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Healthcare is changing, but sometimes it seems like that change happens in fits and starts. This month, we’re looking at four stories about innovation — and the need for innovation — in the American healthcare system.
AI is helping doctors improve the way they talk to dying patients
Not everyone is a natural listener, and empathy comes more easily to some people — yet for medical care providers, both are necessary job skills. Until now, there has been little if any research analyzing doctor-patient communication at scale, but one team at the University of Vermont is exploring an AI solution.
They looked to palliative care for data that would help them identify the moments and modes of communication that help patients and their families feel heard, cared for, and understood. To do that, they collected more than 200 hours of audio recordings of conversations between doctors and patients and analyzed them for pauses, emotional words, and sounds like sighs and crying.
The results revealed that these “connectional silences,” are transformative to doctor-patient conversations, and providers can and should reorient the way they approach these conversations. When providers give patients the space to shift from their default communication style to one more conducive to real sharing and candor, the result is better care, whether the patient is facing terminal cancer or just managing symptoms of stress.
City of Kirkland continues to innovate for their employees
Seattle-area housing costs are among the highest in the country, and for the nearby City of Kirkland, that has meant that many city employees — fully 85% of staff — don’t live in Kirkland. Low- and middle-income employees, in particular, are forced to commute longer distances to work as they’ve been priced out of even traditionally affordable neighborhoods.
In response, the City of Kirkland has become one of several pioneering employers in the area to explore housing support as an employee benefit. In early September, the city council voted to partner with a development company to set aside 34 units in two downtown buildings specifically for city employees. An additional 23 units will become available in another building that’s currently under construction.
Currently, the plan simply reserves a certain number of units for city employees; they won’t receive a discount on their rent, but the units are among the most affordable options in the area, and rent increases will be capped at 3% a year.
Note: The City of Kirkland is a Vera Whole Health client.
Why wellness programs still struggle with proving ROI
While wellness programs and incentives often post strong results, the industry is still struggling to translate them into return on investment (ROI).
The goal of these programs is to decrease healthcare costs by incentivizing employees to make better healthcare choices, but the problem is that these costs are tied to too many other factors. Changing workforce demographics and even a few large claims for self-insured employers can move the numbers significantly.
As a result, even institutions that are happy with their wellness programs often decline to attribute cost improvements directly to these programs. Instead, they look to results like whether employees report that they enjoy work, intend to stay, and would recommend their company as a great place to work.
Tying these positive responses to exact retention rates, hiring costs, and other metrics of ROI is still difficult, but for companies that are trying to improve employee health and satisfaction, wellness programs remain an appealing, short-term option.
The US needs more primary care providers, so why are med schools directing students elsewhere?
By 2032, the American Association of Medical Colleges projects a shortage of 21-55,000 primary care providers (PCPs), and signs of improvement are few and far between. While alternative healthcare models like advanced primary care are gaining steam, US medical students are choosing medical specialties over primary care at an alarming rate.
Specialists make nearly twice as much as PCPs, deal with less paperwork, take on less personal responsibility for patients’ ongoing care, and have shorter work days.
Many medical schools openly encourage graduates to specialize, and the attitude that some students are “too good for primary care” is pervasive. Even students who love primary care often choose other paths because they know our medical system won’t allow them to practice the way they want — the vast majority of PCPs don’t have the time they need to build patient relationships and explore the nuances of patient health.
So what’s next? Healthcare models are emerging that break the cycle of low reimbursement for PCPs, which forces them to see more patients each day to stay profitable. Advanced primary care, concierge medicine, membership-based and direct primary care are among the proposed solutions, but more change is needed if we’re going to have enough primary care doctors in time.
As the American healthcare system continues to evolve, it’s essential that we find a balance between exciting tactical improvements, like utilizing AI to improve doctor-patient communication, and the more complex fundamental problems like simply having enough primary care doctors. We believe that advanced primary care is one of the best ways to improve the process of healthcare delivery for patients, doctors, and even employers and insurers.
