Decisions Need to Involve Patients

The April issue of “Health Affairs” www.healthaffairs.org with support from the Patient-Centered Outcomes Research Institute (PCORI) www.pcori.org, examines how patients and consumers can effectively use evidence to delve into issues related to engaging patients more fully in decisions concerning the delivery of their healthcare.

Very often patients are often left out of the conversation with providers on how to best meet their medical and health needs. Since there is an increased interest in patient-centered care, there is a need for a better understanding of patient’s goals, finding new methods on how to engage patients in their care, and how to better measure outcomes that have meaning for patients.

Joe Selby, Executive Director for PCORI presented opening remarks at the Health Affairs panel discussion held April 7, 2016 to discuss the papers included in the April issue. He also agrees strongly that patients need to be actively included in research and in the clinical decision-making space.

Alan Weil JD, Editor-in Chief of Health Affairs as moderator of the panel introduced Danielle Lavallee, PharmD, PhD, and Assistant Professor at the University of Washington www.washington.edu. She, reported how the paper titled “Incorporating Patient-Reported Outcomes into Health Care to Engage Patients and Enhance Care” resulting from a study conducted by herself and coauthors.

She pointed out how important it is to allow patients to discuss their health concerns, and priorities and the necessity for providers to have real-time access to their medical information. This knowledge can help patients and providers prioritize topics for discussions during clinical visits.

In another study, Kathryn A Phillips and coauthors analyzed data from a survey of over 2,000 adults conducted by Public Agenda www.publicagenda.org with funding from the Robert Wood Johnson Foundation www.rwjf.org at the University of California San Francisco www.ucsf.edu.

It was found that a majority of Americans do not think healthcare costs and quality are associated. Some experts are very concerned that consumers may avoid low-cost care if they perceive cost to be associated with quality.

The presentation of data can also play an important role. An online experimental survey conducted by Jessica Greene PhD, Professor at George Washington University www.gwu.edu  and her research team tested various methods of presenting cost and quality data to determine what displays encourage consumers to take quality  as well as cost into account when selecting a health plan.

To do the study, a sample of 1.025 online adults 18-64 were selected randomly in 2015 by Qualtrics www.qualtrics.com, an online survey software company, to view the same comparative information on health plans displayed in different ways.

It was found that consumers were much more likely to select a high value plan when cost information was summarized, when quality stars were displayed adjacent to cost information, when consumers understood that quality stars signified the quality of medical care, and when high-value plans were highlighted with a check mark or blue ribbon.

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