Douglas S. Levine | Douglas A. Drossman – How Knowledge-Sharing and Patient-Centered Care Could Improve US Healthcare
About this episode
Despite many strengths, the US healthcare system has shortcomings, including unequal access to care, inconsistent quality, high costs, and dissatisfaction. In a recent paper, Levine and Drossman explored misalignments contributing to poorer health outcomes and increased costs in the US compared to peer countries. Their paper models the healthcare system as two parts: patient-provider relationships, and stakeholders. Read More
Patient-provider relationships are the interactions through which patients are examined, diagnosed, and treated by healthcare professionals. Stakeholders are external entities that influence patient-provider relationships, such as policymakers, researchers, pharmaceutical companies, regulators, and investors.
Evidence on health outcomes, costs, and care satisfaction favor the adoption of patient-centered care – clinical practices that respect the patient voice and respond to patients’ individual needs, preferences, and values. However, initiatives promoting these practices have neither led to their uniform use nor emphasized benefits for the overall healthcare system.
Levine and Drossman explain how delivery of high-quality patient-centered care is undermined in the system. For example, stakeholders may prioritize research, without ensuring that advances are applied in clinical settings, and may focus efforts on serving populations, rather than individuals.
Communication between the two parts of the healthcare system currently flows in a single direction, with stakeholders deciding the services, information and treatments available, along with who will provide them and who can access them.
However, stakeholders may make decisions that benefit themselves, rather than patients. Examples include promoting profitable treatments that may not be uniformly effective, or denying insurance coverage for treatments recommended by healthcare professionals.
Healthcare professionals and patients may also contribute to dysfunction in the healthcare system. Providers do this by imposing treatments on patients without including them in their decision-making, and overusing specific products, while patients might fail to communicate their concerns.
Levine and Drossman explain that real-world data are inconsistently collected and used, and are not widely accessible. If accessible and appropriately used, such data could lead to insights about the most effective treatments for individual patients, while highlighting research areas that stakeholders could prioritize.
Building on these considerations, Levine and Drossman introduced a framework for a dynamic, bidirectional healthcare system, where patient-provider relationships and stakeholders share knowledge.
In this system, the key focus of patient-provider relationships would be to deliver patient-centered care, collecting real-world data that guides stakeholders’ activities. Meanwhile, stakeholders would use these data to prioritize patients’ needs, introducing products and policies that support personalized medicine.
Effective leadership and artificial intelligence could play key roles in ensuring the success of a more collaborative healthcare system. Leaders could foster adoption of consistent patient-centered care practices, while machine-learning algorithms could analyze vast amounts of real-world data for use by all system participants.
By highlighting misalignments in the current system and proposing an alternative view, Levine and Drossman hope to shift the US system towards better overall healthcare outcomes and reduced care costs.
Original Article Reference
Summary of the paper ‘Addressing misalignments to improve the US health care system by integrating patient-centered care, patient centered real-world data, and knowledge sharing: a review and approaches to system alignment’, in Discover Health Systems, doi.org/10.1007/s44250-022-00012-8
For further information, you can connect with Douglas S. Levine and Douglas A. Drossman at email@example.com
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