Patient Centered Outcomes Research Companies

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					                      Patient Centered P rimary Care:
                            A Revoluti on in Health Care in the US

Employers that subsidize health care coverage want to provide access to care that delivers
excellent outcomes, creates patient confidence and satisfaction and is affordable for all
who pay -- a challenge we have yet to meet. For many companies, increases in the cost of
health care far outpace increases in revenues and wages, yet nearly half of the U.S.
general public is dissatisfied with the care they receive.

The patient centered primary care alte rnative
We also know that primary care -- a single and continuous source for comprehensive care
that considers the whole person, along with his or her family and community -- supported
by up-to-date and complete information that allows medical professionals to make good
clinical decisions, has a far different outcome.

Research studies in countries where patient-physician relationships focus on primary care
consistently show that people live longer, populations are healthier, patients are more
satisfied with their care and everyone pays less. These "primary care providers" do more
preventive hea1th counseling, perform more screenings and immunizations, and provide
care advocacy and coordination that lead to lower rates of death for heart disease, cancer,
and stroke; and lower rates of hospitalizations for ambulatory care sensitive diagnoses
like pneumonia. Chronic condition management and medical errors and omissions are
significantly reduced with this "patient-centered" primary care.

Primary care is not gatekeeping or restricting access to care. A primary care prac titioner
is a partner in care, a coach, an advisor and the person who assumes overall responsibility
for coordinating care among all heath service providers, always focusing on the best
interests and personal preferences of the patient.

A call to action
Transforming the current health care environment to one that emphasizes "'patient centric
primary care" is within our reach. Models for the primary care practice, which creates a
"medical home" for patients exist today. Technology systems and tools to modernize
medical record keeping, transform the exchange of medical information, and
revolutionize treatment are all around us. Employers have led initiatives to establish
quality measures for physicians and hospitals, promote price transparency, tackle the
crisis of the uninsured, and address other health care system deficiencies. "Patient-centric
primary care'" needs this kind of bold leadership from the employer community.


In response to the building health care crisis, fundamental changes are taking place in the
manner in which care is administered. “Patient-centric” systems are evolving in which
the patient’s well-being and the patient’s responsibility for his or her own good health are
defining treatment and operational policies. This change is made possible by advances in
technology, but it also is being driven by market forces and societal desire to improve the
health of a nation’s citizens, while reducing health care costs.
Medical practitioners, governments, and financing entities in the U.S. and a number of
other countries are applying “patient-centric” approaches to health care. “Patient-centric”
does not imply a fixed set of guidelines; rather it is a fluid and still-evolving definition
characterized by practices that benefit the patient: ensuring that they have timely access
to medical care, are supported to actively participate in their care, receive the best
treatment, at a reasonable cost, while putting into place strategies that will help
individuals avoid becoming sick in the first place.

Putting the needs of the patient first
Patient-centric models put the needs of the patient first, but require greater responsibility
and accountability. Under a patient-centric system, an individual has the right to expect
improved care as long as they educate themselves about health maintenance and wellness
practices, change their behaviors to better manage their health, access health, provider
quality and price information, and contribute an appropriate share to the total cost of care.

By following a patient-centric approach, every segment of the health care system will
benefit: patient health improves; payers reduce costs and premiums by becoming more
efficient; providers improve the quality and safety of their clinical practice; and industry
reduces its financial burden to provide health insurance subsidies to employees.

The tools are here today
Patient-centric, personalized medical care is not a futuristic utopian dream; tools are now
available that are creating more rational, cost-effective, efficient health care processes.

For example, for the past two years IBM has been working with the Mayo Clinic to find
new ways to analyze and organize patient data, with the goal of providing personalized
diagnoses and treatment protocols based on personal histories, imaging, tissue,
biochemical, genetic and other laboratory markers.

The two partners have integrated 4.4 million patient records into a unified system based
on a standard technology platform incorporating rigorous security and privacy features.

With this database, Mayo Clinic researchers are using breakthroughs in genomics,
proteomics and molecular modeling to provide more-accurate care. Patient data can be
compared to data from other patients with similar diseases as we ll as biochemical and
genetic makeup.


Studies from all over the world have now validated the value of patient-centric primary
care combined with advanced e-tools. When clinical decision support and e-prescribing,
for example, are available in patients’ “medical homes” – the settings where they receive
their primary care – real value is added to the quality of the health care they receive.
Examples include the U.S. Veterans Administration (VA) medical care system
transformation in the past 10 years, and what has been done in Denmark. Both of these
examples are models of primary care revolving around the needs of the patient. There is
currently a pilot project in place, and major employers are invited to participate in the
discussion, design, and implementation of a patient-centric system.

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