At the core of our argument is changing the way in which healthcare works with patients in order to ensure they are more active in their own healthcare. We believe that the economic argument for this is clear. Here we outline four next steps to take in realizing the extra value that patients can contribute.
Healthcare spends most of its resource in developing its interaction with patients. If we want to increase patients’ activity we need to review all of these interactions to ensure that each of them increases the capacity of patients to be more active in their own healthcare. At the end of a consultation, does the patient always leave with greater skills to self-manage than they had at the beginning of that consultation? Does every letter, email or phone call leave them with greater capacity to know what they have to do next? Are you checking up that these attempts at improving patient capacity actually work with the patients and are not just empty instructions from medical professionals that have no impact on behavior?
Successful industries that encourage consumers to create value design their products with those that consume them. Healthcare needs to fully involve patients their carers and communities in all healthcare redesign. Our research shows that few patient organizations think that happens at the moment.
The practice of most medical professionals is based upon seeing patients as a set of deficits. For medical professionals to recognize the possibilities of self-management and to see patients, their families and their communities as a set of assets is a departure from the deficit model. One of the best ways of developing the workforce in this direction is to use individual or groups of expert patients to carry out that development. The workforce will also need new technical skills to work with, a number of tools such as decision aids, telehealth and other self-care technology and with real-time information about patient experience. All of the components need to be built into recruitment, induction, appraisal and reward strategies.
It’s time to use patient power and involve families and communities and work with them to improve value, safety and quality and potentially to reduce costs. New skills, technology and approaches are required to do this. Being able to do this will be a differentiating factor for payers, providers and life science companies. But, apart from that it is the right thing to do.
Compared to most medical interventions, the investment in better patient self-management is not expensive. But it still calls for some resource. If the payment system is organized in such a way as to see self-management as just another form of episodic cost, then it is difficult to see where the return on this investment comes from. If however, the payment system is organized to cover an entire patient pathway or population, the return on the investment in better patient self-management is potentially significant.