The concept of patient-centered care (PCC) is an increasingly hot topic in the ongoing discourse surrounding quality improvement.
In an effort to shed light on the current state of PCC as it pertains to cardiovascular medicine, as well as provide a roadmap for future PCC efforts, the ACC Foundation (ACCF) released a special PCC-focused health policy statement
on May 14.
Developed by a writing committee made up of a wide range of representatives from general medicine, the cardiac care team, consumers, and advocacy, the new document is an outgrowth of the ACCF's commitment to develop a patient-centered approach to cardiovascular care, which began in 2009.
"Cardiovascular specialists need to embrace the model of patient-centered care and be leaders in the specialist-led, patient-centered medical home," said Mary Norine Walsh, MD, FACC, writing committee chair, chair of the ACC’s Patient-Centered Care Committee and a member of the ACC’s Board of Trustees. "This document is one of the important ways the College is working to help make this happen and move the PCC concept from principle to practice."
In particular, the paper highlights the need for enhancements of the following elements that are key to PCC care:
- Clinician/patient communications,
- Health literacy,
- Clinician-directed patient education,
- Assessment of patient-centered outcomes,
- Shared decision-making,
- Collaborative care planning and goal setting, and
- Patient empowerment and self-management.
Furthermore, the document urges focused education and training around patient-clinician communications as part of medical school and continuing education curricula, as well as clinician access to (and knowledge of) patient education materials that meet a variety of cultural and/or learning needs and acknowledge patients as respected partners in their care.
"Patients should be encouraged to accept responsibility for managing their health condition and work collaboratively with their health care team," the paper notes. It stresses the need for easy-to-use tools for both physicians and patients that facilitate the development of decision-making strategies and goals.
In terms of health care policy, the paper suggests that performance measurement systems and payment models should "support and promote the explicit assessment of patient-centered outcomes, including health status, as a foundation for guiding PCC." It also urges "sufficient financial reimbursement and/or financial incentive that accommodate for additional clinician time to provide PCC."
The statement also stresses the need to develop a patient-centered medical home for cardiovascular care that demonstrates the ability to manage patients with advanced cardiac disease across care settings, as well as the importance of accumulating and sharing information across all encounters of a single patient to the greatest extent possible, with the ultimate goal of improving chronic disease management.
Looking to the future, the statement touches briefly on the increasing use of personalized medicine and the need for patients to have “clear and realistic understandings of therapeutic options” in order for it to be sustainable. It also calls for the empowerment of non-physician members of the care team to provide PCC and help manage the increasing demands of patients with chronic heart disease.