Addressing misalignments to improve the US health care system by integrating patient-centred care, patient-centred real-world data, and knowledge-sharing: a review and approaches to system alignment

Abstract

Abstract Background The ills of the United States health care system have been debated for decades. Imbalance in the system’s strengths and performance shortfalls stem from misalignments among system participants. Methods We examine the conflicts that health care system participants provoke in essential features of health care—information, products, services, and access—using a two-part model. The first part comprises patient-provider relationships that give rise to patient-centred care. The second part includes stakeholders that influence patient-provider relationships but do not provide direct patient care. Misalignments between these parts interfere with the system’s quadruple aim: to improve population health, enhance both patient and provider care experiences, and reduce per-capita costs. Results Knowledge-sharing and documented practices and tools to implement patient-centred care and use real-world data can help to align the health care system. Patients, providers, and stakeholders should meet patient-centred care objectives because the patient should be the centre of all health care system operations. Alignment is driven by patient-centred real-world data generated by patient-provider relationships and used by stakeholders. Patient-centred real-world data reveal informative portrayals of patient preferences, health outcomes, resource utilization, and costs across subpopulations. These data enable stakeholders to produce patient-centred information, products, services, and access. These stakeholder outputs meet patients’ individual needs, support providers’ personalized care, and improve system-wide care quality, satisfaction, outcomes, and cost-effectiveness. Conclusions Patient-centred real-world data are valuable commodities and an aligning force. The United States health care system must remove barriers to providers’ patient-centred care practices, use patient-centred real-world data generated from ideal patient-provider relationships, and prioritize patient-centred care among all participants.