Trans­form­ing care de­liv­ery

Doc­tors, pa­tients, fam­i­lies act­ing as a team can lead to im­proved health­care

Modern Healthcare - - OPINIONS | COMMENTARY - Dr. Ben­jamin Chu

Deep­en­ing en­gage­ment among pa­tients, fam­i­lies, physi­cians and providers will pro­duce high­erqual­ity health re­sults and lead the way to an­swer­ing the ques­tion: “What is best for the pa­tient?”

Our health­care world is rapidly evolv­ing. Among those changes is a cul­tural one that af­fects those who pro­vide care and the peo­ple who re­ceive it. When I be­gan my med­i­cal ca­reer, pa­tients rarely ques­tioned their doc­tor’s rec­om­men­da­tions or gave their own opin­ions. Con­versely, doc­tors did not want their pa­tient’s opin­ion and sel­dom were con­cerned about the pa­tient’s world out­side of the med­i­cal of­fice or hos­pi­tal walls.

To­day, that cul­tural par­a­digm has been turned up­side down. Now, physi­cians, providers and hos­pi­tals are ask­ing, “How do we do what is best for the pa­tient?” An­swer­ing that ques­tion re­quires that we un­der­stand and con­nect with pa­tients in new ways.

Last year, the Amer­i­can Hos­pi­tal As­so­ci­a­tion’s Com­mit­tee on Re­search, which I cochaired, took an in-depth look at the role of hos­pi­tals and health­care sys­tems in im­prov­ing the to­tal health of the pop­u­la­tion and com­mu­ni­ties they serve. We be­gan by com­par­ing cur­rent def­i­ni­tions of health­care user en­gage­ment. We wanted to iden­tify the be­hav­iors, poli­cies and pro­ce­dures, as well as the in­di­vid­ual and col­lec­tive mind­sets needed to make it pos­si­ble for ev­ery­one in­volved in health­care to be­come a sin­gle, smoothly op­er­at­ing team. This would be a team (the pa­tient, the fam­ily, the care­givers, the or­ga­ni­za­tion and the com­mu­nity) that en­cour­ages peo­ple to stay healthy, does the right thing if they do be­come ill and helps peo­ple avoid be­com­ing sick again.

When pa­tients and fam­i­lies see their physi­cians and med­i­cal staff as part of their very own health­care team, good things hap­pen. Pa­tients are more likely to stick to their treat­ment or preven­tion pro­gram when the physi­cian is their health coach and they are the star player. As a physi­cian, a hos­pi­tal ad­min­is­tra­tor and health­care con­sumer, I know that pa­tients and fam­i­lies who are ac­tive mem­bers of their health­care team have bet­ter re­sults and out­comes, with fewer emer­gency vis­its and hos­pi­tal­iza­tions.

Th­ese are at­trac­tive ben­e­fits at a time when our pop­u­la­tion is ag­ing and we are see­ing in­creas­ing rates of chronic dis­ease.

The an­swer to the ques­tion “How do we do what is best for the pa­tient?” re­quires that we con­nect with pa­tients in new ways.

Bet­ter en­gage­ment with health­care users is clearly a promis­ing long-term strat­egy to an­swer­ing the age-old ques­tion: What is best for the pa­tient?

So how do we power a tran­si­tion into this new con­cept for health­care user en­gage­ment? Let’s start with more in­for­ma­tion, and a bet­ter ex­change of in­for­ma­tion. To be ef­fec­tive in max­i­miz­ing health, hos­pi­tals must be­gin by un­der­stand­ing the unique de­mo­graph­ics of the com­mu­ni­ties they serve. Also, to make a dif­fer­ence ear­lier in the dis­ease process, hos­pi­tals should be­come more proac­tive rather than re­ac­tive with out­reach tai­lored to each pop­u­la­tion’s risks, at­ti­tudes, prior ex­pe­ri­ence and knowl­edge.

And of course, as a key com­po­nent of the team, pa­tients and their fam­i­lies need ready ac­cess to health in­for­ma­tion and knowl­edge so they will fully un­der­stand what their provider is ask­ing them to do.

Providers need in­for­ma­tion, too, so they can an­swer the ques­tion, “What is in the best in­ter­est of this pa­tient?” First, they must un­der­stand what pa­tients want and ex­pect. Sec­ond, they must har­ness the power of in­for­ma­tion tech­nol­ogy so they can use best prac­tices, find gaps in the pa­tient’s care and know if what they are do­ing is work­ing.

On the or­ga­ni­za­tional level, hos­pi­tals are tak­ing steps to in­te­grate the pa­tient and fam­ily per­spec­tive into all as­pects of their op­er­a­tions. For ex­am­ple, some hos­pi­tals and health­care sys­tems are es­tab­lish­ing pa­tient and fam­ily ad­vi­sory coun­cils. Hos­pi­tals are also strength­en­ing their com­mu­nity ties to keep peo­ple healthy and strengthen care tran­si­tions when pa­tients leave their care.

To­day, we are be­ing chal­lenged to im­ple­ment a pa­tient-cen­tered ap­proach to health­care and to also achieve the In­sti­tute for Health­care Im­prove­ment’s Triple Aim: To im­prove the health of our pop­u­la­tion; im­prove the care ex­pe­ri­ence of in­di­vid­u­als and fam­i­lies; and to find the most ef­fi­cient way to do so. This is a sub­tle but still monumental shift in our per­spec­tive.

In this age of tran­si­tion, it will be up to all of us to trans­form our care de­liv­ery sys­tems and cap­i­tal­ize on all th­ese op­por­tu­ni­ties. When we do, we will be real­iz­ing, in the words of AHA, a vi­sion of “a so­ci­ety of healthy com­mu­ni­ties where all in­di­vid­u­als can reach their high­est po­ten­tial for health.”

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Dr. Ben­jamin Chu is chair­man of the Amer­i­can Hos­pi­tal

As­so­ci­a­tion and group pres­i­dent of Kaiser Per­ma­nente’s South­ern Cal­i­for­nia and Hawaii re­gions.

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