Patient Engagement and Involvement
Many times I have heard physicians and other providers lament that the outcomes for their patients would be so much better if they could “get them to listen and follow instructions.” They understand that they can be most effective in treating patients if depop sales the patients would follow all of their directions.
Do the physicians’ or care providers’ responsibilities end with this wish? Can physicians do more than just hope and pray for best outcomes after they deliver directions to their patients? Should providers be more actively involved in helping patients achieve optimal outcomes, providing support after an office visit or after discharge from a hospital? At present more care providers are becoming increasingly involved in helping patients follow orders and in helping them alter lifestyles as needed. This can be seen especially in patient-centered medical homes.
Recent studies provide good reasons why providers should be active in helping patients follow directions. Consider the following facts pulled from various sources:
Only 1 in 10 patients are health literate enough to adequately care for their own health, according to a reprot from the National Center for Biostatistics
The Commonwealth Fund in several studies has found that a growing number of adults avoided a doctor or did not fille a prescription. In 2010, 23.1% reported not filling a prescription in the previous 12 months and 27% skipped tests or treatments.
According to a December 7, 2013 report in Modern Healthcare Dr. Warren Licht of North Shore-Long Island Jewish stated that “When patients are in doctors’ offices, they (might) hear 50% of what’s being said and maybe their relative hears another 30%, but they walk away without 20%.
There are many other sources stating that it is very difficult for patients to follow physician directives and that physicians should not be surprised when they find out a patient has not followed orders.
Because of the advent of payment bonuses based upon the quality of outcomes and because of the growth of payers demands that reimbursement be partially based upon quality outcomes, it is becoming financially necessary for physicians to become more involved in helping patients achieve optimal outcomes for treatment, becoming more patient-centered. Additionally, according to Dr. Victor Montori of the Health Care Delivery Research Program at Mayo Clinic, it is the “ethical obligation to better inform patients” for physicians and care givers.
So what are some of the things that providers can do help patients adhere to physician directives? There are many approaches and there is a great deal of research being done in this area. In patient-centered medical homes there is often a nurse who acts as a case manager for patients with chronic conditions. The nurse helps manage the care of patients who are the mostly costly to provide care to by directly intervening with the patient on a regular basis to see that care directives are being followed. Some hospital groups are doing this too. Modern Healthcare in three part series, Channeling Choices, in late 2013, provided this guidance:
Survey patients’ knowledge and confidence in their ability to manage an illness, and tailor education and services based on the individual responses.
Let patients be a part of decision-making.
Invite questions and discussions from patients about their fears.
Don’t shy away from discussing with patients what they can afford.
Use health coaches to identify gaps in knowledge and draft questions for doctors.