The current method we use to measure patient health outcomes is to follow lab metrics through standards such as HEDIS. Is there a better patient health outcome metric we could use?
This is relevant to my readers because, in a transparent healthcare system, value should be front and center. And with our high healthcare illiteracy, this requires a bit more work.
Call this marketing or communication, or selling. Regardless, it’s critical for a successful patient-doctor relationship.
The Current Patient Health Metric
Let me give you an example. If I wanted to know if my training routine is helping me become a better rock climber, I’d likely test myself on harder problems.
What if I decide to see how long I could hang on a 10 mm edge or how many weighted pull-ups I could do? Sure, it’s a good metric, but it has little to do with my rock climbing goals.
In mainstream medicine, we measure your A1C and how many of your scheduled mammograms and Paps you completely timely.
When what we really should care about is how disease free you were, what the quality of your life was, and how your longevity compared to your peers.
Reductions in mortality alone, without changing morbidity […], led to longer unhealthy life and worse population health; and these effects are more pronounced if mortality decline is concentrated among the sick.The Gerentologist
Why Should You Care?
How do you demonstrate to a patient that they are getting better? Certainly, you could show them that their A1C is improving, but if that’s at the cost of them feeling like shit most of the time, you aren’t going to get very fair. Hence, our current medication compliance rates.
If you have a patient health metric that the patient actually believes in, you might have more success in your practice.
Selecting the Right Patients
I have rock-climbing buddies who don’t care much about improving their game. They are quite content where they are at. They would make terrible candidates to be trained by a trainer.
Others desperately want to improve but aren’t motivated and have excuses and personal barriers preventing them from improving. They, too, would make terrible candidates to work with a trainer.
I am the ideal candidate for a rock climbing coach because I want to improve. I am seeking their expertise to give me tools to improve, especially when I hit a plateau.
Measuring Health Outcomes in Your Practice
If a patient comes to me worried about their health, they likely have a certain fear in mind. It might be dying young, being on many meds, having low energy, or living with daily pain.
They might worry that their A1C is 9.5%, but that’s not why they see me. I’ll play the losing insurance game if I focus on that metric. I’ll lose that customer in due time.
Fear, here, could be one health metric to measure.
Deciding on Health Metrics Together
I don’t see anything wrong with measuring health outcomes. For example, how many medical errors are committed, and what are the rates of surgical complications?
However, these are economic dollar discussions and not patient satisfiers. For our own medical practices, it’s necessary to develop convincing health metrics.
Health metrics in which the patient believes in, aka, have buy-in.
1. Selecting the Right Patients
I interview potential patients in my virtual primary care practice because the wrong patient will waste their money and my time.
Once I identify the right patient, we set out to get to know each other. We begin to build the patient-doctor relationship.
2. Getting to Know the Patient
What are their main medical concerns, and how do they measure health success? What has worked for them, and what has failed?
A patient has to be the CEO of their health, they have to be the quarterback, even if they have never learned how to do that.
I can be the coach or their Chief Strategy Officer, but I cannot sit there with them as they journal, discover their weaknesses, suffer through their failures, and manage their dark thoughts.
3. What’s the Deliverable?
The deliverable is what the patient would define as success. What does health success mean to you? Let’s get granular.
Perhaps the patient wants not to take any medication for their diabetes. They don’t want to have a heart attack at 50 like their father and uncles.
Therefore, how many medication-free days can we achieve? How many life years can we add? And what group of patients can we compare them to to demonstrate success?
3. What’s a Failure?
What would have to happen for them to conclude that this patient-doctor relationship is an utter failure and a waste of time? If it’s that they didn’t achieve their health goals, then, again, we’re wasting each other’s time.
If it’s that they accomplished all actionable steps and obtained no desirable results, then that’s a legitimate failure.
The health metric here would not be met because the patient did the exercises, did the meditation, took the medications, and they are left feeling worse with a higher long-term health risk.
4. Creating a Health Risk Score
I developed a health risk score in my virtual medical and health coaching practices. It’s nothing fancy, but we sit down together and collect relevant risk factors.
I assign each risk factor a weighted value and calculate a risk score similar to how other risk calculators are designed. This is the ideal tool for me and my patient/client to measure their health outcome.