How to Practice Human-Centric Care

Health systems are shifting away from disease-based care.

Sentara Health is embracing a human-centric model of care.

Historically, clinicians have practiced disease-centric care, which focuses on at-the-moment health concerns and episodes. But more and more clinicians are shifting to holistic approaches to care that focus on keeping their patients healthy and partnering with patients to meet health goals.

The human-centric model of care is more of a psychological approach, says Jordan Asher, MD, MS, executive vice president and chief clinical officer of Sentara.

"How does the patient think?" Asher says. "What makes the patient tick? What are the patient's human conditions that cause them to be activated and engaged? The magic happens when you use the human-centered approach to impact disease management."

The human-centric model of care that Sentara has embraced formalizes the movement toward patient engagement and activation that began several years ago. Other healthcare organizations have adopted this approach, including CVS Health.

Asher cites an example of treating an obese patient. In doing a motivational interview, the patient said she was embarrassed when she took her grandson to an amusement park, and they could not go on the roller coaster because the safety bar could not fit over her.

The patient's care team decided to make her health goal to take her grandson to the amusement park the next summer and ride the roller coaster with him. That activated and engaged the patient: It was a care plan that solved a problem that she wanted to solve. The next summer, the patient sent Sentara a picture of her sitting on the roller coaster.

"The care team knows what the problem is, and they find out what can motivate the patient to solve the problem," Asher says. "If I can figure out the patient's activation and engagement motivation, then I figure out the best way to communicate with the patient, I am taking a human-centered approach. I am activating and engaging the patient and figuring out the best way to communicate in the way that works best for the patient to take care of a disease issue."

The primary benefit of shifting from a disease-centric model of care to a human-centric model of care is being able to treat the patient as a whole human being versus a person with a disease.

"The patient is going to respond better to the care team," Asher says.

Another benefit of the human-centric approach is improving the clinician experience.

"Clinicians want to help their patients," Asher says. "Nothing is more unfortunate than when clinicians do not see their patients getting better. By taking a human-centric approach, the patient's likelihood of getting better goes way up, and the joy of clinicians taking care of the patient goes up as well."

The human-centric approach also leads to better outcomes, Asher says, because patients are more engaged and activated to improve their health.

"We have learned over the years that if a clinician just tells a patient what to do, it may not change anything," Asher says. "For example, most people who smoke know it is bad for them. They still smoke despite someone telling them not to smoke. We need to identify what engages and activates a smoker to help them quit."

Getting clinicians to practice human-centric care

Under the disease-centric approach to care, physicians have been trained to diagnose and treat patients to prevent mortality and morbidity.

This is a futile effort, Asher says.

"Physicians fail 100% of the time because eventually every patient dies," he says. "Our definition of success needs to change to where the patient feels they are living life to its fullest. The best way to do that is through the human-centric approach because it helps patients live their lives to the fullest."

"If the physician is helping patients live their lives to the fullest in the patients' manner, it is a better definition of success and gives the physician a better feeling of living up to their calling," Asher says.

Sentara is promoting the human-centric model of care among clinicians through three channels.

"No. 1, we are reaching out to medical schools such as Eastern Virginia Medical School to get the human-centric model of care into the curriculum," Asher says. “No. 2, once we talk with our physicians about the 'why' behind the human-centric approach to care, they start asking for more information. No. 3, by wrapping around care teams that are doing this kind of work, physicians can still diagnosis and treat patients, but the overall team approach is helping to create the human-centric model of care."

The team approach to human-centric care has several elements, Asher says.

One team member can focus on understanding the patient’s activation and engagement level and work with the rest of the team to improve those motivations. Other team members can focus on the specific disease or health concern and how to address them. And other team members can identify the barriers faced by the patient and plot how to overcome them.

"The team considers the patient's social needs, activation and engagement, and disease state, then the team works together based on what is best for the patient," Asher says.