Shared Decision Making in Healthcare
By Rudrani Ghosh
With the patients no longer waiting on the sidelines and becoming active participants of their cure, the notion of information transparency has caught fire. The result has made organizations struggle to keep up with the rising expectation of the consumer.
According to McKinsey Consumer Health Insights Survey (2019), it is revealed that only a small proportion of the respondents were able to retrieve the information they looked for during making decisions and more than 60 percent of patients report that they want more information when deciding where to get care.
Increased information transparency affecting the existing healthcare model
According to Mr. Rajagopal Yadavalli, Director, Forum Business Research, “Gone are the days when a patient would present himself to the doctor and blindly follow the pathway laid for them by the doctor. Consumers are spoilt for choice, and increased information access has enabled them to do their homework.”
While existing business models are being steered in a new direction by the rising expectations of the customers, increased choice pressure also plays a crucial role in driving new business ideas. For instance, start-ups are offering consumers more options, such as healthcare financial wellness platforms that provide the pricing information; they need to make healthcare services more ‘shoppable’.
“Old healthcare models may have to change to accommodate this new context,” adds Mr. Yadavalli, “for example, an OP consultation fee based on an average of 2-5-minute consultation time may not meet the needs of the patient or the doctor anymore. Nowadays, patients may be more than willing to pay for that quality of time and consultation by the doctor which includes explanation of findings and further clarifications to patients’ questions. Continued care post-discharge is also expected today from most patients – these evolving nature of needs by patients demands a change in the delivery models.”
The existing barrier that needs to be shattered
The consumers today expect personalized information to make the right decisions especially in pricing. In current context, there exists a huge gap between what information is available and what the consumers desire for.
“I clearly expect to interpret my billing information but with these uses of medical jargons, I don’t have a clear picture.” – Female, patient relative.
According to Mr. Neeraj Lal, Group Senior Vice President, Medicover Hospitals, “The information flow from the healthcare service provider to the patients should be done in a way where the consumers understand what is covered and what isn’t.” He further adds on the same vein, “I feel if we explain the procedure and approximate estimates of a particular surgery or process in a way that the customer understands, then we will be surely able to gain the confidence of those people. In case of surgeries and critical patients, there should be a counseling session arranged between the doctors and patient relatives (which is usually not done in most of the hospitals.)”
To achieve this transparency in healthcare, Mr. Lal thinks that AI can help us in a big way – the proper use of technology in the healthcare domain is something which needs to be advanced. He brings in the example from one of the hospitals in Ahmedabad, where he introduced the concept of ‘Happiness ICU’– wherein the critical patient was shown to their relatives through a virtual mode while the doctor explains the condition of the patient. This approach, as Mr. Lal suggests, not only helped in attaining higher confidence level among the consumers but also helped the organization to maintain infection control check at critical areas.
Will the promises of patient engagement be realized?
Patient engagement means different to different people. Some considers it to be the expected efficiencies and cost savings, while some talk about it in terms of the interaction and empowerment between the patient and the service provider. Studies reveal that highly engaged patients are more likely to experience better health outcomes than less activated patients. Everyone interested in fostering patient engagement is certain that it will yield benefits both for the clinician and the patient.
Mr. Rajagopal believes that “Most doctors and hospitals continue to focus only on clinical management, and expect their patient to be happy when the outcomes are good. They forget that the flip side is also true – the consumers run for cover and expect the worst when clinical outcomes are not as expected. Most providers fail to understand that engaged patients are willing to take shared responsibility for their health – the middle way that creates a win-win situation.”
The importance of information transparency needs to be realized and “systems have to be implemented to monitor, manage and improve patient engagement as a strategic initiative. There are multiple proven systems for this and while implementing them is no small task,” adds Mr. Rajagopal.
Does greater information transparency affect decision-making (and cost)?
When consumers have access to information that is tailored to their situation, they are likely to make different decisions, often prioritizing factors important to them, such as cost. The trend that was identified by the McKinsey Consumer Health Insights Survey illustrates that:
Across different scenarios, respondents often chose lower-cost options that are of average quality rather than higher-cost, higher-quality options. As the out-of-pocket costs gets increased, even fewer chose higher-cost, higher-quality options.
Most respondents were willing to change their preferred site of care when they learned that someone, they knew experienced a poor administrative experience at that site.
Most respondents chose lower-cost or high-quality options over those that were higher-cost and more convenient.
When armed with transparent information flow, consumers are likely to make different decisions. These decisions include choosing a different provider, often considering reputation, quality, and costs.
“The need for information transparency by the consumer means that they are ready for taking up shared responsibility for their health,” believes Mr. Yadavalli, “depending on the risks and costs the patient is willing to take up and expected outcomes of alternate pathways, only a doctor with higher expertise can guide them.”
“There are multiple studies that have indicated that the number and cost of litigations by disgruntled patients have come down when the hospital has had a well-established policy and processes for patient engagement right from the first step of the patient journey” he adds.
The marvel of information transparency
The healthcare ecosystem is becoming more transparent as the present stakeholders are not only expecting access to information but also often demanding it. Although at times the providers face significant risks of losing patients who are equipped with, for example, information about poor administrative experiences; on the flip side, the evolving healthcare business players view this as an opportunity to build relationships with the consumers by helping them shape their decisions more effectively.