Engaging Consumers for Improved Cost, Quality and Outcomes

Following closely on the heels of the mHealth Summit, the Bipartisan Policy Center (BPC) recently released the research report, “Improving Quality and Reducing Risk in Health Care: Engaging Consumers Using Electronic Tools”. Arriving in the shadows of the fiscal cliff discussion, the report notes that healthcare spending currently places a considerable burden on our economy. And with a focus on cost reduction, implementing the right measures to improve quality and individual health remain tantamount as well.

Originally identified in the 2001 report, “Crossing the Quality Chasm: A New Health System for the 21^st Century”, the Institute of Medicine (IOM) promoted patient-centeredness as one of six key aims for the nation’s health care system, thereby making it well-established and widely embraced today. And building on the January 2012 report, Transforming Health Care: The Role of Health IT, the BPC identified six attributes that emphasize patient engagement’s role in supporting high performance organizations:

1. Organization-wide focus on the needs of the patient

2. Strong organizational and clinical leadership

Bring the patient’s perspective to the design, delivery, and management of care.
Patients are involved in governance and advisory boards to provide input.
Create organizational culture that focuses on the needs of the patient and encourages continuous learning and improvement

3. Access to information to support efficient, coordinated care

Successfully coordinate care across providers, settings, conditions, and time
Care teams and patients have access to an individual patient’s records across settings in which care and services are delivered.
Patient preferences and status are included in the record to inform clinical decision-making
Reminders and alerts for both clinicians and patients help eliminate medical errors as well as gaps and duplications in care
Privacy and security are carefully managed

4. Timely access to care

High-performing organizations provide multiple avenues for patients to receive timely care.
Care teams are available when needed, whether by phone, by mail, online, or in person, including nights and weekends.

5. Emphasis on prevention, wellness, and healthy behaviors

Recognize that providing educational resources and self-management tools to promote prevention and wellness, as well as management of chronic conditions can lead to better health outcomes

6. Accountability, alignment of incentives and payment reform

High-performing organizations continuously measure and take actions to continually improve performance on the cost and quality of care, including patient experience of care and health outcomes.
Clinical, administrative, and patient-generated data inform goal-setting, the identification of areas needing improvement, and the effectiveness of interventions.
Financial incentives are aligned with better outcomes in cost, quality, and patient experience.

In efforts to support cost and quality goals, there have been a number of new models being tested by the Centers for Medicare and Medicaid Innovation (CMSI), including the Medicare Shared Savings, Advanced Payment and Pioneer ACO models, as well as the, Comprehensive Primary Care Initiative Demonstration. Together with the Partnership for Patients: Community Based Transition Care program, these arrangements are helping demonstrate that patient engagement, activation and communication are all associated with lower cost and better outcomes.

Despite the forward movement, significant challenges continue to exist for patient-centered care and patient engagement. Such challenges include the need to expand patient engagement in medical education, post-graduate training and continuing medical education. Making a fundamental shift in practice and reimbursement will not only improve physician-patient interaction, but also help to align participant goals with health, wellness and prevention. And as Susannah Fox, Associate Director, Digital Strategy, Pew Internet & American Life Project, outlines below – organizational culture should embrace the “e” in e-Patient, since engagement is an instrumental step towards achieving the IOM goals.