Elevating the patient conversation with intelligent clinical decision support

Joe Guerriero, Senior Vice President of MDGuidelines, Reed Group

(Editor’s Note: This article is part three of a three part series. Part one is published here. Part two is published here.)

It’s the healthcare industry’s turn to embrace what other industries have known for years: The consumer experience is king. According to a recent study from The Beryl Institute, a large majority – nearly 90 percent – of global healthcare consumers reported that patient experience is extremely important to them.[i] And for the first time, as reported in March 2016 in another recent study, the link between higher patient experience ratings and better outcomes has been demonstrated.[ii] For example, a higher patient experience had a statistically significant association with lower rates of unplanned readmissions to the hospital within 30 days.

Healthcare executives are responding by shifting their focus as well. According to a survey of C-level executives from The Advisory Board Company, two of the four most commonly cited concerns relate to patients’ non-clinical needs, specifically meeting consumer expectations (47 percent) and patient engagement strategies (45 percent).[iii] The correlation between experience, engagement and outcomes is communication and control. When patients aren’t actively involved in their own care, it can prolong recovery times, drive up costs and diminish satisfaction.

Conversely, involving patients in a more open dialogue about their care and treatment decisions changes the picture dramatically. Using evidence-based clinical decision support at the point of care enables improved communication between physicians and patients about treatment plans and expected recovery times, which ultimately leads to more satisfied, engaged patients, better outcomes and lower costs.

Implementing an evidence-based approach that includes clear patient communication is not without its challenges. Physicians often lack the tools they need at the point of care or the tools available are not well integrated with their workflow. Without a complete picture of how to proceed with care that includes robust treatment and prescribing guidelines and reliable estimates of treatment duration, physicians may not adopt new approaches. This can result in poor compliance with treatment plans, unnecessary expense, ineffective or prolonged treatment, and avoidable delays in returning the patient to normal activity levels. Putting easy-to-use tools directly in physicians’ hands facilitates higher patient engagement right from the start.

Evidence-based guidelines create a consistent framework for clinical decision-making, treatment planning and patient communication. When integrated with an EMR system, physicians can review the guidelines while talking with the patient about their diagnosis and treatment as well as easily access recent test results, lab orders and other information to avoid duplication, additional costs and patient frustration. This also provides the opportunity to update information from the patient, such as recent medication changes not yet reflected in their record.

Other evidence-based tools, like physiological duration tables, enable physicians to discuss objective estimates for how long the patient may take to recover. With this objective means of estimating recovery duration, the physician and patient can discuss realistic expectations for getting back to health.

From there, care and resources can be coordinated appropriately toward the goal of returning the patient to activity as quickly and efficiently as possible. How might this look for a patient with low-back pain? While a trip to an emergency department may result in a recommendation of bed rest and a prescription for an opioid for pain, a visit to a physician using an evidence-based approach would have a very different result. The first course of treatment would be to actively involve the patient in specific exercises known from thousands of cases to be more effective than the above approach, giving the patient more control over their care and puts them on track toward a better long-term outcome. As treatment proceeds, compliance is more likely when the patient actively participated in and agreed upon what needs to be done to recover.[iv] Throughout treatment, all care team members have access to the same information, so everyone presents a consistent view of the patient’s plan and progress.

The results of this level of patient engagement and clear communication are encouraging. According to a recent study, hospitals with higher patient experience scores had lower rates of complications, including joint replacement complications and hospital readmissions. It can also have a positive impact on responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, in which patient experience accounts for 25 percent of the score that the Centers for Medicare and Medicaid Services (CMS) uses to calculate an organization’s incentive payment under the Hospital Value-Based Purchasing System.[v]

Using evidence-based treatment guidelines and duration estimates at the point of care encourages positive communication and clear expectations every step of the way. This results in increased engagement and satisfaction among patients as well as better outcomes and lower costs.

[i]State of Patient Experience 2015: A Global Perspective on the Patient Experience Movement.” The Beryl Institute. 

[ii]Association Between Medicare Summary Star Ratings for Patient Experience and Clinical Outcomes in US Hospitals.” Journal of Patient Experience. March 2016.

[iii]Annual Health Care CEO Survey,” The Advisory Board Company, March 2015.

[iv]Engaged, Informed Patients Help Ensure Better Outcomes.” Monthly Prescribing Reference, September 4, 2014.

[v] Scoring: Hospital Value-Based Purchasing. QualityNet. Fiscal Year 2016.

evidence-based tools, intelligent clinical decision support, patient engagement, reducing readmissions, Reed Group


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