Q: What is this new effort and the thinking behind it?
A: The Partnership for Healthcare Excellence is a coalition that draws from every sector of health care across the Commonwealth of Massachusetts — providers, insurers, employers, government agencies, labor unions, family caregivers, and grass roots consumer groups — coming together to respond to a growing need and desire among patients and families to have a voice in their own care and, most importantly, an informed voice. Whether it’s reports from the Institute of Medicine, the work of IHI, other quality leaders, business groups, or think tanks, people are saying loud and clear that until we build a health care system around the patient, we’re not going to fix the problems. And, unfortunately, the patient has until now been put into a subservient role instead of really participating in decision making and care.
The fact is that 80 to 90 percent of the health care we receive in our lifetimes is delivered not in hospitals, nursing homes, or doctors’ offices, but in our homes — in bathrooms, bedrooms, and kitchens — and not by medical staff, but by ourselves and members of our families.
So, the way I look at it, consumers, patients, and family members are among the most powerful and least mobilized stakeholders in the health care system. Consider this picture: a family, a husband and wife, say, with a sick relative, and on Monday they’re in the ICU with 40 people taking care of the patient. On Wednesday they’re on a medical-surgical unit with 10 people taking care of the patient. And on Friday they’re back home, in their dining room, with a bed set up and the medicines all on the night stand, and it’s just them, the two of them, taking care of the patient.
So what this partnership is all about is helping the consumer become informed and engaged, and take on this role as a partner in care. If we want to dramatically change the way patients participate in health care, we have to create that system. This isn’t a quick fix; it’s about culture change, and we know that takes time. So we’re planning for a five- to seven-year campaign. And we have three basic goals: 1) to make consumers aware of the problem of current variations in health care; 2) to encourage consumers to be much more involved in their health care; and 3) to mobilize consumers to be advocates for system change.
Q: Whose idea was it to create this initiative?
A: The initial impetus came from Blue Cross Blue Shield of Massachusetts, who had been looking at the issue of consumer engagement in health care for some time. They identified it as one of the key areas ripe for change in the Commonwealth, and they approached IHI, among others, to be part of a multi-year endeavor. I was fortunate enough to be in that core group that received seed funding from Blue Cross to look at how to make this happen.
Q: How is the group organized, and who’s involved?
A: There’s a board of directors made up of a highly motivated group of people who are actively involved in health care in Massachusetts. They’re people who can draw attention and bring focus. So, you have Howard Koh from the Harvard School of Public Health, also the former Commissioner of the Massachusetts Department of Public Health; John McDonough from Health Care for All; Zolla Torres Feldman of the Great Brook Valley Health Center in Worcester; Paul Guzzi of the Greater Boston Chamber of Commerce; and Peter Meade of Blue Cross Blue Shield of Massachusetts.
Beyond the board, there’s a Leadership Council of about 45 organizations from every corner of the health care community, coming together with the mission of educating and motivating consumers. You’ve got nurses and physician groups, all the major health insurers, state and city business coalitions, along with AARP, Health Care for All, health clinics, support groups for victims of medical error, plus labor unions, groups from the Hispanic community, disability and special needs advocates, home health organizations, and so on. And there will be more groups — for example, we’re going to bring in schools, libraries, and religious groups.
Q: Why do you see the need for the Partnership?
A: The people behind it have done extensive research on consumer attitudes in Massachusetts. Whether we’re talking about primary or secondary sources, it all says the same thing: 100 percent of the time — whether you’re in Memphis, St. Louis, or San Francisco — consumers tell us they want the same thing from providers: Listen to me, respect me, and trust me as a partner in care. And they tell us that, historically, we haven’t listened to them or respected or trusted them. Consumers are not being included; they’re not involved in the whole process. That has to change.
The research also tells us that people understand that an engaged consumer is going to have better outcomes — they know they’ll get well faster and stay healthy longer when they’re involved. In fact, 91 percent of Massachusetts adults agree that people who play a more active role in their health care will get better quality care, including 55 percent who “agree completely” with that. Consumers are also hungering for useful information; with so much to sort through, they’re looking for some guidance on where precisely to find the best resources.
A key factor coming out of the research is the challenge the Partnership faces in trying to reach vastly different audiences because there’s so much variation in experiences and care. If you’re a mother whose child has died of a medical error, your level of engagement is in one place; if you’ve got a chronic illness, it’s someplace else; and if you’re a person 30 or 40 years old, feeling fine, your level is different still. So we want to better understand what each of these types of individuals needs by way of consumer information and support.
The baseline research has given us a solid foundation; we have a measurement plan in place for assessing the impact of the campaign as we introduce a series of interventions.
Q: What’s the campaign going to do? What will consumers see?
A: We’re rolling out a broad public education campaign around the crucial role that the patient can play in their own health care. One of our primary targets for outreach will be women — they typically make health care decisions not only for themselves, but often for children and parents as well.
The campaign will be visible to consumers in several ways, starting with the Partnership for Healthcare Excellence website, where we’ve already begun to share research and information for consumers and all of our partners. We’ve got links to all kinds of resources for great health care information. There are bilingual (English and Spanish) fact sheets to help consumers make informed decisions when it comes to choosing a doctor, preparing for a doctor’s appointment or hospital stay, taking medications safely, and comparing hospitals. Down the road the Partnership will also provide resources on other issues important to consumers, including preventing infections, care at the end of life, elective surgery and medication safety, to name just a few.
There’s currently an ad campaign running in major daily newspapers, weekly publications, and online news services — many targeting the Bay State’s Spanish-speaking communities. The ads, which run through December 10, are designed to motivate consumers with positive language and a message of empowerment. They show pictures of average people — "Alex Paulson is a retired fireman. A favorite uncle. And a great patient." He’s a great patient because he asks questions. It’s as simple as that.
In all the Partnership’s messages, physicians are portrayed as critical partners, because our research tells us that consumers in the Commonwealth admire and respect their doctors and naturally turn to them for help when they’re sick.
Q: Is the partnership part of Massachusetts’ Health Care Reform legislation that’s gotten so much attention nationally?
A: No, the partnership is separate, but there is some overlap and many of the same groups are behind both efforts. Beyond this, we’re all going to make sure that our work is aligned. The Partnership is going to map our work with consumers to the issues that the state’s new Quality and Cost Council wants to work on. And, when we learn about critical issues to consumers, we’ll pass that on to the Quality and Cost Council.
Q: What’s the connection to IHI?
A: The Partnership is a separately chartered 501(c)3 organization. I represent IHI on the Partnership board, and IHI is also a member of the Leadership Council, represented by our director, Laurel Simmons. We’re also very interested in natural synergies between the Partnership for Healthcare Excellence and some of IHI’s existing patient- and family-centered care initiatives, including New Health Partnerships, a national program with the Robert Wood Johnson Foundation and key patient- and family-centered care organizations focused on self-management support. And we’re hoping to benefit from and learn from IHI and other organizations in the Leadership Council who’ve spent years working with highly engaged patients and families.
Q: Is Massachusetts really unique? Are other states forming groups like this one?
A: Not that we’ve been able to determine, but we certainly want to find out about similar initiatives going on elsewhere that can help us. That’s a goal in spreading the word through IHI.org. We’d love to have others’ input no matter where they live. We also want to share what we’re learning.
Q: What would you most like people in the IHI.org community to know — your “take-away message” about the Partnership for Healthcare Excellence?
A: The first thing is, I want to reaffirm the notion that this is happening — the consumer is coming! Across the country, across the world, there’s an increased focus on consumer engagement in health care, being driven by consumers and employers and purchasers.
Whether it’s Newt Gingrich or Steve Jobs in the news — new health care innovations or technologies they’re bringing out, or the fact that health-related information is the single biggest reason why consumers access the web — there’s no question about this; consumers are coming. And, make no mistake, this is going to have a very significant impact on health care organizations.
So I think the Partnership represents a test by one state to see how we can respond in a way that has impact. I think it will be a powerful test, and I encourage people to pay attention — and join in.
For more information about the Partnership for Healthcare Excellence, go to: http://www.partnershipforhealthcare.org/.
11/14/2007
