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Connecting the Whole Person to Whole Care
August 21, 2017

Connecting the Whole Person to Whole Care

As healthcare providers work to deliver the care their patients need, many struggle with how to treat the whole person-their medical, behavioral, and social needs-and the best way to efficiently track their outcomes.
Next Generation Approach and Technologies
So, how do healthcare providers graduate to next generation systems? They must judiciously seek solutions that:
  • Address the whole person, rather than transact referrals.
  • Make the patient—not the referral—the focal point of the solution.
  • Handle multiple social determinants simultaneously.
  • Track and provide visibility into the complete patient journey.
  • Track patient care structured outcomes at scale, and in real-time.
 
The ability to deliver on the above requires a new approach and technology that centers on the patient and the fulfillment of their “total health” journey.
 
So how do you get there? As a healthcare professional, how do you lead your institution to effectively address the social determinants of health and meaningfully impact patient outcomes while yielding measurable outcomes and tangible economic benefits?
 
By taking on a new mindset, and making deliberate decisions like:
  1. Focus on the patients and their co-occurring needs
  2. Seek consistency in your quality standards
  3. Plan for business impact—return on investment (ROI) and return on expectation (ROE)
  4. Standardize your data and report at scale
  5. Focus on the whole person, not the referral

Now, let’s take each one of these decisions separately, and see what you can do specifically to make them happen.
 
1. Focus on the patient and their co-occurring needs
One of the biggest challenges patients face when seeking social or behavioral services is the “siloed” nature of these services.  While each provider may be good at what they do, most are not connected to a broad network of other social and behavioral service providers.
 
Consequently, they face an uphill battle when trying treat the whole person, especially when the patient’s co-occurring needs transcend multiple determinants. 
 
What can you do: Invite service providers to join a collaborative network focused on the whole person and servicing their co-occurring needs collaboratively.
 
2. Seek consistency in your quality standards
As a healthcare professional, to best meet your patient’s multiple clinical needs, would you: (a) give your case worker access to a long e-directory of random clinical service providers, and say “pick one”; or (b) engage them with a known network of interconnected service providers, trained to collaboratively chaperone the patient across multiple clinical services?
 
I have yet to meet a healthcare professional who would chose option (a). Yet, when it comes to addressing a patient’s social and behavioral needs, many choose (b) because it’s easier.
Effectively addressing the social determinants of the whole person requires shedding this double standard, and infusing equal standards of quality across all patient care coordination initiatives, regardless of whether they are clinical, social or behavioral.
 
What you can do: Apply equal levels of quality standards and coordination to all determinants of health, social and clinical.
 
3. Plan for business impactROI/ROE
For every healthcare professional who understands the importance of addressing the social determinants of health, there is an executive in the C-suite who may not, and needs to understand the ROI or ROE associated with the change. When ROI cannot be calculated, using specific metrics to explain ROE may work well.
 
For example, nearly 1 in 5 Medicare patients discharged from a hospital is readmitted within 30 days.5,6 So, although you may not be able to make a direct financial ROI claim, you could safely make the argument that any activity that is aimed at curbing avoidable readmissions is worth consideration. Metrics that address improved patient care, heightened customer satisfaction, desired behavior change, organizational capacity efficiencies, accelerated speed of processing, and error reduction, may also be used.   
 
What you can do: If you cannot develop a direct ROI, demonstrate how your SDoH initiative can impact ROE metrics that are already tracked and part of your executive teams performance management measures.
 


 
Copyright AJMC 2006-2017 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
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