Dr. Jamo Rubin is Founder and CEO of San Antonio-based TAVHealth, a cloud-based platform for complete patient care. The solution is designed to connect care providers to community resources and support services to help a patient transition from inpatient to outpatient to home with successful outcomes. A former cardiac transplant anesthesiologist, Dr. Rubin founded and led Medical Present Value, a contract management and revenue cycle company (now Experian Healthcare) and PTRX, a consumer-oriented pharmacy benefits manager (now Catamaran). He also co-founded and led Tenzing Health, a division of Vanguard Health Systems. In this point of view, he shares his perspective on the meaning of patient empowerment and its role in achieving the Triple Aim of lower costs, better clinical outcomes, and improved patient experience:
Patient empowerment. Although a relatively new concept to healthcare, it’s already a pretty prominent catchphrase. The question is, what does it really mean?
Patients currently wield far more power than ever before over when, how, and where they receive healthcare. In part, that’s because long-term patient outcomes and retention are critical components of the industry’s move from fee-for-service to fee-for value. Yet few patients realize they stand in this position of strength.
The problem is simple: They don’t know what they don’t know. Traditional care delivery models have been built around providers, not patients. Patients have never been fully engaged as real decision-makers in their own care.
All of which means providers today have the perfect opportunity not just to give patients a voice—but to teach patients they even have a voice. That’s patient empowerment.
In promoting the patient voice, providers will no doubt enjoy better patient relationships. But the importance of truly connecting with patients goes beyond mere pleasantries; it’s the key to achieving the Triple Aim of lower costs, better clinical outcomes, and improved patient experience.
The importance of truly connecting with patients goes beyond mere pleasantries.
The growing patient voice
Until recently, patients have had little incentive to make market-based decisions about their healthcare services. Moreover, they generally are more vulnerable and dependent on their doctors than on other service providers.
Think about it: How often will people leave one cell phone company for another over service quality? How often has that happened—at least historically—in healthcare?
Now, however, healthcare expenses are among the most common reasons for filing personal bankruptcy. Patients faced with escalating costs and the rise of high-deductible insurance plans are becoming more engaged and more vocal.
Fortunately, the emerging fee-for-value environment is creating an alignment of physician and patient interests that does not exist in the fee-for-service world. Patients want to spend as little time “in the health system” as possible. Likewise, hospitals and health systems increasingly are incentivized to keep patients healthy and out of high-cost care settings.
The emerging fee-for-value environment is creating an alignment of physician and patient interests that does not exist in the fee-for-service world.
One key way to help both parties is to arm patients with the information and the questions they need to fully participate in their care. Patients need assistance; they need providers who can walk them through unfamiliar territory and connect the traditionally disparate pieces of the care plan as they go.
Value for patients and providers
Providers within the value-based care environment are responsible for more than just handing a clinical care plan to the patient. Instead, they have to ensure patients actually help develop a plan with which they can adhere. That’s a pretty steep departure from traditional fee-for-service responsibilities—but it’s ultimately what will drive the Triple Aim forward.
In the new world order, writing a patient’s prescription will only be one small step in the care plan. The total solution will include giving the patient the right prescription by asking such things as: “Do you have the means to pay for this prescription?” “Do you have a way to pick it up from the pharmacy?” “Are you able to take it properly?” Helping patients overcome social, economic and psychological compliance challenges will be central—not peripheral—to the health system’s responsibilities.
Helping patients overcome social, economic, and psychological compliance challenges will be central—not peripheral—to the health system’s responsibilities.
To stay competitive, hospitals and health systems will need to proactively help patients address the practical barriers that can thwart even the best-laid care plans.
Given these new circumstances, providers must help patients by asking questions—and encouraging patients’ own queries. After all, the physician who treats 10 heart attack patients every week likely understands potential barriers to care better than the frightened patient dealing with his first heart attack. Fee-for-value success requires providers to connect with and empower their patients as never before.
More time upfront
Healthcare’s shift to value-oriented care models is readily apparent. What’s less obvious is the obligation that it puts on providers to empower, engage, and help patients with care plans that include the social, financial, and psychological aspects of care, as well as the clinical.
Taking the time upfront to reduce the unintentional consequences of unresolved social, financial, or community barriers should actually help practices run more efficiently and effectively. That can give providers more time to focus on care delivery, which in turn should lead to higher job satisfaction—and better patient outcomes.