Patient Centric Healthcare Initiative

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Patient Centric Healthcare Initiative

By Dr. Zakiuddin Ahmed

We know that in an ideal healthcare system, Patients should have access to quality healthcare at an affordable cost. These three prerequisites of a healthcare system are the basic right of every individual.

Doctors study medicine to seek, understand and cure patients’ illnesses. Governments and regulatory bodies are continuously seeking to create rules and policies that protect the interests of patients. We see other contributors to the healthcare ecosystem, where laboratories follow strict protocols to diagnose diseases accurately; hospitals create an environment & gather relevant resources to best cater patient needs; industries carry out R&D efforts to produce the best devices and medicines; and educational institutes provide a continuous stream of education for physicians and care providers.

Hence, all these stake holders essentially exist to serve the interest of one beneficiary – the Patient. These stakeholders should ensure that their personal interests and objectives should become secondary and the Patient should always come “First”

This is the essence of Patient Centric Healthcare, where the patient is consciously considered as the ultimate beneficiary of everything the doctors, policy makers, industry experts and health care professionals work for.

The patient centered healthcare movement picked up pace in the US, and rest of the developed world, mainly after the release of the famous report “To Err is Human” by the Institute of Medicine in 1999. This report speaks about creating safer health systems while revealing alarming findings that 44000 to 98000 patients die every year in the hospitals in US due to medical errors. Another report stated that these numbers are actually more than 400,000 per year. Serious concerns were raised regarding patient safety and quality healthcare in hospitals. Hence we see such a strong statement like ‘… the epidemic of patient harm in hospitals must be taken more seriously if it is to be curtailed..’ in the Journal of Patient Safety.

Keeping in mind that medical errors are now considered as the 3rd leading cause of death in the US, we as Physicians and opinion leaders should find out how much our own hospitals and other care facilities could be harming the patients, as they clearly offer lesser quality care standards, processes and safety environment.

We need to collectively address this potential threat to our patients, as custodians of their well being, by first accepting that the problem exists. We need to understand the magnitude of the problem and come up with efficient and effective solutions which are applicable in our healthcare model.

After the release of this report, the medical community shifted its focus towards patient safety researches, with the result that in 2006, the number of search results on patient safety jumped from 59 to 164 articles per 100,000 MEDLINE publications.

The second report from The Committee on Quality of Healthcare in America, Institute of Medicine “Crossing the Quality Chiasm: A New Health System for the 21st Century” came out in 2001 which focuses more broadly on how the healthcare delivery system of the 21st century can be designed to improve quality care.

The IOM report “Crossing the Quality Chiasm” defines patient centric care as:

“Providing care that is respectful of, and responsive to, individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.”

Placing “patient centered care” among the top three, it defines the six aims for good quality care as:

  • Safe
  • Effective
  • Patient centered
  • Timely
  • Efficient
  • Equitable

For WHO, Patient Centered Care is a subset of “People Centered Care”, which it defines as: “Care that is focused & organized around the health needs & expectations of people and communities rather than on disease”

Another useful definition is given by The Agency for Healthcare Research & Quality (AHRQ, USA) which defines patient centric healthcare as “Relationship-based primary care that meets the individual patient and family’s needs, preferences, and priorities.”

The Picker Institute, in conjunction with Harvard School of Medicine, conducted a research in 1993 and identified eight dimensions of patient-centered care, as mentioned in the book, “Through the Patient’s Eyes: Understanding and Promoting Patient-Centered Care”.

These dimensions include:

  • respect for patients’ preferences and values
  • emotional support
  • physical comfort
  • information, communication and education
  • continuity and transition
  • coordination of care
  • involvement of family and friends
  • access to care

Similarly IAPO (International Alliance of Patients’ Organizations) Declaration on Patient-Centered Healthcare (PCH)1 also states that healthcare must be based on the following five principles,

  1. Respect
  2. Choice and empowerment
  3. Patient involvement in health policy
  4. Access and support
  5. Information

With a better understanding of the level of harm being inflicted on the patients due to medical errors and lack of quality care, the patient safety movement essentially picked up momentum in the last decade.  Hence we see more and more organizations and healthcare professionals devoting their time and effort in creating awareness, building collaborations, organizing conferences & stake holder meetings, and developing policies for more stringent quality standards in order to provide a safer & quality environment to the patients.

A number of studies have demonstrated that patient centricity improves the quality of care and patient satisfaction levels. “Research has found a positive link between practice of Patient Centric Healthcare in clinical settings and outcomes” (Little et al., 2001; Stewart et al., 1995; Henbest et al. 1992).

We now see a positive trickle down effect of the patient centric movement across different stake holders within the healthcare ecosystem. As an example, the pharmaceutical industry is now adopting, albeit slowly, a more patient centric focus by developing value added solutions which directly or indirectly benefit the patients.

However, it is the physicians who will play the key role as champions & custodians of this movement and drive it forward.

The below mentioned points, as described by WHO in its document “General Principles of Good Chronic Care’, 2003” can be used by healthcare providers to develop an effective patient centric healthcare model.

  • Develop a treatment partnership with your patient
  • Focus on your patient’s concerns and priorities
  • Use the 5 A’s: Assess, Advise, Agree, Assist, Arrange
  • Educate patient on disease and support patient self-management
  • Organize proactive follow-up
  • Involve ‘expert patients’, peer educators and support staff in your health facility
  • Link the patient to community-based resources and support
  • Use written information – registers, Treatment plan, treatment cards and written information for patients- to document, monitor, and remind
  • Work as a clinical team
  • Assure continuity of care

With the mission to create a patient centric healthcare ecosystem in Pakistan, we should invest in developing systems, processes, solutions & human capital in the following five core areas:

* eHealth – improving access & quality while reducing cost of healthcare

* Quality –  improving outcomes

* Ethics – keeping the interest of patients paramount in every interaction

* CME & CPD – continuous improvement of care through capacity building of HCPs

* Research – creating evidence based innovation

We are launching this Patient Centric Healthcare initiative by publishing relevant articles, news, case studies, referenced material, and interviews & testimonials of opinion leaders in healthcare.

Through this initiative, we aim to establish the fact that patient centricity influences the quality of care, treatment adherence, satisfaction levels of patients & provider while  reducing medical errors and cost of care.

In the upcoming issues, we will discuss in detail the following concepts which further elaborate Patient Centric Healthcare

  • Patient Safety – First Do no harm
  • Patient Engagement
  • Patient Empowerment – ePatient

I believe & envisage that this initiative will create & organize a critical mass of likeminded doctors and allied professionals who will lead Patient Centric Healthcare movement in Pakistan – as Change Agents.

Let us take the first steps towards creating a safer and quality healthcare system for ourselves and our future generations, InshaAllah.

zakiuddinahmed@gmail.com

2017-04-26T12:34:59+00:00