HLM: Why does that lead you to say "patient-centered is no longer enough? "
Millenson: The term patient-centered doesn't fit in these circumstances. This is a description of something that is happing outside the healthcare system's control and will sometimes exclude the traditional healthcare system.
HLM: Why is this change such a challenge for doctors, and how can they respond?
Millenson: This is difficult for medical professionals to put their minds around, that they can be excluded. Talking about shared information, shared engagement, and shared accountability starts to give them a framework to adjust to this.
I want the healthcare systems to adapt and be a good partner… It's better for patient. It's better for the healthcare system. But to do that, they have to understand that they are going to have to give up a measure of control so they can face the future.
This concept [of collaborative care] is dynamic and it recognizes shifting boundaries.
That has not always been the case. It's an ecosystem. Sometimes I'll be engaged with my health plan. I might be engaged with another vendor, and not with my doctors.
Sometimes I want my doctor to engage with those people… It is dynamic. This is what makes it difficult. Boundaries blur.
HLM: You talk about retail stores collecting fitness data and widespread access to interactive web sites. Is that why you mean by a shift of control away from doctors?
Millenson: It's saying that we, the individuals, will control when we interact with the healthcare system and, often, how we interact with the healthcare system.
It may be something that looks like a traditional relationship; it may be a very different relationship. That is going to originate from patients and our collaboration with you (the provider), not your pseudo-patient centeredness.
Tinker Ready is a contributing writer at HealthLeaders Media.