How Patient-Centered Care Continues to Transform Health Care
A movement is underway within the American health care system, a wave that seeks to revise and reorder the fundamental principles of how a person interacts with services and providers.
You may hear the term patient-centered care and wonder what it means, but chances are you’re already caught up in the rising tide. Perhaps you’ve received more targeted treatment from your health care provider or experienced greater coordination between services, such as transitioning from the hospital to your home or another setting.
A national push to put patients first
In recent years, leading health policy groups, such as the Institute for Healthcare Improvement (IHI), have pushed for more patient-centeredness among the health care system on the whole. In a famed 2001 report, the IHI listed patient-centered care as one of the pillars of enhanced health care in the 21st century.
In that report, the IHI noted that “as the system has grown more complex and fragmented, and as providers feel more pressure to see more patients in less time, care has become centered not on the needs of patients, but around the needs of the system itself.”
Other groups, such as the Institute for Patient- and Family-Centered Care, promote the elements that they view as core components of a new paradigm — collaboration, dignity and respect and information-sharing, among others. Also, recent legislation has sought to boost the patient-centeredness of the health care apparatus by incentivizing care coordination and follow-through.
Early indicators show steps to success
A recent report from the Agency for Healthcare Research and Quality (AHRQ) shows that the shift to a patient-focused system is moving in the right direction. Eight out of 10 patient-centered measures have improved over the past decade, reports AHRQ in the 2016 National Healthcare Quality and Disparities Report.
“Person-centered care means defining success not just by the resolution of clinical symptoms but also by whether patients achieve their desired outcomes,” states the report. “About 80 percent of person-centered care measures were improving overall. For example, overall trends from 2002 to 2014 showed significant improvement in provider-patient communication for adults who had doctor visits in the past 12 months.”
How tech can spur improvements
Yet patient-centered care is more than just having a friendly conversation with your primary care provider or specialty physician. One of the critical areas of importance in our digital age is information sharing and health technology.
“Patients now have instant access to health information via their computers or mobile phones. As a result, patients are better informed and more active participants in their care,” explains Daniel H. Solomon, MD, MPH, Chief of Clinical Sciences in the Division of Rheumatology, Immunology and Allergy and former Co-Director of the Patient-Centered Comparative Effectiveness, writing on the Brigham Health blog.
Solomon explains what’s at the heart of patient-centered care in greater detail: “Patient-centered care involves transforming the relationship between providers and patients from the traditional model, in which a care provider prescribes the same treatment for most patients with similar diagnoses or conditions, into a patient-provider partnership that considers treatment options based on a patient’s unique concerns, preferences, and values.”
Wading through fits and starts
The explosion of technology in the health care space is perhaps best exemplified by the near-ubiquity of electronic health records (EHRs). If you’ve been inside a hospital or physician’s office recently, chances are likely that your doctor spent as much time typing into the computer as she did asking you questions.
Like most technological innovation, the increase in EHRs has not come without its growing pains, despite the clear advantages digital medical records bring to the table. One recent study, for example, found that some physicians spend 80 percent of a patient visit looking at a computer screen.
Pushing the envelope further
Some thought leaders are pushing the envelope on patient-centered care even further. Michael Millenson, a consultant and author of Demanding Medical Excellence: Doctors and Accountability in the Information Age, believes the health care industry needs to redefine its vision of patient-centeredness due to “technological, economic and social” factors that are reshaping the game.
Writing in The BMJ, Millenson offers the term collaborative health as a more encompassing way to think about empowering patients. He explains: “Collaborative health describes a shifting constellation of collaborations for sickness care and for maintaining well-being that is shaped by people based on their life circumstances.”
The result is not reform,” he continues, “but a transfer of power in which the traditional system loses some of its control. That system will often be part of well-being and care relationships — providing patient-centered, person-centric or collaborative care — but other times (and not by choice) it will be excluded.”
A ‘shared’ health care economy
Moving to a system that puts technology to work for better patient care, a paradigm that emphasizes “shared information,” “shared engagement” and “shared accountability,” holds vast promise to improve patient outcomes and tamp down medical costs, advises Millenson.
Whether using the term collaborative health or patient-centered care, it’s clear that technology can augment the holistic approach to health care and continue to push for better results without adding to the cost.
