The Transformation Rx Vlog provides a variety of perspectives on efforts to improve the quality and affordability of healthcare.
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Person and Family Engagement in Appropriate Use of Care
With Martin Hatlie, CEO of Project Patient Care
Person and family engagement is the wonder drug of population health in the 21st Century.”
Martin Hatlie leads Project Patient Care, a national organization dedicated to bringing the voice of patients and their families to healthcare improvement work. Mr. Hatlie calls person and family engagement “a natural resource,” one that he ardently believes we must channel in order to successfully transform the healthcare system. “It is emblematic of a paradigm shift. It used to be the doctor knew all and the role of the family was to follow directions and comply.” Mr. Hatlie maintains that old model never really worked, that it is breaking down, and the time is ripe for a new approach.
“It’s better to think of this relationship as a partnership because the truth is it’s often the patient and/or their family who are managing the care. So let’s realize we’ve got this resource of people who want the best options for themselves, that providers want the best outcomes for their patients, and let’s harness the energy they both bring.”
Mr. Hatlie says patients should be approached as partners rather than compliers, that they should be given the opportunity to contribute, and should be equally involved as providers in decision about their own care.
Words matter. Using terms and phrases that everyone has a mutual understanding of is key.
Communication is key and each word matters, starting with “person” or “patient” or “consumer.” “What we really need to get to is the underlying concept – what or who are we really talking about? The engaged user of care is what we are hoping for,” says Mr. Hatlie. Providers who take the time to figure out which term a person prefers will be that much closer to establishing a partnership.
“Some people prefer ‘patient,’ while others find it patronizing. Others prefer ‘consumer’ and find it empowering, while some find it too commercial. ‘Person’ is the term the Centers for Medicare & Medicaid Services is using as they wade through the semantics. It is a resonant term. It is universal – it even applies to the many who are doing research and living lifestyles that keep them well and who don’t see themselves as a patient or a consumer.”
Mr. Hatlie also points out that “person” indicates we bring our whole medical and life experience with us to the provider, as well as our family structures, our economic condition and the various other factors that help shape whether we’re going to get the best results.
What are your recommendations for providers and families who want to pursue these approaches?
Martin Hatlie recommends that providers start where they are. They don’t have all the answers and should listen to the patient and their family members about what their reality is like. “Can they afford their medications? Can they get them? Are they depressed? Really listen to their input and then repeat back to them what you are hearing to confirm you understand their needs and desires.” The entire care team should be trained on building bi-directional relationships through strong communication. This builds trust and gives you the best odds of establishing well-coordinated care that is appropriate and cost effective as possible. “It’s also the best predictor of what your patients are actually going to do when they leave your office.”
For patients and families, Mr. Hatlie recommends coming to appointments with a list of questions, concerns, ideas, or goals. Repeat back to the provider what you are hearing to confirm you understand their advice. Be part of the decision-making – including negotiating what you believe to be the care that is most valuable to you and your family. Last, consider bringing a friend or family member to the appointment. “Bring someone with you who can take notes, ask questions and be a second set of ears and eyes to ensure your care is as cost-efficient and effective as possible.”
What would success look like five years from now?
Five years from now, if we’ve mobilized and harnessed this ‘natural resource,’ people will feel that the health system belongs to them. They will feel a sense of ownership and that the system is working for them. If it’s not working for them, they can say something and corrections will be made.
For providers, success will mean care is a community collaboration. Social services, community groups, and patients are all part of an ecosystem helping each person be healthy.