How do you partner with patients to improve health care?


In order to engage patients as partners in
health care improvement, I hate to say it, but the answers appears to be appallingly
simple. Ask them. I had the opportunity to talk to the different
patients of whom I am one working with the 10 improvement teams that we have at the primary
care clinics at Cambridge Health Alliance. I asked them all, “Why are you doing this?” Every single person said, “Because my doctor
asked me to.” The second half is you have to say, you have
to demonstrate that it’s important to you that we’re there, that we’re not just a check
box that you need to just get ticked and tied, but that you can say, “How can I help make
that possible, or what do you need?” Usually, it’s very simple. Maybe I need a voucher for transportation. Maybe I work full-time, so if you’re meeting
was half an hour earlier, this would be easier. One mother needed it to be okay to bring her
toddler to the team meetings. She does, and it works fine. He drops a sippy cup, somebody picks it up
for him. It’s good, but you have to start by asking. Patients, we don’t know that there are silos
out there necessarily until we run smack into one of them. One of my favorite stories is about one of
the patient partners at a clinic where they were working really hard and figuring out
how to better integrate behavioral health or mental health with primary care. She was sitting in this conversation. We were trying to figure out how much of the
notes should get shared and still protect the patient’s privacy. At one point she looks up, and she says, “Wait
a minute. If my psychiatrist prescribes a medication
for me, are you telling me that my primary care physician doesn’t know that?” He said, “No.” She said, “Hold on. The nexus of my trust in the mental and the
psychiatrist is coming from my primary care doctor. If you do something, I want to make sure that
he knows about it.” Everyone looked up and said, “Yes, of course.” I think there’s something very elegantly,
or almost freeingly simple about having a patient say, “I need this to work. I need you guys to talk to each other, or
I need this process to move more smoothly.” People look at it and say, “You’re right,
you do.” Then they work together to make it happen.

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