FROM PASSIVE PATIENT TO SAVVY HEALTHCARE CONSUMER: How to Seek and Find your Best Care

Michelle A. Gourdine, M.D.CEOMichelle Gourdine & Associates LLC

OBJECTIVES

•Distinguish among an empowered patient, an engaged patient, and a savvy healthcare consumer.

•Define quality healthcare.• Identify and use reliable sources for choosing the best doctor.•Know how to talk to your provider about safe care.• Identify and use reliable sources for choosing a safe hospital.•Define the role of a hospitalist.

THE EVOLUTION OF THE “GOOD PATIENT”

•Previously, being a “good patient” meant being quiet and doing what the doctor said.

•Today, a “good patient” is an empowered patient who▫Is informed, ▫Speaks up, ▫Asks questions, and ▫Makes sure he/she fully understand all aspects of his/her care

An empowered patient must first be an engaged patient.

WHAT IS AN “ENGAGED PATIENT?”

•KNOWLEDGE

•SKILLS

•TOOLS…to take charge of his/her health

WHAT IS AN “ENGAGED PATIENT?”

•Engaged patients have

▫Fewer hospital admissions

▫Fewer ER visits

▫Better preventive care

▫Lower medical costs

A SAVVY HEALTHCARE CONSUMER…

• Understands the 4 P’s▫Provider

Select a quality provider▫Place

What is the best (i.e. highest quality) hospital/facility in your geographic area?▫Procedure

Become educated on your procedure and alternatives▫Price

Estimate the total cost and your out-of-pocket costs

• Source: United Healthcare; www.uhc.com

YOU’RE IN CHARGE!

5 HABITS of a Savvy

Healthcare Consumer

1. I choose doctors who respect my role in my healthcare.2. I choose healthcare that is cost effective.3. I choose health insurance that I fully understand.4. I choose safe hospitals.5. I choose treatment that aligns with my preferences.

WHAT IS QUALITY HEALTHCARE

•2 main types of quality measures▫Consumer ratings▫Performance measures

•Consumer ratings tells you what people like you think about the healthcare they received in their health plan

•Performance measures look at how well a doctor, health plan or hospital prevents and treats illness

CHOOSING YOUR BEST DOCTOR

5 QUESTIONS to Choose the

Right Doctor

1. Are we compatible?2. Is he/she compassionate?3. Does he/she have the proper credentials?4. Is he/she privileged at my preferred hospital?5. Does he/she provide safe care?

RELIABLE SOURCES for choosing a doctor

5 QUESTIONS to Choose the

Right Hospital

1. What is its safety rating?2. How do patients rate it?3. How many of my procedures are performed

there?4. What is its readmission rate?5. Does it provide appropriate care?

RELIABLE SOURCES for choosing a hospital

WHEN RESEARCHING HOSPITAL SAFETY•Research hospitals in your health plan network.•Talk to your provider and family BEFORE hospitalization to tell them

where you want to go and DON’T want to go.

WHEN HOSPITALIZED, SPEAK UP!

• Ask all health care workers who will touch you to wash their hands.• If you’re having surgery, make sure you and your surgeon are clear on exactly

what you will have done.▫Choose a hospital where many of the same surgical procedures have been done

• Ask provider to explain discharge instructions to you , including what you should do once you’re home.▫Medicines▫Follow up appointments▫When you can resume normal activities▫When you can return to work▫Whether you should keep taking your old medicines when you return home

WHEN HOSPITALIZED, SPEAK UP!

• If your doctor orders a test, ask:▫Why the test is being done▫How the test is being done

Blood test X ray Special prep required? Potential side effects?

▫Make sure your test is labeled properly Correct name, spelling, DOB on blood tests

▫Make sure you’re notified of results It’s ok to ask for a copy of the results

IF YOUR CARE IS MANAGED BY A HOSPITALIST…

•A hospitalist is a physician who specializes in the care of patients in the hospital. They practice only in the hospital setting.

•After discharge, the hospitalist transfers care back to the patient’s regular physician.

•To ensure proper communication, be sure to …▫Bring your doctor’s contact information with you and ask the hospitalist to

keep your doctor informed.▫Get a list of discharge medicines and instructions so you can share them with

your doctor.▫Call your doctor and make a follow up appointment.

RESOURCESGeneral• http://www.ahrq.gov/patients-consumers/index.html• http://www.effectivehealthcare.ahrq.gov/index.cfm/options/tool/• http://archive.ahrq.gov/consumer/qntlite/qntlite.pdf•www.healthfinder.gov

Hospital Quality• http://www.medicare.gov/hospitalcompare/search.html• http://www.jointcommission.org/assets/1/6/HYC_hap.pdf• http://www.qualitycheck.org/Consumer/SearchQCR.aspx#• http://www.carechex.com/Default.aspx• http://www.leapfroggroup.org

RESOURCES

Empowered Patient•http://archive.ahrq.gov/consumer/qnt/qnthplan.htm•http://www.ahrq.gov/patients-consumers/patient-involvement/ask-your

-doctor/tips-and-tools/beinvolved.html•http://healthcare411.ahrq.gov/•http://www.ahrq.gov/patients-consumers/care-planning/errors/safety.h

tml

RESOURCES

Physician Quality•www.healthgrades.com•www.apps.ama-assn.org/doctorfinder•www.providerlookuponline.com•www.medicare.gov/physiciancompare•www.ratemds.com

“Creating a healthcare system in which ALL people benefit equally.”

Michelle Gourdine and Associates LLC

www.michellegourdine.com