Can we take concepts in healthcare and make them customary practice to improve patient care and outcomes by advancing patient empowerment and shared decisions? I invite you to consider this question yourself after watching the video and reading the summary from this session of WHIS Talks as global thought leaders discuss patient empowerment and shared decisions.
Terri Coutee: Nonprofit Leadership and Shared Decisions
I am a two-time breast cancer survivor who had successful DIEP flap breast reconstruction. As a trained ESL instructor turned nonprofit leader after my second breast cancer diagnosis, I appreciate the need for clear communication and understanding of language. In cancer care, patients must quickly absorb concepts and terms they have no knowledge of or intended to know about.
Curating communities and discussion based on evidence-based medicine is an important aspect of cultivating the patient process helping them to understand the plethora of terms to use in communication with their healthcare team. This is true in any healthcare sector. I feel strongly and see the positive effects of including patients and healthcare professionals in these communities. When we are asking, listening, and sharing knowledge based on lived patient experience and physician and provider expertise we empower patients and nurture the shared decisions concept.
Furthermore, actively engaging policy makers and financial leaders, emphasizing the economic value of patient empowerment using the shared decision-making model, can bring about the revenue necessary to support ideas and innovations to educate and empower patients to be active participants in their healthcare decisions.
Minas Chrysopoulo, MD, FACS: Physician Innovation in Digital Health
Dr. Chrysopoulo points out in his early training as a physician he watched his mentors interact with patients. He observed the paternalistic approach that was widespread practice then. The physician would basically tell the patient what they should do. He realized as he began his own career as a surgeon specializing in breast cancer care and reconstructive surgery, there was much more to giving patients information than telling them the procedure they should have or making a recommendation. Dr. C knows shared decision-making is standard of care but as he says, unfortunately it is not standard practice.
How do we foster shared decision-making? Through collaboration with the patient. He states what becomes equally important as the physician expertise is the patient’s preference, their goals, available support structure, values, and their cultural background. Anything for their treating team to consider, structuring a two-way partnership, is the core of the shared decision-making approach.
Increasing pressures on physicians, time constraints, increasing burdensome regulation, more time spent typing up required criterion, what Dr. C calls the “check box” system, can hinder the shared decision-making process. Digital decision aids are effective tools to alleviate some of these hindrances to empowering and engaging patients in their healthcare decisions. Giving patients access to the right information, correct curated, expert lead, evidence-based content is why Dr. C developed the Breast Advocate app, a decision aid patients can use in the comfort of their home.
Aubrey Kelly: Developing the Circle of Trust to Empower Patients
Aubrey speaks to us from her personal experience as a mother whose child went through leukemia treatment and recovery. She points out the importance of providing the patient with information. Aubrey emphasizes the need to educate the people who the patient trusts in the model of shared decision-making. When patients are already physically and emotionally compromised it is their surroundings, that trusted support system that becomes as much of an integral team member as the patient.
Aubrey sees important economic incentive in reducing healthcare costs by providing decision aids to patients. This can be accomplished by creating value-based partnerships with the healthcare sector. She feels because we are not currently anchored on improving shared decision-making, furthering the use of digital health platforms has the potential to reduce unnecessary treatments, hospital stays, and therapies for patients.
She points out “If you’ve lived it, you get it.” Consumer platforms for patients to connect to their caregivers and healthcare team is a win/win for both. Studies have shown engaging in shared decision-making results in greater patient satisfaction, improved patient outcomes, patient compliance, and why she developed the MyRabble Health platform.
Susanne Baars: Igniting the Shared Decision-Making Model Through Industry Connections
Susanne begins by stating, “We cannot do without patient empowerment.” The biggest issue we now face in healthcare is health inequalities. The disparities can be found between hospitals, geographic regions, and countries. We all deserve access to the best treatment and care we need. Patient outcomes are a result of access and treatment options in their area.
She points out for patients who do not have a medical background and do not know their way in the medical network you are basically lost. Patients go to the facility available to them and often times with lack of adequate information to optimize their care. Susanne works with hospital systems globally to integrate knowledge bases, get different data types together, working to encourage these collaborations to decrease health care disparities.
Juliana Ascolani: Health Literacy and Patient Empowerment Before You Become a Patient
Juliana illustrates how empowering patients to understand how to live healthy lives and understand the relationship between their health conditions and health habits is empowering them before they even need a health care system. Health literacy can become not only understanding the terms but the how to of living a healthy lifestyle possibly avoiding a hospital admission or going for a treatment for a disease that might be prevented by these healthy lifestyle choices.
Juliana points out digital and technology initiatives help patients achieve this. These initiatives help healthcare providers stay in touch with people who are able to stay in their homes where they are safe and have the tools to make these effective health-life choices.
She gives a solid example of teaching patients how to self-monitor for blood pressure. Patients can track and see the changes. They realize a direct correlation to and benefits of making healthy lifestyle choices and staying on medication while self-monitoring at home. This has shown to result in better patient outcomes.
Shared Decisions and Patient Empowerment Thoughts from the Panel
If time becomes short, what is most important to you? Search people with a shared vision.
Aubrey Kelly, MS, MBA
We need to create a model where the doctor is not the only one who should know everything. We need a combined system of experts who are not necessarily healthcare providers but those who can assist patients with administrative tasks helping them to understand the terms and improve their literacy.
Juliana Ascolani
Technology is an enabler to improve access to care that patients need.
Susanne Baars, MSc, MA.
Let us start a paradigm. We become comfortable with situations, with practice. We need to stop doing that. We need to get a little bit uncomfortable and start having conversations where we are all working together to improve patient care.
Terri Coutee, Founder, DiepCFoundation
Growth comes from being uncomfortable.
Gareth Presch, CEO, WHIS
The six people on this screen are outliers. I would like to implore any physicians, health care systems, clinics watching this, get to know shared decision-making and work to make it a core value in your practice and institutions.
Minas Chrysopoulo, MD, FACS
The Man Behind WHIS Talks
A huge debt of gratitude to a humanitarian I call a renaissance man, Gareth Presch. Your vision starting WHIS, the World Health Innovation Summit, is and will continue to improve good health and well being for patients through shared decisions and patient empowerment.