By Jeffrey LaVaute, MPH, EVP Client Strategy, Managed Markets, EVERSANA
Healthcare leaders often talk about ensuring that the right patient receives the right medication at the right time. On its face, this concept seems straightforward. We know that different patients respond differently to different therapies, such that we cannot consistently replicate randomized clinical trial experience in the real world. Thus, healthcare providers (HCPs) must make their treatment decisions by balancing the need for an efficacious treatment with maintaining safe and effective use of that product.
Jeffrey LaVaute
The promises of a value-based healthcare system remain the light at the end of our tunnel. HCPs are asked to treat symptoms while focusing on long-term outcomes, but constantly must “do more with less.” The influx of Big Data has accelerated our connectivity across the healthcare ecosystem, leading to more visibility into what is driving healthcare utilization, as well as practical solutions to reduce overall costs. As these advances continue, the system will become more efficient and we will understand what is and what is not working.
Doing what is right for the patient is at the forefront of the decision matrix. The affordability of a product or procedure must be considered, as this will surely affect how open a patient is to his or her HCP’s recommendation, the degree to which the patient feels invested in the solution, and how adherent or compliant he or she will be with the recommended therapy. The challenge is that if just one of these elements (efficacy/safety balance, affordability, and adherence/compliance) breaks down, the patient could be at risk from a product safety or disease progression perspective.
Patient centricity is a foundational principle that informs the healthcare decisions that we make. We put patients at the center and build from there, which theoretically ensures that the right patient is receiving the right medication at the right time…and that he or she can afford it. A standard view in healthcare is that patient centricity ensures that patients are receiving an appropriate, safe, and effective treatment.
Putting patients at the center of this framework looks good on paper and sells well, but are we truly engaging patients in playing an active role in managing their healthcare? To answer this question, it is important to consider the following points:
- What role should patients play?
- What are the relevant influences on their behavior (e.g., cultural, economic, geographic)?
- Are we asking patients the right questions?
- Are we optimally leveraging technology to solve these problems?
We know through research and experience that when patients have more trust in their physicians and have a sense of control in their healthcare decision-making, they are more satisfied consumers of their own healthcare.1 This satisfaction leads to increased adherence and compliance, which—in theory—will keep patients safely and effectively using their medications.
A Patient-Centered Culturally Sensitive Health Care (PC-CSHC) model has been developed to better explain the interrelated causal factors that either promote or hinder healthy behaviors.1 This model centers around understanding what influences a patient’s notion of his or her own health and how HCPs can better connect with patients to promote healthier lifestyles, dietary improvements, and medication adherence/compliance.1
Based on an empirical test of the literature-based PC-CSHC, a couple of practical recommendations emerged1:
- Evolve the questions that we ask patients to better identify the type of behaviors and attitudes patients wish to see in their HCPs.
- Encourage HCPs to engage patients using these desired behaviors and attitudes.
Essentially, what this model tells us is that HCPs need to understand that patients are consumers who make healthcare behavior decisions based on a complex set of factors. A “one-size fits all” model will not work if the goal is to ensure safe and effective use of a healthcare intervention. Investing time in understanding the patient journey will yield invaluable insight into what patients want and how to effectively engage them in their own care.
The digital revolution is transferring control and accountability to patients, helping them to take a more active role in their care. Digital solutions such as healthcare apps, patient diaries, and patient health records are powerful tools when put in the hands of a patient who understands how to use them. Another solution is to optimize questions and call scripts used by case managers, nursing staff, and allied healthcare providers as a part of patient support programs. These services create unique opportunities to strengthen our understanding of what patients are going through, provide better support, and to demonstrate empathy.
We must engage patients as partners by leveraging these tools and by developing interactions that demonstrate an understanding of where patients come from, which factors influence their healthcare decisions, and how we can help them to embrace their important role in ensuring safe and effective care strategies. Patients will then take ownership of their health.
Source: Tucker CM, Marsiske M, Rice KG, Jones JD, Herman KC. Patient-centered culturally sensitive health care: model testing and refinement. Health Psychol. 2011;30(3):342-350.
