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Dr Elaine Goodman: Why Health Care Systems Should Consider the Patient Perspective


When clinicians consider the patient journey from beginning to end, they begin to understand how difficult it is for patients to access care, said Elaine Goodman, MD, MBA, clinical lead for population health management, Mass General Brigham.

Elaine Goodman, MD, MBA, clinical lead for population health management, Mass General Brigham, talks about how health care systems can approach care from the patient's perspective while still valuing the clinician experience. Goodman presented on the use of technology to improve population health and value-based care at the Nashville meeting of The American Journal of Managed Care®'s Institute for Value-Based Medicine® (IVBM).


At IVBM, your example of the oncology patient with respiratory illness raises issues that speak to how our current health system does not approach care from the patient’s perspective. Can we change this?

I think we can change it, and I think we have to change it to be successful. This goes back to thinking about the patient experience when you're designing something new or if you're looking at an existing program and trying to figure out how it can be improved, and really taking the time to map out the patient journey, as well as thinking about how things impact your staff.

I don't think anybody is purposefully not thinking about the patient. But sometimes unless you really step through, for example, what is a patient's experience if they're trying to contact my office? What is the experience with this phone tree? What is the experience trying to go through the paging directory? I think it's pretty shocking when you actually go from beginning to end of some of our patients' journeys to see how hard we make it for our patients to do what we ask them to or to access care in our centers. I think, doing that exercise is so important to make sure that what we come up with is actually feasible, not just for our average patient, but also for our patients who maybe don't have the highest health literacy or the extra resources to try and navigate something really difficult.

One thing that I want to pair this with is, I want to make sure that I'm not suggesting that we then do not consider the clinician experience at all, because we need to do that, too. If what patients want, for example, is more access or faster response to their questions to a primary care doctor's office, what we can't then say is, "Alright, we're going to deliver a great patient experience, so primary care doctors, work harder, longer hours, respond more quickly." Even before the pandemic, a lot of our workforce is already working as hard as they really can, and now people are even more tired and need a little bit of a break. So if we do that, not only are people not going to want to work in those jobs, but we also need to be cognizant of how we can preserve their resiliency and their ability to be empathetic and deliver the kind of care that they really want to deliver to their patients.

In parallel, and in concert with considering the patient's point of view and the patient journey, we also have to think about things like how are we going to reimagine team-based care to really support our clinicians so that we can deliver on a patient experience, but we can do that in a way where we've created jobs for our workforce that are sustainable.

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