If you’re familiar with the parable written by Danish author and poet Harris Christian Anderson, April 2, 1805-August 4, 1875, patient empowerment is not just the emperor’s new clothes. Stated differently, if you not familiar with the short story, patient empowerment is not a bandwagon of ballyhoo being driven and ridden by cowardly self-deceived blindfolded conformists, traveling through a fantasyland of nothingness.
At its inception the concept of patient empowerment implied enabling patients to take full control of their health and their healthcare. Opponents to this idea oftentimes cite patients with cancer and other terminal diseases as unable or unwilling to take control of their disease and their healthcare, but that perception is rather narrow and unrealistic. Moreover, full control over disease is rarely achievable by anyone, even doctors.
A broader and more realistic connotation of patient empowerment is the enablement of patients to take an active role and have a greater positive impact on their health, healthcare and healthcare outcomes in relationship to a variety of conditions and circumstances. A few of the many examples are blood pressure monitoring by patients with hypertension, blood glucose monitoring by diabetic patients, and smoking cessation by tobacco users. Meaningful and beneficial patient empowerment does not undermine the provider/patient relationship, but strengthens it.
In addition to being of direct benefit to patients, patient empowerment can also benefit providers. The healthcare provider benefit is tied into the fact that one of the key mandates of healthcare reform is that healthcare providers get patients more engaged in their healthcare. The patient engagement mandates impact reimbursement by third-party payers (insurance companies), whether they be governmental or private. They also apply regardless of whether the reimbursement relationship is traditional or based on one of the new payment models such as an Accountable Care Organization (ACO). Reimbursement benchmarks include things such as cost of care, treatment outcomes and quality of care.
Doctors must also show evidence of using electronic health records in a meaningful way in treating Medicare and Medicaid patients beginning in 2015, or face reimbursement penalties. One of the meaningful-use metrics that will be used is patient engagement in the sharing and exchange of information between doctors and patients via electronic health records and portals, which are points of patient access into the electronic record. Patient engagement in other areas of their healthcare will also help doctors meet some of the clinical quality metrics which will also impact reimbursement.
Although assisting physicians in satisfying quality-of-care and cost-of-care benchmarks set forth by third-party payers may not appear to be of direct benefit to patients, it is certainly an indirect benefit for two reasons. First of all, if physicians are not able to keep their practices open because of dwindling reimbursements, patients will have to find new doctors. Secondly, the greater difficulty physicians will encounter meeting reimbursement requirements related to quality of care and cost of care in treating patients who are not engaged in their healthcare, might well result in physicians electing to selectively treat only patients that are willing to be empowered and engaged.
Although it is yet to be proven that patient engagement through patient empowerment will result in across-the-board quality improvement in health care or lower the cost of healthcare, the notion has certainly been embraced by the powers that matter in the healthcare industry. Therefore, today’s emperor is not wearing a birthday suit. He’s fully and splendidly adorned.
