Patient Activation: A New Perspective for Health Providers

Abstract

Consumer health engagement; involving patients and families; shared decision-making.

These are some of the stated aspirations of the Partnership for Patients, the public-private partnership for improved healthcare quality and safety announced by the Centers for Medicare and Medicaid Services (CMS). The words are hopeful, but the devil is in the details. How do we move the needle on this most important component of a successful health outcome: the patient’s sense of control over their own health? A regional collaborative in southeastern Pennsylvania is working on some of the answers.

Unfortunately, our health delivery processes often function most efficiently when the patient is in a passive mode. Largely due to the economic underpinnings of our healthcare system, high value is placed on standardized, efficient and speedy delivery of care. Dutiful patients who show up on time, wait patiently, sign consent forms without question, and gratefully accept the intrusions of treatment without complaint can provide a respite to busy clinicians working through a high patient workload. By contrast, assertive patients who ask multiple questions, make special requests, and involve demanding family members in their care and decision-making are often considered difficult customers that bog down an otherwise efficient routine. But healthcare providers must begin to recognize that the activated patient should be nurtured and encouraged, however disruptive to our idealized care processes.