What does 'patient-centered care' really mean?

2016 09 06 13 31 23 491 Question Mark Blue 400

More articles referencing patient-centered care are being published in radiology journals, but many of them seem to be missing the mark on what actually constitutes a patient-oriented focus, according to a new study published online in the Journal of the American College of Radiology.

Radiologists are being urged to focus more on patient-centered care -- that is, care that puts patients' own values at the center of clinical decision-making. And they're talking to their peers about the topic, as demonstrated by an increasing number of articles appearing in radiology journals.

But do these articles reflect a true understanding of patient-centered care? Perhaps not, according to the group led by Dr. Andrew Rosenkrantz of NYU Langone Medical Center.

"The expansion of patient-centered care in clinical and scholarly arenas is encouraging," the authors wrote. "Nonetheless, concern has been raised regarding confusion about the true meaning of 'patient-centered' and misapplication of the term to refer to a wide range of initiatives that, though potentially improving quality or the patient experience, do not truly constitute patient-centered care."

Making a difference

In a study supported by grants from the Harvey L. Neiman Health Policy Institute, Rosenkrantz and colleagues searched PubMed for articles in radiology journals that referenced patient-centered or patient-centric care. They found 115 articles, of which 40 were original research (JACR, December 22, 2016).

The number of these articles increased steadily between 2000 and 2015:

  • 2000-2008: Zero to four
  • 2010-2012: Five to nine
  • 2013-2014: 14 to 15
  • 2015: 25

Common themes in the articles were optimizing patients' access to reports and images, patients' experience during the imaging exam, image evaluation, and radiologists' interaction with patients, Rosenkrantz and colleagues wrote.

What is 'patient-centered'?

But improving the diagnostic accuracy of an exam or putting a new technology in place to improve efficiency may not translate to outcomes that make a difference to patients, according to the group.

"Performing a diagnostic study and providing an accurate report to the referring physician is of value to the patient but is not patient-centered," the team wrote. Patient-centered care means "interaction with the individual patients to understand what they want."

The researchers also noted that none of the articles dealt with patient involvement in developing how healthcare is delivered.

"None of the original research articles addressed the direct inclusion of patients in the design of healthcare delivery systems in radiology," they wrote.

There's no doubt that more research is needed, according to the group.

"Further investigation of patient-centered care in radiology is encouraged to encompass a broader range of patient-centered ideals, including such areas as cultural diversity and inclusion, shared decision-making and patient autonomy, a trusting and compassionate patient-physician relationship, and inclusion of patients in the design of healthcare delivery systems," the authors concluded.

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