NEW YORK, NEW YORK December 17, 2018— In a complex and rapidly changing health care landscape, the patient’s point of view frequently goes unheard. To give patients more of a voice in their own care, United Hospital Fund today released a collection of resources to help providers focus on the whole patient and the root causes of health concerns.
The materials are the result of UHF’s Patient-Reported Outcomes in Primary Care-New York (PROPC-NY) initiative, an 18-month project that provided support to three New York City-based health care organizations— the Institute for Family Health, Montefiore Health System, and Northwell Health—to develop and assess methods for eliciting first-hand reports from primary care patients on their symptoms, status, and health goals.
“Over the past decade, primary care has been undergoing a dramatic shift from volume to value,” said Anne-Marie Audet, MD, senior medical officer of UHF’s Quality Institute and leader of the PROPC-NY initiative. “But who defines value? Shouldn’t the patient have the final say? That’s what this project is all about—helping clinicians better understand the diverse needs of patients and tailor care plans to patients’ goals and priorities.”
Included in the package of resources are an implementation guide for primary care practices, three field reports from the health care partners, and an overview of policy and practice implications. The initiative was generously supported by The Engelberg Foundation.
The participating hospital-affiliated primary care practices used questionnaires to collect information from patients about their health, their mood, and such health-related factors as housing insecurity and exposure to toxic stress. The results were made available to physicians and other members of health teams to share and discuss with patients during the office visit.
The health teams reported that the structured questionnaires uncovered important information that patients likely would not have brought up on their own—information that was valuable for them to have when developing care management plans. Armed with this data from patients, health care staff were not only better positioned to help achieve the patient’s goals— they were better able to communicate with other members of their care teams, because they had a common vocabulary for discussing patient concerns.
“We found that using standard questionnaires gave struggling patients the opportunity to open up about their quality of life, depression and anxiety, and social health stressors in a way that rarely happens in health care encounters,” said Dr. Audet. “Physicians found they could jump-start deeper, more probing conversations about issues that have a real impact on health.”
Despite the benefits of implementing patient-reported outcomes as a path toward improved primary care, the teams determined that several barriers must be addressed before their use can be effectively expanded. Current questionnaires can produce results that are difficult to interpret, and there is a dearth of knowledge about what interventions are effective. Additionally, there are not strong policy or payment incentives to drive adoption.
The PROPC-NY implementation guide that is part of today’s release provides a step-by-step roadmap for primary care practices that seek to integrate patient-reported outcomes. An overview of the initiative’s work called “What’s the Upshot?” discusses policy and practice implications, and three field reports from each of the participating health care organizations outline best practices and lessons learned.
“Using patient-reported outcomes can help build patient trust and help providers develop customized care plans that are more likely to be successful because they are focused on the patient’s own goals,” said UHF president Anthony Shih MD, MPH. “PROPC-NY and these reports and guide go a long way toward helping primary care practices achieve those goals and are a continuation of UHF’s efforts to improve the quality of health care by placing the patient’s need at the center of care.”
The report and guides can be downloaded from UHF’s website here.
About United Hospital Fund
United Hospital Fund works to build a more effective health care system for every New Yorker. An independent, nonprofit organization, we analyze public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more on our initiatives and programs please visit our website at www.uhfnyc.org and follow us on Twitter.