion for experience comes through. Anyone listening to this is going to know that. You’re also very passionate about another project called Aubrey Answers.
IL: I am. Thank you for asking. Aubrey Answers is a total passion project — all volunteer-run. It’s just this beautiful thing. One of the things I did to make a name for myself other than a design of products and experience is that I went after language in healthcare. Long, long ago, in a galaxy far, far away, we did research and found out that one of the top three reasons people didn’t trust healthcare — pharma, providers, the whole ecosystem — was the language that healthcare used. So we did a ton of work in translating that language into something people would understand. There are so many stats about providers and insurance. We did a lot of work simplifying the language in healthcare. And then COVID hit. And I love the CDC and the WHO, but they are not fabulous about talking to consumers about complex stuff. So we launched aubreyanswers.com. It is ad-free. It is free resources. We have contact-tracing tools, we just launched a risk calculator, we have answers pretty much to every consumer question that we could find about COVID. And we’ve also asked people to write in and tell us about their experiences with COVID. Lots of great tips on how do you prep? What do you do? What does quarantine look like? If you start to feel sick, what should you do? What are the things you should have stocked up and ready? What’s a pulse oximeter? Just a tone of free resources out there for consumers, because, frankly, we weren’t finding anyone else who was taking such a complex and scary thing and translating it to plain language at a 5th-grade level. So that’s what we did.
DF: Talk about something the world needs.
IL: A trusted source that’s understandable. It didn’t exist! We have a bunch of great writers from all sorts of institutions and public policy people. It’s really beautiful. A beautiful piece of work. I encourage everyone to go and share it with anyone that you serve because it’s pretty easy to navigate. And that’s what’s important. It’s easy!
DF: And you’re probably adding more and more resources as you go.
IL: Constantly. Every time the CDC changes a guideline, we go back and edit and retrofit and update. We’re trying to stay on top of it as things are changing. So, thank you for asking. I really do appreciate it, Daniel.
DF: In closing, is there something you would like a CEO to know that maybe we haven’t covered?
IL: I wrapped this webinar I did with physicians not that long ago. It’s just gratitude. What you’re doing right now, as a consumer and human, I appreciate an enormous amount. CEO, keep your people as safe as you can. It’s a tough world. We’re asking people to do incredible work in a really incredible situation. And here I am, telling you to make it easy and enjoyable while you do it. So, I understand how this can feel some days, and frankly, I just want to end with my appreciation for what you do.
Learn More about How Ingrid and Other Healthcare Leaders Are Shaping the Future of Healthcare
Watch the full interview with Ingrid Lindberg, and be sure to subscribe so that you don’t miss future shows where we interview other industry-leading healthcare CEOs and executives as they look to shape the future of healthcare.
Also, check out Aubrey Answers, which seeks to translate the complicated world of healthcare into plain language, so that you can make informed decisions about your health.