Most in the healthcare industry would say provider organizations have an obligation to offer better care to underserved populations. The question is how.
Dr. Graham Gardner is a cardiologist, and the CEO and cofounder of Kyruus, a patient scheduling and payments technology and services vendor. He has had a long career on the healthcare provider and healthcare information technology sides of the industry.
We sat down with him to discuss patient access, how technology can help with care planning for underserved patients and making the business case for medical groups. Gardner offered an example from his own experience showing how access for the underserved helps enable better outcomes.
Q. You are a proponent of better patient access for underserved patients. Please talk about what’s needed to do this and why it’s important to the delivery of care.
A. So much of the value of healthcare is defined by our ability to access it. As such, meeting the needs of underserved populations is best achieved by improving patient access for everyone. For me, access is not only about being able to see a provider, but also about seeing the right provider.
We know when patients feel comfortable with their provider, they’re more likely to share critical information and engage with treatment recommendations. Ultimately this can generate better healthcare outcomes and bring those in underserved communities a step further toward health equity.
To find the right provider, patients first need access to the right information. That information is different for each patient and for each kind of encounter. For example, when patients seek a primary care provider, they may be looking for someone with whom they can build a relationship with – perhaps for decades.
With that in mind, they might seek out someone with a similar lived experience and/or a provider that is conveniently located near home or work. Conversely, when seeking a specialist for a particular procedure, a patient may prioritize expertise in a certain area, while traveling further to the office for a one-time transaction.
Fortunately, digital health enables organizations to make this information transparent to all patients with access to a mobile phone, empowering patients to research and select a provider that works for them at that moment.
Q. What is the role of healthcare information technology with care planning for underserved patients?
A. The digitization of healthcare data is one of the most exciting developments of the last decade. Patients now have access to provider demographics, scope of practice, photographs, personal statements, videos and patient reviews – information that provides insight into a provider’s expertise and philosophy of care.
Through digital portals and the internet, patients also can search for providers when and how they want. Not only does this enable patients to conduct their research without the time pressures of a call to an access center, it also facilitates exploring questions that may be more sensitive in nature.
For example, someone might be more comfortable seeking out options for gender-affirming care or treatment for a mental health condition if they can review information online. The discretion offered by technology could mean the difference between a person seeking care or not.
Q. What is the business case for medical groups and providers? Why should they welcome the improved transparency and access?
A. Transparent information is fundamental to better matching patients and providers. Providers spend decades training to develop expertise in different areas of medicine, sometimes focused around a specific procedure or ailment, and sometimes also around a specific population or demographic.
Without the right information, patients lack the ability to find the right provider, while providers are often required to re-refer patients to another colleague to properly care for the patient. Not only is this frustrating for both the patient and provider, it also clutters provider schedules, which impairs access for others.
I saw this situation play out firsthand during my years of clinical practice. As medicine has become increasingly sub-specialized, patients have an increasingly difficult time understanding which kind of cardiologist is appropriate for their condition, as an example.
Without the ability to search for specific conditions and expertise, a patient with a cholesterol disorder might seek out care from an electrophysiologist who specializes in heart rhythm disorders. Not only does this provide a suboptimal experience for the patient who may now choose to leave the practice, it also robs the provider of appointments that might generate downstream procedures.
When information about provider demographics and expertise also is enhanced with availability, patients can leverage this data to seek out providers with open schedules instead of queuing up for “Dr. Famous,” who may be booked out for weeks or months. This can have a dramatic load-balancing impact, allowing medical groups and health systems to leverage each of their clinicians in a way that provides high quality – and timely – care for their member populations.
Q. Can you give an example from your experience where you’ve seen care access for underserved patients work well?
A. Many organizations are making an effort to publish content in multiple languages to help patients for whom English is not their first language. This is an important part of providing better access. However, it also is important to think about fluency levels.
Medicine is notorious for its use of long and complicated terms – not to be outdone by a laundry list of abbreviations. This can be confusing for patients and intimidating, highlighting issues of healthcare literacy that may dissuade people from seeking care.
Many forward-leading organizations now are leveraging libraries of terms that help meet patients where they are. Whether a patient types in “AF,” “A Fib” or misspells “Atrial Fibrillation,” these libraries can ensure an electrophysiologist is the recommended provider for that patient.
Similarly, if someone refers to diabetes as “sugar blood,” their search needs to yield the appropriate endocrinologist for their condition. This is again an area where technology can help bridge access and ensure patients with different degrees of healthcare literacy all are offered the right providers to meet their needs.
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