Changing the Office Visit from Transaction to Value Experience

In my estimation a goal beyond the clinical exam of an office visit is to have both the HCP and the patient establish a foundation for better outcomes by managing knowledge and sharing problem solving. In a sense this is a form of shared decision making (SDM) where HCP and patients communicate thus moving the relationship from paternalism to partnership. SDM is labor intensive and best suited to chronic or terminal illnesses. How can the busy PCP change a HC transaction to a learning experience and gain the benefits of SDM?

All practices comprise patients at varying degrees of health status and age. Each segment will reside on a different part of the learning continuum. Say 10 is a highly active involved learner and 1 is a non-learner. The reality is that we can’t expect to move all patients to a 10. The goal is to move patients to be more active in their HC involvement. Say a 2 to a 4 or a 5 to a 6. These small changes can make a difference.

Over the course of six months each patient visit should be accompanied with a short questionnaire to determine where patients reside on the learning continuum.

 1. Do you have a chronic illness or a healthcare problem that you are concerned about? Y/N

2. Are you actively learning about your illness or problem? Y/N

3. If you are active in learning what are your sources? (RankInternet

  1. Social media and groups with similar concerns or illnesses
  2. Friends and family
  3. Medical and scientific journals
  4. Support groups
  5. Healthcare professionals

4. If you have a chronic illness or a healthcare problem but are not actively learning about your illness why?

  1. My HCP is my decision maker
  2. I know a lot about it and am managing it well with my HCP
  3. I don’t have the time or desire to pursue this type of information
  4. I never considered learning more

5. If your health is good and you have no HC problems are you interested in learning more about your health? Y/N

These five simple questions will first open an entry point for discussion. The HCP can identify what problems the patient is seeking to solve, are they active learners, where do they learn, etc. The key for moving the office visit from a drive by transaction to a learning experience is knowing where the learner resides and if they want to learn. 

The data can be put into a database by disease, interest in learning, and other patient demographics. Once this is completed an educational strategy can be identified by segment or group. Outcomes can be as simple as did the patient at the next visit change his or her opinion about learning? Did they add some new knowledge to their knowledge base? Bottom line: the HCP should be the primary resource for patient learning or the most trusted. With a small effort the HCP can control and manage this knowledge channel

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