what works: nine actions to increase patient engagement in healthcare

WhatWorks

Nine actions to increase patient engagement in healthcare

kpmg.com/whatworks

1© 2014 KPMG International Cooperative (“KPMG International”), a Swiss entity. Member firms of the KPMG network of independent firms are affiliated with KPMG International. KPMG International provides no client services. No member firm has any authority to obligate or bind KPMG International or any other member firm vis-à-vis third parties, nor does KPMG International have any such authority to obligate or bind any member firm. All rights reserved.

In many cases, the alignment between what patients want and what is provided is poor. The goals of patients are not given enough recognition in treatment choices and the benefits of shared decision-making and patient and carer involvement are not being realized. As a result, over-diagnosis and over-treatment are now a frequent hazard and a serious cost in many parts of the world.

Introduction


In our report, KPMG identifies nine critical objectives and supporting actions to involve patients, carers and communities in the healthcare process to create a safer, higher-quality, lower-cost healthcare industry.

© 2014 KPMG International Cooperative (“KPMG International”), a Swiss entity. Member firms of the KPMG network of independent firms are affiliated with KPMG International. KPMG International provides no client services. No member firm has any authority to obligate or bind KPMG International or any other member firm vis-à-vis third parties, nor does KPMG International have any such authority to obligate or bind any member firm. All rights reserved.

Creating a patient-centered culture means recognizing that patients, their carers and communities are different from each other.

Create a patient-centered culture

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All healthcare professionals should focus on high-quality outcomes and experiences.

Segment patients to understand their needs and preferences.

Organizational goals and rewards should be linked to a successful patient journey.

Goal-oriented care “encourages each individual to achieve the highest level of health as defined by that individual.”


Understand the patient journey and patient groups to identify priorities for change.

Increase communication and measurement through interviews, observations, and ethnography. For an example, please visit www.iwantgreatcare.org

Create a listening culture.

Incorporate patient and carer input into service design

Involving patients and their carers in service design enhances the patient experience and reduces non-value adding steps, improving efficiency and cutting costs.

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Patients typically make different, less expensive decisions when fully informed about their treatment options.

Establish systems to support shared decision-making

Respect and understand patient preference; “over-diagnosis” or “preference misdiagnosis” wastes resources and affects patient safety.

Develop health coaches and train staff to ensure shared decision-making.

Allocate time to speak with patients to avoid high-cost, unsuccessful care.

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Encourage healthy behaviors and lifestyle changes through coaching and incentives.

Support health management through mobile services, pharmacists and community workers.

Help patients navigate the system through technology.

Enable professionals to encourage and support patient self-care

The vast majority of care is self-care. Patients care for themselves – without nurses or clinicians – for about 5,800 hours per year. Less than 10 of those hours are with a healthcare professional. Support patients’ self-care by investing in these tools and techniques:

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Activated patients – those able and willing to participate in self-care and shared decision-making – achieve better health outcomes at lower costs.

Recognize and mobilize the power of patients, carers and communities

Encourage patients to set their own ideal levels of health and define “success.”

Identify patients’ assets and establish remote monitoring and case workers.

Suggest non-healthcare services and supportive peer networks.

Build and support peer networks for mutual support.

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The biggest gap between what patients needed and what they got was information. If patients do not receive what they need to know, they will not be able to be as active in their own care as we need them to be.

Help patients set goals and adhere to treatment plans by providing online and mobile technology tools.

Provide patients the information they need

Patients need information that is often very different from what doctors think they need.

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Patients should share their own experiences with clinical professionals to potentially affect treatment decisions and create a more patient-centered system.

Involve patients in the teaching and research processes

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Use patients to educate clinical professionals to change the culture of the organization and decisions about treatment.

Research does not currently mirror the priorities that patients think are important. There is limited evidence that patient views are really making an impact.

Survivors Teaching Students, a program offered to nearly 10,000 students, brings ovarian cancer survivors to the classroom to share their stories. These future medical professionals can interact with those affected and learn how to diagnose the disease earlier.

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Community resources are free or very cheap, yet remain under-utilized.

Community engagement helps address issues such as cultural sensitivity.

Sustainable communities support patients, help to recruit and train local workers and assist with economic development.

The ultimate aim is to engage families and communities to create a culture of wellness.

Utilize community assets effectively

Healthcare tends to ask the question, “what’s the problem?” community development asks, “what are the assets we can use and build on?”

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Southcentral Foundation’s Nuka System of Care is a relationship-based healthcare system in Anchorage, Alaska. Native people become “customer-owners,” delivering direct feedback and customizing services to achieve their own definition of wellness.

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To effectively shift the focus of care to what’s most important to patients, measurement and monitoring of the patient experience in real time is essential.

Monitor and measure the patient experience

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Since 2008, iWantGreatCare has collected information from patients about the quality of care they receive in the UK, publishing over 80,000 reviews a month. This system provides feedback to organizations while giving patients the ability to give and read reviews in real time.

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Key measures are perceived humanity of care, pain and dignity, patient-reported outcomes, and complaints.

Information sources include patient stories and interviews, and real-time data captured through electronic devices.

Patient experience must be embedded in healthcare organizations’ strategies, training, performance targets and rewards.


We suggest four next steps to involve patients and maximize the value they can contribute.

Preparing to change

Make interactions count

• Each experience with a patient should increase their ability to be proactive in their own care.

Ensure healthcare is designed with patients in mind

• Encourage feedback to foster effective healthcare redesigns.

Develop your workforce

• Patients, their families and communities are a set of assets and can provide essential feedback and add value.

• Add new skills and technology to promote greater self-care.

Reorganize payment systems

• Patient self-management is inexpensive compared to other medical interventions. It requires resources,

but the potential ROI is significant.

For more information or to download the full report:kpmg.com/whatworks [email protected]

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© 2014 KPMG International Cooperative (“KPMG International”), a Swiss entity. Member firms of the KPMG network of independent firms are affiliated with KPMG International. KPMG International provides no client services. No member firm has any authority to obligate or bind KPMG International or any other member firm vis-à-vis third parties, nor does KPMG International have any such authority to obligate or bind any member firm. All rights reserved.

The KPMG name, logo and “cutting through complexity” are registered trademarks or trademarks of KPMG International.

The information contained herein is of a general nature and is not intended to address the circumstances of any particular individual or entity. Although we endeavour to provide accurate and timely information, there can be no guarantee that such information is accurate as of the date it is received or that it will continue to be accurate in the future. No one should act on such information without appropriate professional advice after a thorough examination of the particular situation.

What Works

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what works: nine actions to increase patient engagement in healthcare

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