What message do former Google CEO Eric Schmidt, CMS Administrator Seema Verma, and White House Senior Advisor Jared Kushner have in common? They all asserted the importance of person-centered care in their respective remarks at HIMSS two weeks ago in Las Vegas.
Person-centered care treats the patient/healthcare consumer as an equal with the care team. The patient’s needs, preferences, and values are at the center of care. While it may seem surprising that this approach isn’t standard, much of our healthcare system is really oriented around the convenience and operational efficiency of the institutions and providers. To be fair, system-centered care can lead to more people receiving care and some degree of cost effectiveness. But the cost includes people disengaging from care due to long waits, unaddressed concerns, and an overall sense of poor customer service.
Healthcare policy is moving beyond minimizing costs, recognizing the importance value and holistic cost effectiveness, exemplified by a wide range of performance quality outcomes. The recent A Bipartisan Blueprint for Improving Our Nation’s Health System Performance asserted this shift. The lives (and quality of life) of the people we’re privileged to serve are essential to both a high-quality and cost-effective healthcare system.
To continue the shift toward person-centered care, we need to change perspectives at both the policy/system level and at the provider level. Policies and systems need to adjust services and benefit packages to enable providers to have effective time with their patients, as well as value the right kinds of outcomes. These outcomes are increasingly non-siloed and sometimes even not within the realm of traditional healthcare (e.g., housing, criminal justice engagement, social services benefits, etc.).
Many providers are trained in a top-down approach that is reinforced by policies, systems, and payment structures: The provider is the expert and just tells the patient what to do. If the patient doesn’t follow the instructions, they are pejoratively labeled as “resistant” and/or “non-compliant.” Provider burnout can exacerbate this process, creating poor customer service and dismissing challenging patients.
As a licensed psychologist who has worked in both hospital and outpatient settings, I have personally experienced all these dynamics. The solution to move towards person-centered care resides in seeing the patients as holistic humans, building a more complete story of their challenges (and strengths), and creating more compassion and motivation to help people navigate their care.
This is where analytics can come in. As more entities are willing and able to share data, particularly across health and non-health services, there are great opportunities to provide more complete insights into what helps people engage (or avoid) their care.
Making person-centered care a reality in California
While I was the Chief of Behavioral Health Informatics at the San Bernardino County (California) Department of Behavioral Health, my team evaluated an award-winning, innovative program that engaged behavioral health consumers labeled “resistant and non-compliant.” Even relying primarily on mental health claims data, we gained significant insights into the behavior of our consumers, fundamentally challenging the resistant/non-compliant descriptor and becoming more person-centered.
There was an assumption that these individuals were not seeking care in our outpatient system. After exploring the data, we learned not only were they seeking outpatient care, but they were doing so repeatedly. A deeper look into procedure codes found more interesting patterns: These folks were receiving mostly crisis and assessment visits. Sometimes dozens per year. But indeed, they weren’t “sticking” in outpatient care. Something was inhibiting their activation into routine outpatient care.
While some of our assumptions about the characteristics and motivations of the target population were wrong, the engagement and activation efforts of the program were highly effective because it delivered person-centered care. The nature of the services (rather than the overall service counts) changed dramatically. There were significant increases in services, such as care planning, collateral contacts (engaging loved ones in care), and individual therapy. The data helped spur new conversations about how we talk about people, how we reach out to them, and how we engage them on an on-going basis.
Analytics was central to continuous quality improvement and to the evaluation that has led to many more policy and systemic conversations. To learn more, check out San Bernardino’s story, including a Data for Good video, or view a longer presentation exploring how data can reduce stigma and discrimination.
These values and priorities are foundational to SAS’ approach to whole person care. It’s not just about combining data sources to report on integrated metrics. It’s about gaining new understandings of people who are seeking help. Better, holistic understanding of their needs and strengths can help us see these trends and statistics as not just numbers, but real lives. Better knowledge and insights can help us find new ways to improve benefits packages, adjust systems that may not truly welcome everyone, and even build compassion that will enhance customer service and result in better outcomes and better value—the foundations of person-centered care.
How might whole person analytics help you view your people and system differently and move toward person-centered care?
If you want to learn more about our approach to analytics and whole person care, you can view this Periscope video of our demo from HIMSS.