One of the more commonly used, yet least understood phrases in healthcare in recent years is “patient centered care.” To some, this is little more than the latest buzzword that denotes an emphasis on better customer service for patients within the healthcare system. But in reality, patient centered care represents a seismic shift in the way physicians and patients alike approach individual healthcare. This is not a flavor of the month but rather a new world order across the healthcare field.
Patient centered care is the practice of involving the patient more directly in every aspect of their care and approaching that care in a way that is cognizant of the needs and values of the individual. In this respect, the approach is customized rather than cookie cutter, as has been the norm in the past. For a more specific definition, the IOM (Institute of Medicine) defines patient centered care as:
“Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.”
Researchers working on behalf of the of Picker Institute and The Commonwealth Fund found there were certain practices that enhanced the practice of Patient Centered Care. They combined these in a list that became known as Picker’s Eight Principles of Patient Centered Care. These are:
In the field of healthcare, as in everything else in life, there is almost never unanimous support. There have been voices that suggest that adopting a Patient-centered care approach is easier in theory than in practice. Some point to inevitabilities where two patients may be in conflict (i.e. waiting for a hospital bed) and doing what is best for one is detrimental to the other.
Others have raised concerns where the wishes of the patient may run counter to the doctor’s clinical advice. If a doctor sticks to his or her professional judgement and contradicts the patient’s wishes, is it really patient centered care? If the patient’s wishes are followed, is it a breach of medical ethics?
At Accreon, we believe that practical patient centered care involves medical professionals and patients working as a team to provide the best, customized care for an individual. It is better for the patient when they play a more active role in the approach and execution of their healthcare regimen. And physicians will stand a better chance of treatment success if the individual needs and values of the patient is factored in to the approach.
Ronald Bachman, president and CEO of Healthcare Visions, succinctly summed up the new approach to patient care when he said, “It’s about engaging employees, employers, medical providers, insurance carriers and other stakeholders in a new relationship that deals with health rather than sickness and disease.”
I’ve seen first hand how advances in Health Information Technology (HIT) have spurred the subsequent advances in patient centered care. Because the core of effective patient centered care is communication. Not just communication between physicians and patients but also communication amongst caregivers. That means family physicians and specialists, ancillary providers and other members of the care team. It’s no coincidence that the technology enabling faster and better communication between stakeholders in the healthcare process, evolved concurrently with the growth of patient centered care.
Designing, building, and implementing the Information Technology platforms and tools that are the foundation of patient centered care is our specific field of expertise here at Accreon. I can tell you that seeing the direct impact this has had on improving the lives of patients, their family care providers and healthcare professionals alike has been one of the most rewarding professional experiences of my life.
Here are just a few ways the latest advancements in HIT are having a positive impact on the development of patient centered care.
Perhaps no advancement in HIT has had as much of an impact in improving patient care than that of EHRs. They have created a permanency that has resulted in faster and better care. When a hospital from another jursidiction can access a patient’s EHR in the immediate aftermath of a car accident, for example, issues such as drug allergies and pre-existing conditions (hypertension, diabetes) can be immediately factored in to the treatment. By being able to instantly identify key characteristics of the patient’s profile, the healthcare provider has taken significant steps towards effective patient centered care.
Other benefits have been citied in the May 2010 Journal of Family Medicine article, Patient-centered Care and Electronic Health Records: It’s Still About the Relationship by William B. Ventres, MD, MA; Richard M. Frankel, PhD. In it they write:
“EHRs offer improved access to clinical data and the opportunity to more readily practice population-based medicine. They can help decrease medical errors. Electronic reminders assist physicians in meeting evidence-based medicine care standards. EHRs also improve the coordination of care as patients move from inpatient to outpatient settings and transition back and forth between subspecialist and primary care offices.”
Patient Portals use the information stored in EHR’s to create another window for patients to have more direct access to their healthcare. A good example of this in practice has been patients given immediate access to lab results through the patient portal. In the online article “How Patient Portals Improve Patient Engagement” the benefits are described as such, “Patient portals go beyond providing patients with a window into which they can view their health data. Most portals include features such as direct secure messaging, online appointment scheduling, online bill payments, prescription refill requests, and sometimes even data update capabilities.”
The theory is fairly sound in how this fosters better patient centered care. The more people are involved with their ongoing treatment or prevention plan, the better chance of success it has.
The advancements in HIT are making the phrase “The doctor is in” obsolete. More and more, physicians are using video call platforms to “see” patients in circumstances where being together in the same room is simply not possible. In the past, this was a barrier to accessing care but now that no longer need be the case. This trend has been noted by Sandra Garrett, president of Georgia-based healthcare provider Jackson & Coker who noted, “Tech-savvy physicians, especially recent graduates, increasingly rely on digital and Internet-based tools to communicate with patients and improve the medical outcomes of the care they provide.”
Once again, today’s technology can be used to tailor a consultative approach to a patient who may find it difficult to get around or travel to a doctor’s office. This customized treatment approach is part of what patient centered care is all about. Helping patients achieve better outcomes by taking ownership of their health through the use of technology is what Accreon is all about.