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Person-Centered Care: The “GPS” to Overall Health
Anthony Palatta, DDS, EdD
I remember my grandfather using a magnetic compass as a guide when we hiked in the wooded areas of upstate New York. Raised in New York City, he viewed the acres of forest on which he'd built his home as a new frontier: "This is all you need to travel the world," he would say. My grandfather placed his trust in the science supporting the Earth's magnetic field along with his own observations and experiences of "knowing true north." However, that theory occasionally came up short, like when we planned a daylong walk only to have our path abruptly ended by a roaring mile-long river or an occupied bear cave.
While visiting my grandparents, a neighbor introduced me to geographic maps. She demonstrated to me that knowing one's way about the land required more than a scientific foundation combined with the traveler's own experience. Combined with the compass and known as "orienteering," one also needed a map to navigate the unknown and unseen aspects of the land that the traveler wanted to traverse. With a compass in one hand and a map in the other, we were able to explore large areas of the woodland more effectively and with fewer surprises-except for anything that might have changed since the map was printed. After all, factors independent of our map also impacted our ability to know the land. For example, what looked like a campground on the map only 3 years earlier was now a small town.
Some years later, the global positioning system, or GPS, was first launched by the US Department of Defense. By using time and position data that are continuously updated from satellites orbiting the globe, GPS users are provided multidimensional, real-time information about their own position relative to the position of their location of interest. With this synchronous data in hand, travelers become more than navigators. They and their destinations become interdependent, interactive, and interoperable-critical participants in a shared system in which accuracy of time and space is improved within a few seconds and meters.
Welcome to the concept of person-centered care.
The analogy of the transition from compass to GPS relates well to the concept of person-centered care: the healthcare provider is the traveler, the compass is the healthcare approach or model, and the destination is optimal healthcare.
The foundational skills acquired at academic institutions and refined by the real-life experiences of practice serve as a healthcare provider's basic "compass" for the delivery of competent care. Yet, similar to the palm-held floating needle, this knowledge tethers to the position of the healthcare provider with no detailed information regarding the destination, or in this case, the person seeking treatment. One could classify this approach to healthcare as provider-centric.
In light of this analogy and applying the concept of orienteering, the map represents the tools that allow a healthcare provider to: (a) assess the patient's condition, (b) diagnose active disease processes, and (c) develop an action plan. In dentistry, our maps include study models, testing agents, and imaging, as well as evidenced-based biomedical and clinical research. And yet, like a map, the data amassed are limited by the time at which they were collected. For healthcare providers who do not regularly keep up with new scientific knowledge, their "maps" can become outdated, meaning their approaches to providing optimal care could be compromised. Also, the data tell us more about the disease itself rather than the person with the disease. One could classify this approach to providing healthcare as disease-centricor patient-centric.
What about the state of the person separated from his or her disease? Do our detailed "maps" tell us everything we can and should know to deliver effective care? What if new information arises or extant information surfaces that our maps failed to include at the time of printing? Enter the GPS of healthcare, or person-centered care. In the person-centered care model, not only does the healthcare provider utilize a "compass" and "maps," but the provider also gains access to real-time data regarding the whole person. Like the GPS, person-centered care delivers a multi-dimensional perspective of the person in relation to his or her disease and overall health, as well as environmental factors that surround and influence the individual.
Already studied in the nursing and medical professions, the person-centered care model, with its potential of affording the dental care provider critical yet typically uncollected or unapplied data regarding the patient's overall health, seems like an ideal fit for a profession such as dentistry and allied dentistry, as both involve procedures that require precision and providers who strive for perfection. Why rely on a compass alone when our profession now has access to GPS?
About the Author
Anthony Palatta, DDS, EdD
Chief Learning Officer, American Dental Education Association (ADEA), Washington, DC. The ADEA CCI 2.0 (adea.org/cci) is an interconnected, multifarious learning community of stakeholders stretching across all facets of health education and practice that enables ADEA members to engage in the changing landscape of healthcare through various educational resources.
This is a condensed version of an article that originally appeared
in the November 2017 issue of the Journal of Dental Education,
published by ADEA.