Population Centered Care Case Study

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Population Centered Care Case Study



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Case Study: User-centered design helped improve health systems for rural populations

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The study also included a survey of patients. These patients were asked to rate the units where they were treated on a scale of Scores ranged from 1. The difference was statistically significant. In particular, the patients gave their lowest ratings to the emotional support dimension, while the staff members believed that the emotional support they provided stood out as a positive aspect of their work. Prior to the recent advances in technology, patient participation was limited to shared decision making SDM , a form of participation that occurred specifically between a patient and their physician in clinical practice, but can be regarded as a step forward.

Changes in modern technology now allow computers to play an increasingly important role in healthcare decision making. Examples of artificial intelligence AI technology that is being used in healthcare include IBM's Watson Health, which is intended to assist in the diagnosis and treatment of difficult illnesses or disease. Physicians can use ailment specific programs such as the Watson for Oncology app, which is aimed at the detection and treatment of tumors.

Artificial intelligence is being used more frequently in patient participatory healthcare. Entrepreneurs have led the challenge to conventional health thinking since Craig Venter took on the NIH with the Genomes Project in Following the institute's inception, Milken launched the Fastercures program, which "brings together patient advocates, researchers, investors and policymakers from every sector of the medical research and development system to eliminate the roadblocks that get in the way of a faster cure".

The Fastercures program proposes patient-center improvements and advancements in the modern healthcare arena. In , the U. Government boosted patient participation by launching its own Patient-Centered Outcomes Research Institute. PCORI is striving to systematize its evaluation metrics to prove where results show improvement. The c organization has faced a great deal of scrutiny over funding, specifically when it was revealed PCORI was funded by a new tax originating from the Affordable Care Act. Four years after the spectacular Genomes Project hoped to call in a new era of precision medicine PM , some opinion leaders have spoken up for reassessing the value of patient participation to be seen as a driver of PM.

In a seminal [ peacock term ] paper on the topic came out written by Hood and Friend. A second success story is that of the patient John W. Walsh, who founded Alphanet, which has funnelled tens of millions of dollars into research on chronic obstructive pulmonary disease or COPD. A more ethically ambivalent development involving patient-funded research involves so-called named patient programs and expanded access.

Taking its name from the "Web 2. Other ways electronic health records can enhance patient participation include electronic health records that alert physicians to potentially dangerous drug interactions, [57] reducing time to review a patient's medical history in an emergency situation, [58] enhanced ability for managing chronic conditions like hypertension, [57] and reducing costs through increased medical practice efficiency. MHealth is bringing promising solutions to meet the growing demand for care. With more and more evidence suggesting that the most effective treatment models involve specialized, multi-faceted approaches, and require a variety of materials and effort on both the physician's and patient's end.

Live videoconferencing appointments have proven effective, especially in the field of mental health , and can be especially significant in providing services to low resource, rural communities. To meet this demand for materials, production of patient-centered health applications is occurring at a rapid pace, with estimates of over , mobile applications available for use already. Patient participation can include a broad spectrum of activities for human subjects during clinical trials and has become associated with several other words such as "patient engagement" or "decision making".

A study reported that " According to early career researchers working in the field of patient engagement in research, this research approach is still in its infancy and will not become mainstream until around Increasingly, patient and public partnerships in health research focus on co-authorship of studies. In the US, trends in patient participation have been influenced by a variety of sources and previous political movements. One such source for patient participation in clinical research was the AIDS epidemic in the s and s. During the epidemic, the AIDS activists argued not only for new clinical trial models, but for the importance of additional social service groups to support a wider range of potential human subjects.

There has been an increased interest among healthcare providers, such as nurses, in cultivating patient participation. For benefits, patient engagement improves patient outcomes as well as clinical trial enrollment and retention. Two of the reasons to cultivate patient participation in clinical research have been the growth of patient organizations along with the development of databases and the concept of a patient or disease registry.

Registries, specifically, not only allow patients to access personal information but also allow physicians to review the outcomes and experiences of multiple patients who have received treatment with medicinal products. Patients have a new resource to help them navigate the clinical trials landscape and find understandable summaries of medical research in the OpenTrials database launched by the AllTrials campaign in as part of open data in medicine.

Precision medicine will change the conduct of clinical trials, and thus the role of patients as subjects. Schork from the Venter Institute in Nature. He cites as reasons for this development a growing interest in 'omics' assays and cheap and efficient devices that collect health data. With cancer being a prime target for precision medicine, patients are increasingly being recruited to participate in clinical trials to help find cures.

From Wikipedia, the free encyclopedia. Redirected from Patient-centered care. See also: Health advocacy and Patient advocacy. See also: Shared decision-making and Artificial intelligence in healthcare. See also: Health 2. See also: mHealth. See also: Health advocacy and Participatory action research. The Virtual Mentor. PMID Journal of Participatory Medicine. ISSN Health Affairs. International Alliance of Patients' Organizations. Retrieved 30 June The new estimates are larger than the previous estimate from roughly a decade ago.

It is also noted that younger adults aged 18 to 24 are more likely than older adults to say they are transgender. The research on transgender people and their health needs is sparse. However, available studies indicate that transgender people experience multiple health disparities due to stigma, discrimination, and unique barriers to accessing quality care. The purpose of listing these is to build an understanding of the difficulties transgender people face so health care providers can help break down barriers. The majority of transgender people experience various forms of harassment, victimization, and discrimination in their daily lives. In addition to facing discrimination, transgender people are more likely than the general population to be homeless, un- or underemployed, and living below the federal poverty level.

Unfortunately, transgender women of color face bias and discrimination on several fronts. For example, an African American transgender woman may face racism, stigma, and sexism in her daily life, with negative or deadly consequences for her health. Because of expectations of discrimination or misunderstanding in medical settings, many transgender people avoid or delay seeing a health care provider. But even when they do access care, they have difficulty finding a provider or being referred to providers who have expertise in patient-centered care for transgender people. Many transgender people lack health insurance, have been denied insurance coverage of transition-related care, or denied coverage of preventive care that is not consistent with the gender their insurer has listed e.

Health insurance plans are not required to cover transition-related care, although some states have made this a requirement. The trauma and stress induced by stigma and discrimination, as well as the related effects of under- and unemployment, homelessness, lack of access to transition-related care and lack of insurance, among other issues, can create a great burden on the mental and physical health of transgender people. The graphic below illustrates research findings from several sources, including the National Academy of Medicine and U.

Transgender women, particularly those of color, have to contend with greater vulnerability to violence. Transgender people have been shown to have higher odds of depression and attempted suicide over non-transgender cisgender people. They may take nonprescription and potentially dangerous hormones, or get silicone injections or have silicone implants to enhance their appearance.

This can lead to a higher risk of illness and injury, further complicating health disparities 7. For instance, sharing needles to inject silicone or hormones may place transgender people at risk for HIV and hepatitis C. Consider having a conversation on the different types of medical care that a person uses, both from a health provider and possibly from a friend or other nonmedical people. Consider discussing possible options for safer ways to get what they are looking for in their health care. This figure illustrates how stigma and discrimination can impact health and lead to disparities and inequities in health These strategies involve all members of the care team, from front-desk staff to clinicians to administrators, and they are based on the principles of being welcoming, responsive, accountable, reliable, and respectful.

One of the most important steps in creating a welcoming environment for transgender people and all people is to address patients using their preferred names and pronouns. For many reasons, this can be challenging in health care environments. Yet using the wrong name or pronoun can cause embarrassment and confusion. Some strategies for handling these situations include the following:. Multiple strategies can help health care organizations create an inclusive, patient-centered, and welcoming health care environment for transgender people. Some suggested strategies are listed below. Resources to help organizations implement these strategies are listed in Additional Resources.

Transgender people use many different terms to describe themselves and their communities. Common definitions and terms are listed below, but this vocabulary is not universal or static. Because the use of these terms changes over time and from one area to another, people may use or understand these words in a different way than what is defined below, or they may use other words to describe themselves and others. If a term that a patient uses is unclear or requires clarification, simply ask the patient what the term means in an open and respectful manner. People may also change the way they describe themselves over time. It is best to give all patients an opportunity to provide information on how they want to be recognized in a health care environment.

Transgender is used here as an umbrella term to describe people who have a gender identity that is different from their sex listed on their birth certificate. Gender identity is on a spectrum. It is important to keep in mind that although some transgender people prefer the binary classification of men or women, many reject it. These terms emphasize a broader view of gender and may provide a more nuanced understanding of what it means to be a transgender person. Not all jurisdictions collect data on gender identity that include transgender people, and some researchers may use older methods that can misclassify transgender women as men who have sex with men.

This can also happen as some transgender people may not identify themselves as transgender in health care settings due to fear of discrimination or previous negative experiences. This mix of limitations can result in over- or under-estimating the number of transgender people. The social worker brings a patient-centered, holistic view—one that extends well beyond the patient's discharge from an acute care or subacute setting. As a key member of health care teams, the social worker is often the one relied on most to address how to meet the person's needs in the community. Social workers' person-centered approach is highly congruent with the practice of case management.

In fact, case management has been a key function of social work since the founding of the profession Commission for Case Manager Certification, Social workers' whole-person perspective and skill set make them valued members of interdisciplinary and, increasingly, transdisciplinary teams. Without a social worker, it may be virtually impossible for these teams to pursue a truly holistic approach. The Case Management Approach Case management is not a profession unto itself; rather, it is a cross-disciplinary specialty practice.

According to the most recent field research conducted by the Commission for Case Manager Certification CCMC in , while nursing was the most common professional background for case managers Although the percentage of social workers has remained constant, the overall number of current CCM certificants has grown, from approximately 30, to 40, Thus, the population of social worker case managers continues to grow. Case management is defined as a "professional and collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs" Commission for Case Manager Certification, For the case manager, the highest level of responsibility is to the patient client.

As advocates on behalf of these individuals, case managers are obliged to coordinate care that is safe, timely, effective, efficient, equitable, and client-centered. Throughout the case management process, case managers act with consideration for the individual's cultural beliefs, interests, wishes, needs, and values. Case managers are responsible for helping clients and their support systems evaluate and understand care options, determine what is best to meet their needs, and institute action to achieve their goals and meet their interests and expectations.

In addition, according to www. The case management process is highly congruent with social work practice. NASW defines social work practice as applying the "values, principles, and techniques" of social work to achieve one or more of the following: "helping people obtain tangible services; counseling and psychotherapy with individuals, families, and groups; helping communities or groups provide or improve social and health services; and participating in legislative processes" NASW, n. Grounded in advocacy and seeking to identify the resources people need to achieve their physical and mental health goals, social work and case management share important common ground.

There are other commonalities and contributions at the intersection of social work and health care when taking a case management approach. Increasingly, case management practice focuses on measuring quality and outcomes; in fact, it is now considered an "essential activity," as defined by the most recent role and function field survey conducted by the CCMC.

Individual case managers across multiple disciplines are experiencing greater emphasis on evaluating quality and outcomes, such that these responsibilities are becoming part of their regular jobs and day-to-day responsibilities. These responsibilities vary, depending upon the practice setting. In the hospital setting, for example, an important aspect of outcomes is improving transitions of care, such as from acute care to subacute or discharge into the community. Improved transitions are key to reducing readmissions in order to avoid penalties and reduced payments from Medicare and other payers because of excessive readmissions within 30 days of discharge Watson, Another factor in reducing readmissions is to ensure patients have the necessary resources and support postdischarge.

In pursuing these goals of better patient follow-up and reducing avoidable readmissions, social workers are particularly well equipped to identify resources in the community, such as meal support for homebound patients or arranging transportation to doctor visits. This expertise makes social workers particularly valuable members of health care teams composed of multiple disciplines. Health Care — The Transdisciplinary Team Across the health care spectrum today, teams of health and human services professionals are increasingly being engaged. These teams are known by different names; one of the most frequently used is the interdisciplinary team, in which different disciplines interact to reach a common goal, with each professional contributing his or her expertise.

A transdisciplinary approach differs from the interdisciplinary in that it requires team members to be sufficiently familiar with the approach of each. With a transdisciplinary approach, the focus remains team based, but all disciplines are "viewed as having an equally important role in the patient's care, and with each team member having expanded knowledge of the role that each discipline plays on the team" Little,

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