October 10, 2013
Patient Empowerment - Not Just the Emperor's New Clothes
"Knowledge Is Empowering"
If you're familiar with the parable written by Danish author and poet Harris Christian Anderson, April 2,
1805-August 4, 1875, patient empowerment is not just the emperor's new clothes. Stated differently, if you not
familiar with the short story, patient empowerment is not a bandwagon of ballyhoo being driven and ridden by
cowardly self-deceived blindfolded conformists, traveling through a fantasyland of nothingness.
At its inception the concept of patient empowerment implied enabling patients to take full control of their health
and their healthcare. Opponents to this idea oftentimes cite patients with cancer and other terminal diseases as
unable or unwilling to take control of their disease and their healthcare, but that perception is rather narrow and
unrealistic. Moreover, full control over disease is rarely achievable by anyone, even doctors.
A broader and more realistic connotation of patient empowerment is the enablement of patients to take an active
role and have a greater positive impact on their health, healthcare and healthcare outcomes in relationship to a
variety of conditions and circumstances. A few of the many examples are blood pressure monitoring by patients with
hypertension, blood glucose monitoring by diabetic patients, and smoking cessation by tobacco users. Meaningful and
beneficial patient empowerment does not undermine the provider/patient relationship, but strengthens it.
In addition to being of direct benefit to patients, patient empowerment can also benefit providers. The healthcare
provider benefit is tied into the fact that one of the key mandates of healthcare reform is that healthcare
providers get patients more engaged in their healthcare. The patient engagement mandates impact reimbursement by
third-party payers (insurance companies), whether they be governmental or private. They also apply regardless of
whether the reimbursement relationship is traditional or based on one of the new payment models such as an
Accountable Care Organization (ACO). Reimbursement benchmarks include things such as cost of care, treatment
outcomes and quality of care.
Doctors must also show evidence of using electronic health records in a meaningful way in treating Medicare and
Medicaid patients beginning in 2015, or face reimbursement penalties. One of the meaningful-use metrics that will
be used is patient engagement in the sharing and exchange of information between doctors and patients via an
electronic health records and portals, which are points of patient access into the electronic record. Patient
engagement in other areas of their healthcare will also help doctors meet some of the clinical quality metrics
which will also impact reimbursement.
Although assisting physicians in satisfying quality-of-care and cost-of-care benchmarks set forth by third-party
payers may not appear to be of direct benefit to patients, it is certainly an indirect benefit for two reasons.
First of all, if physicians are not able to keep their practices open because of dwindling reimbursements, patients
will have to find new doctors. Secondly, the greater difficulty physicians will encounter meeting reimbursement
requirements related to quality of care and cost of care in treating patients who are not engaged in their
healthcare, might well result in physicians electing to selectively treat only patients that are willing to be
empowered and engaged.
Although it is yet to be proven that patient engagement through patient empowerment will result in across-the-board
quality improvement in health care or lower the cost of healthcare, the notion has certainly been embraced by the
powers that matter in the healthcare industry. Therefore, today's emperor is not wearing a birthday suit. He's
fully and splendidly adorned.
This article is for informational purpose only and is not intended to be a substitute for medical consultation with
a qualified professional. If you are unsure about your medical condition you should consult a
By: Victor E. Battles, M.D.
Source: Proactive Health Outlet
Victor E. Battles, M.D. is a board-certified internist with 30 + years of patient
contact. Dr. Battles has been a principal investigator in several clinical research trials and is the founder
of Proactive Health Outlet, a patient empowerment website for increasing health literacy and promoting patient
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