Brian Powers, Amol S. Navathe, and Sachin H. Jain offer a thoughtful and interesting approach to the question of patient-centeredness in a recent blog post on the Harvard Business Review page, learning from service industries. Here's the lede:
Current approaches to patient-centered care are based on aggregated preferences rather than individualized needs. Researchers and health systems deploy focus groups and surveys to assess general patient preferences in an effort to determine "what patients want." But patients are a diverse group with diverse needs. Characterizing general beliefs and preferences alienates those whose needs and preferences do not align with the majority. The result has been a monolithic view of patients and their needs — a framework that prevents the delivery of truly patient-centered care.
The authors call current efforts "well intentioned" but stemming from "a misguided focus on the needs of the average patient." They point to other service industries that have gotten clever at segmenting their customer groups, learning about particular aspects of service that are relatively more important for those segments.
Customer segmentation is ubiquitous across service and consumer product industries, but its application to health care has lagged. As health-care-delivery systems expand and more data is stored in electronic databases, there exists the potential to prospectively segment patients according to their needs and preferences.
Why does the health care segment lag in this approach?
One reason is providers have been reluctant to see health care as a service industry. Only by accepting the reality that it is one can providers learn from the successes of others in the field. And there is plenty to learn.
One commenter notes with approval:
The patient sitting in front of a doctor is no longer "his" or "hers" patient. It is an individual with his own needs. Meaning the center of attention is no longer the doctor and his expertise but the patient. More precise[ly] the demand[s] of the patient. Which [are] not the same as by the doctor perceived demand[s].
Or, as I would put it, "patient-driven care."
Current approaches to patient-centered care are based on aggregated preferences rather than individualized needs. Researchers and health systems deploy focus groups and surveys to assess general patient preferences in an effort to determine "what patients want." But patients are a diverse group with diverse needs. Characterizing general beliefs and preferences alienates those whose needs and preferences do not align with the majority. The result has been a monolithic view of patients and their needs — a framework that prevents the delivery of truly patient-centered care.
The authors call current efforts "well intentioned" but stemming from "a misguided focus on the needs of the average patient." They point to other service industries that have gotten clever at segmenting their customer groups, learning about particular aspects of service that are relatively more important for those segments.
Customer segmentation is ubiquitous across service and consumer product industries, but its application to health care has lagged. As health-care-delivery systems expand and more data is stored in electronic databases, there exists the potential to prospectively segment patients according to their needs and preferences.
Why does the health care segment lag in this approach?
One reason is providers have been reluctant to see health care as a service industry. Only by accepting the reality that it is one can providers learn from the successes of others in the field. And there is plenty to learn.
One commenter notes with approval:
The patient sitting in front of a doctor is no longer "his" or "hers" patient. It is an individual with his own needs. Meaning the center of attention is no longer the doctor and his expertise but the patient. More precise[ly] the demand[s] of the patient. Which [are] not the same as by the doctor perceived demand[s].
Or, as I would put it, "patient-driven care."
This is spot on. While segmenting is important, reality to day is everybody is a segment of one. The one's aggregate in and out of groups. For example, I do not have a doctor. Were I to become ill I'd go to a retail clinic-because of convenience, price transparency and speed. If I could get that from a "regular" doctor I would do so.
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