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Risks and Benefits of Patient Engagement

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Risks and Benefits of Patient Engagement

By Jock Hoffman, CRICO

Related to: Clinical Guidelines, Communication, Diagnosis, Emergency Medicine, Primary Care, Informed Consent, Nursing, Obstetrics, Other Specialties, Surgery

It is a rare discussion among patient safety experts when someone in the room (physician, lawyer, CEO) doesn’t interject, “Let me tell you what happened the last time my mother saw her doctor.”

No matter what our role is in working to perfect patient safety, reduce adverse events, and prevent malpractice claims, we often also get to see systemic imperfections from the patient or family member’s perspective. Indeed, those anecdotes often help build the narratives we use to frame improvement efforts.

One such improvement effort is better coordinated care delivery systems. A recent New York Times article predicted that, by 2020, accountable care organizations (ACOs) and similar care consortiums will have replaced the U.S. health insurance industry. While that’s speculation, providers do need to ramp up their ability to explain new health care delivery models to the patient populations they will be managing. In doing so, those “my mother” patient-perspective narratives become even more poignant for participating physicians.

A key requirement for ACOs and similar entities is more fully engaging patients in their health-related decisions. Exactly how to achieve patient engagement is still a bit murky, but the essential component is enabling patients to conduct well-informed discussions with a coordinated team of providers about their health, care options, and medical decisions. The expected consequence is that patients who appreciate the more focused and synchronized approach to their care will make informed decisions that benefit both themselves and the overall population. An additional benefit is that a more engaged patient population serves as another layer of patient safety protection.

Of course, a patient’s motivation to be engaged in her care can be counterbalanced by skepticism if she doesn't perceive a direct benefit. Friends, family and the popular media may influence an attitude that patient engagement is just a new tactic for advising everyone to diet and exercise more often. And, even without any external influence, change may engender frustration or distrust for some patients.

For example, decisions regarding what tests are ordered, what consults or referrals are proffered, and what treatment or medications are recommended, may be challenged. Increased access to medical records may introduce unfamiliar terms or information displays that trigger requests for clarification. How you answer your patients' questions will be a key aspect of their attitudes toward engagement and a healthy physician-patient relationship.

CRICO, and other organizations are working to identify best practices for aligning patient engagement with patient safety. The better that physicians, and the organizations they’re affiliated with, are informed about risks and enabled by proven solutions, the better equipped you’ll be to help “my mother” become an engaged patient.

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April 26, 2012
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