Briefing: Patients as Consumers

The Health Affairs www.healthaffairs.org briefing held March 5, 2019 at the National Press Club, discussed issues involving Patients as Consumers. The Health Affairs March 2019 issue examining consumers’ thoughts and ideas on their role in the healthcare system was supported by The Patient-Centered Outcomes Research Institute https://www.pcori.org and the New York State Health Foundation https://nyshealthfoundation.org.

Alan Weill, Editor-in-Chief for Health Affairs emphasized how the role of the patient/consumer can involve decision-making and requires using the appropriate data and tools to determine if the right information is available to make the right choices involving the quality of health and medical care.

As technology plays an important role in the medical and healthcare fields, Ming Tai-Seale, PhD, Professor, Department of Family Medicine and Public Health at the University of California, San Diego https://ucsd.edu took part in a panel discussion.

She provided information on the study Technology-Enabled Consumer Engagement: Promising Practices at Four Health Care Delivery Organizations appearing in the March issue.

The study points out how important for both patients, hospitals, and providers to initiate the use of technology in order to have the essential and correct information available at the right time for each patient.

She explained how the patient’s journey can vary across the care continuum and can be improved when patient-centered technology is integrated into the care process. For example, the Ochsner Health System https://www.ochsner.org, a not-for-profit integrated delivery system in Louisiana serving over 700,000 patents a year, uses technology in their hypertension program.

The Ochsner Health System facing the prevalence of uncontrolled hypertension, enrolled patients in the “Hypertension Digital Medicine” pilot study. Initially, 80 percent of the patients signed up for the program were instructed to complete an online survey through a patient portal, to evaluate diet, physical activity, medication adherence, and social determinants of health.

The next step was to provide patients with an electronic blood pressure device capable of transmitting home blood pressure readings directly into EHRs. If patients were unfamiliar with digital tools, they were instructed on how to use Ochsner’s “O Bar” available at primary care sites so they could be educated and trained on the use of connected home devices and apps.

Today, the program has expanded to all Ochsner locations and has over 3,000 active participants. The pilot study reported after six months, that blood pressure was under control in patients eighty percent of the time and patients reported greater satisfaction with their care.

In another study location, researchers at Stanford Health Care https://stanfordhealthcare.org customized their EHR-based patient portal, called the Stanford MyHealth application. This portal enables automated patient check-ins upon arrival at a clinic and provides an indoor navigational tool so that patients are able to find their way around the hospital.

Their patient portal enables the oncology department to help doctors work with patients facing unaddressed stress and provides answers to questions that patients face when addressing severe medical issues. This use of technology has provided help to over 6,000 patients seeking psychology therapy. The platform also enables patients to access their health data via mobile and web-based apps, including laboratory, radiology, and pathology information.

UC San Diego Health’s https://health.ucsd.edu new Jacobs Medical Center, has hard wired the inpatient rooms with digital technology, put tablet computers in each patient’s room enabling access to room controls (lights, temperature), and also provides the inpatient portal “MyChart Bedside.”

This study reports that two-thirds of the patients used room controls and one third of the patients used the portal from their bed to access test results, photographs of their healthcare teams, schedule of medications, upcoming procedures, and is able to view educational materials.

At another location, Sutter Health https://www.sutterhealth.org  installed “My Chart” to enable patients to securely message their clinicians and supporting clinicians quickly. A survey of portal users reported that 65 percent of the patient had reduced one or more office visits annually and over 70 percent were satisfied with the messaging service.

Other panel discussions at the Health Affairs briefing to help the consumer/patient covered Engaging in Research, Shopping for Care, Implications of Health Plan Design, and Choosing a Health Plan.

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