Several articles in the Wall Street Journal today focus on “innovations in health care”. The innovations they are referring are not new technologies or imaging tests but rather how to get the medical profession to think about patients as partners in their care. In “Patients as Partners”, the article describes the Collaborative Chronic Care Network where patients can input their response to new treatments into an online data base and interact with pediatric gastroenterologists through a messaging services. Information such as whether they are taking their medication as prescribed is collected. However, the studies to date have involved less than 10 patients and the challenge is how to scale this up.

 

Another article “Numbers, Numbers and More Numbers” describes the efforts by Insurers and PBMs to predict an individual’s compliance with medication and the risk of a hospitalization. This has driven a surge in collaborations between 3rd party payers and technology companies to push “analytics” allowing the targeting of individuals who could benefit from the “personal touch”.

 

For the business world, Customer Relationship Management (CRM) is a given. Successful companies do it well. You can’t help clients if you don’t bring them into the solution. Why is this a foreign concept in healthcare? Why must our profession be paternalistic when it has been shown in many studies that patients who share in the decision making and are informed partners in their care have better outcomes?

 

The problem is that our current office visit is not designed to provide sufficient time nor is there is a structure to easily initiate patient empowerment/engagement that can continue beyond the office visit. In an interview in today’s Boston Globe, Dr. Russell Phillips, the new Director of the Harvard Medical School Center for Primary Care, highlights the need to manage patients at high risk and improve patient engagement and empowerment. But how do we do this given the severe time constraints and increasing administrative tasks that do not directly relate to patient care?

 

Perhaps we need to redesign what occurs between the patient and physician during that 14 minute office visit interaction. Perhaps lessons can be learned from the Khan Academy (http://www.cbsnews.com/8301-18560_162-57394905/khan-academy-the-future-of-education/) where teaching is being transformed from a one way delivery of facts from a textbook to instead ‘flipping’ the classroom where students and teachers engage in interactive learning. In the Khan model, textbook review is relegated to time outside the classroom. Passport to TRUST is a platform that could similarly drive this interactive process, readily integrate into a physician’s workflow, and importantly shift the burden of health to be shared by both an informed patient and their physician that extends beyond that 14 minute office visit.