MSL Washington DC SVP Chuck Alston gave this presentation in April 2013 at QualitySync II, a Medicare quality improvement conference in Virginia committed to "Transforming Care Through Innovation". Chuck presented to an audience of health care providers his best research-based thinking into communications and engagement with consumers and patients in the wake of the Affordable Care Act and the general restructuring of health care delivery in the United States.
What the Healthcare World Looks Like to Patients New reforms, coupled with the increasing complexities of medical treatments, have propelled a wave of innovations to raise the quality and lower the cost of healthcare – all with significant implications for the way providers communicate with patients and their families. Now more than ever, it is important to engage patients as they navigate today’s new healthcare landscape. By connecting with the public in the right way, providers can offer the guidance needed for patients and their families to become more knowledgeable consumers, which ultimately leads to better health outcomes. Participants in this session will be able to: Assess the impact of healthcare reform on patients’ understanding of the new medical landscape.Understand the role providers play in improved patient knowledge and the benefits of engagement and the new healthcare delivery and payment reforms.Evaluate research-based findings for improving provider-patient communication.Identify strategies to increase patient knowledge and improve health outcomes based on new emphasis to drive behavior change toward wellness, access to preventive care, and medication adherence.
This is a map of the world before Columbus sailed the ocean blue.Like Columbus, we are venturing off the known mapADVANCEAs I hope to show, that’s where much of health care communications is right now1/6 of economyRestructuring – not fast enough for payers, too fast forsmeproviders, bewildering to patients – more than models threatened, holds potential personal threatPeople don’t’ want to think about health care way payers are, providers are being forced to, and how some wish consumers would
The first lesson
The goobledygook lingo of heath care reform the way it appears to consumers
TeamsValue etcAre laden with baggage unapparent on the surface
Let me pause here a second and let you soak some of this inOn the left, some of those terms on the previous slideOn theright, what people think ofwhen they hear those terms
Such is the pull of physician care that majorities of those who have an initial preference for a doctor over another care provider hold thatposition even if it means appointments are briefer (73 percent say that’s worth the tradeoff), the doctor doesn’t know them as well (60 percent),or it’s harder to get an appointment (56 percent).• While doctors are present, continuity is lacking. Two-thirds of patients say they don’t see the same care provider every time they visit their facility. Nearly six in 10 of them would prefer more regular contact with the same caregiver – a desire that helps open the door to considerationof alternatives.• For many, preference for a doctor falls short of a demand. One-third have no preference for a doctor over a nurse or physician’s assistant,and more are open to non-doctor care under specific circumstances. Among those who initially prefer a doctor, nearly four in 10 shift theirpreference to a non-physician provider if it means it’s easier to get an appointment. And just 23 percent of all low-income Californians prefera doctor across every condition tested.• Openness to non-doctor alternatives rises in some groups, for example among younger patients and those in better health. And among peoplewho don’t currently see the same care provider each time, a not insubstantial four in 10 are content with that arrangement. Insight can begained from closer examination of this and other more flexible patient populations, provided in the full report that follows.
As always, as communicators we seek to meet consumers where they are –not where we wish them to be – and then craft strategies for taking them where we want to go.Reiterate These were developed as defensive messages – not to take the story to the public, but to respond if asked. We can see that in first takeaway.This is not a conversation most consumers want to engage in. The focus groups made it abundantly clear that consumers do not want to think or talk about how, when or why their healthcare providers are paid. Little to no knowledge about how the current reimbursement process works, and linking money or payment to their health andhealth care makes them uncomfortable at best, very angry at worst.Especially in this economy, the notion that physicians should be paid differently to do high quality work or go the extra mile to give their patients the care they need is a non-starter. The messages in this report therefore, are best used reactively rather than proactively.
Find better ways to pay for careMake sure the way insurance pays for health care is consistent with way you want to receive itMaking sure every dollar is spent wisely
As part of a yearlong trial, primary care doctors at three major, diverse health centers -- Beth Israel Deaconess Medical Center, Geisinger Health System and Harborview Medical Center-- invited their patients to read their visit notes online. 105 doctors and more than 19,000 patients participated in OpenNotes. After 12 months, doctors and patients reported on their experiences:
OpenNotes: ResultsAs part of a yearlong trial, primary care doctors at three major, diverse health centers around the country invited their patients to read their visit notes online. 105 doctors and more than 19,000 patients participated in OpenNotes. After 12 months, doctors and patients reported on their experiences: Patients Were Enthusiastic Patients used the notesOf those with notes available, 84% of Beth Israel Deaconess Medical Center patients and 92% of Geisinger Health System patients opened at least one note. At Harborview Medical Center, where patients were using the portal for the first time, 47% opened at least one note. And 20-42% (depending on the site) shared their notes with someone else, usually family members or relatives. They reported important benefits77-85% reported better understanding of their health and medical conditions. 77-87% felt more in control of their care. 70-72% said they took better care of themselves. 60-78% reported doing better with taking their medications. They did not feel overwhelmedVery few patients (1-8%) reported being confused, worried, or offended by what they read in their doctors’ notes.
Scientific information from researchThe training and experience of health professionalsPatient’s goals, concerns, preferencesEach element is complementary and important to the right health decision for each individual patient Patients and providers should communicate about all three