5 steps to restore trust in American health care


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Trust is critical to public health. People who do not trust the health care system put their health and lives at risk, because they are less likely to visit a doctor, they are less likely to come in conversations with clinicians, and they do not follow medical advice and prescriptions. Such mistrust can weaken doctor-patient relationships, leading to this The patient’s performance is deteriorating And Increasing doctor burnout.

Conversely, when a physician can build trust, patient satisfaction improves. That case: Evidence It shows a direct correlation between specific health care practices and quality outcomes.

Christmas Research It shows that there is trust in the US health care system – as in other areas of American society, incl The government, ScienceAnd Media – It is decreasing. Among the reasons are leadership failures, inequality, political politicization, and growing doubts about our collective ability to address society’s most pressing challenges and promote well-being for all. Given the damage, building public trust in the US health care system should be a priority during the pandemic. This article provides tips on how to do it.

The impact of the epidemic on public confidence

The Covid-19 pandemic has served as a worrying test of public confidence in the US health care system, and exposed systemic gaps. 48% of respondents in the United States said the pandemic has eroded confidence in our health care system’s ability to deal with major health crises. 2022 Edelman Trust Barometer: Trust and Health. This sentiment is not surprising given that the number of people who have died from Covid-19 in the US has exceeded 1 million. than any industrialized country.

Several factors contribute to this lack of trust, including vacillating guidelines and a lack of coordination at the federal, state, and local levels. The epidemic has shown that our public health infrastructure is inadequate to deal with major health crises if they are not properly supported. For example, in some parts of the country, public health communication networks are forced to rely on outdated technologies. Busy fax machines Flood of Covid-19 test results.

Exacerbating the cycle of distrust, the Covid-19 crisis has exposed the impact of long-standing disparities in access to health care among Hispanic, American Indian and Alaska Native and Black populations. Those differences contributed Higher rates of covid-19 infection and death among these groups compared to their white counterparts.

Finally, long before the outbreak, the decline of rural health care systems and the erosion of local news outlets fueled the growth of medical and news deserts, leaving many rural residents with limited sources of reliable information about health care, including vaccinations. The spread of mobile phones and social networks. This has certainly contributed to lower vaccination rates among people living in rural areas compared to people living in urban areas.

Rural residents are also older, poorer and have chronic conditions, all of which contribute to higher rates of Covid-19 infection, hospitalization and death. This demographic ranks with low-income Americans as having the lowest levels of trust in health care. Recent survey.

Physicians and health care organizations can take the following five steps to address factors that contribute to eroding trust in the health care system.

1. Support the movement toward value-based care.

Accelerate the move away from the dominant “fee-for-service” model that encourages more care, but better care—and toward “value-based” payment models that focus on the quality of care delivered to patients. Because prepaid, value-based health care models give organizations the flexibility to develop new capabilities that improve care delivery, those that do, including Kaiser Permanente, have shown they are better prepared to respond to major disruptions and other market changes during the pandemic. Because their priorities are in the right place: the patient’s best interests.

For example, Kaiser Permanente has invested primarily in advancing technology over the past two decades – including web, mobile and video platforms. That’s why we were well-positioned to respond to the COVID-19 outbreak, allowing us to continue seeing and treating patients when shelter-in-place orders halted the day-to-day operations of many healthcare organizations.

Values-based organizations recognize that building trust with patients requires cultural competence and are willing to invest in customizing services to meet individual cultural and linguistic preferences. Building trust is especially important in communities where distrust of health care organizations is common and cultural and linguistic differences are barriers to accessing health care.

Kaiser Permanente’s focus on cultural and language competency facilitated its efforts to reach and win over unvaccinated patients in such communities during the Covid-19 pandemic. Pop-up vaccination clinics have been installed in local areas, including barbershops, churches and community centers, where community organizations can share clear and accurate information about vaccinations in languages ​​patients understand.

2. Rethink public health infrastructure.

The United States must build a public health care technology infrastructure that facilitates communication between public and private health care facilities, allowing them to provide real-time information about emergency room visits, hospital admissions, and deaths from COVID-19 or similar public deaths. Health concerns.

Physician leaders who support public health system reforms that result in greater capacity, access, and public health initiatives are more likely to develop public trust.

The broad demand for such measures from the US health system has contributed to the support Health care requirements Earlier this year, $8.5 billion — an increase of $582 million — was allocated to the Centers for Disease Control and Prevention (CDC). Special attention was given to improving the country’s public health infrastructure, including data collection and monitoring.

3. Using technology to improve access.

Encouraging adoption of technologies that engage and serve patients by making healthcare more convenient and more connected Telehealth, remote control and digital diagnostic equipment. These types of technologies have been shown to increase access to care while also making care more seamless and less complicated.

Much of the discussion around telehealth focuses on making care more accessible and convenient for patients who have grown accustomed to the convenience of food delivery and ride sharing. But the telehealth spectrum is much broader than that. With technology, we can mobilize knowledge and expertise quickly and seamlessly, not people, which can dramatically improve care delivery and patient engagement.

For example, in helping recovered heart failure patients, Kaiser Permanente’s Virtual cardiac rehabilitation program Care teams can use an app combined with a digital watch to track these patients’ exercise, activities, medications and heart parameters. Patients enrolled in the program were nearly twice as likely to complete the recommended course of rehabilitation as compared to traditional face-to-face interactions.

4. Shift more hospital-level care to the home.

Close gaps in healthcare access by effectively moving care to the phone and home. Kaiser Permanente Advanced care at home program It allows patients who are not ready for hospital to receive acute level care in the comfort and safety of their own home. During the outbreak, such care was essential to connect patients with the acute care they needed. He secured hospital beds and staff for Covid patients to ensure their safety.

Treating patients at home can lead to good results and high levels of patient satisfaction: more than 90% of patients give the programs. High marks. And Research It shows that patients treated at home have fewer readmissions and complications than those receiving traditional inpatient care.

In order for such home care programs to continue, the US Congress must act to extend it. Acute hospital care at home Issued by the Centers for Medicare and Medicaid Services (CMS). Those restrictions helped expand access to safe, hospital-quality, home-based care for patients across the country during the pandemic.

Kaiser Permanente is one of 110 health care organizations. Advanced care at home combinationSupporting the intended modernization of hospital patient care. That would extend billings and provide a more specific path to the growth and expansion of hospital-at-home programs.

5. Cut the red tape and engage patients.

Health care institutions must build systems and structures to facilitate patient participation and make their voices heard. Clinicians and health care organizations must respond to patient feedback with options that align with patient priorities and values, creating the necessary trust for physicians and patients to participate in shared decision-making.

No patient should have to endure unnecessary red tape or long journeys in traffic to get their health care needs met. Non-patient-facing healthcare systems are healthcare organizations that facilitate patient contact with their physicians and healthcare teams. Many local and international studies Higher patient engagement has been shown to lead to better health outcomes.

To better meet a patient’s current care options, Kaiser Permanente offers easy-to-navigate online tools that guide patients to the most convenient way to meet their needs – from self-care and emailing their doctors to scheduling office visits, video visits or e-visits.

Every interaction with a patient is an opportunity to build trust. It’s critical that clinicians and healthcare organizations make every moment count—now more than ever.


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