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  • Redefining a Patient-Centric Approach

    Ever since the term patient-centric came into favor, it has been applied to many activities. To physicians, it means a very specific focus on the diagnosis and care of each patient—treating everyone as a unique and special person; however, to non-healthcare professionals, it means finding messages and platforms that address particular patient populations, or even helping individual patients understand things like the adherence methods that work best for them.

    Lately, the term "people-centric" has been suggested to modify the overall understanding of patient-centric. This has been suggested because patient-centric still might typify a person as belonging to a category and prevent seeing that person as a living, breathing human. No matter the perspective, it is useful to examine the difference a people-centric approach might mean.

    For instance, the Affordable Care Act and the Patient-Centered Outcomes Research Institute both aim at outcomes not just as a medical metric but from the viewpoint of the patient, too. This has to consider factors that might be missed initially, but that might be picked up in the kind of post-care surveys that many hospitals are offering these days. These ask questions not only about the results of care, but also about the satisfaction with all aspects of a person’s experience during that care.

    Address Care Complaints

    The easiest way to understand this is to think about yourself as a patient—something you may be numerous times in your life. If you ever had a complaint or concern about the care you received that was unrelated to whether you got well, this concept will resonate with you.

    One example of a program that addresses these kinds of issues for both patients and healthcare professionals is a specific communications platform designed for hospitals. It conveys messages to both providers and patients, which many other platforms do as well. Where it is unique is that it "understands" more about the people.

    It knows, for instance, which physicians are on call, so it does not automatically send an alert to someone who is asleep at 3 a.m. It also knows when physicians prefer to be contacted and on which device, eg, from 9 a.m. to 2 p.m. on a mobile phone, from 2 p.m. to 6 p.m. by email, and after that on the service. It also understands that physicians are human. Rather than "fire and forget" an alert, it follows up to determine whether the alert has been acted upon. All this is less about "quality" of care or content of information than it is about treating physicians with respect. This program applies the same kind of "What could go wrong?" thinking to patient reminders as well.

    Similarly, PDR has launched an initiative that speaks to the person side of the equation, diving deep into the psychology of the adherence conundrum. More than 30% of first-time prescriptions are not filled. Often this is because patients do not understand their condition or the potential benefits of the medication; they may have coverage or financial obstacles; or they may be skeptical about whether the physician is just "trying this out" on them as an experiment.

    To address these gaps requires both prescriber and patient education and insights into provider-patient engagement. We needed to reinforce the provider-patient relationship and increase the odds of the patient understanding, trusting, and following through on prescriptions.

    Three Important EMR Aspects

    Working with prescribers who use an electronic medical record (EMR) system, we looked at three important areas: the technology (how to coordinate with more than 300 EMR, EHR, and eRx apps), the operations (requiring a knowledge of brand, manufacturer, and health plan needs), and most important, trust and acceptance. This last aspect is about bringing value to providers, offering trusted information into the workflow.

    We developed two communications programs in the prescriber workflow, for both the providers and for pharmacists. To be sure the messaging was on-target, we conducted a wealth of market research and message testing among more than 1,200 prescribers (interviews and quantitative surveys) and research into patient-focused, in-workflow education (provided by prescribers to their patients). This helped demonstrate the value that patients place on trusted information offered immediately by their healthcare provider—which encourages EMR/EHR/eRx partners to include this information in their offering. Best practices regarding how to message in workflow are routinely captured and shared with PDR clients.

    The important part to understand is that this goes beyond just getting the right information to the right person at the right time—all of which are important, but not the whole story. Our goal was to gain insight into why 30% of prescriptions go unfilled and find solutions to the human dimension of the problem: the people-centric part. It is not necessarily a requirement to replace the term patient-centric, but the perspective is important. If we think of the person receiving care as "you or me," and want information that understands our human nature rather than just treating us as a disease carrier, we will go a long way toward making healthcare not only more educational but also more effective.