Ask Adele: March questions answered by Adele Allison
Wednesday, March 12, 2014
Posted by: Joy Ingram
Adele Allison is the National Director of Government Affairs, SuccessEHS, a Division of Greenway. SuccessEHS is a non-voting member of NWRPCA
Patient-Centered Outcomes Research
understand patient engagement is starting to be measured and may impact
the future of reimbursement under health care reform. How are these
measurements being developed and how will they impact my providers as
You are correct! Effectiveness of care will be measured in the
future, including a key component focused on patient-centeredness. As I
have said many times, when folks hear “patient-centered,” they
immediately jump to the health home. Bear in mind that the health home
is a model of patient-centeredness specifically designed for the primary
care provider. However, all providers are being called to address
patient engagement, not just primary care.
The value of patient engagement — and the price of the disengaged
patient — grow clearer every day. Disengaged patients have been shown to
account for 8 to 21 percent higher costs than engaged patients. These
numbers go a long way to explain the recent outpouring of federal
initiatives and policymaking linked to patient-centeredness, which comes
as no surprise:
One federal effort supporting patient engagement is the Patient
Centered Outcome Research Trust Fund, established by the Affordable Care
Act (ACA) in 2010 to promote research focused on improving health
outcomes through patient-centeredness. Most of this trust fund,
estimated to reach $5 billion by 2019, goes to establishing and funding
the work of the Patient-Centered Outcomes Research Institute (PCORI).
PCORI seeks to produce and promote “high integrity, evidence-based
information that comes from research guided by patients, caregivers and
the broader healthcare community.” To date, the institute has funded
nearly 280 grants totaling over $464.4 million in patient-centered
comparative clinical effectiveness research projects.
What has this research revealed so far? At the recent Alliance for
Continuing Education in the Health Professions (ACEhp) annual
conference, Dr. Freda Lewis-Hall, MD, FAPA, chief medical officer of
Pfizer and member of the PCORI board of governors, shared what she
termed the “three dimensions of deep customer insight”:
- Depth of the Evidence. Decision-making should eliminate
one-choice conversations between the healthcare provider and the patient
or extended caregiver. It is no longer a matter of thinking about what
health care choices mean to the physician, the hospital or the
administration, but what these options mean to the patient — and this
way of thinking must become intuitive.
- Breadth of Care. The care team extends beyond the
patient-provider microcosm to encompass experts and other caregivers,
all of whom must be involved in the patient’s care. As an aging
population intersects with strained household and government budgets,
millions of Americans will become caregivers for loved ones. Providers
must integrate the various sources of data —systems of care, claims,
electronic health records (EHR), labs, patient preferences, research and
more — to engage the entire care team.
- Width of Possibilities. Providers should think beyond
continuing education to continuous education: that is, education related
to clinical decision-making, on demand, in the decision-making moment.
This requires the adoption and use of strong health information
technology (HIT). Technologies such as clinical decision support
systems, lab results, imaging reports, medication information, patient
data and other tools can make data available whenever and wherever
necessary to inform clinicians. A well-designed EHR can filter
patient-specific information, provide diagnostic support, and allow
providers access to contextually relevant reference materials.
Providing patient-centered care means going beyond traditional
delivery models to implement fundamental changes designed to empower
providers, patients and caregivers as active, informed participants in
managing healthcare. PCORI will continue to take a leadership role in
exploring the data available for patient-centered comparative clinical
The PCORI 2014 funding cycle is underway. Learn more.
Greenway supports efforts to ensure the patient’s voice is heard. Learn more about our participation in a PCORI project.
firstname.lastname@example.org to submit your questions to “Ask Adele.”
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