Strategies to Develop Patient Centred Care

Strategies to Develop unhurried Centred C beSneha PraveenMIS Practicum Final ReportAnalysis of online patient reviews and its effect on health dish out providersIntroductionWith the advent of social media, online forums have become a major platform where users share their views and these platforms affect all the involved stakeholders sometimes positively and sometimes adversely. Word of mouth has become an great tool for publicity and sometimes a bad review posted without ulterior motives washbowl do much damage. Most of such reviews and posts that we read on platforms like twitter, Facebook and online forums affect our decision making as we tend to trust judgment of others.But health wield as an industry is still not very patient centric and not enough splendour is given to patients vista. This case is stock-still more valid in the context of USA as on that point is no official channel for patients to leave their reviews and experience about a health tuition provider. Thi s is very surprising as all other industries food, retail, and consumer industries revolve around what customers have to say and millions of dollars are spend on customer satisfaction, whereas, healthcare industry still relies on their processes without bothering to collect feedback from patients they serve. The main reason accredited to this could be that as payers, insurance companies and as religious service providers, physicians play the most important role. Patients in this context are mere subjects of treatment who are assumed to be not very vigilant of their own health condition. But is this slur same all around the world? And if not, then US healthcare films to adapt and learn from such countries to break its care and service forest. unmatched such online forum implemented in the United Kingdom is Patient Opinion. This forum acts as a bridge between patients and healthcare providers to servicing improve the healthcare bore provided by National Health Service (NHS) to its citizens. In this paper, I will analyze data collected from patient opinion forum and present by findings answering how USA hobo benefit from a review outlet like Patient Opinion and how this forum has helped NHS to improve their quality and service.Why Patient-Centric CareIt is well proven that any industry benefits from customer reviews and helps in reducing cost and improve service. Slowly, healthcare needs to go on towards Patient- relate care which supports active involvement of patients and care givers. It elbow room being responsive to patients preferences, needs and feedback to ensure that service quality improves and slowly there is more involvement of patient in healthcare delivery and design. 1A patient centered care has below attributes 2Whole-person care.Coordination and communicationPatient support and empowermentReady accessAutonomyA patient centered care focus on guiding patients by giving them information about options and risks. It means considering pati ents preferences and background and valuing their feedback. According to 2001 Institute of Medicine a focus on patient centered care is one of the factors constituting high quality health care.Source http//hcca-act.blogspot.com/2011_11_01_archive.htmlThe current system is physician centered which means that effective care is defined by physicians standards and skills instead of express on patients satisfaction from the service rendered. For example- orthopedic surgeons use the Harris Hip score to judge the success of a hip replacement. This was designed but by physicians and does not include any feedback from patients to include their satisfaction from the procedure 3. Thus, it is impossible to correctly define the output of any mock up in healthcare until the patient experience has been taken into account for.What Patients WantMost tools that we use to judge patient satisfaction or outcome of a medical service cannot be accurately quantified. Also, the success metric for a medi cal care varies from physician and patients point of view. An example of such tools was administered by Steward.et al in 2000 where many physician-patient interactions were audio taped and patients rated these conversations. After synopsis, it was deduced that patients recovered faster, had better emotional health and perceived the care as satisfactory if the care was patient-centered. The assent of patients on their healthcare providers improverd when there emotional needs were taken care of by the physicians leading to less number of diagnostic tests and fewer referrals.A similar methodology can also be used to study physician empathy. Researchers at Jefferson University developed the Jefferson scale to test physicians empathy where physicians rated their own empathy but this scale could not be used to judge patient satisfaction. Thus, a new scale called Jefferson Scale of Patients perception of doctor Empathy was used which judges patients rating of physicians empathy which c orrelated to patients satisfaction. Mostly what patients regard is a relationship of empathy with physicians, who can help them communicate with the problem and develop a personal relationship with them. The perception of care is different from physicians and patients point of view and we need to move our focus from whats the matter with our patients to what matters to our patients. 1Hindrance in achieving true patient centric careOne of the most crucial factors stopping US in achieving true patient centric care is the current reimbursement system and focus on physician practice pretense. There is no measure in US to gauge the quality of care, empathy and relationship of a physician with patients. Reimbursement is not correlated to these factors, instead it is based on per patient encounter. Due to this, firsthand care physicians focus on increasing the volume of patients and reduce the time spent with each patient. Most physicians are in a hurry and under stress which leads to m isdiagnosis, useless tests and referrals, decrease in quality of care and a very formal relationship between physician and patients. 6Next important factor is that physicians active by infirmarys are incentivized or prized depending on number of patients that they bring but there is no measure to the quality of care they impart. The volume of patients precede quality because the financial benefits are huge e.g.-Each lab tests physicians order, each referrals they recognise, benefits hospitals in terms of huge monetary benefits which in turn becomes a basis of primary care physicians salaries. Thus, understandably what drives physicians is to employ methods to increase volume of patients, decrease time spent with each patient and other ways to legalize each patient-physician interaction. 3The third hindrance is hospitals hiring generalists called hospitalists to provide care to patients with the goal of reducing patient days per admission. This might lead to improve in care for a certain amount of time but the reason behind hiring such individuals is not to improve patient care but instead to benefit hospitals financially.The Patient Centric Approach modelPatient Centered aesculapian HomePatient Centric medical home helps address the patient centric coming by emphasizing on high quality patient care and lower the healthcare cost. They reorganize primary care practice by recognizing the importance of patients experience and works on system based approach to transform health services being offered. PCMH centers their service on fourth-year with acute care needs, patients with physical disabilities and with specific preferences in terms of culture and values.The care offered is comprehensive and designed to meet patients needs including physical and mental attention, degenerative care and long term assistance like help in performing daily ablutions for patients with functional limitations. 8Accountable Care OrganizationsACOs have been set up with the goal o f ensuring high quality of care is given to patients at the right time to prevent medical errors and reduce medical costs. Mostly ACOs are form by group of doctors and hospitals who voluntarily come in concert to serve Medicare patients. 9The basic promise that ACOs hold is to have patient centered care and treat patients with empathy, care and work towards avoiding unnecessary costs and develop a personal relationship with patients. Thus, government should incentivize formation of more ACOs to ensure more patient- centric approach.Strategic IT enthronizationIT is the obvious answer to increase efficiency, reduce medical errors and improve quality of care in US. Though there are many facets of IT that can be used, use of Electronic Health Records (EHR) and Electronic Medical records (EMR) are the most important tools to use.EMRs are digitized version of patient record keeping for a physicians. EMR has been subservient in reducing medical costs overtime by enabling better interactio ns between departments and monitoring patients visiting time and medical information. Patients can also log on and know about their health records and be better prepared.EHRs stores patients records so that if needed emergency departments can access it before giving them any medicines. This saves the cost of duplicate tests because all the data needed to prescribe medicines are present in EHRs.Feedback and review model Patient OpinionPatient opinion was founded in 2005 and is the leading feedback platform for healthcare in UK. They allow patients to write their reviews/ stories about their experience and tag the accompaniment provider. Other users can then favorite the post if they have experience the same thing. Patient Opinion also has an analytical engine which does sentiment analysis for each hospital and show what areas need improvement and which departments received positive reviews.The hospitals can read these reviews posted about them and respond to the complaints and prais es. This helps them to improve their quality of care and address the issues raised by patients.Patient Opinion is a social enterprise and a NGO which is independent of NHS but share the same values. It is funded through and through user subscriptions, healthcare providers and healthcare Commission. Providers subscribing to Patient Opinion get the access to all patient feeds and can respond to the reviews. Though, use of patient opinion by patients is free. Patient Opinion is available across England but not (yet) the rest of the UK. It covers all acute trusts. As of today, 600 hospitals are registered with patient opinion and working together to improve the healthcare quality in UK. 5How Patient Opinion fits the review modelIt allows patients to give feedback on their health services and to see what others are public lecture about. It also acts as a platform to hear and respond to reviews and complaints posted by patients. They can compare their ratings with other hospitals and fin d out which of their departments are doing rock-steady and bad. All the opinions are reviewed before publication and editorial policies are public. The critical reviews are marked and directed to the healthcare providers while maintaining patient identity.Below are some feedback posted by patients for Kings donkeywork Hospital over a period of 2 weeksTaking Kings Mill Hospital as our example for this study, let us look at some figures which help us better understand the Patient Opinion model*Data collected is for the month of AprilAnalysisAnalysisAs of now, for the entire Patient Opinion database, feedback opinion so far is around 50% positive, 30% mixed and around 20% critical.Below is data of number of posts till dateIn the last month, of all the posts, 53% had a response from hospital staff and 6% of responses actually lead to change. The numbers do look small but in the larger picture, it is an incremental change which slowly is ever-changing the face of UK healthcare.Conclusi onPatient centric healthcare is the answer to the problems of rising cost and low quality of healthcare in USA. A patient centered communication gives more satisfaction to patients and increase their faith on the physician and treatment. Emotional health is better when patients feel that they have a personal comparison with their physicians and their preferences, culture and values are being considered while treatment.It is very important to increase emphasis on physicians empathy towards patients and introduce feedback model to increase efficiency of hospitals. Patient Opinion is bringing change into the healthcare scenario of UK by making patient reviews an important tool of decision making. Hospitals are responding to these reviews, trying to make amends and improve the quality of care. Currently, healthcare of USA is financially driven and patients are not treated as a valued customer. In future, if we want the healthcare cost to go down and expect better service, it is very im portant to bring the focus on patients and build the system around them.References1 Jo Anne L. Earp, Elizabeth A. French, genus Melissa B. Gilkey Patient Advocacy for Health Care Quality2 Bechtel, Christine.If You Build it, Will They Come? Designing Truly Patient-Centered Health Care.Health Affairs3 http//healthaffairs.org/blog/2012/01/24/patient-centered-care-what-it-means-and-how-to-get-there/4 Moira Stewart, Judith Belle Brown, Allan Donner, Ian R. McWhinney, Julian Oates, Wayne W. Weston, John Jordan, The Impact of Patient-Centered Care on Outcomes5 https//www.patientopinion.org.uk/info/about6 Improving Patient Opinion Mining through Multi-step Classification, Lei Xia, Anna Lisa Gentile, James Munro, Jos Iria7 http//www.ncqa.org/Programs/Recognition/PatientCenteredMedicalHomePCMH.aspx8 Ensuring That Patient-Centered Medical Homes Effectively Serve Patients With Complex Health Needs, AHRQ9 http//www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/10 http//www.ncbi.nlm.nih. gov/pmc/articles/PMC64755/