Quality Care Revolution: How Patients Hold The Key to it?
Sandeep (Sandy) Gupta
Co-Founder and Chief Operating Officer - Innovaccer
How does one define quality care? There is no one single definition as some say it is determined by the use of sophisticated technology and the prowess of the IT infrastructure, while others tend to focus more on patient-centricity. Patient-centricity, in particular, has been the talk of the town for quite some time. Lately, it has become the driving force behind large-scale structural and cultural revamping of various healthcare organizations. But the question still looms- how can healthcare organizations achieve quality care with patient-centricity?
Smarter care for smarter patients
Quality care is not only about cost-effectiveness, but it also means that the preferences of patients are considered without unnecessarily adding to the burdens of the care teams. Therefore, to realize this goal, it is imperative to understand the role of patients and their families in the care journeys.
Back in the old days, our healthcare system did not revolve around the needs of the patients. They weren’t exactly aware of the issues that affected their health, and they entrusted the providers with major decisions on their health. They played a rather passive role which was often a result of the limited initiative and access to information related to their health.
However, things are gradually changing. We’re witnessing a revolution of sorts in terms of technological advancements with every passing day. For instance, patients are now equipped with critical information about their health statuses, precautions they need to take, and prescriptions that they are subjected to. Not only are they more informed in today’s day and age, but can also be critical of the care being delivered to them.
It is important to define what providers need to focus on, what patients need to understand, and what they wish to achieve together. Ideally, the more patients are involved in the care continuum, the more likely they are to recover rapidly. Likewise, the more informed the physicians are about their patients’ vitals, the more they can focus on key issues that largely determine their health. Healthcare organizations need to align their practices in accordance with the patients' needs. The concept of patient-centric care is not merely confined to the treatment they provide but is defined by the practices and culture that they follow.
“This is a paradigm shift from how things were before. Families act as voluntary caregivers when the physicians and nurses are looking after other patients. They are often the first ones to notice changes in patients’ health,” a New Jersey-based PCP recently quoted in an article.
Efficient care with utilization optimization
In value-based systems, utilization patterns often determine the overall profitability and reimbursement levels. Cases of excessive utilization are ample and spread across varied domains, and can directly or indirectly result from inaccurate diagnosis, physician’s unawareness of patient’s past records, non-uniformity in care structure, among other things. For healthcare organizations, more the utilization, lesser the profit margins.
Knowing the patients better can work wonders for healthcare organizations. They need to focus on high-risk patients, patients with chronic diseases, regular ED visitors, and essentially any patient who can potentially result in higher utilization levels. A patient’s health is a function of multiple parameters which the care teams must be aware of, and therefore, quality care is a distant dream without patient involvement.
In 2017, per dollar, 86 cents were spent on patients with chronic diseases across the states. According to other estimates, 5% of the total patients (either high-risk or chronically ill) make up for more than 50% of the expenditure.
Patients’ role in successful technological implementation
More often than not, excessive utilization is a direct derivative of poor care coordination. Care coordination—right from patient engagement to the allotment of care teams—widely affects the standard of the care delivered.
Creating a single repository to bring data from all facilities together, generating insights to prioritize patients as per the needs, encouraging patients to adhere to medication guidelines, et al.—advanced care coordination systems broadly cover every aspect of patient care. Most healthcare organizations are now embracing this need and setting up such systems. But a care coordination system is still unsustainable without proper patient participation. Patients can act as a bridge by assuring continuity within and between services. Coupled with suggestions and addressing the concerns of the patients, care teams can actually carve out plans in the best interests of patients.
Technological drivers might just act as an able support for the care teams in most cases. To begin with, if the care-teams have timely access to the entire patient-data right from the lab data to medical history at their disposal, they can devote more time listening to the patient. Similarly, if the care-teams have a dedicated portal or dashboard for each patient, they can track every patient’s needs and vitals in real time. In the more extended run, all these care touchpoints can help in substantially increasing the quality of care delivered.
“Coordinated care” translates to “efficient care.”
The road ahead
In a recent survey, 90% of healthcare leaders listed improving consumer experience as a priority for their organizations. Patient-centricity goes beyond prescribing medicines or curing diseases, and nowadays care is defined by what happens both within and outside of the healthcare system. With healthcare organizations striving to make care more logistically sound, the future of healthcare will depend on how the patients and providers simultaneously evolve. In the years to come, more focused efforts in the direction of value-based care will see the light of day, and patient preferences will keep driving healthcare.
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Duals Health Plan Operations Expertise | Licensed Clinician | Six Sigma Certified | Data Fluent
6 年Yes! Coordinated care equals efficient care!
you mean we hold passports right
Chief Clinical Officer at CareLink
6 年Well said!
Mother...Wife...Instructor...Learner...Consumer...& Professional with an opinion on EVERYTHING!--Using lived and learned experience to inform policy and practice to improve outcomes and create sustainable impact.
6 年I share many of your sentiments. Just to add a few additional thoughts. If we are to truly move forward we need to ensure that technology compiles clinical AND social data; we need shared and cumulative systems that can be maintained and accessed by the patient and travels with them—ensuring all provider data is collected in one singular place; and lastly, we need to ensure that the screening tools built into the technology systems aid in reducing bias—thereby decreasing health disparities. A lot to wish for from technology and data, but hopefully a possibility.