Competencies To Achieve Truly Patient - Centered Care Patients , Providers , And Systems Need To Acquire A Specific Set

Studies show that patients want to be more involved in their own health care. Yet insufficient attention has been paid to the specific competencies of both patients and providers that are needed to optimize such patient engagement and shared decision making. In this article we address the knowledge, skills, and attitudes that patients, physicians, and health care systems require to effectively engage patients in their health care. For example, many patient-physician interactions still follow the traditional office visit format, in which the patient is passive, trusting, and compliant. We recommend imaginative models for redesigned office care, restructured reimbursement schemes, and increased support services for patients and professionals. We present three clinical scenarios to illustrate how these competencies must work together. We conclude that effective shared decision making takes time to deliver proficiently and that among other measures, policy makers must change payment models to focus on value and support education and discussion of competencies for a modern health care system. O ften described as fragmented, uncoordinated, and unbalanced, the health care system in the United States provides costly and suboptimal care. To achieve better health, better health care, and lower per capita costs—the so-called Triple Aim—many health care organizations, health plans, and government programs are moving forward with initiatives that put the patient at the center of the care system. A number of these initiatives—such as the Physician Quality Reporting System and accountable care organization pilots—have targeted the Triple Aim goals by, for example, improving transparency through public reporting or altering financial incentives through payfor-performance reimbursement strategies. The ABIM Foundation’s “Choosing Wisely” campaign seeks to inform providers and patients about the overuse of tests, procedures, and therapies that are potentially of little value. And the patient-centered medical home model of care seeks to transform primary care. Essential to these quality improvements is the concept of patient-centeredness, or understanding care from the patients’ perspective. Studies show that patients want to be partners in their own health care, especially when confronted with a decision about which treatment option to choose. Yet insufficient attention has been paid to the specific competencies needed by patients, providers, and health care systems to optimize patient engagement. In this articlewe aim to identify these competencies to increase the potential of achieving the Triple Aim (a brief doi: 10.1377/hlthaff.2012.1120