Trust is important to public health. People who mistrust the health care system are less likely to see a doctor, are less likely to engage in conversations with clinicians, and are less likely to follow doctor’s advice and prescriptions, putting their health and lives at risk. exposed to Such mistrust can undermine physician-patient interactions, worsen patient outcomes, and increase physician burnout.

Conversely, patient satisfaction increases when doctors can build trust. That’s important: Evidence shows a direct correlation between superior healthcare experiences and quality outcomes.

However, research shows that trust in the U.S. health care system is declining, as is trust in other areas of American society, including government, science, and the media. Factors include failed leadership, rising inequality, political polarization, and growing skepticism about our collective ability to tackle society’s toughest challenges and promote well-being for all. Given the risks, rebuilding public trust in the U.S. healthcare system, which plummeted during the pandemic, should be a priority. This article provides recommendations on how to do that.

The impact of the pandemic on public confidence

The Covid-19 pandemic has put a stress test on public confidence in the US healthcare system, exposing systemic gaps. According to the 2022 Edelman Trust Barometer: Trust and Health, 48% of people surveyed in the U.S. say our healthcare system is well equipped to handle a major health crisis due to the pandemic. He said he lost his confidence. The sentiment is not surprising given that Covid-19 has killed more than one million people in the United States, the highest among developed nations.

Multiple factors contributed to this loss of trust, including wavering instructions and lack of coordination at the federal, state, and local levels. The pandemic has also shown that we are ill-equipped to deal with a major health crisis if public health infrastructure is not properly supported. For example, in some parts of the country, public health communication networks have been forced to rely on outdated technology such as fax machines overwhelmed by his massive Covid-19 test results.

Further fueling the cycle of distrust, the Covid-19 crisis has revealed the impact of long-standing disparities in access to healthcare among Hispanics, Native Americans, Alaska Natives, and Blacks. These disparities contributed to the higher Covid-19 infection and mortality rates in these groups compared to their white counterparts.

Finally, long before the pandemic, the decline of rural health systems and the erosion of the local press fueled the growth of a medical and news desert, with many rural residents losing their trust in health care, including vaccines. Information sources were limited. Popularization of mobile phones and social networks. This almost certainly contributes to the lower vaccination coverage of people living in rural areas compared to those living in urban centers.

Rural residents tend to be older, poorer and with underlying medical conditions, all of which contribute to higher Covid-19 infection, hospitalization and mortality rates. This population, along with low-income Americans, has the lowest trust in the health care sector, according to a recent survey.

Physicians and healthcare organizations can address the erosion of trust in the healthcare system by taking these five steps:

1. Support the transition to value-based care.

Focusing on the quality of care provided to patients, accelerating the move away from the dominant “fee-per-service” model that encourages more care but does not necessarily provide better care. Move to a “value-based” payment model. Because the upfront value-based healthcare model gives organizations the flexibility to develop new capabilities that improve healthcare delivery, organizations with these capabilities, including Kaiser Permanente, will face significant disruptions and other market disruptions during the pandemic. demonstrated its readiness to handle the dynamics of That’s because their priorities are in the right place. It’s in the patient’s best interest.

Kaiser Permanente, for example, has spent the last 20 years making upfront investments to get the most out of technologies such as web, mobile and video platforms. As such, we are poised to respond to his Covid-19 pandemic and continue to see and treat patients virtually, even when shelter-in-place orders halt the daily operations of many other medical institutions. I was able to.

Value-based organizations also understand that building rapport with patients requires cultural competence and are willing to invest in tailoring services to individual cultural and linguistic preferences. doing. Building trust is especially important in underserved communities, where mistrust of healthcare providers is common and cultural and language differences can be barriers to access to healthcare.

Kaiser Permanente’s attention to cultural and linguistic competence has facilitated efforts to reach out and recruit unvaccinated patients in such communities during the Covid-19 pandemic. Pop-up vaccine clinics were set up in neighborhoods such as barbershops, churches, and community centers, and community organizations shared clear and accurate information about vaccines in a language patients understood.

2. Rethink public health infrastructure.

The United States must build a public health technology infrastructure that facilitates communication between public and private health care organizations. This will enable us to provide real-time data on emergency department visits, hospitalizations, Covid-19 or similar public deaths. threat to health.

Physician leaders who advocate for improvements in public health systems that bring affordability, access and support to public health initiatives are also more likely to increase public confidence.

Widespread demand from the U.S. health system for such measures helped support the health care budget, including $8.5 billion (an increase of $582 million) in allocations to the Centers for Disease Control and Prevention (CDC) earlier this year. You may have Particular emphasis was placed on improving the country’s public health infrastructure, including data collection and monitoring.

3. Leverage technology to improve access.

Encourage adoption of technologies such as telemedicine, telemonitoring and digital diagnostic tools that engage and serve patients by making healthcare more convenient and more connected. These types of technologies have been shown to increase access to care while making care more continuous and less temporary.

Much of the telemedicine conversation centers around making care more accessible and convenient for patients who have grown accustomed to the ease of use of meal delivery and ride-sharing apps. But the scope of telemedicine is much wider than that. Technology has enabled the rapid and seamless transfer of wisdom and expertise rather than people, significantly improving the delivery of care as well as patient engagement for improved outcomes.

For example, in helping recovering heart attack patients, Kaiser Permanente’s virtual cardiac rehabilitation program uses a combination of apps and digital watches to help care teams track these patients’ progress through exercises, tasks, medications, and cardiac measurements. Patients enrolled in this program were almost twice as likely to complete recommended rehabilitation courses compared to traditional face-to-face patients.

4. Move hospital-level care into the home.

Bridging the gap in healthcare access by getting more care right on the phone and at home. Kaiser Permanente’s advanced home care program provides acute care in the convenience and safety of the home for patients who cannot reach the hospital immediately. During the pandemic, such care was essential to connect patients with the urgent care they needed. Securing hospital beds and staff for Covid patients while keeping them safe.

Treating patients at home can lead to better outcomes and higher patient satisfaction. Over 90% of her patients gave the program the highest possible score. Studies have also shown that patients receiving care at home have lower rates of readmissions and complications than those receiving conventional inpatient care.

To continue such home care programs, Congress must act to extend the home acute hospital care waiver issued by the Centers for Medicare & Medicaid Services (CMS). These waivers have allowed patients across the country to expand access to safe, hospital-quality home care during the pandemic.

Kaiser Permanente is one of 110 healthcare organizations belonging to the Advanced Care at Home Coalition that supports the proposed Hospital Inpatient Service Modernization Act. The bill would extend exemptions and provide a more secure path for the development and expansion of home health care programs.

5. Reduce bureaucracy and maintain patient engagement.

Healthcare organizations must build systems and structures to foster patient engagement and ensure that their voices are heard. Clinicians and providers also need to respond to patient feedback with options that align with patient priorities and values. This builds the trust doctors and patients need to participate in shared decision-making.

You don’t have to endure unnecessarily layers of paperwork or long commutes to meet your medical needs. Healthcare systems that don’t meet patients where they are are losing out to healthcare organizations that make it easier for patients to engage with doctors and healthcare teams. Multiple national and international studies have shown that higher patient engagement improves health outcomes.

Kaiser Permanente provides easy-to-navigate online tools to better meet patient demands for timely care options. This allows you to schedule clinic visits, videos, visits, or electronic visits from self-care and email questions to your doctor.

Every encounter with a patient is an opportunity to build trust. Now more than ever, it’s important for clinicians and healthcare organizations to cherish every moment.

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