Maren Batalden, M.D., M.P.H., is Interim Chief Quality Officer, Associate Director of Graduate Medical Education for Quality and Safety, and Director of Medical Management for the Accountable Care Organization at the Cambridge Health Alliance in Cambridge, Massachusetts. Throughout her career, as a researcher, hospitalist, teacher and leader, Batalden has advanced what it means for clinicians to partner with patients in “coproducing” health care.
The Betsy Lehman Center: The term “coproduction” first emerged as a way to describe the relationship between suppliers and consumers in education, banking and other service-oriented businesses. What does “coproduction” mean in health care, and how does it differ from other efforts, such as patient-centered care and shared decision-making?
Dr. Batalden: There is a lot of vocabulary around how we can provide care that better meets patients’ needs. Patient-centered care. Patient engagement. Patient and family engagement. Patient activation. Human-centered design. For me, all these terms are friends. It is surprisingly easy for health care professionals to forget that we cannot produce health or well-being in another person on our own. We have to work in partnership with our patients. If I go to my doctor because I want help managing my diabetes, I cannot expect her to lower my A1C. The hemoglobin A1C is an outcome that lives in my body. My doctor can give me advice. She can prescribe medications, refer me to specialists, but there is a lot about my well-being that I cannot outsource. My health outcomes are also determined by how I eat, how much I exercise, how I respond to the advice that I am given.
In the way we design, deliver and regulate health care, we sometimes act as if health were produced by health care professionals. The idea of coproduction reminds us that — for better or for worse, whether we like it or not — we are always creating health outcomes in partnership with patients and their families.
The Betsy Lehman Center: Cambridge Health Alliance is a safety-net system that serves patients from vulnerable and low-income communities. Does education or income level affect a patient’s ability to coproduce health care?