Throughout this summer, I have been slowly noticing the similarities that have tied my Duke Engage experience together with my policy internship. The most evident is the concept of incorporating and valuing the perspective of the individual – something that often slips through the cracks.
The month of July was one of constant movement for the Alliance for Health Policy, the health policy organization that I have had the privilege of working at. Within the span of three weeks, we have organized three public briefings, one congressional briefing and a thought leader summit. These have covered a myriad of current health policy topics including surprise billing, comparative effectiveness research and, most recently, patient experience measurement.
Within the healthcare space, there has been a paradigm shift away from the traditional fee-for-service (FFS) reimbursement model and towards value-based care. Value-based care is a reimbursement methodology that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. A key facet of this is that these outcomes are determined largely by the patient and their wishes. To more effectively deliver this patient-centered care, the health policy community has utilized the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS survey. This survey is designed to measure patient experience of hospital care.
To highlight the perspective of the patient, our briefing included Denise Durgin Maloney on the panel. Denise is a breast cancer survivor who shared her experience with her various healthcare providers. She recounted times in which her providers openly discussed and included her in conversations regarding topics such as treatments and times for discharge. These experiences that seemed to provide her with some semblance of control over a scary situation were extremely impactful to hear.
In my DukeEngage world, we have recently had extremely poignant programming. Two that come to mind are our trip to the Center for the Study of Social Policy and the film Beasts of the Southern Wild. At the Center for the Study of Social Policy, we were fortunate enough to meet with their president, Frank Farrow; executive vice president, Judith Meltzer; and their chairwoman of the board, Carol Spigner. While there, we discussed the child welfare system in the United States. Throughout this experience, all I could think of was how little agency the child in these situations always has. Someone brought up the point that if a child is adopted, they have no choice in whether they get to know that or not.
Beasts of the Southern Wild, a beautiful yet heartbreaking film, explores the importance and implications of choice. Hushpuppy, a young girl of five or six, lives in an unconventional community – possibly a place ravaged by a hurricane. Despite lacking the traditional objects that mark a comfortable and healthy living, Hushpuppy and her father feel at home there. After attempts to displace her, Hushpuppy makes the decision to return and stay.
Although seemingly disjointed, these three events have demonstrated to me the importance of incorporating the perspective of the individual or the community into every endeavor, especially when you are seeking to serve in a civic capacity.