Taking action to implement patient autonomy in the health care system.
The first post in this series of blogs focused on women, our prominence in the health care and how patient autonomy was largely something we could infuse into the system. The second post focused on the policies implemented in society and what women have done to encourage the manifestation of autonomy.
This piece shall focus on one tool that can be used to bridge the void and increase the amount of patient autonomy. This may come as a little bit of a shock but part of the answer is using the platforms that are prominent now. Yes, I’m referring to the use of social media. Throughout this post I’ll be referring to a slide deck for a presentation given at Ignite Boston event on April 12, 2016.
The idea is in summary below (Figure 1.0):
We start first by acknowledging that when it comes to spending on health care in the United States, projected amounts are a bit through the roof. A study completed by The Henry J. Kaiser Family Foundation in 2014, forecasts that spending will increase to $866 billion As you can see from slide 3 of the presentation linked below. From 2016 to 2017 the net spending on Medicare is projected to be somewhere around $562 billion (as shown below in Figure 1.1). In actuality, the spending for March 2016 is $591 billion, for Medicaid at $371 billion and children’s health is sitting at $13 billion. That spending is broken down into how many people it’s spent on. Largely those with employment while close to 80 million people are in the Medicaid and CHIP brackets.
The issue is that the number of people are increasingly needing Medicaid and the spending of the part of the patient and the government is only increasing. In the same study conducted by The Kaiser Family Foundation, as of December 2015 there were only 3 states with a negative percent change. A positive percentage change indicating that more individuals are enrolling in Government Assisted Health Care. Of these individuals, half of those adults who walk into their doctor’s office leave not knowing or understanding what they’re meant to do. Of the patients who do walk in to their doctor’s office 90% know little to nothing of their continual health care.
Scary. Much of the population in the U.S. and Canada know nothing about their own health. What’s worse is that even more are unwilling to learn because the information is formulated in terms that are incomprehensible. This lack of knowledge on the part of the patient and lack of training on the part of the health care practitioner leads to needless visits and repeated mistakes. Mistakes and repetition are costly in any sector and the health care sector is no exception. In 2015 The Centers for Medicare and Medicaid reported that these repeated visits lead to over $768 billion, while over all the U.S. Health national expenditures resulted in roughly $3 trillion or $9,523 per person (as shown below in Figure 1.2).
I can’t even stretch my brain to imagine that number. While policies are cost cutting, this encourages doctors to see as many patients as possible in order to make up for lost capital. It can therefore be argued that cost cutting has lead to an increase in spending on both sides of the doctor-patient relationship.
~Now the good news is that there are simple solutions that will:
- Increase (even by a small percentage) a patient’s knowledge,
- Increase their access to information thereby increasing their autonomy also
- Decreasing both patient, hospital and government spending
First, values and priorities need to consciously be realigned and focused on the construction of holistic relationships from the patient and likewise from the doctor. By this I mean, the doctor must encourage questions and share information pertinent in the simplest of terms. For the patient this means training and an understanding of what procedures are called for and why. The value of continuity per patients has been estimated by The Kaiser Family Institute as worth $180/year. Given the amount of patients a doctor typically carries, the value is compounded and therefore quite high.
Second, if these values are to be attained, a clinic and or hospital must nurture these relationships with training sessions and informational guidelines. Allowing for a realm of informational intelligence to manifest. This would also include follow up visits and informing the patients of preventative measures that could be taken.
Thirdly, an avenue of accessibility must be fostered through the above two steps. How you may ask? Well this is where social media comes in. In a clinical questionnaire conducted by PwC HRI Social Media Consumer Survey, it would found that 41% of patients said that the use of social media would affect their choice of doctor and/or health care facility. An article published in the U.S. National Library of Medicine also states that doctors who are using social media have increased from 41% in 2010 to 90% in 2011 and it is nearly 100% today. In keeping with the above, over 60% of doctors have reported a positive trend in their relationships with their patients with an increased use of social media. The article sites the drawback of social media to be a lack of security but measures and innovation are trending in such a way as to limit that.
The Mayo Clinic in Australia has implemented a social media plan into their health care practice and refers to it as a catalyst (as seen below in Figure 1.3)
, meaning it speeds up productivity and communication. The Mayo Clinic has since reported an increase in patient satisfaction. What has been discovered merely supports the idea that social media should be implemented in a systematic and strategic way. Families are already turning to Facebook, Twitter and YouTube to suss out their answers. Women are also most prone to have an app on their phone to inform them about their health stats. WebMD, a trusted online resources, reports over a million visits a day. The point is patients are using it, doctors are using it the health care system should use it as a whole. What do you think?
While the above is true and statically proven via interviews, case studies and surveys, still only 26% of the hospitals in the US are using social media to their advantage. Thinking positively though, this has improved from a few years ago when the practice was frowned on as only entertainment for teeny-boppers.
In conclusion, there exists a problem, there is an increase in the amount of patient/doctor spending and it can be solved by increasing patient knowledge and autonomy. We increase patient autonomy by nurturing holistic relationships and providing information. We increase it by creating catalysts and avenues of accessibility. One such route is via social media.
Products out there designed to increase patient autonomy.
- “Health Policy Brief: Patient Engagement,” Health Affairs, February 14, 2013, http://www.healthaffairs.org/healthpolicybriefs/