THE ROLE OF PATIENT VALUE AND PATIENT-CENTRED
CARE IN HEALTH SYSTEMSas is their all too frequent development without real patient input. PROMs, however, should only
be the beginning, with other relevant metrics needed to map the patient experience and the non-
clinical outcomes that may matter to patients. Even the creation of metrics will not be enough. Again,
workflows, payment schemes, and training will need to change for their full integration. Until all of this
happens, adequate measurement, and therefore patient-centred care as a whole, will remain in the
starting blocks.
It cannot be done without making patient engagement the norm. Efforts to improve patient-
centred care without patients’ input are likely to fall short. China’s experience over the past two
decades reflects what can happen when even well-funded, well-intentioned reform fails to understand
what patients really think and want. To some degree, this problem is far from unique to China. Too
often, some patients are more active in health systems than others, with patient-centricity the prize of
successful advocacy movements, while health systems can become less interested in those with other
diseases. Here, cultural change is essential. Patients need to step up, but for this to work well barriers
to doing so should fall. It is not about taking power away from the clinician and provider in order to
give it to patients. Partnership needs to become the default state of clinician-patient interaction if
patient-centred care is to become a reality. For this to occur it requires more than just cultural change
on the part of clinicians and patients; policymakers too need to listen and act in an appropriately
supportive manner.