The problem in that room wasn't software, and it wasn't conviction. The commitment is real. The machinery underneath it is missing.

Which is why, when I launched The Patient Experience Strategist interview series this month, Rick had to sit in the first chair. He's spent nearly 30 years on the question almost nobody answers well: how do you turn "patients first" from a value into an operation?

Rick Evans recently retired as Chief Experience Officer at NewYork-Presbyterian, a system with 11 hospitals, 55,000 employees, and roughly 700 outpatient sites, and remains with the organization in an advisory capacity through the end of this year. Becker's named him one of the hospital and health system CXOs to know in 2025.

He is not a critic throwing rocks from outside. He's the person holding the bag at one of the most complex systems in the country, and he sees opportunity in the industry. Delta and Amazon already keep people informed in real time when something matters to them. Healthcare has not closed that distance. A patient's family can track a package to the door but can't get an update on a loved one heading into surgery. That gap, he said, is not a technology problem. It's a design problem.

Nobody at that hospital decided the patient's family doesn't matter. Everybody there believes the opposite. The commitment just never got turned into anything: there's no process for updating the family, and no one whose job it is to notice when it doesn't happen.

Conviction is everywhere in healthcare. Machinery is rare.

Operationalizing patient experience means converting the value statement into things that show up on an org chart and a budget: a named owner, observable behaviors, redesigned processes, and a seat at the table where decisions get made. If you can't point to those four things, you don't have a patient experience strategy. You have a poster.

And the gap is measurable. Experian Health found 89% of patients want the ability to schedule appointments anytime through online or mobile tools, while MGMA polling shows only 11% of medical group leaders report a majority of their patients self-scheduling. Nobody in that 89% doubts the industry's intentions. They just can't get an appointment.

Rick walked me through four pieces of that machinery. Each one you can take back to your organization.

I asked Rick what newer experience leaders consistently underestimate. Patient experience, he said, is a value everyone claims and almost no one is accountable for. Every executive salutes the flag. But as he put it, if it belongs to everyone, it belongs to no one.

Whenever I walk into a system to figure out where trust is breaking down, this is the first question I ask, before anything else: who owns this? Not which committee. Which person, with which goals, reviewed in which meeting. A value can survive without an owner. An operation can't.

And owning it looks different than most leaders expect. "We're in the business of influence," Rick told me. Most experience leaders command no service lines, no nursing units, no revenue cycle, no beds. The job is moving people you don't control, with evidence and relationships, carrying the patient's voice into rooms the patient will never enter.

Values fail operationally because no one can see them. So Rick translates. He calls it citizenship: every person who walks through the door of the hospital has a role in the patient's experience, from finance to housekeeping, and he treats that role as a standard of behavior rather than a sentiment.

His most repeatable version: "When you're approaching the hospital, the earbuds should come out."

The earbuds rule is small. That's exactly why it works. It's observable, it's universal, it requires no budget, and it tells every employee the experience starts in the parking lot, not at the bedside. You can't audit "we put patients first." You can absolutely audit whether the earbuds came out.

One small behavior, made visible and non-negotiable, does more operational work than a hundred mission statements.

Rick's explanation of that quiet ballroom is why I do the work I do.

The reason patients still can't book their own appointments is not missing technology. The scheduling modules are usually already licensed and sitting inside systems these organizations own today. In Rick's words: "It's more culture change than technology." Every physician carries a private rule book of templates, protected slots, and visit types. Multiply that across thousands of physicians and you get an operation no patient could possibly be allowed to touch. Delta operates one flight schedule. Your health system is trying to operate thousands of them at once.

So the barrier to a patient-centered front door turns out to be an internal negotiation about autonomy and habit. The same is true of almost every patient-facing fix: the billing letter nobody rewrote, the referral that dies between departments, the discharge call that belongs to no one. We keep buying tools to route around culture, and the culture wins every time.

A technology gap belongs to the CIO. A culture gap belongs to everyone in the leadership room.

Every leadership team in healthcare is fielding AI pitches right now, and the budget conversation has quietly replaced the strategy conversation. Rick runs both through the same filter, and it costs nothing to use. Just because we could, should we? And the follow-up: how will this be used to enhance the humanity of healthcare?

Watch what survives those two questions. NewYork-Presbyterian runs AI against routine EKGs to flag structural heart disease a cardiologist's eye would miss. It passes because it makes the clinician more capable in front of the patient instead of putting a screen between them.

When health systems ask me where to start, this is the closest thing to an answer key for Rick's two questions I've found. Every proposal is funding one of three jobs. Some work never needed a human, so let the machine take it completely. Some work needs your people, and the right tool makes them faster and sharper at it. And the entire point of funding those first two is the third: buying back time so the moments that need more humanity actually get it, the scared patient, the hard family conversation. A proposal that can't tell you which job it's doing isn't a strategy. It's a purchase.

Rick was with me on every part of that, and by the end of the exchange the reason was obvious. The spending question and the should-we question are the same question. You're not evaluating technology. You're deciding which work deserves a human.

The filter only has teeth because of who's in the room when it gets applied. Rick has pushed his own team on exactly that: where does the patient and family voice sit in our AI governance? At the table while the choices are made, with standing to change the outcome, not in a satisfaction survey after the tool ships. The systems that skip this step will automate their way into the exact distance from patients they've spent the last decade apologizing for.

The old model treated patient-centered care as a culture initiative: a value to communicate, a training to roll out, a banner to hang. The new model treats it as an operating discipline with the same machinery you'd give any business priority: ownership, observable standards, process redesign, and governance. The cost of staying in the old model is already on your books, you just don't label it that way. It looks like leakage to the system across town, and like families who quietly stopped recommending you. When 89% of your patients expect to reach you on their terms and your operation can't answer, the gap doesn't read as a values problem to them. It reads as the truth about your values.

Four moves, borrowed directly from Rick's playbook:

Watch the full conversation with Rick on YouTube

One question for you

Your strategy deck says patient-centered. If I walked your building tomorrow, where would I see it?

Let’s get to work,

Ebony