The Growth of Patient-Centered Care | E. 110

The Healthcare Leadership Experience

US health systems are slowly adopting a patient-focused approach. Shanil Ebrahim, Partner in National Life Sciences & Healthcare Consulting Leader at Deloitte Canada, explains its benefits to Jim Cagliostro.

Episode Introduction

Shanil explains why healthcare needs to move away from the ‘’one-size fits all’’ approach to patient care, why patients should be treated as partners, rather than recipients, and the impact of a healthcare model designed around systems. He also outlines why patient-centered care is an investment in quality and efficiency and highlights the benefits of adaptability in leadership.

Show Topics

• Patient care goes beyond managing health conditions

• Healthcare is designed around the needs of the system

• ‘’Patient feedback should shape everything we do’’

• Funding the cost of change

• A champion for patient care

• Improving the patient experience leads to better outcomes

• Leadership tip: embracing adaptability

05:12 Patient care goes beyond managing health conditions

Shanil said patient-centered care is designed around patient preferences.

‘’Ultimately, when you think about that term, at its core, patient-centered care is about ensuring that healthcare systems and all of their processes are fundamentally designed around the patient's needs or their experiences or their preferences I should say. And this approach goes beyond just treating diseases or managing health conditions. It's about considering patients as active participants in their own healthcare, which means that any sort of treatments or healthcare plans we develop, it's not about just focusing on clinical guidelines alone, but how do we deeply integrate that with the individual's lifestyle or their cultural background or their personal preferences into how those treatments are actually planned and executed?’’

10:45 Healthcare is designed around the needs of the system

Shanil explained how the historical context of healthcare models affects patient care today.

‘’…your question really gets at the heart of many challenges that we face in healthcare today, irrespective of where you are, whether you're in North America or globally, and you have to consider that historically, our healthcare models were designed more around the needs of the healthcare system than the needs of the patient. All you have to do is look at things like financial models of all of these health systems, which is focused on volume and paying for services that a doctor provides over value of the services or take healthcare organizations like hospitals where they prioritize operational efficiency, where you have a ton of metrics around that over personalized care. And even though we may make patient-centered care sound easy and obvious, transitioning to that type of care is a big paradigm shift when you consider that historical context. And it requires both a shift in mindset and operations.’’

11:48 ‘’Patient feedback should shape everything we do’’

Shanil explained why the starting point is to consider the patient perspective.

‘’And to me, first and foremost, it starts with leadership commitments, whether your ministers or C-suite execs at hospitals to re-envision what healthcare should look like from a patient's perspective. And this means aligning the organizational culture with patient-centric values and training your workforce to adopt this approach in every interaction in every decision. And when you think about what are practical first steps that you can actually take, it often involves gathering extensive patient feedback to understand their experiences and needs better. Something that we talked about obviously just at a length. And this feedback that we get from these patients should shape everything we do from policy to bedside manner. And technology plays a pretty crucial role here because it can be leveraged to improve communication with patients. It can be leveraged to offer more personalized health management tools or provide healthcare professionals with real-time data that is much more patient-specific, so that they can continue iterating in terms of what they need to do on a daily basis.’’

16:19 Funding the cost of change

Shanil said the initial cost of transitioning to patient-centered care should be viewed as an investment in quality and efficiency.

‘’Now in the US, where the healthcare system is more privatized, funding might come through insurance reimbursements or through investments by private health systems where they're looking to improve patient satisfaction and reduce long-term cost. You can't think about this as a short-term game, and you have to be able to measure what the value of the investment is now on something that hits long-term as well. And this is where whether your insurer or providers like hospitals, they could also tap into incentives offered by government programs or payers for meeting certain patient care standards and patient outcomes as well. So that's kind of giving you a contrast between those public health systems and the private healthcare systems, right? But regardless of the country, the initial cost of transitioning to patient-centered care needs to be viewed as investments. And these investments, by the way, Jim, are not just financial. They're investments in quality and efficiency, that over time lead to cost savings, right? Because you are reducing interventions over time, you're reducing hospital readmissions over time, and you're also improving the management of chronic conditions. So right now, if we're aligning with those value-based care models, which by the way is gaining a lot of traction worldwide, it provides that financial incentive to improve those patient outcomes and that naturally supports a care approach or a patient-centered care model.’’

19:15 A champion of patient care

Shanil said the role of patient experience officer is increasing but change starts with the CEO.

‘’The question is how do we enable patient experience to be at the heart of the organization, because that's what ultimately it is, right? And usually it is a step-wise approach. So the first thing that we end up trying to see is who's going to be the champion? And largely, we want it to be the CEO of the organization. If it really comes from the top and they have their strategic priorities and strategic comparatives centered around the patient, it sends a message to not only the C-suite, but across the organization as well. So that's where we usually like to see it's starting right from the top. Now as we start to see this penetrate or proliferate throughout the organization, it's an interim solution, which is where you would want someone who owns this as a mandate going forward once the CEO has actually set its goals and the role of the patient experience officer is increasing quite a bit, and especially in larger, more modern type of healthcare settings because it bridges a gap between clinical care and patient satisfaction and someone has a mandate to continuously challenge that. Like isn't it great if we end up seeing the type of conversations that is happening between the patient experience officer and the CFO, which may end up having different imperatives where the CFO is not only thinking about the long-term cost, but of course thinking about the short-term cost as well and focused on operational efficiency indicators, whereas the patient experience officer is thinking about the long-term value that we're providing as a healthcare system.’’

22:55 Improving the patient experience leads to better outcomes

Shanil said capturing and measuring the outcome data is the key focus.

‘’In a value-based healthcare model, the focus is squarely on patient experience and outcomes. Because the fundamental principle behind this is that these factors directly correlate with the effectiveness of care. And in terms of reducing costs or the burden on the healthcare system, and a better patient experience often leads to higher levels of patient engagement, which is critical for the success or uptake or adoption of treatment plans and ultimately improves overall health outcomes, which is the end goal of whatever we're trying to do, right? So even in simpler words, when a person or a patient feels supported and valued, they're just much more likely to actually follow medical advice and maintain their health regimens. This kind of connecting on the diabetes example that I actually provided earlier as well. And when it comes to the measurement, you can measure these patient outcomes over time to see how effective it is, whether it's measuring recovery rates or complications or taking holistic approach and measuring quality of life, which there's a significant amount of instruments or questionnaires around it, and they all serve as indicators on how we're effectively doing this and how effectively this value-based system is actually operating. But to be able to do that, and this is also turning out to be a fundamental problem or enabler that we need to fix, is we need to be able to capture all of this, this outcome data and these experiences that patients are having, and then we need to measure that data and have some analytics to offer us insights into how we're doing.’’

26:32 Leadership tip: Embracing adaptability

Shanil explained why adaptability has helped him to stay ahead.

‘’…this is not just from a personal standpoint, but I also think about it from my team and the entire ecosystem because we're moving from traditional models of healthcare and healthcare delivery to highly tech enabled healthcare, and that shift is going to continuously increase as well, right? And ultimately, when you think about that tech enabled world, it's not about new software or fancy tools, it's just about a whole different way of thinking about patient care, thinking about patient data differently, thinking about how we improve effectiveness differently. And adaptability, ultimately thinking about all of these types of changes and in these type of contexts, for me as a leader, it means leading my team through this transition, ensuring that they are not only trained in new technologies, but they're also mentally prepared to embrace these type of changes, which is different because now it involves shifting our mindset from this is how we've done it previously, to what's the best way to do this now. And one thing I love about adaptability is that there's a lot of these sub-characteristics that are inherent to it to enable you to think differently. Because adaptability means you have to keep an open mind. Adaptability means that you have to be willing to learn continuously. It means you have to be resilient; you have to show that you're not afraid to pivot when the situation calls for it. And this approach, or this principle or this guiding principle, we'll call it, has not only helped me personally stay ahead, but it has also ensured that I can help lead my teams to continue to deliver high quality solutions to our clients no matter what changes come our way. So that would be the number one thing that I would share with your audience.

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You’ll also hear:

Healthcare is about people; Shanil’s passion for improving patient care: ‘’….the reason I do this personally is because one, I'm really passionate about it and it really stems from personal and professional commitment to making healthcare better and more accessible, especially for underserved and vulnerable populations, which has been a common thread throughout my career in terms of serving those populations.’’

Moving away from the one-size-fits-all approach to patient care: ‘’… we need to involve patients more directly, ensuring that they have easy access to their health information. We have to support them through various channels that respect their time, that respect their preferences, respect their individual life circumstances. And it's all about moving from your classic one-size-fits-all approach to something that is more tailored, more holistic, and responds to the needs of the patient.’’

Creating a healthcare experience where patients are partners not just recipients: ‘’…if we truly want to do this right, we have to measure the true value from it because all the things that I'm saying are also hypotheses that are based off of research…..And the ROI should be that if we provide tailored approaches to patients, they'll be better managed. They will get to positive outcomes faster, which means incurring less costs in the long run and everyone should benefit.’’

Why patient-centered care means a focus on the patient journey: ‘’And any sort of position, whether you call it a patient experience officer or someone wearing the hat of a C-suite executive that champions a patient experience, they would be focused on the patient journey through the healthcare system and ensuring that we're empowering the patient's experience. And one of the main reasons for creating such a role is let's have someone who systematically addresses and improves all aspects of patient experience.’’

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