MedCity Influencers, Hospitals

Navigating the Journey from CMO and Physician to Patient

Even with my “VIP” access to the healthcare system as a physician who practiced in my community, I’m still struggling to coordinate my care as a cancer patient. I believe patients need more from their payers, providers, and digital health collaborators when it comes to care coordination and navigation.

As a practicing physician and passionate healthcare executive, I’ve been proud to earn a lot of different titles and recognitions in my life. Each of these titles says something about my professional and personal journey.

Recently, however, I received a title I never asked for: cancer patient. And not one of my previous accolades truly prepared me for the dizzying, frustrating actuality of being on the patient side of healthcare.

Payers, providers, and digital health experts may think the right changes are already being made. And the reality is that fruitful changes to the patient experience are happening, just not at scale and swiftly enough where change is specifically needed the most.

To break through a long legacy of deeply entrenched systemic challenges, including administrative barriers, data silos, and poorly aligned financial incentives, we must reinvent the way we interact with the three domains predictive of a high-quality patient experience: people, processes, and technology.

Making it easier for patients to advocate for themselves

Even with my “VIP” access to the healthcare system as a physician who practiced in my community, I’m still struggling to coordinate my care. I’m breaking out every trick in the book. I’m making phone calls to clinicians, specialists, and care managers and leaving messages. I’m even texting them directly, and yet I’m still trying to schedule an important surgery in time for me to return to work by a specific date and get timely approvals for my chemotherapy.

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I consider myself a knowledgeable and persistent self-advocate, and yet I’m overwhelmed with this patient process. Now imagine if I’m not familiar with how healthcare works. Or I’m not comfortable communicating in English, or I miss a crucial visit because I don’t have transportation that day. My ability to get the support and care I need is going to be nearly insurmountable on my own.

Patients need more from their payers, providers, and digital health collaborators when it comes to care coordination and navigation. The industry is starting to invest more in these areas — but not at the speed required to improve outcomes, reduce costs, and power a patient experience that is collaborative, rather than inhibitive. Patients simply should not have to take on these burdens on top of the challenges of taking care of their own health.

Interoperability and health information exchange will play a large role in smoothing out the communication between providers and payors. However, we also need to expand the use of personal health system navigators and patient champions. That means assigning responsibility to someone — whether that’s an oncologist, a primary care provider, or a care management partner — for being the “captain” of the care team.

Value-based care incentives will help to financially support this approach but only if providers and payers continue to make these roles a priority and financially invest in them. Moving forward, the focus for payors, providers, and digital health experts must be on accelerating the speed at which changes to the patient experience are happening and then actually reaching the patients they serve. Time is of the essence for all patients, and that includes me now, too.

Leveraging more of the right data and insights at the right points in the patient journey

Many cancer patients receive a big book of information when they get their diagnosis, filled with “helpful tips” and explanations about their condition.

In theory, it’s a great idea to equip patients with a guidebook. But we assume that the patient has the time, emotional capacity, and health literacy to sit down and read 300 pages from cover to cover. And they don’t — or at least, I certainly didn’t.

As a result, providers and payers make a lot of assumptions about what a patient has been told, yet the patient hasn’t absorbed that information in a meaningful way.

The same can be said on the provider and payer sides. Electronic health records can surface endless streams of data to a user, but if it isn’t organized in an intuitive and precise manner, the provider cannot utilize the information to make an informed decision and instead feels overwhelmed and ill-equipped to provide optimized care. And payers can’t determine if care is reimbursable or whether the right care was truly provided.

Too much of the wrong information (or even the right information presented in the wrong way) might be worse than no information at all. Changing the equation will require ongoing work to optimize provider-facing workflows using AI and other methodologies, as well as altering our strategies around patient-facing communication.

Fixing the heart of healthcare by putting people in the center 

Ultimately, the current environment means that the patient experience is a desperately lonely one. It’s isolating and frightening for patients and caregivers, and it’s also demoralizing for providers to see people struggling so much to navigate their care.

We have to make compassion a key value indicator again by addressing the structures and processes that lead to frustration and burnout on all sides of the clinical relationship.

We are largely relying on changing financial models to help us accomplish this goal, but it has to be about more than just the dollars. Innovative financial incentives must be tied to the right measures of a positive experience, including both quantitative metrics (time to treatment, cost, and clinical outcomes) and more qualitative assessments of how well patients feel cared for.

For example, we might even consider measuring health systems on their clinicians’ experiences, doing more to tie financial success to the development of a culture that supports clinicians, reduces burnout, and promotes staff retention.

No one should feel alone when interacting with the healthcare system, including the providers who meet with dozens of anxious, upset patients and caregivers every day. In this time of financial and technical transition, we (providers, payers, and digital health companies — including CCS, where I lead as Chief Medical Officer) have an opportunity to transform the healthcare system back into a people-centered community of care that benefits all members.

Photo: fotosipsak, Getty Images

Arti Masturzo is the Chief Medical Officer at CCS, a leading provider of clinical solutions and home-delivered medical supplies for those living with chronic conditions. Dr. Masturzo is a board-certified MD and a healthcare transformation executive with extensive experience in the delivery of services across multiple sites of care. She has nearly 20 years in medical leadership, including roles as CMO and a deep focus on clinical innovation across her career. Dr. Masturzo’s success is a result of a combination of factors, including strategic vision, operational mindset, collaborative approach, and a strong passion for helping improve patients’ lives by innovating care delivery models and fostering technology-enabled products and services that lead to measurable impact and positive change.

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