Patient engagement: ‘We don’t want to be managed, we want to be supported’

Healthcare providers need to better incorporate the patient into a new care team model that makes them, not the physician or the specialist, the focal point, especially for patients with chronic illnesses, a panel of experts said today at Stanford University’s Medicine X conference. That’s likely to include non-clinical peer care coordinators who can help […]

Healthcare providers need to better incorporate the patient into a new care team model that makes them, not the physician or the specialist, the focal point, especially for patients with chronic illnesses, a panel of experts said today at Stanford University’s Medicine X conference.

That’s likely to include non-clinical peer care coordinators who can help bridge the gulf between the old, top-down directives from physicians while including a better understanding of data and true cost structure.

For Stanford Coordinated Care, a capitiated internal medicine practice focused on chronic conditions, the team approach has proven effective in curbing patient behaviors that either contributed to worsened outcomes or don’t improve the life of the patient, said Ann Lindsay, co-coordinator. And it’s worked because of intense engagement rather than sending a patient home and simply hoping for the best.

“For people with chronic conditions, relationships are really important,” she said. “The more the jobs can be spread across a care team, the better the care can be.”

She cited a study in the New England Journal of Medicine that found 40 percent of all premature deaths among the chronically ill were attributed to patient behavior, a clear indication that follow-through from the provider side barely registered.

The role of non-clinical coordinators should grow, which in turn can permit the physician to focus exclusively on medicine and treatment versus administrative tasks and documentation, she said.

For the patient, a simple mantra should register with every provider: “We don’t want to be managed, we want to be supported,” Lindsay said. “At Stanford, we actually say ‘support the patient, manage the specialist.’ ”

Patient engagement is taking on new forms, as well.

Mike Evans, of St. Michael’s Hospital in Toronto, told the crowd of its YouTube medical school and interactive story-telling methods to better communicate with patients, rather than simply sending literature and emails.

Above all, the relationship with the patient needs to be re-imagined to include the care team-based approach and empathy, panelists said.

The panel included Erin Moore, a patient advocate, and Vivian Lee of the University of Utah Health Sciences.

Here are a few tweets from the conference so far: