Even in this day and age with all of our smartphones, internet savvy and media hype, when we go to the physician for a check-up many of us tend to sit back, listen and nod in response to a doctor’s advice on our conditions or treatments. Not very participatory, is it?
Many efforts are underway to engage patients to become part of their healthcare team. These attempts at communication and shared decision-making represent a critical step in moving patients closer to the core of their care, and our health system closer to patient-centered care. The availability of technology that fosters information exchange amongst all parties, as well as cultural changes among health professionals who are caring for patients, is enabling this partnership of collaborative care.
To push the envelope even further, the health care legislation that mandated that all physicians must have electronic health records, also mandated that by 2014 providers need to more actively engage patients by providing them with the capability to electronically view, download and transmit relevant information from their provider’s electronic health records, including lab test results, a list of current medications and hospital discharge instructions. The legislation also requires that physicians engage in email with patients.
It all comes down to good doctor-patient communication. When patients are given access to their medical information and assisted so that they understand what it is about, they respond to their treatment options in a more open and rational, less emotional way.
Collaboration enables patients and providers to better identify needs, perceptions and expectations. It results in patients who are satisfied with their care, who follow advice and adhere to the prescribed treatment, which generally results in a better outcome. There are many barriers to good communication in the doctor-patient relationship, including patient’s anxiety and fear, and doctors heavy workload, fear of litigation and unrealistic patient expectations.
We know that patients are first turning to the Internet to find health information and often bring that information to their office visit and ask questions about what they have read. According to a PEW Internet and American Life Survey, “fully 80% of adult Internet users or about 93 million American have searched for at least one of 16 major health topics online. This makes the act of looking for health or medical information one of the most popular activities online after email and researching a product or service before making a purchase.”
Collaborative care goes way beyond Internet surfing and gathering health information. Patient to provider, provider to provider, clinician to patients and caretakers; these interactions are all part of the effort to give patients their health data and include them as a part of the health care team. It is a cultural change for both patients and providers when each team member’s unique knowledge, skills, needs and abilities are considered, as well as the demographic, social, and financial considerations of the patient.
Some of the ground rules for this collaborative care model include:
Patients have the right to see their information that physicians have historically kept to themselves. They are entitled to obtain copies or summaries of their medical record and to have their questions answered.
Patients and providers must mutually discuss the benefits, risks and cost of appropriate treatment alternatives.
Patients should receive guidance from their physicians as to the optimal course of treatment
Patients have the right to make an informed decision regarding the health care that is recommended by their physician and can accept or refuse any recommended medical treatment.
Patients have the right to independent professional opinions
Patients are entitled to courtesy, respect, dignity, responsiveness and timely attention to their needs.
Patients have the right to confidentiality and their health information cannot be shared without their consent.
Physicians have the obligation to coordinate patients’ care so they experience continuity of care.
When I see my doctor and discuss my complicated health issues with him, by having access to my health information, I know that I can make intelligent health decisions. When I am a respected member of my health team and experience collaborative, patient-centered care, I know that this is right for me, for my family and for the millions of health care consumers who need to become a more integral part of their own health care. Not only will this approach improve the quality of care for everyone, but it will, over time, reduce the cost of care because patients will take more responsibility, better adhere to treatment and conserve our limited health resources.