Closing the Loop. An important first step towards patient-centered care.

25 October 2016, Written by James R. Mault, M.D., F.A.C.S., Senior VP and Chief Medical Officer

Closing the Loop. An important first step towards patient-centered care.
In 2001, the Institute of Medicine (IOM) defined patient-centered care as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions."

Patient-centered care is more than a trend and has moved from academic vision to implementation, with many early models demonstrating improved outcomes, including improvement in net revenue per adjusted admission1 and lower total cost of care.2,3 Patient- centered measures are also playing an increasingly important role in the transition from volume to value. The advent of CMS’ national hospital value-based purchasing program and the program’s incentives to measure and improve the patient experience4 have created an additional catalyst to embrace patient-centered care.

On the surface, the concept appears simple, but patient-centered care is not precisely defined, although individual components can be measured and tracked to help establish standardized milestones. One of these patient-centered components is patient communication and patient engagement. There is a significant body of evidence demonstrating that better communication can lead to improved clinical outcomes in the management of diabetes, hypertension and cancer.5

One of the biggest opportunities in patient-centered care is activating and motivating the patient by closing the communication loop. With the majority of patient activity happening outside of the hospital or clinic, improving communication and data fluidity represents and immense opportunity to personalize care. Connecting patients and providers has proven to have both an emotional and behavioral affect effect on patients. Patients that are remotely connected and monitored report reduced anxiety and physiological symptoms associated with anxiety.6 In addition to this emotional security blanket, remote monitoring and communication is a powerful stimulus for accountability and has proven to significantly improve self-care and adherence by as much as 56% in obstructive sleep apnea patients.7

Technology can play a pivotal role in closing the communication loop by providing near real-time patient surveillance and asynchronous communication between the patient and the entire care team. This feedback loop and connection with their care team enables patients to respond and act in the moment, allowing providers to encourage ideal behavior, course correct and further stratify patients and execute dynamic and personalized care plans.

When we can consistently close the loop on communication and patient data and enable "always-on" care that is tailored to the individual, we’ll make great strides in delivering the patient-centered care that our patients need and want. It’s something to think about this month, during Patient-Centered Care Awareness Month.

What are your thoughts on patient-centered care, and do you think closing the loop and liberating health data can indeed make a difference? Share your thoughts in the comments below.

1 Robison J. What is the "patient experience"? Hospitals are becoming increasingly frustrated - and wasting money - trying to hit the wrong target. Gallup Management Journal Online. 2010:1-3.

2 Stone S. A retrospective evaluation of the impact of the Planetree patient-centered model of care on inpatient quality outcomes. HERD. 2008;1(4):55-69.

3 Charmel PA, Frampton SB. Building the business case for patient-centered care. Health Finance Management. 2008;62(3):80-5.

4 HCAHPS fact sheet (CAHPS hospital survey): Centers for Medicare and Medicaid Services; 2010 [updated 2010/09/15/].

5 Levinson W, Lesser CS, and Epstein RM. "Developing Physician Communication Skills for Patient-Centered.Care." Health Affairs 29 (7):1310–18, 2010.

6 Centura Health remote patient monitoring program. Developing a Successful Remote Patient Monitoring Program. Becker’s Health IT & CIO Review. October 04, 2013

7 Nurit F, Hirsch-Allen AJ, Goodfellow E, et al. The Impact of a Telemedicine Monitoring System on Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial. Sleep 2012 Apr 1; 35(4): 477–481.

About the Author

James R. Mault, M.D., F.A.C.S., Senior VP and Chief Medical Officer

James R. Mault, M.D., F.A.C.S., Senior VP and Chief Medical Officer

James Mault, MD, FACS, is the Senior Vice President and Chief Medical Officer of Qualcomm Life. His leadership responsibilities include Strategic Planning and Business Development, M&A, New Product Innovation and R&D, Clinical/Regulatory Oversight, Health Policy, Government Affairs and External Affairs. Dr Mault came to Qualcomm Life through its 2013 acquisition of HealthyCircles, a Care Coordination RPM Platform Company founded and led by Dr. Mault in 2009. Prior to starting HealthyCircles, he was the Director of New Products, Business Development and Clinical Programs for the Health Solutions Group at Microsoft. Dr. Mault has more than 35 years of experience in senior executive positions in the Health IT / Med-Tech industry as well as clinical medicine. Dr. Mault has founded five Health IT and medical device companies, raising over $100 million in working capital and leading these companies to develop novel devices and software technologies, FDA approvals, and strategic partnerships with Fortune 500 companies, culminating in M&A and IPO exits. He is the inventor of over 80 Patents for a variety of novel health information and medical device innovations. He has been board-certified in General Surgery and Cardiothoracic Surgery, having specialized in heart/lung transplantation, thoracic oncology and critical care. He conducted medical research under grant awards from the NIH, American Cancer Society, etc., and is the author of more than 60 scientific articles, chapters and books in the published medical literature. Dr. Mault received his Bachelors and Medical Degrees from the Univ of Michigan, and completed General and Cardiothoracic Surgery residencies at Duke Univ Medical Center. Dr. Mault provides global thought-leadership on various Boards including the Consumer Technology Association’s (CTA) Executive Board and Chair of the CTA Health & Fitness Technology Board, the ATA, AdvaMed, NSF Nano-systems Engineering Research, and the WEF Healthcare Working Group.

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