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The Power of Perception

Temple University Patient-Centered Care Research College of Public Health

Today’s healthcare providers have an incredible array of tools and techniques to help their patients. But often they forget that one of the most powerful aspects of providing high-quality medical care is simply asking the patient: “What do you want?”

Michael Halpern, associate professor of health services administration and policy, says that’s changing. A growing trend in healthcare puts patients front and center, prioritizing their own decisions about the healthcare they receive. Halpern recently led a team of researchers analyzing the healthcare experiences of patients with cancer during their last year of life—a critical period when it’s important to maximize a patient’s quality of life. And what Halpern and his team found—published this week in Cancer—could have big implications for developing more effective cancer care programs.

The researchers used a new database developed by the National Cancer Institute called SEER-CAHPS, which provides an unprecedented view of how patients with cancer view their healthcare. Halpern says that among other information, the database tracks patients’ responses to some simple but profound questions: “How would you rate your physician, your health plan, your overall care? Were you able to get the care you needed? Did you get it quickly?” Questions like these are important, because a patient’s perception of their health—and their healthcare—can have a big impact on their actual well-being.

The research team’s study uncovered a number of factors that influence a patient’s experience of the care they receive. Foremost among these was a patient’s perceived health status—in other words, how they feel about their general health and their mental health. Typically, the researchers found, people who feel better rate their experience of care more highly.

“What this suggests is that particularly among individuals with more advanced cancer, it’s important to look at the symptoms they are experiencing, what their unmet needs are, and what could improve their sense of health,” says Halpern. In other words, treat them as an individual. “Each patient has different symptoms, wants, needs and concerns,” he says. This means providing a wider range of services to choose from—both major resources like palliative care, mental health counseling and pain management, and smaller things like transportation assistance that make life just a little easier.

Other researchers are examining the power of patient-centered care, too—and what they’ve found underscores the importance of this research. “There’s been some very important work recently on supportive and palliative care that’s aimed not at treating the cancer, but treating patients’ symptoms,” says Halpern. “It’s been shown that making patients more comfortable and relieving their symptoms may lead to longer life. So it’s possible that taking other steps to improve the experience of care and make patients more satisfied could also lead to better outcomes—and potentially even longer life.”

Halpern hopes to use this study to develop new programs that ask patients with cancer about their unmet needs and give these patients more input in their treatment plans. He says that doing that requires healthcare providers to ask some big questions: “What is most important to patients in the medical care experience? What do they want to have happen to them over the next few months? If we can develop programs that take those things into account, I think there is tremendous possibility to enhance the experience of care.”

Posted:  September 26, 2016