Shelley is an Independent Director on the Australian Podiatry Association (APodA) Board and has a medical imaging background, specialising in nuclear medicine technologist and diagnostic sonographer. She is a member of the faculty of the Australian Council on Healthcare Standards, Improvement Academy with responsibility for educating health professionals about the National Safety and Quality Health Service Standard 2, Partnering with Consumers. In 2017, Shelley founded her experience-centred advisory firm, Experience 360, which is made up of a tight-knit community of passionate, purpose-led individuals motivated to ensure patient insights are leveraged to deliver better outcomes for all.
The following article is an adaptation of this APodA podcast on patient-centred care. To listen to the full range of APodA’s podcasts, head here.
This article kickstarts a four-part monthly series by Shelley which focuses on the nuances that drive patient-centred care, why it matters more than ever, how to better understand these dynamics, and how to measure its effectiveness.
Patient-centred care isn’t new. Whilst the approach has been around for decades, Australia has lagged behind and we are only now starting to gain traction. Led by early adopters in the UK, US and Sweden, there is widespread recognition that adopting patient-centred care as ‘business as usual’ is not a ‘lip service’ approach, instead it requires fundamental changes to how services are delivered and to roles and relationships between patients, health care professionals and teams.
In Australia, The National Safety and Quality Primary and Community Healthcare Standards define patient-centred care as an approach to the planning, delivery and evaluation of health care that is founded on mutually beneficial partnerships among healthcare providers and patients.
A patient-centred care approach is recognised by these defining features:
I recognise three key drivers as to why patient centred care is gaining momentum in Australia right now, being: Government-led change, tech-led change and client-led (patient-led) change which are combining to create a perfect storm for the adoption of a patient-centred care.
This first driver is a realignment in government policy; shifting from performance outcomes focused on inputs, volume and activities (fee-for-service) to measuring patient value and health outcomes. Over the last five years, there has been increasing investigation into the sustainability and cost effectiveness of healthcare, and many states and territories have started to invest in a value-based health care approach to achieve this.
In 2020, the Commonwealth and the States signalled their agreement to share responsibility to integrate systems and services to improve health outcomes for Australians (signing the COAG Public Hospital Funding and Health Reform agreement). They committed to system wide reform of healthcare delivery systems to pay for value and outcomes, indicating adoption of a value-based healthcare approach, which is good news for our health systems and patients.
In 2021, The Australian Commission On Safety and Quality in Health Care (ACSQHC) released the Primary and Community Healthcare Standards for services that deliver health care in a primary, allied health and/or community setting. The standards are person-centred, and describe the processes and structures that are needed to deliver safe and high-quality health care. And while they are currently voluntary, from mid-2022 healthcare services will be able to become accredited to the Standards.
The introduction of these reforms and standards set a clear expectation that Australian health care is transforming to patient-centred, value-based care delivery.
The second driver is the rapidly changing and competitive environment we find ourselves in; a lot of this is driven by technology.
For patients, their focus is to track outcomes by connecting their digital devices, wearables, health apps and platforms to help them achieve their goals.
For healthcare professionals, rather than the traditional focus towards a competitive practice down the road or in the next suburb, there is a shift in focus to big data, patient analytics, collaborative tech partnerships and innovative ways of working.
And new digital competitors are emerging who may not even be on the radar of health professionals yet.
Large corporations like Google, Apple, Amazon and Telstra have been spending billions of dollars investing in healthcare, and they’re looking for a return on those investments. Many of us pay these companies to collect our healthcare data on a daily basis through our wearable devices. They’re the tech giants who know our likes and dislikes intimately; and they’re incredibly customer focused.
So, how does this rise in technology-based entrepreneurialism relate back to patient centred care?
We can learn a thing or two about this accelerating shift in power and the wealth of those organisations. They’re creating these massive customer platforms that can observe in real time what is going on in the lives and needs of their customers. These tech entities are experiencing success because they are able to systematically approach customers, recognise change, anticipate their needs and quickly execute. Then they gather more data, they continue to hypothesise and synthesise information repeatedly, and iterate quickly.
In comparison, the healthcare sector is slow to respond and largely flying blind. We struggle. We’ve got pretty weak signals from insufficient or fractured data. We’re not that great at aggregating data or analysing what it might tell us about our patient’s experiences. We have poor feedback loops and insufficient capability to rapidly shift and evolve to the changing environment.
The nimble qualities in the tech sector represent a powerful mechanism for us to embed into healthcare.
We need to start asking ourselves: how can we pivot based on patient feedback and new information? Or how can we capture patient data more effectively to realign our approach in response to what this data is telling us? This is the patient experience, and podiatrists as well as other healthcare professionals are well placed to capture these insights. The saying that knowledge is power remains true.
Finally, the third driver supporting the adoption of patient-centred care delivery are our patients themselves. They have rapidly changing expectations and this is driving a significant culture change for us as healthcare professionals.
Today’s patient is overwhelmed by information and requires support to make sense of their health data. At the same time we, as healthcare professionals, are being challenged by patients who may ask more questions, or different questions during consultations. While patient perspectives are not yet deeply embedded across all aspects of the future development of healthcare, if you fast forward to the patient of tomorrow, you’ll come to recognise them not just as a full member of the care team, but engaged at all levels of the organisation.
Tomorrow’s patient will drive their own health journey, be the keeper of their medical information, integrate a suite of healthcare related digital tools to empower their own health, and request diagnostics to inform their health pathways. Importantly, they’ll be connected to and interpret their data and self-monitor through wearable devices, as many already do. As they already do in sectors outside healthcare, digital natives will walk with their wallets and effectively “vote” for their healthcare experience by going somewhere else. This digitally savvy generation will shop around and be the ultimate deciders of whether we’re successful as healthcare practitioners, or not.
These three drivers combine to create a perfect storm for the adoption of a patient-centred care right now. Government policy is changing, the entrepreneurial space is largely driven by technology changes, and our clients themselves are changing. Patient centred care offers an opportunity for podiatrists to fundamentally change how health services are delivered and to embrace new roles and relationships with patients and teams.
Podiatrists are well placed to take advantage of this opportunity. Are you ready?
Next month: The lesser known benefits of patient-centred care
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