When it comes to non-episodic care, the reality is that most of the caregiving burden is borne by patients themselves. Around the clock, patients monitor their own health, assess their progress, and reach out for intervention when necessary. Yet many providers do not empower or enlist patients to be a co-owner of those health outcomes.1
With patients who are more digitally literate than ever, technology offers an opportunity to take patients off the bench and turn them into active healthcare team members.
While the opportunity to get patients involved seems appealing, through the 2021 Healthcare CEO Future Pulse we found that health leaders are roughly split in their confidence in enlisting patients. Just over half of executives (56 percent) believe patients will develop the ability to self-manage their health.
When looking at these questions through the lens of self-identified organizational transformation personas, innovators indicated that they were almost twice as capable to engage patients as co-designers versus the late majority and laggards. Meanwhile, the early adopter and early majority personas were more highly confident in patient ability to self-manage versus the innovators. This contrast suggests that innovators, who tend to employ technology more, will engage patients in development of the tools they deploy, while early adopters and early majority players will focus on allowing patients to take on more responsibility of their day-to-day self-management.
When it comes to engaging patients as co-designers of their care, 51 percent intend to let patients get their fingerprints on their care. But only two in seven (28 percent) are currently making use of patient-peer networks to help patients share their stories and support others. When looking at the perception of patient ability to self-manage through an organizational view, hospitals are much more confident in their capabilities, 62 percent versus 44 percent among health systems – the hypothesis being that hospitals have confidence in how they equip the patient upon discharge, and that the community and the patient themselves are prepared to take on that task.
“We’ve had a paternalistic view of this for too long,” says Rob Webster, CBE, chief executive South West Yorkshire Partnership Foundation Trust and lead chief executive, West Yorkshire and Harrogate Integrated Care System in the United Kingdom. “If we recognize that people have assets, and that they’re going to self-monitor and self-manage, we need the skillsets required to engage with them.”
Dr. Dawei Wang, president Liaocheng People’s Hospital in China shares similar views.
“Better outcomes could be achieved by empowering patients to manage their own health. I believe patients could play a more important role in future healthcare. With the latest technology and relevant applications, both patients and medical staff could obtain timely and accurate data to support better prevention, treatment and rehabilitation.”
Dr. Dawei Wang
President Liaocheng People’s Hospital
(China)
Meanwhile, Dr. Christian Elsner chief financial officer of the University Medical Center of Johannes Gutenberg University Mainz in Germany sees a gradient to this shift: “Patients are getting involved first in the administrative end – taking on ownership of completing documentation and scheduling; we’re now exploring how to get them involved in product design, and eventually into technology-supported self-management.”
Technology seems to be the bridge that will bring the patient-provider team together. Webster says, “If you’ve got a problem, you can look after it yourself. But you’re supported through connections to people who have the technology and solutions to help if you’ve got a few things wrong. You’re part of a team… That’s what people want.” This is seconded by Dr. Maurice van den Bosch, CEO of OLVG Hospital Amsterdam in the Netherlands, “Until this date, our health journey is transactional,” he says. “We need to design a ‘digital lobby’ or a ‘digital front door.’ We need a digital point of entrance for patients to begin their health journey.”
Partners in prevention
Rob Webster recognizes the role that providers can play in supporting patients in managing their chronic conditions. “You can’t be cured of having a learning disability, asthma, diabetes, COPD, dementia frailty or being a child with special educational needs,” he says. “You just can’t.”
For these patients, he feels that healthcare organizations should create longer-term care relationships that emphasize support over managing morbidity.
“You’re a partner with us. We’ll always be together in some way, shape or form,” he explains.” We might not see each other very often for a time, but at some point, we’ll pop up for a health check. Or you’ll have an exacerbation of your issue, whether it’s physical, mental or a social crisis.”
Such an approach is fundamentally different than the dominant approach, which he describes as “get broken, get sent to hospital, get fixed, go home.”
“We work together,” he says, describing a better way of doing things, “And it’s good because we know you.”
Rob Webster recognizes the role that providers can play in supporting patients in managing their chronic conditions. “You can’t be cured of having a learning disability, asthma, diabetes, COPD, dementia frailty or being a child with special educational needs,” he says. “You just can’t.”
For these patients, he feels that healthcare organizations should create longer-term care relationships that emphasize support over managing morbidity.
“You’re a partner with us. We’ll always be together in some way, shape or form,” he explains.” We might not see each other very often for a time, but at some point, we’ll pop up for a health check. Or you’ll have an exacerbation of your issue, whether it’s physical, mental or a social crisis.”
Such an approach is fundamentally different than the dominant approach, which he describes as “get broken, get sent to hospital, get fixed, go home.”
“We work together,” he says, describing a better way of doing things, “And it’s good because we know you.”
Rob Webster, CBE
Chief Executive
South West Yorkshire Partnership Foundation Trust
Lead Chief Executive
West Yorkshire and Harrogate Integrated Care System
(United Kingdom)
Key takeaways
Patient empowerment can create a ‘win-win’ situation by reducing the burden on strained health systems, improving patient experience, and generating better health outcomes by intervening sooner.
Empowering patients can take different forms, whether it be equipping them with information to participate in decision-making or by providing them with the tools and technology to manage and monitor their own health.
Digital will play an increasing role in empowering patients as the ‘front door’ to care – allowing for better navigation, avoiding unnecessary consultations, and helping reduce barriers to care access, but also changing the ways workforces need to operate, be trained, and interact with patients.
How to take action
As health leaders build their roadmaps to the future, they should expand upon who they envision are stakeholders and participants in this process. To be truly patient-centric, providers should involve patients from the design, execution and feedback of care quality. To facilitate this, patients should be engaged by ‘being at the table’ during product and process design.
To increase self-management, patients should be better equipped with technology and supported by staff (clinical and administrative) who are educated to empower patients as part of their workflows.
1 Elissen, A. et all. (2013 March 23). Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches. BMC Health Services Research volume 13, Article number: 117 (2013),https://bmchealthservres.biomedcentral.com /articles/10.1186/1472-6963-13-117