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ACP-ASIM Foundation unveils initiative to improve health care communication

From the May 2001 ACP-ASIM Observer, copyright 2001 by the American College of Physicians-American Society of Internal Medicine.

By Phyllis Maguire

The ACP-ASIM Foundation announced an ambitious initiative to help physicians communicate better with patients and each other, and to help patients get better information from physicians and a growing list of publications and Web sites.

The Foundation’s new campaign, called a “signature initiative,” will focus on improving communication to boost health care quality. The multimillion-dollar, 10-year project will try to eliminate communication glitches that compromise patient care and overall health.

Robert B. Copeland, MACP, Chair of the Foundation's Board of Trustees, explained that internists are plagued by communication difficulties, in part because they treat so many chronic diseases and health conditions in the elderly. When the various members of a patient's health care team have problems communicating critical information to each other, he said, patient care suffers.

Dr. Copeland notes that many key health care problems stem from a failure to communicate well.

Foundation officials explained that they met last fall with leaders from the government, insurers, philanthropy groups and consumer organizations to discuss a wide array of health care issues. They realized that almost all the key health care problems identified during these meetings—from patient safety to health care literacy and generalist-specialist information gaps—stem from problems in the chain of communication.

Foundation officials concluded that medicine needs to enhance the trust between patients and clinicians. They also concluded that better information-sharing and coordination of care are essential to that process.

"We can get stock market quotes and bank account information in a matter of seconds, but it can take weeks to get a patient's hospital records," Dr. Copeland explained. "Internists are frustrated that there is no respect for the time it takes to communicate and earn patient trust, and trust is fundamental to medical care.”

He noted that the situation is getting worse. Physicians must devote significant time to helping patients wade through reams of questionable health care information, he explained, even as they spend large amounts their time communicating with payers.

While Foundation officials acknowledge that tackling the different layers and types of health care communications will be a daunting task, they say the potential payoff is too great to ignore.

"The beauty of the initiative is in the breadth of this endeavor, the wealth of the opportunity that lies before us, the magnitude of the problem that we are engaging," Alan R. Nelson, MACP, Special Advisor to the College's Executive Vice President and Chair of the Foundation's Signature Initiative Subcommittee, said at an Annual Session reception. "We know we can make health care better and more efficient if we can improve the clarity and precision of communication within the system."

The Foundation intends to tackle the following basic areas of health care communication:

  • Clinical care communication. The new signature initiative will identify projects to improve communication among physicians, patients and their families, and within clinical care teams (particularly between generalists and subspecialists). The new initiative will examine how physicians and providers can better communicate treatment details and risks to patients and their families, and how they can address cultural differences and literacy issues. The campaign will also explore how existing technology can improve the communication of clinical and billing information.

  • Skills education. The Foundation will work with academic centers and accrediting organizations to address how communication skills are taught to medical students, residents, physicians and other providers. The initiative will also examine curricula, continuing education activities, and licensing and certification requirements.

  • Information for the public. The initiative will work to improve what and how health care information is communicated to the public. It will examine how patients can better communicate with providers to get answers to clinical questions, find accurate information on the Web and better understand the content of direct-to-consumer advertising.

The Foundation will form partnerships with other foundations, industry groups, nonprofits and the government to generate funding and support for the initiative. It will offer project grants to practicing physicians and organizations to develop and test new techniques in clinical communications, innovative care models and educational enhancements.

Dr. Copeland noted that input from College Governors and members at chapter meetings will be "absolutely necessary" for the Foundation to learn about the communication issues that affect internists, patient care and relationships with payers and managed care organizations.

"It won't be easy and it won't be quick," Dr. Copeland said of the project, "but it should lead to a more trusting and stronger healing relationship."

The signature initiative is one of three Foundation projects. The Foundation is also developing a research fellowship initiative and is funding its third year of annual grants. (For more on the Foundation's grants program, go to ACP-ASIM Online at www.acponline.org/journals/news/feb01/grants.htm.)

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