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12 Oct 2023

Person centred care

Health Care

Signs point that this more engaging means of health care treatment is just what the patient ordered.

More than just a paradigm shift, the advent in New Zealand of Person Centred Care, sometimes called Patient Centred Care (called Participatory Medicine in some countries) has come about, like many great revolutions, with people who dared to challenge the status quo.

While there have been dramatic changes in traditional roles and responsibilities, this approach has largely helped to make health care more engaging and more robust.

Within more traditional health care structures such as the former Hospital Boards and single owner operated General Practices, new terminology and positions evolved in the subsequent structures through to and inclusive of Primary Health Organisations (PHO’s – groups of General Practices); and Community Health Providers such ‘for Maori by Maori’ Iwi Providers; and for ‘Pacific Islands by Pacific Islands’ Providers; that never would have existed in previous health and social service structures. During 2022 Te Whatu Ora – Health New Zealand was established, the single entity that runs all former 20 District Health Boards (DHB’s) and its partner organisation Te Akawhai Ora – Maori Health Authority.     

All the above changes since the late 1980’s have created roles such ‘Director of Patient Experience’, designed to ensure patients’ voices are heard loud and clear.  Such changes revise organisation values and support attitude changes, inclusive of promulgating the concept that everyone matters in delivering for and with the patient rather than to.

The International Society for Participatory Medicine (‘The Society’) sought to bring together all of the stakeholders in healthcare (patients and their families, healthcare professionals, healthcare assistants, funders, and others) to encourage collaboration, communication and cooperation that will foster provider/patient engagement, patient empowerment and education.

Claims include the state of knowledge, the impact of the new phenomenon of ‘e-patients’ on the healthcare system, and the quality of care received indicates:

  • The Internet plays a crucial or important role as it helps patients and their families/support networks cope with a major illness. Initially many clinicians underestimated the benefits and overestimated the risks of online health resources for patients.
  • Medical peer support, inclusive of online support groups, are an important healthcare resource.
  • “…the Net friendliness of clinicians and provider organizations—as rated by the e-patients they serve—is becoming an important aspect of healthcare quality.”
  • According to one study, the advent of patients as partners is one of the most important cultural medical revolutions of the past century.
  • In order to understand the impact of the e-patient, clinicians needed to, and several already have, move beyond "pre-internet medical constructs."
  • Medical education continues to adapt to incorporate the e-patient, and education of health care professionals prepares students to work efficiently and effectively with the e-patient.
  • For example a 2011 study of European e-patients found that they tended to be "inquisitive and autonomous" and that they noted that the number of e-patients in Europe appeared to be rising.
  • By 2012 a study found that e-patients uploading videos about their health experienced a loss of privacy, but also gained positive benefits from social support.
  • Then by 2017 a study utilizing social network analysis found that when e-patients are included in health care conferences, they increase information flow, expand propagation, and deepen engagement in ‘information seeking’ when compared to both physicians and researchers while only making up 1.4% of the stakeholder mix.
  • The pace of change (per the examples above across a six year timeframe) show the acceptance of e-patient experiences and expectations by patients and health professionals is moving at a fast pace. As technological options increase, the impacts of e-patient options and experience can only deepen, broaden, and improve.   

 

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Date Published: July 2018

Reviewed: September 2022

To be reviewed: October 2025