One of the largest health care conferences, HIMSS (Health Information Management Systems Society) took place last week and patient-centered care and the patient role in the care team was a key topic. The realization that patients have more information about their diseases and treatment options and have the right as well as the understanding to be making decisions about their care in conjunction with their health care professionals has finally taken hold in the medical establishment. It is about time.
In 2001 The Institute of Medicine (IOM) published a study that outlined the guidelines for a new health care model, patient-centered care. The report attempted to explain why it is so important that the health care establishment change their approach of treating disease and prescribing medication that most providers learned in their medical training, to an approach that centers on the whole patient and not on the particular disease that needs to be treated. The IOM described patient-centered care as:
“Respectful of and Responsive to individual patient preferences, needs and values and ensuring that patient values guide all clinical encounters.”
The IOM suggested ten rules that the 21st century health care system should follow. They include:
Rule #1 Care based on continuous healing relationships.
Rule #2 Customization based on patient needs and values
Rule #3 The patient as the source of control
Rule#4 Shared knowledge and the free flow of information
Rule #5 Evidence-based decision making
Rule #6 Safety as a system property
Rule #7 Need for transparency
Rule #8 Anticipation of needs
Rule #9 Waste continuously decreased
Rule #10 Cooperation among clinicians
(Crossing the Quality Chasm , National Academy Press, 2001, pages 6,1 66 - 83)
It has taken the entire decade for most health professionals to recognize the importance of this approach and incorporate the rules outlined by the IOM into standard practice. It has taken a decade for the health care system to finally admit that including the patient in the care team. and providing patients with the information to participate in the decision process will result in better, safer, more efficient care delivery and better outcomes, while controlling costs. Hopefully this will resolve some of the problems inherent in our current system.