Transcript The Informed Patient Study: The Way Forward for Europe

The Informed Patient
Information to and Communication with patients:
the role of Health Professionals
Peter Singleton
Senior Associate, Cambridge University Health
Will better information help?
Information may not
change behaviour, or
may be misinterpreted
Change in choices may
not materially affect
outcomes (or effects
counterbalance)
Choice
Informing
Outcome
May be significant
barriers to access
Evidence
Research may not
support information
provided, so information
is flawed; there may be
no firm or clear evidence
Change in outcomes may
not be identifiable or
measured; may be lost in
other effects
TIP-2: The Informed Patient
an EU Framework for Action
Professor Don Detmer and Peter Singleton
Senior Associates, Cambridge University Health
EFA: Five main areas
• Involvement of European Commission,
Member State governments, & Localities
• Public Communications and Engagement
• Education of public and professionals
• Research Agenda
• Formal Network Development
Key Goals
• Higher standards for patient
involvement and information provision
across Europe
• Better health and health awareness
among the public/better media reporting
• Communication skills for professionals
• Gathering evidence and promoting best
practice
Priority Actions
• Bring together stakeholders to consider
coordinated action (1b, 1c, 2a)
• Address professional education (2c,3a,3b,3c)
• Engage media in better reporting (2f,2g)
• Engage public at work and schools (2b, 2d, 2e)
• Improve PILs with medicines (1g,2h)
• Establish network and centre for best practice in
health information provision (1d, 1f, 5)
TIP-2 Conclusions
It is critical that policy-makers in EU institutions
and member states recognise :
– The need to involve the public more fully in their
health and healthcare;
– The crucial function that health information plays in
effecting this;
– How to deliver such information effectively over time
and through as many channels as possible;
– A coordinated framework of actions must be
undertaken rapidly to improve the effectiveness of
care delivery and to manage total healthcare costs
How does this affect HCPs?
Priority Actions – detail for HCPs
•
•
•
•
•
•
•
CPE to encourage info-seeking by patients (2c)
Guidelines for patients & public (2h)
Require CPE in Communication Skills (3a)
Develop curricula in Communication Skills (3b)
Involve patients in developing & delivering CPE (3c)
Research on best practice in health information (4b)
Information needs through ‘patient journey’ (4j)
The role of Healthcare Professionals
• Patients prefer to seek info from doctors
• Patients trust clinicians most for info
But …
• Doctors don’t listen (at most 17 secs!)
• Patients don’t remember what doctors tell
them
• Doctors selected & trained to solve patient’s
problem not to consult with patients
Need to change the mindset of care
From - Medieval: Master Craftsman/Guilds
– Apprentice-based learning
– Personal expertise is core
– Expert/product-centred
To - Modern: Industrial/Process management
– System-based learning/Knowledge
management
– Work-flow analysis/component model
– Quality is at core of system
– Patient-centred
Need to see patient perspective
• Focus on patient experience
• Look at ‘patient journey’
• See whole process not just clinical
experience
• Find out what patient wants to know – what
they need to make decision and to help
them cope
… The Patient Perspective
Povert
y
Work/
Income
Social/
Esteem
Quality
of Life
MEDICINE
Fear/
Pain
Personal/
Psychological/ Family/
Self-efficacy
Support
SEX!
Seek feedback from patients
• Existing feedback in healthcare
– Adverse drug reaction (ADR) reports
– Some analysis of routine data
– Some ‘near-miss’ reporting
• Feedback from patients
– They ‘experience’ the condition, treatment,
and service (or lack of it)
– May be slightly less accurate, but more
representative (cheaper & fuller records?)
– What do they look for?
e.g. information leaflets
Case Study: IDS International
• IDS provide leaflets from from healthcare
providers, charities, and industry to doctors’
clinics across Europe
• Uptake is monitored to see which are popular
• Sample questionnaires gain feedback as to
why taken, how useful, and what else might
be helpful
• System also frees surgery staff from
organising and free to patients and doctors
• Simple arrangement to the benefit of all; and
feedback allows improvement
Conclusion for HCPs
•
•
•
•
Recognise need to change culture
Recognise medicine as part of wider care
Need to involve patients, carers, and public
Need to support individual professionals
better:
– Awareness and skills training
– Best practice and models of care
– Easy access to patient-oriented materials
“If you think education is
expensive, try ignorance.”
- Automobile Bumper Sticker
Thank you.
Full Report at
www.jims.cam.ac.uk/research/
health/tip/tip_f.html