Finding What Matters Most to Patients

Research shows that the importance of patient-reported outcomes, improved decision support, and care coordination is growing rapidly as new payment models transform healthcare delivery. This has led to the use of new measures and communication techniques, including shared decision-making and motivational interviewing. Using patient-reported outcomes at the point of service helps providers identify what matters most to the patient in front of them now. Describing treatment options and deciphering a patient's preferences effectively is a process, which has been likened to arriving at a diagnosis. Providers make a medical diagnosis by discerning a patient's primary complaints, past history, exam findings, and test results. A preference diagnosis can be thought of similarly. Providers work with their patients to identify what matters most to them, discuss the risks and benefits of the available treatment options, and support the patient as needed through the decision-making process. Once informed of their options, patients frequently chose treatments that require modifying their habits. Motivational interviewing helps patients and providers understand what matters most now and design care plans that provide appropriate support. While many healthcare providers and leaders may be familiar with patient-reported outcomes from research articles, and have heard of shared decision-making and motivational interviewing, few have experience using them. Fewer still understand how each relates to the other. This book helps leaders and healthcare providers better understand how to use patient-reported data to their advantage at the point of service. The book provides the background for developing shared knowledge and shared language, along with extensive examples of dialogue between providers and patients. In addition, the book contains personal interviews of subject matter experts who have significant experience using these measures. The result is a comprehensive understanding of how these measures and techniques can help providers, organizations, and patients navigate this modern healthcare management opportunity.

Thom Walsh, PhD, is the Founder and Chief Strategy Officer of Cardinal Point Healthcare Solutions, an Adjunct Lecturer at the Dartmouth Institute for Health Policy and Clinical Practice, and a Visiting Associate Professor of Community Medicine at the Oxley College of Health Sciences at the University of Tulsa. He holds an MS degree in Physical Therapy, an MS in Clinical Evaluative Sciences, and a PhD in Health Policy. Known as an excellent teacher and mentor, he draws on extensive clinical, research, and consulting experience to help people and organizations to navigate a rapidly changing healthcare environment. His clinical career spanned private practice and academic settings, including the development and launch of a multidisciplinary spine center at the Dartmouth-Hitchcock Medical Center. His writings on patient-reported outcome measures, healthcare costs and utilization, shared decision-making, motivational interviewing, and ethical leadership have appeared in numerous publications, including the BMJ, JAMA, Spine, The Journal of Healthcare Management, Forbes, The New America Foundation, and The Atlantic. His first book, Navigating to Value in Healthcare, was released in 2017. Dr. Walsh also enjoys hiking, running, reading, and writing. He volunteers with a mountain search and rescue unit and Team Rubicon, a disaster relief and humanitarian aid organization.

Foreword. Preface. The Long Road to Finding What Matters Most to Patients. Introducing the OODA Loop. Patient Reports Measures Help Find What Matters Most. Patient Reported Measures in Action. Shared Decision Helps to Find What Matters Most. Shared Decision Making in Action. Motivational Interviewing Helps Find What Matters Most to Patients. Motivational Interviewing in Action. Putting It All Together. Subject Matter Expert Interviews. From Experts on Patient Reported Measures. From Experts on Shared Decision Making. From Experts on Motivational Interviewing. Summarizing the Interviews.