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October 13, 2015
Not that long ago—as recently as 30 or 40 years—patients did what their doctors said: they followed doctor’s orders. And, frankly, so did the nurses, techs, and everyone else—no questions asked. But times are changing rapidly, and now patients and providers have very different expectations of one another. We are—or are striving to be—in an age of patient engagement. But what exactly does that mean?
Fueled by TV ads for everything from pharmaceuticals to health care insurance, consumers of health care have more information—and more choices—than ever before. The mystery of health is often unlocked for patients by a quick search using online resources, social media, and digital communities to learn about an ailment or a procedure, ask questions and compare notes, and publicly rate (or berate) their doctors and hospital experiences. It is becoming increasingly common for providers to email prescriptions, keep electronic records, and offer online appointment scheduling and secure messaging. Pharmacies now provide urgent care and perform minor surgeries, offering convenient alternatives to traditional emergency rooms and hospital operating rooms. Increasingly, patients don’t even see their primary care physicians, and instead consult a nurse practitioner or a physician’s assistant (often to save money).
These changes are not limited to any one health care system or patient group. The dialogue about and access to information is changing what patients expect to receive, hear and see. Patients served by the Military Health System (MHS) are no exception. Here, the dynamic is complex: with a culture that incorporates rank and the need for warfighter readiness, military treatment facilities (MTFs) across the country are faced with the pressure of continuing to deliver exceptional health care to service members and their families in a health care marketplace that is costly and competitive.
Booz Allen has been on the forefront of helping the MHS navigate the complexity of patient expectations and perceptions as well as provider needs. The support Booz Allen is delivering goes to the heart of many aspects and influencers regarding patient engagement, including perceptions about access, quality care and patient safety. In fact, the firm was tapped by the Defense Health Agency to support the 2014 Military Health Review mandated by the Office of the Secretary of Defense, and our findings provided the MHS with data foundational to the trajectory the MHS is on now—implementation of high reliability organization (HRO) principles system-wide to boost patient safety, laser-like attention on quality, access to care that drives best practices further down and into MTFs across the country, and culture change initiatives to help move the MHS toward greater interoperability and consistency.
The idea that the patient and his/her caregivers must be mutually engaged is rooted in the practice of medicine, and as this notion re-emerges to prominence, it is placing new demands on how providers and patients see themselves in the care transaction. Clinical and non-clinical staff are being urged to no longer simply accede unquestioningly to doctors’ orders. Inevitably, the drive toward patient engagement is calling for a change on the delivery side of health care. Health care teams are learning how to engage and integrate more seamlessly with one another. As the culture of HROs is being embraced by health care organizations across the country, there is an increased focus on performance metrics that require collaborative approaches to quality, safety, and access among practitioners and staff who work together on the patient’s behalf.
Booz Allen sees these priorities through a systems lens because patient engagement, quality, safety, access, and business performance are all tied together. The goal is to drive optimum use along with high performance to promote the strategic and financial well-being of MTFs. To that end, our design thinking methodologies give MHS executives deeper insight into how patients actually experience their care journey and provide previously untapped data points that are being used to inspire new and innovative thinking and problem solving. Our process improvement experts assist in designing processes that reinforce standardized, high-quality care delivery. Our health care professionals specialize in setting and managing quality, access, and safety metrics, facilitating implementation of HRO principles, and providing organizational change guidance. Predictive analytics experts develop decision-making modeling to help MTFs leverage resources and make tough calls on where facilities may be needed, for example. Booz Allen’s change communication practitioners deliver messaging, information, and education content to patients and consumers of care as well as employees—a preponderance of whom are themselves MTF beneficiaries. Through their efforts the latest capabilities in knowledge-sharing, social marketing, and digital media are leveraged to reach and expand patients’ ability to engage meaningfully in their health care experience.
This blended approach mirrors the very nature and spirit of patient engagement where the goal is to involve and inform patients in their health—and health care—through the support of integrated health care teams and tools. These days just “following doctor’s orders” is no longer sufficient: each of us has a role to play. The transformation that is underway now means all of us must work and learn together in new ways.