Patient Driven Healthcare and Hospital Efficiency

Can patients help make hospitals more efficient? The short answer is yes; but that efficiency evolves over a long period of time as opposed to having some informatics programmers create an overnight solution. A key contributor to this efficiency is patient driven healthcare, and the availability of apps is moving us in that direction.

The idea of patient health records is slowly being replaced by the availability of specialized and user-friendly apps. The FITBIT® generation has extended into the development of more extensive and reliable (government sponsored in some cases) apps that allow patients to gather their own precise heath information as opposed to, or in addition to, having to visit the doctor.

Patients can, for instance, use an app to get accurate blood pressure results. An app is more accurate than a manually used blood pressure cuff and can save patients an unnecessary trip to the ER if they misread or don’t apply a cuff correctly. It can also help to save a trip to the physician because they are taking their own readings.

In short, patients can now choose to be responsible for gathering and keeping their own healthcare information. The results from multiple individual apps can eventually be integrated into a medical note –but into a separate folder so that the note, as well as the physician, is not overwhelmed with information from disparate sources.

Dave deBronkart, a founder of and the Society of Participatory Medicine, believes that it’s time for a patient driven healthcare information economy. “People perform better when they’re informed better – this applies to clinicians and patients.”

In this scenario, patients own their own medical information and keep it in open source software in a similar manner to how they currently keep their financial records. All the information is in one place and no one is allowed to contribute unless they have all the relevant information.

Not all patients have the same degree of proactivity and self-responsibility, so in order to achieve the goals set out above, patients need to be categorized according to how much proactivity they can handle.

Dave deBronkart says, “A widespread experience among many clinicians is that patients don’t know anything. If you keep information out of patients’ hands then it doesn’t make sense to blame them for not knowing anything.”

So in order for patient driven healthcare to have an effect, physicians need to be able to speak to patients at their own level. They can do this by using a Patient Activation Measure (PAM) – a well-validated questionnaire that healthcare providers can ask patients and, in a couple of minutes, obtain a reliable measure of where the patients are on the empowerment scale.

  • Level 1: powerless – patients have given up – they are overwhelmed and passive
  • Level 2: there may be something they can do but they still haven’t taken any action – they may still believe that their health care is not in their control
  • Level 3: as soon as they start a diet, they are taking action, even if they immediately fall off the wagon – they are an active part of their health care team
  • Level 4: the patients are good at it and keep going even if things don’t go well for a while – they are their own advocates

If patients are at Level 3 or 4, they can have a dialogue with clinicians about how to proceed next.

Patient empowerment and its effect on patient driven healthcare is an area of medical practice that is not taught yet. However, as it becomes apparent that patients’ involvement in their own healthcare will help control and drive down medical costs (including hospital admissions and readmissions, medication, and lifestyle adherence), this, too, will change.

If you would like more information on patient driven healthcare, please download our white paper Understanding Value-Based Healthcare.

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