Conclusion and Future Direction
The MIRT model of health care delivery relies on active participation of patients and their caregivers. This model is effective, benefits patients (see Table 1), caregivers, health care workers, and hospitals, and will reduce costs because the cost of outpatient therapy is much lower than that provided in the hospital.[15] Hence, the MIRT model's emphasis on outpatient therapy and patient-partnership will undoubtedly impact health care costs by reducing the need for 24 hour staffing and maintenance of inpatient units, decreasing the rate of expensive hospital-acquired complications[10 11] and the need for large capital investments for hospital expansion.
Applying the MIRT model to other medical conditions and settings will face challenges because it requires a change in the "health care culture" from one driven by health professionals and systems to one which embraces active patient participation. The major issues now facing the US health care system represent a unique opportunity to embrace such a paradigm shift. It will also be critically important to educate students in training about the powerful impact of patient partnership on health care outcomes.
MIRT's program will continue to strive for excellence in patient care through partnership with patients to identify and implement novel strategies such as the use of a MM-specific smart-phone application, which will allow patients direct downloading of their test results, as well as the broader implementation of patient/physician electronic communications and the adaptation of novel technologies that enable remote electronic monitoring of vital signs, cardiac, and respiratory functions. These measures will likely further encourage patient participation in their care and decrease the frequency of the need for visits to MIRT's health care facility and, hence, enhance patient comfort, convenience, and satisfaction with the care delivered.
"[When patients] participate more actively in the process of medical care, we can create a new health care system with higher quality services, better outcomes, lower costs, fewer medical mistakes, and happier, healthier patients. We must make this the new gold standard of health care quality and the ultimate goal of all our improvement efforts:
Not better hospitals,
Not better physician practices,
Not more sophisticated electronic medical systems,
Happier, healthier patients."
–Charles Safran
Competing Interests
The authors have declared that no competing interests exist.
This manuscript is dedicated to Thomas Ferguson, MD, a pioneer in patient participation who coined the term "e-patient" to describe individuals who are educated about and engaged in all decisions related to their health. Dr. Ferguson envisioned a health care delivery system built on an equal partnership between e-patients and health professionals and systems that support them.[1] Before Tom's untimely death in 2006, he was putting the final touches on the White Paper in consultation with the group of advisors he dubbed the e-Patient Scholars Working Group.[2] His vision continues to guide the authors in their quest for a patient-partnered health care delivery system.
J Participat Med. 2011;3 © 2011 Society for Participatory Medicine
Published here under license by The Journal of Participatory Medicine. Copyright for this article is retained by the authors, with first publication rights granted to the Journal of Participatory Medicine. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.
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