Patient-Centered Healthcare: From Patient Experience to Human Experience

WHAT IS THE PATIENT-CENTEREDNESS DIMENSION OF HEALTHCARE QUALITY?

Patient (or person) centeredness is an evolving dimension of high-quality healthcare services that focuses on “providing care that is respectful of and responsive to individual preferences, needs, and values and ensuring that people’s values guide all clinical decisions.”[1] Patient involvement is a condition for patient-centeredness and is seen as a strategy to achieve patient-centered care.[1]

Despite significant variations in patient-centeredness reported globally by various reports, healthcare organizations across the globe have been actively working on various person-centeredness strategies in the pursuit to provide high-quality health outcomes.[1,2] Patient and family-centered care encompasses “an approach to the planning, delivering, and evaluating health care grounded in mutually beneficial partnerships among healthcare providers, patients, and families.”[3] The primary outcome related to patient-centeredness and patient and family-centered care is patient experience, which is “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”[4] Future operational patient-centered healthcare models aim to achieve a state of excellence in human experience in healthcare “that is grounded in the experiences of patients & families, members of the healthcare workforce and the communities they serve.”[4] To achieve this optimistic goal, healthcare systems are increasingly moving toward new models of care with co-design and coproduced healthcare services that are shifting the conversation from “What’s the matter with you?” to “What matters to you?”[1,2] The patient and family engagement across all the levels of a healthcare system, from coproduced shared decision-making at the point of care to co-designed organizational process and national healthcare policy framework, is crucial for improving patient-centeredness across the continuum of the healthcare journey.[1,2]

HOW DOES EXPERIENCE-BASED CO-DESIGN SERVE AS A CORE STRATEGY TO IMPROVE PATIENT CENTEREDNESS ACROSS HEALTHCARE SYSTEMS?

Experience-based co-design (EBCD) strongly emphasizes incorporating the lived experiences of patients, families, and healthcare providers throughout each stage of an improvement cycle. In this collaborative process, services are cocreated with patients and families, regarded as valuable partners in shaping the healthcare experience.[5] EBCD seeks to proactively craft experiences rather than merely optimizing processes to enhance patient and provider experiences within the healthcare environment.[5] Increasingly adopted by healthcare organizations worldwide, EBCD has demonstrated its effectiveness in fostering sustained and efficient delivery of healthcare services while also driving improvements in patient experiences.[5] The main stages of an EBCD improvement approach are summarized in Figure 1.

Figure 1.

Main stages of experience-based co-design (EBCD) approach. Modified with permission.5

The rigorous EBCD approach allows improvement project teams to develop a deep understanding of what lies at the heart of patient experiences, both positive and negative, and identify unique issues and opportunities that other improvement methods may overlook. The EBCD celebration event allows the co-design team to continuously engage with each other after implementing a patient-centered improvement solution, resulting in sustainable improvements and a culture of continuous improvement in patient-centered healthcare services.[5] The EBCD approach has also reduced healthcare costs in other quality improvement projects.[5]

THE IMPORTANCE OF ALIGNING ORGANIZATIONAL VALUES AND CULTURAL IMPROVEMENTS TO ENHANCE PATIENT-CENTEREDNESS

The alignment of organizational values with cultural improvements is instrumental in enhancing patient-centeredness within healthcare settings.[6] Research indicates that the culture within healthcare organizations significantly influences patient outcomes, with an effective and patient-centered culture correlating with improved care experiences and higher satisfaction levels among patients and staff.[6] Leadership and executive alignment are pivotal in shaping the organizational culture to prioritize delivering compassionate and connected care.[7] Key components for enhancing patient experience and fostering a supportive culture include acknowledging and valuing staff contributions, fostering interdepartmental networks through effective leadership, promoting employee engagement, and involving patients and their families in decision-making processes.[7]

A crucial organizational strategy for cultivating a patient-centered culture is ensuring that organizational values are integrated into the day-to-day operational processes of healthcare services.[8] This entails aligning actions and behaviors with the overarching values of the organization, thereby reinforcing a culture that prioritizes patient needs and preferences.[6–8] Additionally, establishing patient and family advisory councils and providing staff empathy training are essential strategies for fostering a culture of patient-centeredness.[7] These initiatives empower patients and their families to actively participate in shaping their care experiences while equipping staff with the skills and mindset necessary to deliver compassionate and empathetic care.

WHAT ROLE CAN CAPACITY-BUILDING PROGRAMS PLAY IN ENHANCING PATIENT-CENTEREDNESS?

The interprofessional frontline patient experience leaders within healthcare organizations are essential for nurturing a sustainable culture that prioritizes patient-centeredness at the forefront of healthcare and continually strives for improvement.[9] Healthcare organizations can strengthen patient-centered practices, improve the quality of care, and ultimately enhance the overall healthcare experience for a diverse patient population by strategically integrating patient experience capacity and capability development programs into the broader healthcare framework.[9] Additional initiatives aimed at building staff capability and capacity in patient-centeredness within healthcare organizations encompass a range of approaches. These include service excellence training programs that enhance patient-provider communication to ensure more effective interactions.[9] Moreover, empathy training initiatives are used to cultivate staff behaviors that align with providing compassionate and patient-centered care.[7]

LEVERAGING DIGITAL TECHNOLOGY AND ARTIFICIAL INTELLIGENCE TO IMPROVE PATIENT-CENTERED HEALTHCARE

Globally, healthcare systems are experiencing profound shifts as they prioritize the patient experience, leveraging technology and reviewing the healthcare journey to meet the changing patient demands. Many patients of today expect immediate and personalized care, rejecting the traditional approach to healthcare. They seek a trusted partner in decision-making and desire a comprehensive view of their health.

Digital technology, including mobile applications, patient portals, and telemedicine platforms, offers opportunities to enhance patient and family engagement in healthcare.[10] These tools empower patients to access their health information, communicate with healthcare providers remotely, and participate in shared decision-making processes. For example, telemedicine enables virtual consultations, allowing patients to receive care from the comfort of their homes while maintaining active engagement in their healthcare journey. Additionally, mobile health apps provide resources for patient education, medication management, and tracking health metrics, promoting proactive self-management and informed decision-making.[10]

Artificial intelligence (AI) holds immense potential for revolutionizing patient-centered care by enabling personalized interventions and treatments tailored to individual patient needs and preferences.[11,12] AI algorithms can analyze vast amounts of patient data, including electronic health records, genomic information, and wearable device data, to identify patterns, predict health outcomes, and recommend personalized care plans.[1,12] By leveraging AI-driven decision support systems, healthcare providers can deliver more precise and timely interventions, optimize treatment strategies, and improve patient outcomes. Furthermore, AI-powered virtual health assistants and chatbots offer continuous engagement and support opportunities, providing patients with personalized health information, reminders, and guidance throughout their healthcare journey.[1,10–12]

WHICH MEASUREMENT FRAMEWORKS ARE USED TO ASSESS THE PATIENT-CENTEREDNESS DIMENSION OF HEALTHCARE QUALITY IN VALUE-BASED HEALTHCARE?

In pursuing value-based healthcare, which focuses on achieving the best patient outcomes while minimizing costs, measurement frameworks play a crucial role in assessing the patient-centered dimension of healthcare quality.[13] Among these frameworks, patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) serve as foundational tools.[13]

PROMs are standardized questionnaires designed to capture patients’ self-reported health status, symptoms, and quality of life outcomes.[14] PROMs are essential to quality improvement efforts as they provide the patient’s perspective concerning areas of high quality and aspects of care where improvements are needed.[14] PROMs are arguably the best way to assess constructs that relate to patient-centeredness, given that patient-centered care is responsive to the patient and is guided by patient preferences. PROMs can also collect information that can only be obtained from patients, such as whether they received adequate pain relief.[14]

By quantifying patients’ perspectives on their health and well-being, PROMs provide valuable data for evaluating the effectiveness of healthcare interventions in achieving desired outcomes.[14] PREMs capture patients’ experiences with healthcare services, including communication, access, and care coordination.[14] These measures offer insights into the quality of care from the patient’s perspective, highlighting areas for improvement and opportunities to enhance the patient experience.[14]

Integrating the concept of value-based healthcare into measurement frameworks involves assessing the relationship between patient-centeredness and healthcare outcomes relative to the costs incurred. This entails evaluating the value delivered to patients in terms of improved health outcomes, enhanced patient experience, and efficient resource utilization.[13]

In addition to PROMs and PREMs, other measurement frameworks may be used to assess patient-centeredness within value-based healthcare. For example, the Kirkpatrick model for program evaluation provides a comprehensive framework for assessing the effect of capacity-building programs and interventions on patient-centered outcomes.[9] This model considers multiple levels of evaluation, including the reaction of participants, learning outcomes, behavioral changes, and the ultimate results achieved in terms of improved patient outcomes and healthcare efficiency.[9]

By combining PROMs, PREMs, and other measurement frameworks, healthcare organizations can comprehensively understand patient-centeredness and its alignment with value-based healthcare principles. This enables organizations to make data-driven decisions, optimize resource allocation, and continuously improve the quality and value of patient care.

WHAT ROLE CAN MEDICAL PUBLISHERS PLAY?

Medical literature publishers can actively seek out and incorporate patient perspectives into research publications, clinical guidelines, and review articles by collaborating with patient advocacy groups, patient advisory boards, and community organizations.[15] Soliciting patient input during the peer review process can further enhance the inclusion of diverse perspectives.[15] Facilitating patient engagement in the research process is vital for ensuring that research findings are relevant and meaningful to patients.[15] Publishers can allow patients to participate in peer review, editorial boards, and research dissemination activities.[16] Encouraging the submission and publication of research studies focusing on patient-centered outcomes, preferences, and experiences is essential. By highlighting such studies, publishers can help shift the research paradigm toward a more patient-centered approach.

Ensuring that medical literature is accessible and understandable to patients is crucial. Publishers can achieve this by using plain language, clear formatting, and visual aids in their publications. Providing lay summaries alongside technical articles and offering translations and audiovisual formats can accommodate diverse patient populations.[15] Developing educational resources and patient information materials based on evidence-based research and guidelines empowers patients to make informed decisions about their healthcare and navigate complex medical information more effectively.[15,16] Journals supporting open-access initiatives that make medical literature freely available to patients and the public can increase the accessibility of research findings. This eliminates barriers such as subscription fees or paywalls, allowing patients to access and engage with the latest medical information. By embracing these principles and practices, publishers can improve patient-centeredness in healthcare, bridging the gap between research and practice, and thereby fostering a healthcare system centered around the needs and preferences of patients.

SUMMARY

Advancing patient-centered healthcare requires a multifaceted approach that integrates patient perspectives, enhances organizational culture, builds staff capacity, leverages digital technology and AI, and promotes collaboration across healthcare stakeholders. By prioritizing patient-centeredness in research, practice, and policy, healthcare organizations and stakeholders can work together to create a healthcare system that puts patients at the center of care delivery.