Todd Berner | Patient Engagement

Todd Berner | Patient Engagement

The Introduction of Open Notes

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Five years ago, researchers from Harvard Medical School partnered with Geisinger Health System (Pennsylvania) and Harborview Medical Center (Seattle) to launch a pilot program called Open Notes. Open Notes is a unique initiative that encourages health care providers to share their office notes with their patients. The researchers tracked the results of the patients having access to these notes, finding that having access to the notes makes patients more engaged in their own health care. Although there were already healthcare providers that voluntarily offered access to their notes to patients, the launch of Open Notes has successfully increased the interest in this idea.

Todd Berner - Doctor NotesCurrently, researchers involved with Open Notes estimate that around 5 million people see physicians that share their notes as part of this same initiative. Doctors across 20 institutions around the country, including major academic medical centers and health systems, are active participants in Open Notes. Even providers not directly involve with the study have taken part in this growing trend, which is beneficial for both doctors and patients.

Open Notes, according to advocates, is shifting the doctor-patient relationship from being less paternalistic and more of a partnership in keeping up with an individual’s health status. Being able to read the notes a doctor is taking about the current status of your health makes the entire situation easier to understand for many patients. A doctor telling a patient that he or she is pre-diabetic is one thing, but reading it from their notes on your own time is entirely different and may serve as a wake up call to many patients who will begin to take better care of their health. By creating these engaged patients, health systems are hoping to improve the overall service they provide while reducing healthcare cost all around for both patients and the entire healthcare system – patients are are active participants in their health are also likely to be healthier in the long run.

Hospitals Listening More and More to Patients

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According to Kaiser Health News, hospitals across the United States have been taking big steps toward providing better services to patients and their families. One such step has been involving patients and family members in advisory boards, many of which have a direct line to hospital administrators and financial boards. This has been seen as very innovative and has been gaining a lot of popularity. According to data collected by healthcare organizations in 2013, 40% of hospitals had some iteration of a patient advisory board.

Doctor-at-Laptop-Listening-to-Patient_jpg-300x228For hospitals, the incentive to turn toward their patients to improve services has already existed, but for many years hospital administrators seemed have ignored the need for input from those they served. One such incentive for improving patient satisfaction is the correlation between medicare payments and patient satisfaction scores. After implementing patient advisory boards, many hospitals, like Michigan’s Spectrum Health which began creating patient-led boards 10 years ago, have seen significant increase in patient satisfaction scores.

At Michigan’s Spectrum Health, Andy DeVries serves on one of their 13 patient groups after being hospitalized with life-threatening injuries following an accident. In his years working alongside Spectrum Health, Mr. DeVries has seen the increase in status that patient groups have had over a decade. In his case, he has even helped human resources at the hospital in the process of hiring doctors and nurses. The human resources department relied on Mr. DeVries to clue them in on what to look out for when hiring, something a patient should know very well after being attended by a variety of different hospital staff.

With the growing popularity of patent advisory boards/committees, many hospitals have encountered some flaws in the system. The most pressing to some hospitals has been finding a diverse enough group of patients who not only have the willingness to help, but also have the time. A diverse group of patients is necessary, as it would allow the hospital to tackle a wider range of issues that would benefit a wider range of patients and families. Nonetheless, many hospitals have been benefiting from these boards tremendously and some see it as just the first step in improving the type of service and care they give to their patients.

Hospitals Working to Improve Patient Satisfaction

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Jordan Rau, in a piece featured on both NPR and Kaiser Health News, examines the case of Rowan Medical Center and how the hospital is reacting to the increasing importance of customer satisfaction in the healthcare industry.

Medicare began requiring hospitals to collect patient satisfaction data 8 years ago, and this data has begun to carry more weight in recent years. Since 2012, the Federal government considers the satisfaction of patients in determining the pay level for each hospital. Even some private insurers have followed suit.

The Rowan Medical Center in Salisbury, NC is hoping its efforts will prove effective

The Rowan Medical Center in Salisbury, NC is hoping its efforts will prove effective

The Rowan Medical Center has had some of the lowest levels of patient satisfaction in recent years. Just last year, the hospital lost nearly $30,000 in federal pay, and that amount could reach much higher levels if they do not improve soon. In a survey, patients at Rowan report they are much less satisfied with the pain control and wait time at the hospital.

Next month, the federal government will be simplifying the consumer reviews creating a five-star rating system for hospitals. Government officials are hoping that this system will prove easier for consumers.

In the past few years since this policy was implemented, many hospitals have successfully improved their patient satisfaction, but quite a few have remained stagnant.  On a national level, hospitals have, on average, improved staff communication, cleanliness of the rooms, and a number of other categories.

One hospital in particular that has markedly improved is the University of Missouri Health System. They performed a series of live simulations with paid actors. Doctors were forced to address non-medical situations in these simulations in order to improve their communication skills.

Rowan, despite implementing sweeping changes, has yet to improve their scores. Emergency room wait times are down dramatically to half an hour, and the hospital’s doctors and nurses are receiving training on “bedside manner.” Nurses are visiting patients every hour, and spending more than seventy percent of their day with patients. Rowan executives believe that as long as they continue to try to make the patients feel more welcome, the scores will improve over time.