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Patient Empowerment: Not Just the Emperor’s New Clothes

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If you’re familiar with the parable written by Danish author and poet Harris Christian Anderson – April 2, 1805-August 4, 1875 – patient empowerment is not just the emperor’s new clothes. Stated differently, if you are not familiar with the short story, patient empowerment is not just a caravan of ballyhoo-filled, blindfolded, self-deceived conformists traveling through a fantasyland of nothingness.

At its inception the term empowerment implied enabling patients to take full control of their health and healthcare. Opponents to this idea oftentimes cited individuals with cancer and other terminal diseases as unable or unwilling to take control of their illnesses and care. That perception is rather narrow and unrealistic though. Rarely can anyone achieve full control over their state of well-being – even doctors.

A broader and more realistic meaning of patient empowerment is the process of enabling individuals to take an patient empowermentactive role which has a favorable impact on their health and healthcare outcomes. This broader view is even more applicable to the present time because of the many changes which have been introduced into the healthcare industry, including newer healthcare models which require shared decision-making on the part of patients and greater involvement in their care. Appropriate empowerment does not undermine the relationship between patients and providers. It strengthens it.

In addition to benefiting patients, patient empowerment can also benefit healthcare providers. The benefit to providers rests in the fact that healthcare reform mandates doctors and other providers to engage patients more in their care. Patient empowerment is the process by which patients achieve that degree of active participation and assume the degree of required responsibility for their healthcare.

Patient empowerment also affects reimbursement of physicians and other providers. Successful involvement in one’s healthcare does or will affect reimbursement for their services regardless of whether the care model is a traditional one or is one of the newer one such as an Accountable Care Organization (ACO).  Reimbursement benchmarks include things such as cost of care, treatment outcomes and quality of care.

Another example of the effect of patient empowerment on provider reimbursement is in the use of electronic health records. Doctors must show evidence of using electronic health records in a meaningful way in treating Medicare and Medicaid beneficiaries beginning in 2015, or face reimbursement penalties. One of the meaningful-use metrics that will be used is patient engagement in the sharing and exchange of information between doctors’ and patients. That sharing requires patients to use portals connected to doctors electronic health record systems to send and receive information. Engagement in other areas of their healthcare will also help doctors meet some of the clinical quality metrics which will impact reimbursement.

Although assisting physicians in satisfying quality-of-care and cost-of-care benchmarks set forth by third-party payers may not appear to be of direct benefit to patients, it is certainly an indirect benefit for two reasons. First of all, if physicians are not able to keep their practices open because of dwindling reimbursements, patients will have to find new doctors. Secondly, the greater the difficulty physicians encounter meeting reimbursement requirements related to quality of care and cost of care, the more likely they are to elect to treat primarily patients who are willing to be empowered and engaged. The reason is they are more likely to be able to meet the quality-of-care and cost-of-care requirements with that group.

Although it is yet to be proven whether patient engagement through patient empowerment will result in across-the-board better healthcare outcomes or lower healthcare costs, the notion has certainly been embraced by the powers that matter. Therefore, today’s emperor is not clothed in his birthday suit.  He’s fully and splendidly adorned.

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