September 19, 2014

Maria Barhams

Elements of a Patient-Centered Encounter: Enhancing Patient Engagement and Accountability

Increasingly provider compensation and penalties are associated with the quality of care they deliver to their patients and whether those patients heed their advice. Although there is not a quick fix formula to ensure a patient complies with provider guidance, strategies exist to enhance patient engagement and accountability.
Strong patient-provider relationships are associated with better health outcomes (a key focus of the impending Meaningful Use Stage 3 requirements), reduce unnecessary healthcare expenditures, and decrease risk for malpractice claims. Minimizing a provider’s time to support patients between office visits is also important. This often requires the use of 3rd party evidence-based tools and resources.
So how does a provider enhance communications with their patients?

  1. Build Patient Rapport-Some patients may feel uncomfortable sharing their concerns with a provider for lack of understanding, cultural variances with respect to authority figures, or uncertainty about what information is important or necessary to enhance their healthcare experience. As a provider, asking questions to understand the patient health literacy level, personal concerns & behavioral barriers, lifestyle, and other factors will help to guide how you can best deliver information and support. In turn, over time, this communication strategy will create an environment that facilitates an open dialogue and partnership with your patient.
  2. Gather Patient Information-Cultural factors may influence how a patient defines their health status and what limitations/barriers exist to improving self-management of disease. It is important to dialogue with patients to better understand both their health literacy as well as perceived challenges. Equally important is understanding what will motivate patients can vary significantly from patient to patient. The process of neuro-associative conditioning whereby providers can help influence positive behavior by helping patients establish positive anchors for goal achievement (i.e. improving ones health to experience a grandchild’s graduation). Helping patients establish other lifestyle goals is also important to benchmark short-term progress, such as engaging in regular exercise, improving one’s diet, setting goals to eliminate from their regimen over time, etc.
  3. Engage Early-Patients are more impressionable at the time they are diagnosed with a disease or condition versus months and/or year later. Engaging patients early creates the catalyst for a “Teachable Moment” and can have a greater and more sustainable impact on their personal health.
  4. Create an Action Plan-Once you have agreement on the current health status and behavioral motivations & anchors, providers can be better informed to communicate a desired action plan. What are the three to five actions, habits, etc. that patient can do between office visits to help them achieve their health goals? If there are opportunities for quick wins, include them on this list. Acknowledge their successes towards achieving these goals as this will help to build a partnership between the patient and the care team. Whenever possible, help the patient make the connection between their behavior change and the achievement of their goals.

“Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.”
Taking a bit of time from the point of encounter to give your patient tools, support, and resources that are culturally relevant and sensitive to their current life stage will help them to be more engaged in their healthcare experience and ultimately protect your financial bottom-line.

About Maria Barhams

Ms. Barhams joined DrFirst in 2014 as the director of population health after beginning her career at the National Institutes of Health (NIH) as a fellow in 2007. In her public service capacity, she leveraged her background in biology and public health/health services administration in various analyst, administrative, intramural, and extramural functions across the NIH. Most notably, Ms. Barhams supported the revision of clinical guidelines and risk stratification of a rare disease affecting patients with compromised immune systems. These guidelines were later adopted and published by the American Academy of Neurology. Ms. Barhams is passionate about public health and the rapid diffusion of evidence from research into real-world clinical settings to improve patient outcomes and reduce disparities. In her capacity at DrFirst, she supports the realization of this vision via DrFirst's technology solution, Patient Advisor.