Academic journal article Journal of Health and Human Services Administration

Empowering Patients to Become Better Partners

Academic journal article Journal of Health and Human Services Administration

Empowering Patients to Become Better Partners

Article excerpt

Healthcare administrators are constantly pushed to improve quality, provide state-of-the-art care, and increase efficiency. However, administrators also need to reduce costs which then can impact delivery and quality of services. With the large influx of newly insured patients into the healthcare system because of the Affordable Care Act, more demand will be placed on the limited healthcare capacity to deliver services.

If we do not act, as more insured individual enter the US healthcare system, a foreseeable prisoner's dilemma will occur. As more individuals enter the already overburdened US healthcare system, system breakdowns will occur, leading to a lower quality of care for all patients. The predicted logical outcome of a prisoner's dilemma is that each patient will choose selfishly to maximize their care which will reduce services for others and thus no patients will achieve their best possible outcomes. However, if we can create a healthcare system that is Pareto efficient, all patients will maximize their utility and thereby have the best outcomes.


In current healthcare system, providers are struggling to manage comprehensiveness of care within time constraints of a visit so patients are being asked generally to take a more active role to assure their optimal health outcomes (Beasley et al., 2004). Patients who recognize that they are partners in their healthcare understand that self-management assures their health is appropriately managed (Audulv, Asplund, & Norbergh, 2010; Gallagher, 2010). For any patient training to be successful, the training program will need to evoke the individual's own motivation, rather than trying to install something that 'is missing' (Huffman, 2009). Recent studies have shown that peers can help each other build self-management skills by sharing experiences & support (K. Lorig, 2002, 2003; K. Lorig et al., 2010; K. Lorig, Ritter, & Plant, 2005; K. Lorig, Ritter, Villa, & Armas, 2009; K. R. Lorig & Holman, 2003; K. R. Lorig et al., 2008; K. R. Lorig, Ritter, Laurent, & Plant, 2006, 2008; Russell et al., 2009) and that patients believe ongoing interactive discussion groups to learn about their disease and associated self-management skills from other patients is extremely beneficial (Russell, et al., 2009). However, peer support groups are costly to implement and have ongoing facilitation and training needs that can become a burden on already overwhelmed staff. Hence, an educational training tool that is completely electronic but still evokes the 'touch' of a real world scenario is a possibility.

Patient/Provider Communication

Currently, healthcare encounters are generally organized from the provider's perspective, so patient engagement depends on creating a healthcare system (including providers) where patients can communicate during their existing visits with providers. A partnership between patients and providers, based on both shared decision making and two-way communication, may be necessary for developing the patient skills and confidence needed to self-manage their health and prevent chronic disease progression (Dennis et al., 2012). To date, much of the effort to 'fix' communication during the clinical encounter has focused on composition of the healthcare workforce, cultural competence/cultural humility of healthcare providers, and role of community participation in promoting health.

While all patients may experience communication difficulties with their providers, there is increasing evidence that provider bias and stereotyping contribute to health disparities (Burgess, Warren, Phelan, Dovidio, & van Ryn, 2010). Research comparing provider and patient perceptions of the clinical encounter revealed information dissimulation because of contrasting class differences between the patient and provider (Waitzkin, 1984).

Although there is evidence that patients of all socioeconomic class and educational backgrounds have equal desire for information, providers often expect that poorly educated, lower socioeconomic class patients would want the same level of information as better educated, upper class patients (Waitzkin, 1984). …

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