Today’s doctor is, by and large, and expert at providing “epistrophic” care – healthcare delivered in episodes, during catastrophes. It’s what happens to patients in between those medical emergencies that causes the wheels of the American healthcare system to bog down.
And that’s where healthcare is failing its patients.
Daniel Sands, MD, an assistant professor at the Harvard School of Medicine and co-founder and co-chairman of the Society for Participatory Medicine, said today’s clinicians aren’t meeting the needs of an increasingly engaged and empowered patient population because they’re still too focused on what they’re good at – delivering critical care – and not paying attention to the spaces in between. They’re not communicating and collaborating with their patients outside the office, using “frequent life touches” to figure out what those patients are doing each and every day that affects their health and health management.
To do this would require a paradigm shift in the nation’s healthcare system, Sands said; one that focuses on prevention and management. One that pulls in mHealth tools and platforms, from wearables to home monitoring systems to communications technology to the whole Internet of Things. And one that relies far more heavily on the patient’s own point of view.
“Healthcare is a collaboration,” said Sands, who keynoted the first day of the two-day HIMSS Patient Engagement Summit in San Diego.
Patient engagement is a nebulous term, said Jonathan R. Slotkin, MD, medical director of the Geisinger Health System’s “Geisinger in Motion” program. It’s often called a soft science because it’s hard to measure and – so far, at least – determine value from. But with the nation’s troubled healthcare industry shifting to a consumer-facing system that place value over volume and rewards positive outcomes, it’s important that healthcare providers see the value in what they’re patients are thinking and feeling.
However, that takes many doctors out of their comfort zone.
“We’re moving from healthcare to health,” stressed Sands, who says the patient is the most underused resource in healthcare these days. “And we’re moving from the (doctor’s) office to the home and, actually, anywhere.”
Clark Kegley, assistant vice president of information services at Scripps Health – who launched his career in healthcare after basically having a doctor ignore him during a critical time in his family’s health history – said providers need to redefine value. It’s not necessarily what they know or have been taught that will help a patient, but a collaboration of medical knowledge and the patient’s own personal habits and desires.
“Patient engagement is not how much money I can make in the next 30 minutes (of a doctor’s office visit),” he said. “It’s how much of an impact I can have over the next 30 years.”
To make that impact, providers need to not only treat the patient as an expert, but use technology to reach those patients when and where they need it. Recognize patient-generated data for what it’s worth – maybe not an objective rendering of the patient’s health, but a measurement of how a patient is actually living and reacting to healthcare decisions.
Alicia Staley, Akari Health’s chief patient officer, pointed out that patient-generated data might not be technically accurate, but it’s more important to the patient, and so it holds more value to the patient in the care plan. Who can define pain better, she asked, the patient feeling pain or the nurse looking at the patient? A certain medication might be effective in treating a patient’s problem, but if that patient is miserable in the process, that may lead to more serious physical and behavioral problems down the road.
In the end, Sands said, America has to stop looking at healthcare as a service industry, like a car wash, and more along the lines of a lifelong collaboration.
“People are experts in everyday living,” said Kristina Sheridan, department head of enterprise transition planning and execution for the MITRE Corporation, which has developed a patient-facing engagement app.
And that’s what matters most to them.