Why Obama is Losing the People

The big story today, cover of the WSJ and The NY Times, is that the administration is losing public support for health care reform. Of course they are.

Up until let’s say a year ago, for the most part, other than an occasional report on rising costs or a story of some particularly bad case of someone being wronged by the system, most of us, the patients, just cruised along griping about waiting at the doctor’s office or how much things cost, but generally feeling like we were getting good care and there was nothing we could do about the other stuff.

Now the cat’s out of the bag. We have been inundated for months with all kinds of details about how health care works: doctors get paid to order tests - not to keep people healthy, we get treatments that are unproven and expensive, doctors and patients don’t communicate and worse. We understand the relationship between health care costs and businesses closing. We understand that working people lose their insurance coverage every day. We hear that other countries insure everyone, health care costs less and people live longer.

Patients have been empowered with information, and guess what, we want answers. It turns out that when someone takes the time to engage the patient, we understand pretty well. Is it possible they weren’t counting on that?

How can the administration get the people back on board?

By assuring them that they will be heard. By making sure that their voice is hard wired into the billions dollars that doctors will be paid to utilize HIT technology. By promising, and then making good on that promise by writing it into the bill, that the definition of meaningful use of an EMR, the definition of quality, requires the ability for the patient to input clinically significant data about the care they're receiving, and their understanding and their input into their treatment plan, directly into their medical record. By insisting, and paying for this data to be collected, analyzed and acted on to improve therapeutic partnerships between patients and caregivers.

Hardwire the patient - the voter, the employee, the premium payer - into health care reform and they will give their support even if it hurts a little.

Bill Fox, JD, MA

Executive Director

CPIR

Health Reform - Where's the Patient?

President Obama made a big speech last night. I watched it. Then I watched two hours of commentary about it on cable. This morning I read the transcript of the speech, and read the N.Y. Times and some other stuff about it on line.

Guess what - despite all the talk about patient centered care we've been hearing, not one word from any of the pundits about how the patient might actually be able to contribute information - data - about what's happening when he sees his doctors that could reduce the cost and raise the quality of health care. Given that the patient is involved in every single billable transaction with his health care providers, this struck me as a sort of major oversight.

What sort of information might the patient have?

Did the doctor apply the latest evidence based standards for his condition?

Did the doctor effectively communicate what he needed to do to manage his condition?

Did the doctor seek to form a therapeutic partnership with him facilitating dignified accountability and better self management of his condition?

The ability to measure just these three things could bring about deep, game changing improvements and value to our health care system.

What kind of changes?

• Empowered Patients
• Expanded Transparency
• Mapped Performance
• Intensified Accountability
• Intensified Compliance
• Improved Utilization
• Improved Outcomes
• Protected Consumers
• Reduced Fraud
• Reduced Capita Spending

The National Center for Patient Interactive Research is developing innovative, technology driven approaches to the successful engagement of the patient in the care process, and to creating a true therapeutic partnership between the patient, the physician and other care givers.

Patient-generated data can help to transform the current health care model. At the moment, this is the only voice which is not being heard on a systematic, standardized and measurable basis.

The patient should, and can, have a central role in developing their treatment plan. The communication facilitated and fostered by this therapeutic partnership is the key to improving health outcomes related to chronic diseases and reducing disparities among vulnerable populations.

Third party collected, patient generated data is the gold standard of unbiased quality measurement. This data must be analyzed to understand what is and is not working. This will bring confidence, integrity and transparency to the process.

Bill Fox, JD, MA

Executive Director

CPIR