How to Design an Inclusive Healthcare System

While some experts predict this year’s healthcare advancements will involve highly technical solutions, others believe improvements to the patient care experience will result from a simple mindset shift. How can the health system approach each user uniquely taking into consideration lifestyle factors when determining care? How must social and health institutions work together in ways they haven’t before?

As the practice of medicine has advanced, focus has shifted from recommending condition-specific treatments to designing care that improves and reconciles factors unique to each health consumer.

“Major players and leaders in the field have evolved their thinking to approach systems and people more holistically in many cases.”

Jeffrey Blank, Managing Director, TreeHouse Health

Many predict 2017 will be the year this progresses even further. A variety of determinants affect a patient’s ability to maintain or manage care. MentorMate partnered with Medical Alley Association to interview local experts and share their predictions helping healthcare evolve toward a more inclusive, empathetic patient care experience in the new year.

1. Care Context

Consider a food-insecure diabetic. The ability to maintain a predictable meal schedule also impacts glucose stability. Only by managing nutrition and intake can other diabetes management techniques be effective.
Just as American psychologist Abraham Maslow theorized, humans prioritize. Only when basic needs are met (read: food, water, warmth and rest) can we move onto address other components of health like type of diet, level of exercise and even medication adherence.

“Understanding the context people are coming from is the the only way to create interventions that make a difference.”

Glafira Marcon, Lead Organizer, Healthcare.mn

2. Patient Agency

Patients today must collect, sort and synthesize incredible amounts of information. As comorbidities increase so do the connections and requirements needed to adhere to care. Depending on age, cognition, occupation and a variety of other related determinants, patients attempt to meet the demands the current healthcare system makes on their ability to track, report and pay for care. In fact, in 2017, some experts predict patients will seek even more control and influence over care decisions.

“I think people, more and more, need to be co-managers of their own health. In looking at the health and wealth connection as deductibles increase, people are spending more and more on their own healthcare, they have more incentive.”

Jeffrey Blank, Managing Director, TreeHouse Health

Other experts question a health consumer’s ability to effectively co-manage care and whether it’s truly in the best interest of the patient care experience.
When age, stress or instability among other factors is introduced, patients are less able to advocate for and actively participate in treatment decisions.

Looking forward, Minneapolis expert Sara Ratner sees case workers playing a role collecting and relaying information. The shift would alleviate the burden of organization/distribution from providers and patients allowing them to focus on recommending and managing care.

“There needs to be some system that is independent of the providers, and general healthcare system, to facilitate care coordination rather than putting the burden on the providers.”

Sara Ratner, SVP Compliance and Corporate Systems, RedBrick Health

How Can the Healthcare System Reduce Inequities Between Populations?

Use Patient-Funded Wearable Data as a Support Tactic Not a Silver Bullet

Technology access is important to consider in proposing treatments. Especially if user-generated health data is more fully folded into care. Only comparatively privileged groups can afford to independently fund wearables/smartphones.

“In the past couple of years, there has been a lot of focus on consumer-facing solutions, wellness and apps used to influence behavior. What we’ve seen whether it’s a device, an app or a website is: They succeed at reaching the people who are predisposed to being engaged. I’m really interested to see whether we’ll be able to create something to reach people who do not engage in mainstream ways.”

Glafira Marcon, Lead Organizer, Healthcare.mn

Partner With Social Organizations to Treat Patients Holistically.

If healthcare shifts to a model where caseworkers coordinate patient care, as some industry experts predict, it may be easier to vet patient barriers to better health management and address them with aid.

By factoring context into care, the following are examples of variables impacting wellness that could be managed as a component of treatment:

• Clean water
• Transportation
• Nutrition
• Shelter
• Technology access
• Mental health stability

Treatment isn’t delivered in a vacuum. Only by exploring how to manage the variables impacting adherence can the full potential for prescribed treatments and the complete patient care experience be realized.