Giving Patients a Seat at the Table

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

A recent brief from the Robert Wood Johnson Foundation has interesting observations about patient engagement. The brief states that while engagement is primarily  about motivating and empowering patients to be active participants in their care, it also can mean giving them a seat at the table to improve the care they receive.

Successful programs have three components: engagement, collaboration and transparency. The transparency piece is the most interesting, I think, because it’s the hardest to implement.

The brief tells the story of Aligning Forces for Quality — South Central Pennsylvania’s (SCPA) implementation of the Patient Partners program, which gets patients involved in quality improvement efforts. SCPA clinicians were understandably wary of exposing deficiencies to patients, but they found being transparent helped patients understand how the system works. The quality improvement groups started by looking at small items, such as the way a practice uses its phone system.

Through structured meetings and meeting evaluations, Patient Partners helped SCPA practices adopt new techniques, including a reminder card to schedule well-child visits and experimenting with “brown bag” medication review appointments. The program, which includes 36 practices and 125,000 patients, focuses on patient communications and self-management.

Allowing patients to influence healthcare systems and policies is critical for culture change. That’s what the foundation means when it talks about engagement. It describes how Massachusetts Health Quality Partners (MHQP) formed the Patient and Public Engagement Council. Council members use their experiences and patients and family members to help MHQP establish strategic goals and develop public reports on the community’s quality of care. The council recently worked with Consumer Reports to develop a first-ever rating of patient experiences with 500 primary care practices.

Similar success occurred with collaboration at Greater Detroit Area Health Council (GDAHC), which created a six-month cardiac disease prevention exercise program with twice-weekly exercise advice sessions, additional sessions with primary care physicians and dietitians, pedometers and a cooking demonstration. Program graduates who lost weight and lowered their blood pressure reached out to community organizations to implement similar programs. More than 700 patients now have graduated from the program.

We can learn a great deal about all forms of patient engagement from these types of programs, especially since Health Affairs found that patients without the skills to manage their healthcare incur costs up to 21% higher than patients who are highly engaged in their care.

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