Determinants of patient participation for safer care: A qualitative study of physicians' experiences and perceptions

There is a paucity of research on physicians' perspectives on involving patients to achieve safer care. This study aims to explore determinants of patient participation
for safer care, according to physicians in Swedish health care. We used a deductive descriptive design, applying qualitative content analysis based on the Capability‐Opportunity‐Motivation‐Behaviour framework. Semi‐ structured interviews were conducted with 13 physicians in different types of health care units, to achieve a heterogeneous sample. The main outcome measure was barriers and facilitators to patient participation of potential relevance for patient safety. Analysis of the data yielded 14 determinants (ie, subcategories) functioning as barriers and/or facilitators to patient participation of potential relevance for patient safety. These determinants were mapped to five categories: physicians' capability to involve patients in their care; patients' capability to become involved in their care, as perceived by the physicians; physicians' opportunity to achieve patient participation in their care; physicians' motivation to involve patients in their care; and patients' motivation to become involved in their care, as perceived by the physicians. There are many barriers to patient participation to achieve safer care. There are also facilitators, but these tend to depend on initiatives of individual physicians and patients, because organizational‐level support may be lacking. Many of the determinants are interdependent, with physicians' perceived time constraints influencing other barriers.

The full article can be viewed below.  

June 2018 report from PwC's Health Research Institue (HRI)

Employer medical cost trend has plateaued. While the predictability is a welcome change from the wild swings and peak double-digit trends in the 2000s, steady as she goes is not good enough. Medical costs continue to grow as a percent of total employee compensation, making even the current trend unsustainable.

PwC’s Health Research Institute (HRI) projects a 6 percent medical cost trend in 2019, consistent with the 5.5-7 percent range of the previous five years. But employers continue to struggle to contain their employee coverage costs. Medical costs continue to grow, yet the workforce’s health and performance aren’t improving. Average labor productivity growth of 1.1 percent over the last 10 years falls far below the 2.3 percent average of the last seven decades.1 Efforts by employers to cut utilization have mostly run their course. Employers and consumers are plagued by high prices that continue to grow because of new, expensive medical services and drugs, and other factors, such as consolidation. HRI’s analysis measures anticipated medical cost trend in the employer-based market, which covers about half of non-elderly Americans.2 Changes to government health insurance, including Medicare, Medicaid and plans sold on the public exchanges created by the Affordable Care Act (ACA), are not within this analysis’ scope.

Patient matching compares data sources from different health IT systems, doctors’ offices, and hospitals to decipher if they belong to the same patient. The process recovers data from health records and identifies commonalities based on personal traits, such as demographics, to find a “match.”  Patient matching improves patient safety and clinical care by establishing continuity of care among patients with multiple records at one provider or across various providers. The patient matching process allows organizations to develop a complete record of the patient’s health history and medical care.

Our August Technology & Analytics Workgroup Meeting included executives from 4Medica and the Nebraska Health Information Initiative (NeHII) who suggested the following considerations for success when developing a patient matching solution:

• Is your enterprise-wide duplication rate below two percent?
• Does your current Master Patient Index solve all of your identity matching and resolution problems – across all data sources and locations within your organization?
• Do you feel that you are spending too many resources (money and human capital) to continuously clean up identities in your data sources?
• Do you currently use unlimited historical and clinical data enrichment available to help with more precise matching?
• Is your organization at risk by having duplicate identities?

Patient matching has raised fears about false matching, privacy, and consent. According to a survey from Black Book Research, around 33% of all denied claims are linked with inaccurate patient identification, which costs the average hospital $1.5 million and the U.S. healthcare system $6 billion annually. Implementing the appropriate patient matching steps will help your organization better serve patients, while saving money.

To build a 360-degree view of a patient:

• Share data transparently
• Promote informed patient-centric care coordination
• Segregate and identify clinical information from each data source to ensure most up to date information for a patient in real-time.

Press release on the patient matching collaboration between NeHII and 4Medica.

Research on Hybrid Information Evaluation Type Watching Technology for the Improvement of QOL of the Elderly

The increase in living alone and old households due to aging of the society has led to a decline in the quality of life (QOL) of elderly people. How to maintain and improve the quality of life for elderly people is a pressing issue of society. We watch over the elderly from both aspects of health-related QOL and subjective QOL and work on creating a social system that realizes a safe and secure life for the elderly. In this research, we promote the health information database which holds health related information in the shared database system such as the cloud by the will of the person him/herself, and develop a method for mining various kinds of life log information and medical/care related information in a hybrid manner. In this paper, we propose a remote watching method inferring resident's behavior related to the operation of electric appliances from the measurement of total load current of the household. We also attempt to perform hybrid data mining by combining subjective mood data and objective data with wearable sensors that can collect biological data. We aim to provide a system that brings a safe and secure life to the elderly by carrying out assessment and early detection of abnormal symptoms of them such as depression and dementia.

The full study can be downloaded below.  

Presentation slides and recording from 8/22/18 Webinar.

For many stakeholders, the healthcare experience can feel siloed and fragmented. In reality today, care management is limited to the windows of time patients and providers have during in-person appointments to discuss quality of life, lifestyle habits, monthly device readings, and adjust treatment. This is because providers only have access to a fraction of the valuable information about patients’ health outside the four walls of the hospital.

However, the use of digital health devices and apps – like in-home medical devices and wearables – can extend care beyond these walls and provide better insights into patients’ health. These devices and apps generate valuable patient data that, when incorporated into the clinical workflow and a continuous program of care, lead to more efficient and effective treatment that can lower costs and improve outcomes.

In this webinar, three stakeholders – including a patient with type 2 diabetes, a provider who designed and managed remote care programs, and a health technologist specializing in data workflows and analytics – will share their perspectives on the value that patient-generated health data (PGHD) and digital health devices offer remote care programs.

Participants will also gain practical guidance on:

-Best practices for implementing and scaling a remote care program with digital tools
-How best to engage and empower patients with data-driven remote care programs
Join the webinar to hear from a patient discussing their firsthand experience participating in a remote care program, and the perspectives of a technologist and provider on the implementation and operation of such programs.

Speakers:
-Drew Schiller, CEO, Validic
-Steve Van, Patient Advocate
-Martin Entwistle, President and CEO, Ares Health Systems

The lack of "alignment" between providers and payers hampers integration of care and services and is a primary driver of our high healthcare costs.

Lynda Rowe of InterSystems reviews a recent NEJM Heath Catalyst study on the topic and outlines thoughts and hypothesis on how to “cross the chasm."

Healthcare was a key discussion topic in the White House and Congress for most of 2017. In 2018, the healthcare industry will continue to experience rapid change. From blockchain tech to precision medicine an artificial intelligence, change in the healthcare system shows no signs of slowing down.

Click on the link below to view the detailed infographic posted by the Duquesne School of Nursing.