“Putting the Patient at the Center of Their Care and Their Care Team”
Nancy Hansen, MPH, BSN, Assistant Vice President, Population Health Management, Drexel University College of MedicineNancy Hansen has a contagious enthusiasm for putting the patient at the center of their care and their care team. “This is a relationship that is two-sided,” says Hansen. “While the patient should have expectations of the healthcare team, the healthcare team also has expectations of the patient: that they’re a full partner in their healthcare, that they jointly work together to establish goals for the patient and use the concept of shared decision making.”Hansen is Assistant Vice President of Population Health Management at Drexel University’s College of Medicine where she helps manage large, multi-specialty, multi-provider practices. When it comes to establishing that crucial provider-patient relationship, she recommends open discussion of all expectations so both sides know what to expect from that relationship. The provider – or other care team member – should talk in-depth with the patient about all of the team members who will be involved in their care, what their role and expertise is, and how each person will help the patient meet their health goals.
If Hansen could pick one resource or tool to ensure success, it would be a well-trained, highly-functioning, multi-disciplinary care team. “It takes time. You have to establish roles and responsibilities for everybody and really determine who is at the center of that team,” explains Hansen. “The traditional model puts the physician at the center of that team and across the nation we’re now putting the patient at the center of that team.”
One component that Hansen has helped develop at Drexel is “Staff Grand Rounds,”which is based on the tradition of “grand rounds” where licensed staff participates in continuing education. Drexel closes all practices one Friday afternoon every other month for training that includes non-licensed staff on different health topics ranging from nutrition to cancer screenings and prevention, to communication styles and motivational interviewing. “This is to show unlicensed staff how important they are and make sure they’re up-to-date on their knowledge.”
Many of the approaches Hansen has helped put in place over the years stem directly from lessons learned – sometimes the hard way. “Maybe we had a room full of really smart people who came up with ideas and then told everybody what to do,” says Hansen. “You can imagine, as adults, that really doesn’t work out so well when you’re looking at practice transformation. Now that we include all staff and the patient, we are seeing a higher level of satisfaction all around.”
To hear Nancy’s full interview and comments – in her own words – click on the video image above. |
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Meet the Doers
Interviews with HealthDoers Network Participants
Interview Topic: Enhancing Care Delivery by Deepening Patient-Provider Relationships and Developing Community Partnerships
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Michael Ruiz de SomocurcioVice President
Payer and Provider Collaboration at Regional Cancer Care Associates LLC
Greater New York City Area
In an environment where providers are paid based on schedules packed with short appointments, how do you develop the relationship that is so important to care for the whole person?
Although our physicians treat cancer, many of our patients have other co-morbid conditions that can impact their treatment. As value-based care and the concept of population health gains more traction, it becomes important that our physicians work closely with other providers/hospitals to ensure our patients receive appropriate treatment and coordinated care. It’s also imperative that patients and caregivers have a greater voice in the care provided so they fully understand their treatment options. Regional Cancer Care Associates (RCCA) operates 29 practices in New Jersey, Connecticut, Maryland, and Washington, D.C. and is one of 195 practices nationally that are part of a CMS innovation program called the Oncology Care Model (OCM). The main principle of OCM and our other value based programs is providing patient centered care. RCCA has pushed all of our chips in when it relates to these models as we have been an early adopter. Not only does it require coordination around the care provided, but there has been an added focus on psycho-social needs and financial counseling, which have large impacts on patients as well.
If you could wave a magic wand to achieve instant adoption and effective use, what one real model, tool or resource would you recommend for practices in order to achieve the objective of deeper patient relationships?
I would love to see a technologically integrated system where EMR’s all spoke with each other so that if a patient is in the hospital or ER, that we would be notified in real time. A system that can monitor our high-risk patients at home and where our care team is notified when interventions may be required. Lastly, where patients can easily download their information and we can push education and notifications in an intuitive enough way so that patient engagement can increase. All of these things would then be available in a cohesive and integrated way. We are not that far off with this concept as there has been a lot of progress with these things, but they are mostly done in silos and not integrated. A truly efficient system would have this integration.
It has been said that lack of time and deep relationships with patients are the missing ingredients that lead to provider burnout. What are your thoughts and how do you overcome that?The practice of medicine has become more and more administrative. Studies show that 17% of a physicians’ time is spent on the bureaucracy of healthcare: this includes billing and collections, preauthorizations, negotiating contracts and quality reporting. With the advent of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and value-based care, the Center for Medicare & Medicaid Services (CMS) and health plans are requiring more of physicians. Lack of performance in these models can negatively impact physician revenue as well. Does this mean that patients are actually getting better care as a result? These tasks directly take time away from patient care. Physicians will have to do more, but it is critically important that changes occur as efficiently as possible while utilizing existing workflows. Not all tasks require a physician, however. RCCA has hired staff to support them both from a clinical and business standpoint. We have nurse navigators to help coordinate patient care, clinical documentation specialists that support our EMR and quality capture and reporting, and data analysts and informatics folks to compile the data we receive so we can distribute across our organization.
What are key strategies that you recommend to overcome provider burnout?
As I mentioned previously, having folks work at the top of their licenses to help support our physicians is critical. Information sharing is key as well – RCCA receives a lot of information from Medicare and our health plan partners. We are lucky to have active physician leadership in our organization who have created a great culture. Providing them information and data as to why we are in certain contracts or agreements and how each are performing individually shows them the result of these interventions. As the results show better patient experiences and outcomes, I think it gives them a new-found excitement as to the potential of what can be accomplished. It’s a journey, but a highly rewarding one.
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Highlights from the Online Community
We have had many lively discussions in the past few weeks. A few highlights are below.
- Stop by the discussion on Care Delivery: Deepening Patient and Providers Relationships. Share your experiences, thoughts, and questions here.
- “This is worth the read.” – Elizabeth Mitchell shared JAMA Forums’s Reframing the Health Policy Discourse. Find the article and the conversation here.
- Share Your Work Series: ACLC Case Study Briefs – Targeted, Tactical Learning for Providers – Read more here.
- Watch remarks from health and human services secretary Tom Price to the Physician-Focused Payment Model Technical Advisory Committee (PTAC). Read more and share your thoughts here.
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| HealthDoers Stories Wanted!
Know of an interesting project that you or someone else is working on that could be shared with our community in 2-3 minutes of talk time?
Raise your hand here to sign up or recommend another HealthDoer. Share a few details and we’ll be in touch. |
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Announcements and AlertsHealthDoers Has Updated to a New Platform! The HealthDoers Open Community has updated to a new platform with a new look, a new feel, and new features – all while maintaining its functionality. Here is what you need to know:
- You will use the same URL link as always – no need to change bookmarks.
- The system requires you to reset your username/password (use the “sign up” tab) – but your PROFILE will still be there – no need to create a new one!
- There is online chat help, short videos and written instructions if you need help navigating the updated site.
- If you are part of multiple online communities within HealthDoers, you will be able to move from one site to another with a single login. This benefit will be available once all communities migrate to the new platform, which will be soon.
We are making every effort to ensure this transition is as seamless as possible. If you have any questions or concerns, please contact Lydia Kinney at lkinney@nrhi.org. |
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