The Future of Medicine: Focusing on the Patient Experience for Better Outcomes

Last Thursday began the twelfth National Days and second Rioplatenses Days of the Collaborative Latin American Forum on Quality and Health Safety, in order to expand collaboration in quality initiatives in the area.
The event has the participation of different experts and guests from different countries. Among them, Dr. Christina Akerman, an academic at the University of Texas and former president of the International Consortium for Health Outcomes Measurement (ICHOM), presented at a conference entitled “The Future of Value-Based Health,” where she spoke about the challenges of medicine.
During the pandemic it was more evident that being healthy and having health systems that provide high-value care are key things to achieve a world that develops well, which is why it is necessary to reevalue certain aspects. “Today’s approach to health is not an end result that matters to the patient, but more about what is done and not so much about what is achieved. In health we need to be able to answer what people need most when they seek treatments, this includes, the functional improvement of the ability to live productive and functional lives,” said Akerman.
She mentioned a 2017 OECD report that says at least a fifth of health expenditures should be channelled to better use, the numbers show that patients are harmed at the point of care or receive unnecessary treatments as they do not improve.
“Everything has to be based on the patient experience. First of all we have to start focusing on patients, this is key to understanding the unmet needs of them with certain medical diseases or in some segments of the population.”
In addition, he mentioned that today due to the dynamism of health experiences, it is impossible to set structural results. “Health outcomes are not structural metrics, they are not indicators, but it is the experience of patient care, of asking them how were we?”
In addition to the above, the academic was emphatic in saying that “the results that matter most to patients, in general, are how care affects their abilities and quality of life, and that is why we need to ask the patient, to cover all relevant health outcomes.”
One example in particular: localized prostate cancer
This cancer currently has a good life expectancy. When asked about the aspects that matter to patients, they pointed out two areas: staying continents and maintaining sexual function.
At the Martini clinic in Hamburg they tracked what sexual function and continence are for years and have lowered the risks of these aspects. “It is very important to realize that many important health outcomes can be reported only by patients. It’s not a math-based clinical report.”
The importance of the process
There are three layers to health outcomes for medical conditions: survival, what the journey to survival is like, and what kind of life we want to survive towards.
“When we live with a chronic disease, long-term survival is very relevant, but for these patients health is not an episode, it is their daily life. Here it is important to ensure comfort, that is, the success of reducing the burden of the disease (for example emotional anxiety) and tranquility, which is the success of reducing the stress of treatment, “said the expert.
The International Consortium for Health Outcomes Measurement (ICHOM) is a non-profit organization that seeks to transform health care systems by measuring patient outcomes through standardization of metrics. Their logic is based on creating a type of game based on a disease and focused on the health outcomes that matter most to patients.
“That’s why patients are directly involved in defining which game plays out, including functional status, symptom load and quality of life, aligned with ability, comfort and calm,” Akerman said.
The role of data in health
Currently, the OECD Paris initiative is helping to build the capacity of countries and organizations to capture the voice of patients.
According to the specialist, a systematic measurement of standardized results by institutions is necessary. These will improve the comparison of outcomes and support health professionals in identifiingwhere the most important results are achieved. In addition, they will learn from the processes, strengthen these results and promote the dissemination of these practices. “However, today larger-scale comparisons are difficult to implement due to the lack of computer interoperability between different health systems in countries, continents and the entire world,” he said.
Despite the above, the expert affirms that computer communication around the world is being improved. In addition, he adds that digital technology is fundamental, since it opens many opportunities.
The challenge
“Only 3% of the OECD’s total health budget is spent on disease promotion and prevention and to measure and improve outcomes that matter to patients this is the north to restore health to its purpose. If we manage to reduce the waste of the system, we will have more resources to prevent,” said the expert.
During the talk, which lasted about an hour, the academic incited the idea of the need to incorporate patients into the health system, in order to have real results, which go beyond the quantitative of survival. It is necessary to transform the system so that it focuses on how people live during and after a treatment or an illness.
 

Original source in Spanish