Transforming care delivery

Deepening engagement among patients, families, physicians and providers will produce higher-quality health results and lead the way to answering the question: “What is best for the patient?”Our healthcare world is rapidly evolving. Among those changes is a cultural one that affects those who provide care and the people who receive it. When I began my medical career, patients rarely questioned their doctor's recommendations or gave their own opinions. Conversely, doctors did not want their patient's opinion and seldom were concerned about the patient's world outside of the medical office or hospital walls. Today, that cultural paradigm has been turned upside down. Now, physicians, providers and hospitals are asking, “How do we do what is best for the patient?” Answering that question requires that we understand and connect with patients in new ways.

Last year, the American Hospital Association's Committee on Research, which I co-chaired, took an in-depth look at the role of hospitals and healthcare systems in improving the total health of the population and communities they serve. We began by comparing current definitions of healthcare user engagement. We wanted to identify the behaviors, policies and procedures, as well as the individual and collective mindsets needed to make it possible for everyone involved in healthcare to become a single, smoothly operating team. This would be a team (the patient, the family, the caregivers, the organization and the community) that encourages people to stay healthy, does the right thing if they do become ill and helps people avoid becoming sick again.

When patients and families see their physicians and medical staff as part of their very own healthcare team, good things happen. Patients are more likely to stick to their treatment or prevention program when the physician is their health coach and they are the star player. As a physician, a hospital administrator and healthcare consumer, I know that patients and families who are active members of their healthcare team have better results and outcomes, with fewer emergency visits and hospitalizations.

These are attractive benefits at a time when our population is aging and we are seeing increasing rates of chronic disease. Better engagement with healthcare users is clearly a promising long-term strategy to answering the age-old question: What is best for the patient?

So how do we power a transition into this new concept for healthcare user engagement? Let's start with more information, and a better exchange of information. To be effective in maximizing health, hospitals must begin by understanding the unique demographics of the communities they serve. Also, to make a difference earlier in the disease process, hospitals should become more proactive rather than reactive with outreach tailored to each population's risks, attitudes, prior experience and knowledge. And of course, as a key component of the team, patients and their families need ready access to health information and knowledge so they will fully understand what their provider is asking them to do.

Providers need information, too, so they can answer the question, “What is in the best interest of this patient?” First, they must understand what patients want and expect. Second, they must harness the power of information technology so they can use best practices, find gaps in the patient's care and know if what they are doing is working.

On the organizational level, hospitals are taking steps to integrate the patient and family perspective into all aspects of their operations. For example, some hospitals and healthcare systems are establishing patient and family advisory councils. Hospitals are also strengthening their community ties to keep people healthy and strengthen care transitions when patients leave their care.

Today, we are being challenged to implement a patient-centered approach to healthcare and to also achieve the Institute for Healthcare Improvement's Triple Aim: To improve the health of our population; improve the care experience of individuals and families; and to find the most efficient way to do so. This is a subtle but still monumental shift in our perspective.

In this age of transition, it will be up to all of us to transform our care delivery systems and capitalize on all these opportunities. When we do, we will be realizing, in the words of AHA, a vision of “a society of healthy communities where all individuals can reach their highest potential for health.”

Dr. Benjamin Chu is chairman of the American Hospital Association and group president of Kaiser Permanente's Southern California and Hawaii regions.