Most healthcare outcome improvements are attributed to clinical, operational, or financial process changes in the acute care setting. It’s often skilled clinicians who get the credit for reducing readmissions, length of stay, or costs of care—and rightfully so. But patients, too, can play a considerable role in improving their own care. Many patients, especially those with chronic conditions, want to play this role; they just need the assets (e.g., tools, information, environments) to participate. Data and digitized health—and instruction on how to use them—are proven means for building patient empowerment strategies. This shifts the balance of care from the hospital and clinician to the community and patient, and produces meaningful, patient-centered outcomes.
If clinicians can understand how data empowers their patients, and why empowerment is important, they can realize greater efficiencies in clinical processes and achieve outstanding outcome improvements. As highlighted in this article, unique case studies around the world show the powerful impact of data-driven patient engagement.
Empowering patients is giving patients control over healthcare in ways that clinicians may not typically consider. Patients want ownership over the things that matter most to them, such as measuring and monitoring their own biometrics and having access to condition-specific information when and where they want it. Clinicians can help patients understand the important role patients have in managing their own health challenges.
Beyond the time they spend with doctors and nurses, patients with chronic disease spend 5,000 hours a year on other activities that directly affect their health: deciding what to eat or drink, deciding how certain exercise and activities will impact their lives, and deciding what medications to take and what medical advice to follow. These decisions take place outside the clinical setting, yet the typical healthcare model focuses on optimizing the limited time patients spend with their doctors. Empowering patients means giving them data—and the technology and education to process it—so they can more effectively use, or reduce, those 5,000 hours. Many unique programs exist to demonstrate the positive impact and time-saving potential of empowering patients with technology.
The NHS in the United Kingdom is successfully using a program that gives patients more control over their daily, at-home care and optimizes the time they spend on these activities. A team at NHS Stoke on Trent (now Stoke Clinical Commissioning Group) created the program, Florence (Flo). Flo is a simple telehealth system that uses mobile text messages to help people manage their chronic conditions and other healthcare issues. Flo sends patients reminders and helpful tips customized to their needs, whether it’s managing diabetes, living with chronic obstructive pulmonary disease, or learning how to breastfeed. It’s a perfect illustration of using data and digital health to empower patients to manage their disease.
Empowered patients are a potent resource for generating outcomes improvement. Empowering them with data and innovative ways to manage their own care can generate impressive results. Here are five ways data empowers patients to become owners of their own healthcare journeys.
Patient engagement has been likened to a blockbuster drug that, if not used, should be considered a form of malpractice. Empowering patients with easily accessible and actionable data increases their engagement and results in better clinical outcomes, greater patient satisfaction, and lower costs.
Kaiser Permanente ran a Collaborative Cardiac Care Service pilot program that used technology and data to develop patient engagement through proactive patient outreach and education. Patients in the program had an 88 percent reduced risk of dying of a cardiac-related cause when enrolled within 90 days of a heart attack, compared to those not in the program. Clinical care teams reduced overall mortality by 76 percent and cardiac mortality by 73 percent. Patients engaged by the coordinated care program clearly fared better.
Data helps patients achieve the outcomes they desire and gives them independence rather than simply having them follow clinical plans. When clinicians ask patients what matters to them, rather than what’s the matter with them, a very different picture can emerge of what’s important in their healthcare. What’s important to patients are outcomes that define their ability to function well, feel well, and survive longer. And costs often decrease when clinicians follow patient wishes and focus on patient-centered outcomes, rather than following strict clinical protocol.
My Life, My Dialysis Choice effectively puts data and technology into patients’ hands. It’s a patient-centered app that takes patient preferences into account while they make dialysis choices. The app asks questions about a patient’s preferred lifestyle and goals while on dialysis, then tailors a program to match those preferences. How important is travel? Spending time with family? Keeping a pet? Avoiding pills? Based on the answers, the app asks for a star ranking of different treatment options, then advises on next steps.
My Life, My Dialysis Choice focuses on what matters to the patient and promotes patient engagement. It’s an example of how data empowers patients to choose appropriate care and improve their own health.
Data and technology can help patients practice self-care. When patients administer their own care, the outcome improvements can be remarkable. Ryhov County Hospital in Jönköping, Sweden, evolved into a self-dialysis center because one patient asked about doing the procedure himself. He was taught to use the dialysis machine, interpret lab values, and document his care. Self-dialysis led to less variation and fewer complications. The patient and staff educated other patients and, eventually, a new wing was dedicated solely to deeply engaged patients performing self-dialysis. Today, 60 percent of all dialysis patients self-administer, and the center is heading toward a goal of 75 percent. There are fewer complications, some patients avoid subsequent care, and per-patient costs are lower by one-third to one-half.
Patients often misunderstand the language of healthcare. Care instruction for patients with chronic and long-term health conditions requires carefully targeted communication in terms that patients understand. Giving patients access to their own data and control over generating that data (e.g., self-dialysis, self-measuring, self-screening) significantly improves how patients comprehend and complete their care instructions.
Sharon Rising, a midwife at Boston Medical Center, created a new model for prenatal care that rethinks data and data-generating tools. When a woman learns she is pregnant, she can join the Centering Pregnancy program, a group care model that includes 10 two-hour, group visits with other moms due in the same month. Visits are conducted in a conference room rather than an exam room. Each patient measures and records her own vital signs, then shares the record with her physician and midwife, shifting the balance of care from the clinician to the patient. The group dynamic involves sharing, relationship building, and reassurance from other moms who are going through the same life-changing process.
This model of care reduced the risk of preterm birth by 33 percent, reduced racial disparities for preterm births, and nearly doubled the number of Centering Pregnancy participants who breastfed over those in a comparison study.
Data helps clinicians think outside the walls of the acute care setting to develop new protocols that directly impact patients and lead to substantial outcome improvements. Sheffield Teaching Hospitals in the United Kingdom needed a better way to discharge older patients. It considered discharging these patients to their homes first, and then assessing their support needs in the environment where they live rather than inside the hospital. Early in the process, the team was unsure that the “admit to home” idea would work, but through several plan-do-study-act cycles, processes improved and a new program emerged. It eventually grew to serve 10,000 patients in one year, who got home three to four days faster, saving 30,000 to 40,000 acute-care bed days. Data and a unique patient engagement strategy generated dramatic cost, process, and patient experience improvements.
Healthcare needs to adapt to numerous changes sweeping through the industry. Patient expectations of healthcare delivery and outcomes are changing as technology permeates society and the healthcare economy. Healthcare providers can take advantage of these opportunities and adapt in ways that shift the conventional thinking of how healthcare should be delivered.
Patients want to be involved in practicing their own care, managing their own conditions, monitoring their own results, and producing their own outcomes. Asking what matters to patients, rather than what’s the matter with them, reduces the burden on clinical staff and resources, improves communication between patients and clinicians, and significantly increases healthcare’s value.
Clinicians must empower patients with data and tools that give them appropriate decision-making power and control over their own care. Shifting the balance of care from clinicians and hospitals to patients and the community can improve the patient experience, reduce costs, and improve processes to make healthcare more efficient.
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