This week the NEJM published an article by Manary, Boulding, Staelin and Glickman “The Patient Experience and Health Outcomes”. This article examines the question “Do patients’ reports of their health care experiences reflect the quality of care?” The authors examine the fact there is little if any consensus on this topic. Some studies show there is no relation to quality of care and is associated with poor outcomes. Other studies found better patient experiences, more than adherence to clinical guidelines, are associated with better outcomes. This is an excellent review and in part speaks to the growth of social media and patient’s involvement in their care.
The money shot in this article is this line “…studies have shown that patient-experience measures and the volume of services ordered are not correlated: in fact, increased patient engagement leads to lower resource use but greater patient satisfaction.” I realize this is not improved patient outcomes but it is about patients being self actualized around their healthcare.
This finding speaks volumes to social media and the topics addressed during the Sunday evening chat at #hcsm. Patients involved in their own healthcare effect cost and are more satisfied with their care. When we address the problems we want to solve we are more involved and take greater control over our lives. As involved active patients we become advocates for our healthcare as well as helping others seek solutions to similar problems.
There is more we can do to improve and increase patient engagement in order to realize improved outcomes, greater satisfaction, and lower cost. We can drive patient’s to become more healthcare active, aid them in learning about their health.
This is not something we randomly apply to any patient. It is something that becomes part of the exam and the in-office visit. The physician should be performing a brief needs assessment on all patients. Damn, it’s not like we are not being handed reams of paper at a visit to fill out. A short assessment to determine where the patient resides on his/her self-learning continuum, where they turn to for knowledge, what are the health problems they want to solve, and do they want to be part of an office based community?
Let’s be real, we will never get near 100% participation but we will realize small committed groups of patients and that demographic will tell us about other groups within our practice. It will drive patient changes and improve outcomes. Changes we can drive in one group will translate to other groups. And this becomes self-actualized through the reality of social media and learning. These patient success stories will be shared and will drive new entrants within a practice.
This trend will not continue on its own without some help. It may be largely driven by the economy and the fact many more Americans are unemployed and struggling to pay their healthcare premiums. Now is the time to leverage what is happened to create deep links to behavioral changes and improved outcomes. Simple small steps at the office level one practice at a time will reap great benefits. Today not tomorrow.