COPD insider

12 ways COPD care has changed in the past year for  patients, providers, and health systems

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The end of the year is an ideal time for reflection – and with the days of December winding down, it’s beneficial to look back at the huge leaps made in 2019.

 

To commemorate a successful 12 months, we’ve compiled 12 of the most impactful trends our Insiders have discussed – reflect how they’re rethinking COPD care, moving minds forward, and setting innovative new standards. Prepare to be inspired as we summarize some of the exciting ways we’re continuing to transform care, together.

Patients are spurring a change in the dynamics of care

 

Patient-centric care has been an increasingly important theme this year, and many patients have gotten more involved in their own care to try to achieve better outcomes.

Contributors

Krystal Craddock, BSRC, RRT-NPS, AE-C, CCM

Krystal Craddock, BSRC, RRT-NPS, AE-C, CCM

COPD Case Manager UCal Davis
Bobbie V. Kumar, MD, MBA, FAAFP

Bobbie V. Kumar, MD, MBA, FAAFP

Medical Director, Swedish Edmonds Urgent Care Director, Complex Care Management for Vituity
Keith T. Kanel, MD, MHCM, FACP

Keith T. Kanel, MD, MHCM, FACP

Clinical Associate Professor of Medicine  University of Pittsburgh
Jerry Krishnan, MD, PhD

Jerry Krishnan, MD, PhD

Associate Vice Chancellor for Population Health Sciences University of Illinois Hospital and Health Sciences System

1: Patients are more engaged with providers.

What used to be a largely prescriptive doctor–patient relationship is rapidly transforming into a collaboration. Patients are asking thoughtful questions and making their opinions an important part of the treatment process. The doctor–patient relationship is more personal than it used to be, and both sides of the partnership are benefitting. Patients appreciate having their feelings and opinions incorporated into their treatment plans, and they tend to become more knowledgeable about their conditions as a result.

2: Patients are becoming better educated.

Whether they’re familiarizing themselves with the risk factors that can cause exacerbations or working toward proper device use, the theme is the same: knowledge is power. Patients who are more engaged are more driven to learn, and better-educated patients are setting themselves up to get more out of care.

3: Patients are increasingly paired with dedicated case managers.

What better way to provide the level of personal care each patient deserves than to have a dedicated champion overseeing and coordinating their care? As more and more health systems recognize the need for case managers, greater numbers of patients are benefitting from having a personal advocate in their corner. Case managers serve as liaisons between members of the care team to coordinate varying treatments, and ensure that everything is properly addressed, and that treatments or medications don’t conflict or negatively interact. They also check in with patients to make sure they're adhering to treatments and living in safe and healthy environments. It's all about providing the support patients need in the quest to drive down COPD readmissions.

4: Patients are participating in more positive spins on treatment.

Dealing with COPD is far from fun, patients appreciate it when providers help them participate in hobbies or family activities.

 

When patients can participate in aspects of life that might previously have been challenging or off-limits, they become more motivated to adhere to their COPD-treatment plans.

 

“You can start a pulmonary rehab program with just exercise and education as the goal and then grow it into something where you’re starting yoga classes and you’re starting choirs and different things for your patients,” says Krystal Craddock, a COPD case manager. “We didn’t know at first whether or not it would be something that was accepted by the pulmonary rehab department as well as the patients, but they just welcomed it with open arms and they’re still going.”

Providers are adding personal touches to care

 

With a greater emphasis on patients, providers have been challenging themselves to fine-tune their existing skill sets, practice alternative approaches to care, and take treatment to new levels.

5: Providers are embracing their roles as champions.

COPD management requires a broad range of caregivers, but assigning one person to advocate for or "own" the patient can be an effective approach. Along with being the patient's "champion," he or she should also be a cheerleader and an optimist. When something goes right, it should be celebrated.  “Recognition and encouragement are really important,” says Dr. Bobbie Kumar, “not just to the ego but to continue down that path.”

6: Providers are working hard to improve their listening skills.

There are any number of reasons why adherence is a challenge with COPD patients. One of the best ways to find out what’s holding them back is to listen. Most providers already consider themselves to be good listeners, but by paying extra attention to nonverbal cues, doing their best not to multitask, and asking clarifying questions, they’re taking care to a new level. Doing so not only ensures you understand what’s going on in a patient’s life and helps you see the bigger picture more clearly, it also lets your patients know you are interested and truly invested in their care.

7: Providers are working to understand diverse patient populations.

Factors like socioeconomic status, cultural background, geographical location, and health literacy make each patient unique. Rather than being barriers between healthcare providers and patient populations, these factors can be the key to unlocking better, more-tailored care. Whether it’s taking extra time to find a more affordable prescription for a patient with limited means, or making important resources available in multiple languages, providers are increasing their focus on each patient’s background and taking appropriate action to elevate care.

8: Providers are empowering patients with new techniques, like motivational interviewing.

Factors like socioeconomic status, cultural background, geographical location, and health literacy make each patient unique. Rather than being barriers between healthcare providers and patient populations, these factors can be the key to unlocking better, more-tailored care. Whether it’s taking extra time to find a more affordable prescription for a patient with limited means, or making important resources available in multiple languages, providers are increasing their focus on each patient’s background and taking appropriate action to elevate care.

 

“I am so in awe of the power of motivational interviewing to make a difference in the lives of these patients,” says Dr. Keith Kanel. “I've seen so much transformation with patients that are charged with these self-management burdens, overcoming them just by having the power of tapping into their own value sets.”

 

By investing the time to empower your patients, you gain back significant time by fostering their ability to self-manage and remain healthy at home.

Health systems are adapting to a rapidly changing healthcare landscape

 

As the challenges of COPD care delivery have continued to grow, it’s imperative to have the right programs in place to improve the quality of care while reducing the cost of it. In order to do this, our Insiders have been taking creative new approaches to implementing system-wide changes.

9: Health systems aren’t limiting their thinking to just healthcare.

It’s easy to look to other COPD programs for inspiration when redefining your protocols. But many programs still use the same protocols that have been in place for years. Emulating them can limit the evolution of care that patients desperately need.

 

To set the programs at the institutions apart, executives are looking at the design of programs outside of healthcare. Starbucks is a prime example. Their business model is customer-centric.They personalize drink orders, have rewards programs for frequent customers, and provide a reliably excellent customer experience. By applying this same design approach to their COPD care plans, and putting patients at the center of the model, the leading COPD care organizations are reaching new heights.

10: Health systems are testing programs that improve access to care.

When it comes to redefining protocols and programs, there may be no bigger risk than proceeding without a clearly defined plan. In 2019, our Insiders implemented innovative pilot programs designed to make care more accessible.

 

Dr. Jerry Krishnan of the University of Illinois Hospital and Health Sciences System, for example, recognized that transportation was a roadblock to care for many patients. He helped launch a 4-month program called Project Pronto.

 

“We engaged Lyft and put together a system where we pay for transportation for people to get home,” Krishnan says. “If they come to our medical center and they need to get home, they don't have any other way, we will actually pay Lyft to take the patient home.”

 

The project was so successful that it was permanently implemented by hospital leadership. 

11: Health systems are trying new ways to expand care teams, like community health workers (CHWs).

CHWs serve as a cost-effective extension of the inpatient care team, taking steps to educate patients and their families while checking in with a watchful eye to make sure things are going smoothly. By monitoring patients at home and addressing potential problems early, they see to it that preventative action is taken before the situation escalates into a full-blown exacerbation or readmission. One-third of CHWs work on a volunteer basis, but even those that hold paid positions are considered cost-effective. Whether it’s looking into CHWs or exploring other alternative, more-affordable routes to effective care, health systems are finding creative ways to cut costs while improving care.

12: Health systems are taking advantage of technological innovations to strengthen care.

Today’s new challenges beg for new solutions. To integrate care delivery and reduce COPD readmissions, health systems are embracing virtual care. A few examples of helpful new technologies that help bridge the COPD care gap virtually are:

  • Unified systems that trigger alerts for PCPs when COPD patients are admitted to the ER
  • E-consults between providers and patients, and between different providers on the care team
  • A centralized database of how-to resource videos for patients
  • Artificial intelligence navigator tools via an app or Amazon Alexa™️

 

These are just a select few ideas worth pursuing; the realm of possibilities that technology brings is ever-growing.

Carrying COPD care forward

 

COPD care is always changing, and together, we’ve made great strides in 2019. We’re honored to have played a role in your journey this year, and we hope you feel a great sense of accomplishment and achievement. By reflecting on our progress this year and recognizing ways we can continue to improve, let’s carry the momentum of a successful year of COPD care into 2020 and beyond. 

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