Bringing patient-centricity into the lab to improve patient health

As labs become more focused on improving efficiency and output through digital transformation and advanced technology, there needs to be a focus on safeguarding and even continuing to improve patient-centered care. 

Over the past 27 years, Matthew Zachary's work has been primarily recognized for his commitment to "making healthcare suck less," per the title of his podcast, "Out of Patients." As a cancer survivor, a former advertising agent, and a patient advocate, Matthew shares numerous new and unconventional approaches to push the dialogue forward to advance patient-centered care. 

In part II of our conversation with Matthew Zachary, we explore how patient-centricity has a role in improving population health management and data sharing and actions leads may take to offer more patient-focused care.

Q: Population health management is a focus area for laboratories, and COVID-19 exacerbated its importance. In your opinion, what is involved in effective population health management among patient communities? 
 

Matthew Zachary:

The COVID-19 pandemic changed the world, and we must reflect on where we are. Population health management is impacted by social determinants of health. For example, your zip code and education determine whether you will live or die, an unfortunate reality we're now fully aware of and focused on in the US. 

I'm liaising with some of the administrations within the US government to identify how we can limit the variations in health literacy by ensuring everyone has access to everything they need to make informed health decisions. This includes access to affordable quality care, navigation services, and a supportive community in and out of the clinic.

The issue at hand is how to ensure – nee guarantee – every patient is made aware of this ecosystem as soon as they walk in the door to make the best decisions about their care that are most important to them and no one else.

Q: There is a correlation between a patient's engagement in their health and improved behaviors that may promote better outcomes. How do you see health literacy as an indicator of patient engagement?

Matthew Zachary: 

So when I look back at my career in traditional advertising before the internet, the issue was identifying the ideal customer and how they prefer to receive information and make decisions. Today things are very different because targeting people based on race, region, zip code, etc., is easy; now it's all about how you want them to consume the information.

As an example, from my experience, I've noticed that Native Americans in Alaska are not listeners of podcasts or radio. They primarily consume information through tribal linguistics. I worked with the American Cancer Society in the Navajo Nation to better understand where health literacy happens. It's really about trying to understand the best approaches to provide information so that people can make educated choices and decisions that benefit themselves and their loved ones. 

The average patient has no idea what social determinants of health means, although it is everyone's job to understand how to implement ideas behind this. From an advocate perspective, it comes down to the messenger, the message, and what you want people to do by hearing it. 

All of this comes down to trust. For example, many cultural populations in the US are naturally hesitant to trust the healthcare and medical industry based on a history of systemic atrocities done to these cultures and communities. There are lots of hurdles to overcome. 

The role of every stakeholder within the system is to constantly remember that, proverbially, there is a person at the end of the pill and that a human's life is always the end user. One practice could be to put yourself in that position. Perhaps you or a loved one are personally in or have been in that situation. Everyone who works behind the scenes in one form or another is a patient advocate. 

Q: With the increasing use of digital health solutions, how are patients' attitudes towards sharing their personal data with healthcare providers changing?
 

Matthew Zachary: 

The good news is that data collection has climbed off the charts in the last five years. I remember people's hesitancy when it came to sharing their data and privacy. Now society is much more comfortable. It should also not be surprising to anyone that your home devices are listening to you. You can tell them not to, but they do. Data acquisition and collection will continue to be improved and refined. If AI doesn't destroy us, then we will be better as a society. 

Here, The mercurial roulette game is the restrictions on digital health solutions coverage and the payer system's ever-changing whims. You can redefine what preventive coverage entails. 

During the pandemic, there was a debate over whether payers would still cover telehealth and pharmacists prescribing vaccinations without needing the American Medical Association's (AMA) approval. The vast public trust and adoption of this decision demonstrated that change in preventative coverage benefits all parties and is something I would fiercely advocate for.

Even though coverage of genetic and medication testing may be at the mercy of certain uncontrollable factors, lab managers can advocate for this change by weighing in on where the cost benefits lie. Thought leadership and influence of this kind rely on collaboration with activist patient communities who can lead the charge and contribute to the shared decision-making of corporate strategy.

Q: Many big tech companies are starting to enter the healthcare space. As a strategic founding advisor for Google Health, how do you see these big tech companies entering the industry impacting the daily runnings of more traditional clinical labs?
 

Matthew Zachary: 

My perspective is almost laughable because Google made a lot of assumptions. When we started the conversation, I mentioned how no one trusted eBay in the nineties. By 2007, still, no one trusted the internet. The iPhone had not yet launched when I joined Google Health, and Android may have just been released into the marketplace.

There was no way for the Americans even to think it was okay to trust anything. Amazon was starting to sell more than books, and there was more mass adoption in that space. I believe Google made these tragic assumptions that if we build it, people will use it because we ought to have a billion people searching today, which was misinformation.

To some degree, my role on the council was mainly as a token cancer patient. I didn't have a powerful platform or an influential podcast then. I was barely running my non-profit to beat cancer at the time. Google had the foresight to bring actual cancer advocates to the group. 

No one initially wanted to trust Google Health with their health data in my opinion, these companies are fundamentally missing the idea of patient-building trust. In the case of essential medical information, access, and literacy, they function as data retail companies. 

For any healthcare provider, trust and human connection are the foundation. Only so much you can automate will make your life easier. To make a difference, providers need to begin listening to people like me because thousands of "me" in this country have so much information to share about how it works and what we care about. 

Q: What are some words of advice that you would give to lab leaders who want their organizations to be more patient-centric? 
 

Matthew Zachary: 

Investing in things beyond the apparent operational logistics will change patient experience with increased value to all parties regarding staffing and efficient tech and supplies. This way, with patient experience prioritized, there is more value. And with more value comes enhanced outcomes. One example could include something as simple as a more personalized and thoughtful approach to customizing communications to reflect the inclusivity of cultural backgrounds. One size does not fit all.

As I said above, never forget there is a proverbial "person at the end of the pill." Regardless of operational challenges and managing the many nuances of plugging into the system, maintaining a corporate culture of purpose brings humanity into practice.

Another example of an implementable tactic could be working with HR on sensitivity training, hosting live events with patient communities, and getting employees involved in local charitable events to meet and interact with those who benefit from their operations.

In conclusion, there is no lab without the patient. And while it may sound like I am beating a dead horse, recognition of this fact has been a 25+ year effort by tens of thousands of patient advocates to force the industry to change.

As it turns out, investing in recognition of the patient's experience is the very definition of being patient-centric in the real world, and it works. Just try it and see. Treating these patients with attentive service and dignity is critical. Lastly, if you advocate the right way, everyone wins.

Want to hear more from Matthew Zachary and learn more about becoming a patient advocate within the lab? Then check out part 1 of our interview, Healthcare advocacy, innovation, and the lab experience.