By: Dr. Robert Fearn
Patient-centered care has been a fashionable phrase since I entered medical school. It has driven changes in undergraduate training and it forms the basis of every interview, appraisal, or assessment in a medical career. Though, at times it can feel a little token. As a doctor, a patient and a carer I can see that medicine is often anything but patient-centered. Whether it is waiting endlessly for routine appointments, the impenetrable barrier of medical secretaries, or the form filling and waiting on arrival it can feel that the whole system is designed to put you in your place. For most who dip in and out of healthcare for relatively minor complaints this is an irritation and inconvenience. For people suffering from chronic, terminal or recurring conditions it can come to dictate their lives.
It’s not that healthcare does this on purpose. There isn’t any kind of conspiracy to belittle patients and exaggerate the importance of clinicians, however, it can sometimes feel that way. As with any complex system that has evolved over time, parts of the system that work well enough on their own have great cavernous gaps between them that we expect the patients and their caregivers to navigate. Good clinicians and their teams will always try to advocate for their patients, but it’s hard to do this for them all. Patient-centered care fails when it provides unfettered access to resources for the worried well whilst ignoring the stoic sick who suffer in silence not wanting to bother their doctor. It should be about providing patients with the tools to understand their own condition and take part in decisions about their care. It’s also about removing barriers to those who many, for whatever reason, don’t access the care they need.
This is the great opportunity for technology and systems design. Used properly, remote monitoring can act as a bridge between a patient, their own physiology and the medical team looking after them. At the simplest level, data can be collected from patients in their own time and often automatically, saving time and reducing bureaucracy in appointments. Health coaching provided by other patients and reinforced by digital links can help make sense of health data and physical symptoms, as well as providing psychosocial support. Healthy behaviors can be reinforced and adaptations encouraged, boosting quality of life as well as improving clinical outcomes. Back-end triage based on sound and broadly accepted clinical principles ensures that clinical teams are alerted when the health status of a patient changes with summaries available when they come for a routine follow up. This can provide more time for clinicians to focus on the issues that matter most to patients and deepen a trusting bond that is vital to the compact of care.
The reality is that systems are not designed to treat patients badly, they are simply not designed at all. Applying simple, human-technology interventions like these can greatly enhance care without requiring top-down change in established healthcare systems. This provides a more honest and tangible path to patient-centered care than currently exists.
At the HOPE 2019 conference we will be bringing together patients, clinicians and technology leaders in an effort to identify how working together can truly benefit outcomes. The schedule of keynote speakers, patient "TED"-style talks and innovative events will engage, entertain and inform the audience, hopefully inspiring us all towards truly personalized medicine.
Register via the link here!