Pulling Back the Curtain on Primary Care

07 May 2014
Patients without the skills to manage their health care incur costs up to 21 percent higher than those of patients who are highly engaged in their care, according to recent research published in Health Affairs. Patient engagement begins with giving patients the tools they need; at its most advanced, it also can mean that patients work directly with providers to provide feedback and strive to improve quality.
Patient Partners is an advanced form of consumer engagement where patients volunteer to join their ambulatory care practice’s quality improvement leadership team (QILT). The concept for Patient Partners originated with the Aligning Forces for Quality Humboldt County Alliance and was passed from peer to peer. With the Patient Partners program, one or two patients take a behind-the-scenes look at the health care practice and give feedback to doctors. Patient Partners either manage their own chronic condition or have cared for someone with a chronic illness, so they know firsthand about the challenges patients face in chronic diseases. The perspective of a patient familiar with chronic disease management has proved to be an invaluable tool for practices in York and Adams counties.
More than just advisors, Patient Partners are active members of their practices’ QILTs and contribute the patient viewpoint to practice-level redesign work as the providers strive to achieve patient-centered medical home recognition and improve health outcomes for their entire patient panels. To date, Aligning Forces for Quality–South Central Pennsylvania (AF4Q SCPA) has recruited, trained, and supported more than 56 Patient Partners in practices participating in SCPA’s Patient-Centered Medical Home Collaborative or Enduring Learning Forum.
For example, Patient Partners point out simple areas ripe for improvement. “Whereas normally a practice might assume a brochure they put together will be so helpful to their patients, Patient Partners will correct course. They’ll say, ‘No. Just give me specific, actionable steps,” said Kathy Hutcheson, consumer engagement coordinator with AF4Q SCPA.
Fifty-six Patient Partners are involved in practices currently, with 50 more undergoing training in May before joining a practice. AF4Q SCPA helps practices recruit patients and equips the partners with four hours of training on PCMHs, health care payment, group dynamics, health literacy, and patient empowerment. After this in-depth session, Patient Partners are supported with monthly webinars or phone calls where they can discuss emerging topics. The support from AF4Q SCPA also provides safe space to ask questions. 
Now, more experienced Patient Partners mentor new Patient Partners, as well as serve on a steering committee. Mentors check in with newer Patient Partners and have helped AF4Q SCPA develop training materials. They even lead phone calls and in-person meetings. “It’s great to have it grow, but the program itself needs to change and adapt,” said Hutcheson. “Because they’ve had so many experiences and seen their practice transform, the steering committee members are the best people to guide the program.”
“Patient Partners have a great impact on patient engagement,” said Christine Amy, AF4Q SCPA project director. “Providers have become used to quality measures but struggle with patient engagement. It’s a different perspective entirely.”
“Patient Partners are the ones stopping a practice from doing something that is unnecessary—and saving the practice time and money. For example: Can I access my records online? Does my wheelchair fit in the room for my visit?” added Amy.
During a recent round of interviews with practices involved in the program, all placed a high value on having patients engaged in the process. Practices felt having Patient Partners helped them become more patient centered, increased transparency, and brought an important perspective to practices that had previously been lacking. “Now we are getting requests from other organizations for help in building their own Patient Partners programs,” said Amy. “It’s becoming one of the key sustainability elements going forward.”