Honoring the individual through person-centered, holistic care
Kerianne Guth is Director, Clinical Strategy, UnitedHealthcare Community & State and Tom Tracy is Senior Director, Clinical Strategy, UnitedHealth Group.
To establish a relationship with our members built on trust, UnitedHealthcare practices person-centered, holistic care, which creates a partnership between a member and their care team, with equitable decision-making authority for everyone involved. This approach considers an individual’s holistic needs and recognizes that an individual is not just one set of experiences or symptoms. Practicing person-centered care shifts the focus from just responding to a menu of conditions or diagnoses to a focus delivering care that honors individualized choices, desired outcomes and goals.
The foundations of a person-centered approach
The three principles that drive person-centered thinking and care are: a deliberate culture, espoused values and artifacts. The first is the creation and maintenance of a deliberate organizational culture that operates under a set of shared assumptions. One such assumption is that all people have the right to information about their options for care and support to make informed decisions. The second principle is espoused values. Espoused values are how person-centered care is reflected in our engagement with those we serve, such as when a health care professional asks an individual about their preferences, and self-reported strengths, capacities, needs and desired outcomes for their health and care plan. The third principle is artifacts, which refers to memorializing an organization’s deliberate culture and espoused values related to person-centered care. A treatment/care plan is one example of an artifact. Organizations committed to delivering person-centered care ensure their treatment or care plan captures the individual’s preferences and desired goals. This demonstrates a service provider’s commitment to partner with the individual to create a plan that helps individuals achieve their personal goals. Artifacts, such as a treatment/care plan, are often the reviewed by regulatory or credentialing bodies as evidence that an organization is delivering person-centered care.
Placing the patient at the center of care decisions
Put into practice, person-centered care ensures that any care delivery or care coordination is within the context of the individual service recipient. What are their health goals, wishes and desired outcomes? How do they define themselves? Service providers are encouraged to take direct quotes from patients without interpreting what is said so that the next person reading that quote reads it in the voice of that patient and not as an interpretation in the provider’s voice.
While the service provider is seen as having knowledge, training and a set of tools that can be used in the service of a patient, each patient is seen as the expert on their lived experience. This places them at the center of each decision or recommendation. The service provider’s role is to help them understand how the treatment plan can be integrated into their whole life experience. When each individual or service recipient is seen for the capacities they bring, service providers can more effectively bring crucial, helpful and accurate information relevant and applicable to that person’s unique needs.
Operating as a person-centered organization
The concepts and language of holistic, person-centered care are hardwired into UnitedHealthcare’s culture, policies and assessments. We engage members as partners with vital expertise and perspective regarding their health care experience. At an organizational level, our Member Advisory Committees ensure that we capture the voices of the individuals we serve so that we deliver what our members expect and want from us. This includes letting us know when we’re missing the mark so that we can change, adapt and evolve our programs to be more person-oriented and create a more engaged membership.
Recently, our care management team assisted a member with multiple hospital admissions and medical conditions, including vocal cord paralysis due to a cancer diagnosis. The member shared that her son had power of attorney and requested he be engaged in decisions about her care.
When a care manager spoke with her son, he expressed fear that he would soon lose his mom if she did not receive cancer treatment and heart surgery. The UnitedHealthcare multidisciplinary care management team helped the member’s son effectively engage with his mom’s cardiologist and oncologist. As a result, the member was scheduled for heart surgery and the initiation of chemotherapy was scheduled to begin post-surgery. The member’s son said that “getting the pointers from the team, explaining that it is my right to be involved in my mother’s plan and speaking directly to the two specialists was the best solution I’ve received in the last 30 days for my mother.” This story exemplifies how keeping the person and those who are important to that person at the center of care decisions can result in life-changing outcomes.
