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New Thinking and New Rules for Patient-Centeredness


Fundamentally rethinking and refocusing on patient-centeredness is central to building a health care system that improves quality and controls cost. But patient-centeredness must permeate an organization from the 'exam room to the board room'. A new white paper, Building Patient-Centeredness in the Real World: the Engaged Patient and the Accountable Care Organization explores how the new Accountable Care Organizations (ACO) might go about doing this through the 'three R's': redefinition, rules and role models.

The paper redefines patient-centeredness as being composed of separate but intertwined ethical, economic and clinical components. For instance, traditional professional notions of 'duty to the patient' are different from the marketplace behaviors of 'consumerism' and different, too, from the concept of the patient as genuine clinical partner. The paper examines how ACOs provide a structure for turning all three concepts into a functioning reality.

The white paper then takes the Medicare rules for ACOs related to patient-centered care and translates them into simple framework that can be used by even non-ACO providers to build in patient-centeredness.'  For example, one rule promotes shared decision-making tools to help patients assess treatment options based on their own 'values and convictions.' The medical literature shows that helping people become more prepared and effective partners in their health and health care can yield significant clinical, economic and social benefits.

Finally, the white paper provides role models of change, providing case studies of organizations that have successfully instituted exam-room-to-board-room change to improve care and costs. Two of the most prominent examples include the Family- and Patient-Centered Care program in orthopedics at the University of Pittsburgh Medical Center and the outpatient health coaches program at Mercy Clinics in Des Moines.

Developed in collaboration with the National Partnership for Women and Families and supported by Aetna, this white paper can be accessed on the National Partnership website.

More Blog Posts by Michael Millenson

author bio

Michael L. Millenson, president of Health Quality Advisors LLC, is a nationally recognized expert on improving the quality of the American health care. He is the author of the book “Demanding Medical Excellence: Doctors and Accountability in the Information Age,” and he holds an adjunct appointment as the Mervin Shalowitz, M.D. Visiting Scholar at Northwestern University’s Kellogg School of Management. You can follow him on Twitter @mlmillenson.

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