I have had a few moments in my life where I have experienced thoughts of impending doom. You know, when you thought you were on the right track and something happens to wake you up to see a totally different perspective? I like to call it the moment of “what did I just get myself into?” One of the big ones in my life happened when I entered nursing school and was working in a large multi-specialty clinic. It was there that I was thrown into the wolves and experienced the reality of patient care.
A Different Era in Healthcare
Think back to 1996 and how your doctor’s office was run. Did it take over a day to get a call back from the nurse to answer the question you had for the doctor? Do you remember the hassles of getting lab results called to you, and the minutes or hours of time you spent on the phone just trying to get a person on the phone to explain what each lab result meant? What about times when your chart just came up “missing” and the person on the other line could only say, “Sorry, we will call you once it has been relocated.” It sounds crazy, right?
That was my world then. Paper charts would be piled high all over the office. On some days, I couldn’t even get through the door of the doctor’s actual office due to stacks of charts piled as high as they would go and strewn all over the floor. The phones rang non-stop from the moment the office opened to the minute it closed. Messages taken for the doctor were lost on a daily basis, and patients were always double booked and patient wait times were at an all-time high. And if you thought the office experience I had was bad, the experience at the hospital was even worse. My first year as a new grad was an experience I would not want to endure ever again.
I remember repeatedly thinking, how can I be the kind of nurse I want to be with a healthcare system that is so broken? But, I was at my point of no return. I had already taken the magical red pill and chosen to go down that rabbit hole. Since I had sealed my fate, the best that I could do was to make the most of it and put my focus on the patients as best as I could. Little did I know that taking the red pill would prove to be a good thing.
Patients: The Center of It All
Fast forward almost 20 years and here we are. As much as our healthcare system still has to go, I look back to those early years of my nursing career and realize how far we have come. I have been privileged to witness and been a part of a number of technologies that hospitals have deployed to increase patient safety and efficiency. Some of them have worked well. Some of them have not. What we have finally discovered is that for healthcare costs to decrease and the wellness of our population to increase the patient must be at the center of it all.
With the vast search capabilities of the Internet, and the explosion of smartphones, whether we like it or not, the e-patient awakening is here. Gone are the days of patients waiting to rely on the doctor’s office to give them the information that they need. The wasted minutes spent on the telephone waiting to understand an abnormal test or lab result are also a thing of the past. Internet search capabilities are endless. And although there is misleading information out there, most top searches come from reputable government or hospital websites. The use of smartphones and handheld tablets has made way for all kinds of medical apps to help patients with health education and different types of engagement tools. Social media has given patients and caregivers a sense of community and the ability to rally around one another in times of need.
Patients now go into their doctors’ offices feeling empowered, and not lost or confused. Knowledge is power, and patients are finally feeling strong enough to take on a bigger role in their health because they have the resources to do so. They now come armed with questions and ideas that even make the doctor’s stop and think.
When We Know Better, We Do Better
One of my favorite quotes comes from Maya Angelou’s 1969 autobiography, I Know Why the Caged Bird Sings. The quote simply states, “When we know better, we do better.” This statement is so true in every aspect of our life. As healthcare is transforming at a rapid rate and the healthcare model moves toward a patient-centric approach, healthcare providers are beginning to understand the importance of having patients involved in their care.
A recent Health Affairs study demonstrated that patients who actively participate in shared decision-making with healthcare providers have better outcomes and lower health care costs. Of the 33,000 patients studied, researchers found that patients who did not actively participate in their health had 8 to 21 percent higher costs than patients with high engagement levels.
As David deBronkart, an international patient engagement spokesman and a former cancer survivor who is also known as “e-Patient Dave,” stated at a recent patient engagement conference, “Patients perform better when they are informed better.” Echoes Angelou?
Make It Easy to Do the Right Thing
We are yet again at a point of no return. Only this time, for me it is not a point of impending doom. These are exciting times for us as a healthcare society. I feel like we have finally discovered the missing link to transforming healthcare. A statement that is so simple, as what Angelo and deBronkart have indicated can be so profound. To be successful, it is up to us to provide the right information for our patients; deBronkart says it best, “Information alone doesn’t change behavior, even for smart people.” He says we must also, “Make it easier to do the right thing, and make the messages that healthcare delivers to patients clear and concise.”
Patient Activation is Key
It doesn’t stop at just providing the right information either. Patient activation is a key component. We need to engage them in ways that make them want to do better. Some may require more motivation than others. Some may need gentle reminders. Some may need community resources they can turn to that give them the support that they need. It is up to us to listen to what each individual needs and provide them the tools to help them succeed in their health. Patient engagement is not one size fits all. It is up to us to provide the quality and brand of information not only that they need, but that they deserve. If patients perform better when they are informed better, then it’s up to us to perform better, too.
