Patient centred and personalised health care will not be a reality for regional Australians without the health system itself being made more user-friendly from the patient view.
The lived experience of individuals negotiating the health care system is of primary importance and should be considered central to the health care proposition.
Participants in recent health seminars conducted by USQ’s Institute for Resilient Regions have been critical of the current health system for being difficult for patients to negotiate and presenting a barrier to achieving health equity for regional patients.
They spoke of “disjointed pathways between health services” and “lack of communication with patients” making for unnecessary and challenging complexity that for patients made the health system difficult to navigate.
Some said many regional patients had their existing stress levels compounded by a health system dogged by registration, documentation, and communications issues.
While better integration of patient health records and data across the patient’s clinical spectrum was a need readily identified, the current situation was a time-consuming, confusing pathway to receiving appropriate care – and for some a disengagement with the opportunity and need to receive care.
Practical innovation opportunities
Lessening the burden on the patient to arrange and update various health professionals on their diagnosis and treatment, and to coordinate their various appointments was suggested by many participants as a priority.
Others reported that the employment of ‘nurse navigators’ had assisted positively the health care experience of those regional cancer patients fortunate enough to access their services.
But with the limited availability of patient facilitation resources, there was the risk that without further investment by government, demand would overwhelm the existing deployment.
Improved continuity of care (communication, care pathways, care coordination, integrated care and collaboration) to prevent patients ‘falling through the gaps’ in the service delivery system are essential if regional health is to improve.
From the perspective of medical and allied health practitioners, there was a strong preference for building a system around the regional patient rather than trying to fit the regional patient into an existing system.
A regional patient-centric approach highlights the importance in regional medicine of determining the patient’s true or desired health care outcome set against the actual patient experience.
Quality of care and quality of life are notions needing conciliation with the patient’s full and active complicity.
Determining what brings about the best result for the patient with the least burden on their emotions, physical well-being, finances and time might also require the re-writing of guidelines and result in the increased utilisation of tele-health services to form part of health decision-making.
Policy implications/possibilities
For many regional health stakeholders, a ‘back to basics’ patient-centric approach makes most sense – at least that was feedback received in our health symposia during Resilient Regions Week.
Such a strategy would be assisted substantially by the implementation of a “health concierge” service, patient-focussed, and capable of providing contact continuity and coordination to the patient as they navigated the pathway to effective and timely health care.
Others suggested that better integration of patient care could be strengthened also by remunerating general practitioners for the time spent advising and referring patients to specialists and other advanced pathways.
All of this costs money, but much of the opportunity for improvement could deliver efficiency and savings too, meaning that “user friendliness”as an operative idea for the system is not necessarily financially burdensome.
Research is needed which will deliver innovation that results in:
- Integration of data collection and evidence base as routine practice, as well as transparent reporting to build an evidence base to inform health service infrastructure requirements and future research goals;
- Establishment and evaluation of patient-centric navigable health systems based on unified medical records, easy sharing of information between patients and practitioners and continuity of care;
- Better use of data sources and data collection methods to achieve outcomes collaboratively;
- Increased health literacy and behavioural change in the community; and
- Improvements in the efficacy and effectiveness of the health care system particularly in regional districts.
Smart outcomes from this process and a professional roll-out of the resultant innovation should mean a much better user-friendly experience for the regional patient.
These observations are drawn from a report about Resilient Regions Week 2017 prepared by Professor John Cole and Dr Sonja March drawing on notes of proceedings compiled by Dr Fiona Crawford-Williams, Dr Belinda Goodwin and Ms Arlen Rowe.
Professor John Cole 