Recipients of the Presidential Scholarship for the AcademyHealth Institute on Advocacy and Public Policy were invited to blog about select sessions during the 2013 National Health Policy Conference. Susan E. McClernon, M.H.A., a Ph.D. candidate at the University of Minnesota – Twin Cities, wrote the following session summary. The National Health Policy Conference featured a session designed to highlight innovative and disruptive efforts to put patients more in the center of their health care. The session was facilitated by John Santa, director of Consumer Reports Rating Center. At the core of this kind of care is an open dialogue between patients and their health care providers, allowing the patients to make informed decisions based on their own specific circumstances. For example, Dr. Berwick has defined patient-centered care as actively promoting shared decision-making between patients and clinicians and customized care at the individual level. Dr. Epstein defines patient-centered care as “an interaction between an informed, activated, participating patient and family; an accessible, well-organized health care system; and a patient-centered community of clinicians." Patients are resourceful and can gather relevant information within and outside the traditional health care system. An evidence-based study demonstrated that patient-perceived patient-centered care correlates with better recovery from their discomfort and concern, better emotional health two months later and fewer diagnostic tests and referrals. In the session, Dr. Delbanco shared findings from a recent study of an innovative patient-centered care collaboration using Open Notes, funded by the Robert Wood Johnson Foundation. Open Notes was developed and studied as a tool to enhance patient-provider communication and patient safety by sharing all written clinician notes from the electronic medical record openly with the patient. He reported that their study results showed that four out of five patients read their Open Notes. As a result, 70 percent were taking better care of themselves and 99 percent of the 20,000 patients in the study said it should continue. Physicians rated their satisfaction with the Open Notes study at 74 percent satisfaction and, perhaps more importantly, 85 percent of patients said it would affect their choice of provider. Dr. Delbanco highlighted key areas where Open Notes has significant implications for clinician transparency, ACO implementations, for patient safety, quality and for peer review. The Mayo Clinic and Geisinger Clinic recently adopted the Open Notes system. Charles Ornstein, president of the Association of Health Care Journalists, reported on disruptive methods his organization is using to communicate information to consumers. He shared details regarding two examples of consumer friendly Web-based portals intended to improve informed health care decisions at : 1) Dollars for Docs provides access to drug and medical device company payments to physicians; and, 2) Nursing Home Compare reveals a searchable way to view nursing home deficiencies as reported by state accrediting agencies. Recently, they have launched a Facebook group to encourage consumer discussion on how to improve patient safety. Patrick McCabe, from GYMR Public Relations—a public relations firm that specializes in health, health care, and social issues—stressed the impact of the current American Board of Internal Medicine (ABIM) campaign, Choosing Wisely, which has already brought 36 specialty physician groups together and identified 130 ways to reduce wasteful spending . The success of this message to 725,000 physicians and 55 journal articles, despite the purpose to reduce costs, was because physicians were included, it required simple action, it was not threatening and costs were never mentioned. Focus groups conducted reinforced that consumers are beginning to talk like consumers and do not believe more care is always better care. Jessie Gruman, executive director of the Center for Advancing Health, spoke to the importance of listening to the patient’s perspective in the health care environment. She noted that the update of mobile devices is only a partial solution as 58 percent of disabled patients are over 50 years of age and only 50 percent of adults with disabilities use computers. Mobile applications alone will not transform the health care system, but do have the ability to improve health and simplify life for those with chronic disease and illness. Overall, the session identified recurrent themes of how resourceful patients’ and consumers’ use of disruptive media and technology will assist in further engaging consumers in health understanding. As more “data” becomes available, it must become accessible information to be useful for consumers. Stirring up improved engagement and patient-centered care builds trust and can significantly affect quality, patient safety, and costs.  

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