Benefits of howRU

Benefits of howRU include:

  1. Data Collection
    • Applicable to most patients and conditions
    • Use across different care settings (hospital, clinic, GP, home)
    • Consistently understood without training
    • Quick to complete in seconds
    • Simple aggregate scoring system
  2. Use at point of care
    • Promote patient-centric care
    • Aid communication and shared decision-making between patients and clinicians
    • Identify aspects of patients’ condition that may have been overlooked
    • Provide real-time feedback to clinicians
    • Improve continuity of care and handover
    • Monitor progress of individual patients
    • Training, audit and clinical governance
  3. Reporting and feedback
    • Easy to interpret results
    • Responsive to changes and differences between patients
    • Monitor outcomes for groups of patients
    • Case-mix adjustment
    • Monitor health needs in a population
    • Provide comparable information for management and commissioning
  4. Technology
    • Incorporate into routine health care processes
    • Multi-mode data collection (touch screen, web, paper or telephone)
    • Technology platform independence
    • Suitable for integration with clinical computer systems.

 

At Point of care

Although clinicians may greet the patient, by saying “how are you?”, the response is seldom recorded in a structured way that allows comparison over time. howRU provides a new communication channel for patients to tell their clinicians how they feel and what they can do, in a way that is standardised, computable, easy to understand and suitable for tracking changes.

howRU supports patient-centred care by improving communication between patients, their clinicians and their wider support network.  In this way howRU can enhance the doctor-patient relationship, build mutual understanding, enable safer handover and improve continuity of care.  howRU data could become a standard part of each patient’s presenting history and their electronic medical record. 

howRUdata can be used to detect unexpected changes and to prompt remedial action before problems escalate to another level of severity, requiring more expensive and inconvenient care.  Sharing howRU data between patients and clinicians provides a language for patient-centred care, which patients and their families can use to express how they feel, articulate their own values, preferences and needs, and understand the options available in terms of care and treatment in ways that they can relate to.

Historically, the patient’s principle clinician provided continuity of care, and could remember how the patient was. However, today the patient sees different clinicians and care professionals across multiple care domains and disciplines.  Without continuity of the carer, continuity of care becomes difficult.  howRU can data can be used to share and communicate longitudinal data for out-of-hours services, accident and emergency and multidisciplinary team meetings.  Shared knowledge of the patient’s howRU history may reduce the need for “just in case” admissions.

Knowledge of what happened to similar patients helps clinicians and patients to understand the likely outcomes for the choices that they make, choose the most suitable treatment, educate and reassure the patient that they are doing as well as expected.

howRU provides a feedback loop that helps clinicians monitor patients’ progress, whether recovering from illness or treatment or coping with long term conditions. This same information can be used to align the incentives that drive each stakeholder – patients, clinicians, managers, commissioners, politicians and taxpayers.

Healthcare Management and Commissioning

Managers in all parts of the health service (hospitals, community, primary care and social services), can use howRU data to help monitor outcomes of different health care activities, identify wasted effort, optimise patient value, identify inequalities and improve efficiency, effectiveness and productivity.

howRUdata can be reported in ways that are relatively easy to understand and interpret by patients and clinicians alike.  Results should be published as quickly as possible. Outcomes transparency enables payers and commissioners to identify problem areas, drive up quality improvement and help patients make choices based on evidence. 

Comparisons need to allow for case-mix variation because, even with the best care, high-risk patients, such as those with multiple co-morbidities, tend to have worse outcomes and higher costs. Risk adjustment requires data on patient demographics (age, sex and location), diagnoses and treatment.

Managers can use howRU data to monitor population needs and inequalities, and the clinical and economic effectiveness of care services. At an individual patient level, howRU data can provide evidence for defending medico-legal actions.

Commissioners need health outcomes data from healthcare providers to take decisions on resource allocation, health inequalities and value for money, based on  results, not just costs. Contracts with care providers will be based increasingly on the outcomes achieved, adjusted for case-mix, not just activity.

Managed care services need outcomes data to identify, risk stratify and manage high-risk patients, using algorithms and care pathways to contain their costs of care.  Currently such programmes place most emphasis on clinical measures such as blood pressure and test results and process measures such as visits, admissions and length of stay.  

Policy makers recognise the necessity to monitor value provided, in terms of health outcomes, as well as activity and resource use. Ultimately it is the patient’s own perception that matters most. These ideas are central to the NHS reforms in England and the establishment of Accountable Care Organizations (ACO) in the USA.