Behavior change requires coaching. Improvement is not just about process improvement. Population health will only come about with widespread coaching support.
We can view most of the layers below this one as technology layers. This layer is social. This layers points to the missing role–the role of coach and navigator.
When we asked our patients what it would take to redesign American health care they consistently asked for only three things:
- Their own health record (Patient and Family Layer–though they do not ever refer to themselves as patients) and
- Continuing education and training to care for themselves and their loved ones.
The Navigator-Coach function was clearly the most important to them–it regularly kept them from needing to be seen in the emergency department or admitted to the hospital.
So long as the health care providers a paid predominantly for visits or admission rather than outcomes, positive patient experience, or cost of care–this layer, and the three functions in it, will languish. The moment the payment method really shifts, this role, this layer, becomes the key to success and the technology is enabling this function.