“Patient-centered care” is an oft-touted ideal in health care today, so a group of researchers decided to find out whether it really works. Peter Reed, Douglas A Conrad, Susan E Hernandez, Carolyn Watts and Miriam Marcus-Smith examined healthcare reform in Washington State to get “an in-depth and personal perspective of patient-centered care innovation from the people at the front lines of health care delivery and innovation.”
The researchers focused on reforms stemming from the state’s Blue Ribbon Commission for Health Care Reform 2007 report:
- The patient-centered medical home
- Shared decision-making, including legal protections for physicians who formally use shared decision-making tools
- Payment reform, including protection for participants from antitrust action related to tight payor-provider collaboration
The researchers discovered that healthcare organizations which focused on patient-centered care were not able to do so exclusively. Factors such as cost containment, quality improvement and organization survival were heavily considered in the decision making processes.
In addition, research demonstrated that the process of innovation is heavily dependent on organizational culture and leadership. Organizations which were successful in implementing patient-centered care did so by capitalizing on their leadership, human capital, and adaptive culture. Organizations which were less successful were plagued by inertia, resource deficits, fee-for-service payment and regulatory limits on scope of practice.
One of the barriers to innovation is the lack of collaboration between health plans and health providers. The health plan organizations focused on cost-effectiveness while the providers were more concerned with delivery processes. Although there are many shared objectives between the two types of organizations, they rarely collaborated to innovate and provide patients with efficient and cost-effective care.
Successful transformation of the health care system requires cooperation between providers, health plans and policymakers. Clear policies which detail a vision for patient-centered care and delineate steps to achieve this will foster innovation and collaboration. The necessary steps include leadership training, incentives and leeway for experimentation, information sharing between organizations and changes in healthcare financing and delivery.
Healthcare reform which puts the patient in the center is a positive measure, but it still has a long way to go to create a healthcare system in which the patient receives the best possible care.
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