Dr Dennis P. Scanlon Discusses Patient Engagement in Quality Efforts

I would say that we’re making progress in terms of engaging consumers in quality of care, explained Dennis P. Scanlon, PhD, professor, Health Policy and Administration, and director, Center for Health Care and Policy Research, Pennsylvania State University.

Transcript

How engaged are consumers in quality efforts and how can we better engage patients?

I would say that we’re making progress in terms of engaging consumers in quality of care, and of course when we talk about quality of care, I think we think about a variety of different dimensions. There's what the outcome is for the patient, pending what clinical circumstance or procedure that they need. Knee replacement is a very specific example of, you want to be functional again, you want to be relieved of pain, you want to be able to sort of get back to doing things that you can do, so forth and so on.

There’s also just the general patient experience and satisfaction with the healthcare system itself, which may include things like being involved in treatment decisions and sort of shared decision making. And then, of course, there’s the cost of care. So, I think in terms of what’s really pushed, a little bit, the involvement of patients is, the move toward high-deductible health plans in more additional first dollar out-of-pocket costs coming out of patients’ pockets.

I don’t want to pretend that its pervasive, that people are shopping around like they are for consumer goods, like autos or refrigerators. But, I do think that more first dollar coverage, for better for worse, has led people to think about what the cost implications are, as well as the quality implications, the overall value equation for decisions that they’re going to make. There are some pretty good tools available, but the evidence still suggests those tools are not used as much as we would like them to be used. And, we still very much live in a system where referrals from friends and family, going where your doctor refers you to. You know, “this is a good orthopod, I suggest you have your surgery done here.”

Often times, one of the challenges too, is that by the time you get into care and you’re being referred for specialty care, you’re already in a system of care and yes, you have the ability with broad plan choice to go outside of that, but it’s very difficult when you’re kind of already working with a primary care physician or family physician who’s referring you to the specialist. So, I think we are making progress, but it’s slow, and I suspect that we’ll continue to make more progress in that area.