Patient-Centered Care Explained with 5 Examples

Elderly patients exercising

Patient-centered care strives to make the patient an active participant in their care journey, rather than a recipient of impersonal care handed down by an overworked healthcare system. Instead of treating conditions in isolation, patient-centered care orchestrates highly personalized and integrated care. Medical services are tailored to a patient’s unique set of physical, emotional, and social needs.

This healthcare approach aims to empower patients, improve clinical outcomes, and ultimately foster a more compassionate and effective healthcare system. Through patient-centered care, patients build relationships and establish deeper trust with their healthcare providers. This trust proves especially beneficial for patients with multiple chronic conditions, as chronic conditions require a lifelong investment in care and self-management.   

In this article, we will explore principles, examples, and applications of patient-centered care and how ChartSpan’s services like Chronic Care Management (CCM) and Annual Wellness Visits (AWVs) can help you deliver this care to eligible Medicare patients. 

What is patient-centered care?

Patient-centered care is a healthcare model that prioritizes individual patients’ unique needs, values, and preferences. Patient-centered care emphasizes listening to patients, educating them on their conditions, providing emotional support, creating compassionate environments, and actively involving them in their care. 

The model empowers your patients to collaborate with you, share in the decision-making process about their care, and pursue clinical outcomes personalized to their long-term health goals. Patient-centered care also highlights the importance of enlisting the support of patients’ family members, friends, and community in their wellness journey. 

In the patient-centered care approach, the focus shifts from fixating on a patient’s specific medical conditions to a comprehensive, holistic view of the patient’s physical comfort, mental well-being, and individualized health goals.

What are the eight principles of patient-centered care?

The British healthcare research firm Picker Institute established eight principles of patient-centered care that form a framework for healthcare providers. These principles outline key aspects of care delivery that prioritize the needs, preferences, and values of patients and encourage a more respectful, empathetic, and collaborative approach to healthcare.

The Picker Institute’s Eight Principles of Patient-Centered Care 

  1. Respect for each patient’s values, preferences, and needs. Patients should be treated as partners in their wellness plans. Healthcare providers should forge reciprocal partnerships with patients that reflect each patient’s unique values.
  2. Coordination and integration of care. Avoid disjointed, disruptive care delivery. Facilitate effective communication across a patient’s care continuum. Ensure all aspects of a patient’s health are considered. 
  3. Clear information, education, and support. Create the conditions for patients to proactively participate in their healthcare journey by providing clear communication about care plans, lab results, and overall health.
  4. Attention to physical comfort and environmental needs. Provide patients with a safe, comfortable environment. Address their physical comfort and pain management.
  5. Emotional support. Recognize the emotional impact disease has on patients. Offer patients sensitivity, empathy, and reassurance.
  6. Involvement of family and friends. The involvement of a patient’s circle of loved ones should be welcomed and supported. Empower a patient’s family and friends to support them in their healthcare journey.
  7. Continuity of care and smooth transitions. Reduce readmission by emphasizing seamless transitions between care providers and settings. Ensure each patient is confident in their ability to care for themselves after discharge. 
  8. Fast and reliable access to care. Provide patients with access to the right services at the right time. Focus on the availability of appointments, specialists, and ambulatory care. Minimize wait times for referrals, treatments, and scheduling.

Five examples of patient-centered care

The principles of patient-centered care inform all elements of a patient’s healthcare, from Annual Wellness Visits and routine physicals to hospitalizations and surgical procedures. Below are some examples of how the principles of patient-centered care can be applied to your practice. 

1. Create individualized wellness plans 

Patient-centered care hinges on creating treatment plans tailored to the needs and preferences of individual patients. Each patient’s wellness journey is influenced by their cultural background, personal values, and socioeconomic conditions. You must integrate these factors into a patient’s wellness plan to achieve a patient-centered approach to healthcare.

For example, a patient who comes from a cultural background that emphasizes natural remedies may have a preference for traditional medicine to treat their chronic conditions. You can honor this by encouraging the use of safe and reliable natural remedies alongside conventional medical interventions. Patients are more inclined to follow treatment plans when they are individualized to meet their needs and match their worldview.

However, it is equally important that wellness plans capture the full picture of a patient’s physical health. Wellness plans should be designed to assess and mitigate risks, close gaps in care, promote long-term health maintenance, and encourage healthy lifestyle adjustments. If you do not have a complete understanding of your patient’s health, you cannot administer patient-centered care. 

2. Encourage collaborative decision-making

The goal of shared decision-making is to give agency to the patient while ensuring that their treatment plan is evidence-based and effective. In the patient-centered care model, all clinical decisions are guided by the patient. 

To successfully enact patient-centered care, you must have sensitive, evidence-based conversations about a patient’s diagnoses, treatment options, and risk factors. Invite patients to become active participants in their care decisions, encouraging them to ask questions and explore options. And invest in educating patients on their conditions and strengthening the patient’s overall health literacy. 

When a patient feels listened to and respected, they are more likely to trust their physician’s recommendations and take responsibility in their wellness journey. Patients who are actively engaged in their care journey are more likely to adhere to wellness plans, advocate for their needs, and take preventative and proactive measures for their health.

3. Build relationships through compassionate communication

Compassionate, active listening is a core principle of patient-centered care. Ongoing patient communication extends beyond the decision-making process. Addressing the individual needs, values, and preferences of a patient requires ongoing investment in communication and relationship-building. 

Dedicate yourself to building relationships with patients that allow you to provide maximized patient-centered care. For example, understanding a patient’s family dynamics helps providers know which family members to include in conversations about treatment. Discussing a patient’s fears and traumas can help providers improve the physical and mental comfort of patients. 

4. Provide patients with emotional support

Another core tenet of patient-centered care is providing emotional support to patients. Studies consistently demonstrate a link between emotional and social support and improved clinical outcomes for patients. 

Patients without strong support systems may experience anxiety or depression, which can lead to poor adherence to treatment plans and lapses in necessary lifestyle changes. Patients experiencing fear or physical discomfort may be unable to adequately process information and participate in conversations with their healthcare providers.  

Patients suffering from chronic conditions are also at a higher risk of suffering from loneliness. Elderly patients with chronic illnesses often live alone and face social isolation, which can exacerbate both physical and mental health conditions.

Creating a healthcare environment where patients feel emotionally supported is therefore crucial for clinical success. You should be able to compassionately address the fears of your patients. This can include fears about the financial ramifications of an illness, the impact of diseases on a person’s personal and professional life, or anxiety about pain and discomfort associated with treatment and surgeries. 

5. Facilitate internal information sharing and coordination of care

When managing multiple chronic conditions, patients are likely to consult with numerous healthcare providers and specialists that may span several healthcare organizations. If communication falters between these agencies, patients and providers alike will lack the necessary information to make collaborative, patient-centered care decisions. 

Gaps in care coordination can have a detrimental impact on a patient’s progress, morale, and healthcare costs. Consequences of poor care coordination include overprescription of medication, duplicated tests and screenings, and unnecessary hospitalizations. 

Alarmingly, patients with multiple chronic conditions are more likely to receive poorly coordinated care. This is because of the complexity presented by their co-existing conditions and their broader utilization of healthcare services. 

The patient-centered care approach requires patients to be kept up-to-date with all pertinent information about their conditions, progress, and screening results. A patient’s medical information should be shared fully and in a timely manner with both the patient and their family members. Patients should not feel confused about their clinical status or fear that information is being withheld from them by their care providers.

Patient-centered care vs. value-based care models

Patient-centered care shares many common objectives with value-based care. Value-based care rewards healthcare practices for the quality rather than the quantity of services administered. Value-based care aims to promote positive clinical outcomes by improving quality through care coordination, communication, accessibility, and cost.

However, there are apparent tensions between the two approaches as well. Value-based care defines quality through the perspective of the provider, payer, or organization, rather than the patient. Patient-centeredness is a consideration in value-based care, but not the dominant metric.

Programs like Chronic Care Management (CCM) help unify the two overlapping care philosophies of patient-centered and value-based care. CCM programs facilitate early, effective interventions and the delivery of both high-quality and patient-centered solutions. 

CCM services provide patients with many of the core principles of patient-centered care, like emotional support and care coordination. CCM also facilitates ongoing patient education and engagement. The consistent communication provided by a CCM program builds trust and strengthens relationships between providers and patients.

By aligning patient-centered care’s focus on the individual with value-based care’s emphasis on quality, your practice can optimize care administered to patients. Individual patients feel respected and engaged in the management of their conditions. Unnecessary procedures are avoided, the waste of resources is reduced, and healthcare costs are lowered. 

CCM is a powerful tool to further involve patients in the decision-making process and their overall care journey. The result is improved patient satisfaction, better clinical outcomes, and recurring revenue for your practice.  

How ChartSpan helps practices deliver patient-centered care

Our services at ChartSpan are designed to help your practice deliver high-quality, patient-centered care by building strong relationships, engaging and activating patients in their individualized care journeys, and providing ongoing communication and coordination of care.

Create individualized wellness plans with ChartSpan’s RapidAWV™ 

ChartSpan’s Annual Wellness Visit (AWV) software, RapidAWV™, transforms your practice’s 

administration of Medicare wellness visits and creation of wellness plans. This service proactively assesses eligible Medicare patients’ risk factors and care gaps through Health Risk Assessments (HRAs). 

Based on the patient’s responses to the HRA, you can create a personalized care plan. These plans are customized to deliver high-quality, preventative care based on the conditions, risk factors, and gaps specific to the patient.  

In addition to setting up patients for clinical success and long-term well-being, AWVs also generate an additional revenue stream for your practice through Medicare reimbursements. These highly individualized care plans provide a strong basis for any patient-centered care plan.

Build relationships and offer assistance through CCM care teams

Through ChartSpan’s CCM program, every enrolled patient receives a dedicated monthly call. Care coordinators use these calls to build relationships with the patients and have the opportunity to learn more about the patient’s beliefs, preferences, and values. 

If our care team encounters information that conflicts with the care plans established by a patient’s primary care provider, they can note this in the patient’s file and communicate this information with your practice. 

During these calls, patients have the opportunity to discuss their progress, concerns, and any new or worsening symptoms. Patients can share the obstacles they are encountering with medication, self-management, transportation, and lifestyle change implementation. Our care team members can connect patients with resources to help alleviate these difficulties. 

Care team members can also address the emotional health of the patient and provide them with encouragement, companionship, and connection to community resources during these calls. They are trained to proactively identify signs of loneliness and depression, administer clinical depression screenings (PHQ-2 and PHQ-9), and guide patients on the next steps in treating their mental health. 

Patients enrolled in our CCM program also have access to a 24/7/365 nurse call line. This line can be used to discuss a patient’s symptoms, concerns, or medications, but fundamentally, it also ensures that patients are never alone in their care journey. 

Learn more: How CCM can relieve practice workload.

Partner with ChartSpan and deliver patient-centered care through Chronic Care Management and AWVs

When your patients are enrolled in ChartSpan’s CCM program, they receive a new standard of care that centers every patient’s unique journey. ChartSpan’s AWV software unlocks detailed insights into each patient’s health risks and helps you create meaningful, effective, and patient-centered care plans. Contact us to learn more about how our services can help your practice strengthen trust, bolster patient satisfaction, and improve your quality of care. 

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Jon-Michial Carter is the Co-founder and Chief Growth Officer of the largest managed Chronic Care Management (CCM) company in the United States,...

Published: August 28, 2023

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