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Ask Adele: March questions answered by Adele Allison

Wednesday, March 12, 2014   (0 Comments)
Posted by: Joy Ingram
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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



Question: I 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 reform matures?



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”:

  1. 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.
  2. 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.
  3. 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 effectiveness research.

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.

Please contact membership@nwrpca.org to submit your questions to “Ask Adele.”

NWRPCA welcomes and regularly publishes white papers and articles submitted by members, partners and associates with subject matter expertise. The appearance of any guest publication in our Health Center News database represents the views of the author and does not constitute endorsement by NWRPCA of the stated opinions or perspectives, nor does it suggest endorsement of the contributor's products or services.

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