- When Jordan Asher, MD, MS, from MissionPoint Health Partners tries to engage his patients in self-management and health improvement activities, he doesn’t just think about how to move a needle on a quality measurement. Instead, he thinks about how these strategies and skills are going to help his patients in their everyday lives.
This technique has proven effective for Asher, who serves as MissionPoint’s Chief Clinical Officer and Chief Innovation Officer. Since MissionPoint joined the CMS Medicare Shared Savings Program in 2012, the practice has served over 90,000 patients while still reducing healthcare costs, emergency department visits, and readmission rates.
According to Asher, the key to achieving these results has been prioritizing patients’ personal needs and allowing their clinical needs to follow.
“We have a very strong belief that in order for you to have a better health status, which includes healthcare, I need to think about you as a human being,” Asher told PatientEngagementHIT.com. “How do I activate and engage you?”
Using strong patient-provider communication skills, Asher first identifies a patient’s personal needs and then considers them in the context of the patient’s health needs. This knowledge helps Asher determine how to best engage his patients and introduce them to various self-management activities.
“We don’t look at people as diabetics; we look at them as people that have a bunch of life issues that happen to have diabetes,” Asher said. “If we can engage you and activate you around your true needs, your overall needs, we can better have an impact on your clinical issues.”
Providers can’t simply tell a patient to lower his blood pressure and expect positive results. Instead, they can tell the patient that in order to participate in the family activities he desires, he needs to have lower blood pressure and a healthier heart.
Adopting this mindset might require providers to change their approach to the patient-provider relationship. For example, as an internist, Asher’s instinct is to mediate clinical issues and managing chronic illnesses that may shorten his patients’ lives. However, his patients are likely most concerned with their day-to-day activities and living comfortably. Asher says he needs to be concerned with these needs, as well.
By recognizing this changing relationship, Asher understands that his patients often need him to be a partner in improving their life.
“What I really need you to do is be my trusted partner and help me with my issues that I have before I can even address the issues that you think I should be focused on,” Asher said, illustrating the thought process for many of his patients. “Because I’m just trying to live my day-to-day, and I’m not even worried about you preventing me from dying, I’m just trying to get through the next day.”
Providers should not only focus on how they can educate their patients to see what they want patients to see, but also determine what patients might like to know to improve their everyday lives.
“What are the issues that you have, how do I help you deal with those?” Asher questioned. “During that process, how do I activate you and engage you with the end result being improved health? It’s a completely 180 degree way of looking at it.”
Asher offered the example of treating a patient with chronic obesity.
“When working with an obese patient who needed to lose weight, the medical education side would be, ‘let me educate you, Mrs. Smith, on why you need to lose weight,’” Asher explained. “Do you not think that person already knows that? Our model would be, ‘hey Mrs. Smith, tell us what you like doing. Tell us what has bothered you in the past as it relates to your health.’”
From there, Asher says, Mrs. Smith might reference a certain activity or lifestyle goal she has, and Asher can tell her how losing weight will help her achieve that. Through this shared goal, Asher can engage Mrs. Smith to improve her health and ultimately lose weight.
This role as a health and lifestyle partner is rooted deeply in MissionPoint’s mission, Asher said. For example, all of the practice’s providers are trained as health coaches and have at least some background in behavioral health.
However, the ACO wants to continue its commitment to person-first healthcare. Going forward, Asher wants to look into new healthcare and patient engagement philosophies, potentially employing more psychosocial and behavioral health professionals.
“I would like to hire social scientists and social anthropologists,” Asher said, stating his future goals for the ACO. “We are just scratching the surfaces of learning what the behavioral economics of our members are, what the social hooks are, what the literature is around that. We want to take much more direction in trying to learn and innovate around those things.”