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Joanne Yoong

Joanne Yoong, Senior Health EconomistCentre for Economic and Social Research, University of Southern California; CEO, Research for Impact  Japan

Joanne Yoong, Senior Health Economist
Centre for Economic and Social Research, University of Southern California
CEO, Research for Impact

Can you introduce yourself briefly and share your connection to patient engagement?

Joanne: My name is Joanne Yoong, an Economist with the Centre for Economic and Social Research at the University of Southern California where I lead the Washington DC and the Singapore office. Here in Singapore, I lead my own research and training in consultancy firm called Research for Impact. It’s an action research organisation and I have a visiting appointment here at the Yong Loo Lin School of Medicine, in the Centre for Implementation and Behavioural and Science as well as the Sim Kee Boon Institute for Financial Economics at the Singapore Management University. Yes, so I’m very interested in the health of both the financial and health systems so I work a lot in financial literacy as well as health literacy and I look a lot at consumer decision-making in both these fields which has a lot, I think, of common factors and what’s also very interesting for me is that health decision-making, especially at later ages, is financial decision making. And for me, understanding the health of patients and health systems are two issues that are very deeply intertwined so having patients be engaged in all aspects of their health decision making from the clinical aspects to the social aspects to the financial aspect, is very close to my heart and goes to my research areas.

From your perspective what does a sustainable health system mean to you?

Joanne:  As a health systems researcher and economist, we typically think of sustainable health systems as systems that are efficient in many ways. That they use resources in a way that is technically efficient, that is allocatively efficient, so we put the resources to their best use across the health systems, and at the end of the day are also equitable. But I think if we take a bigger perspective of sustainability we are seeing a couple of new dimensions come up, especially in recent years, that we haven’t thought about as deeply, but we now know are just as important. Health systems have to be sustainable from the point of view of the broader environment, so we have to think about what we think of Environmental, Social and Governance (EGS) goals in the relation to health systems, they have to be culturally sustainable, so they have to be built in a way that at the end of the day for a specific country in specific setting makes sense in the long term. And at the end of the day, they also should be politically and ethically sustainable, so they have to be able to be robust, I mean we are all living now in the COVID-19 age where health systems resilience is a very important part of being sustainable as well, that means really all of these dimensions together.

How do you think Patient engagement can support sustainable health systems?

Joanne: Patient Engagement, I think, is crucially important if we talk about being not just patient-centred, but person-centred from a health systems perspective. At the end of the day, if you want to build health systems that are truly sustainable from the bottom up, patients and their families need to really understand the choices that they are making, they have to be bought into those choices, they have to be activated to sustain those choices, all of these things really matter. We know that clinical management is the start of a patient journey but at the end of the day, behaviour in the community before you see the doctor, after you see the doctor and how you spread that within your community as well, all of that is critical to making sure that whatever we do in the clinical space really has traction and at the end of the day, leads to better population health. So I think Patient Engagement is really key for better clinical outcomes but also for better social outcomes. We now begin to understand that social determinants of health are so important and if we don’t have Patient Engagement on a much deeper level, it’s going to be impossible for us within the health system to understand what that really means in broader context. And last but not least, we know that social health is important, physical health is important, mental health is important, but also spiritual health is important and people need to feel empowered, people need to feel that they have ownership of their health and they need to be able to work towards those goals together with the health systems so I think patient engagement on that level is again another dimension that we’re talking more about these days and it’s really critical on a  more holistic understanding of what it means to be healthy.

In what ways are patients are being engaged either in your own country or other countries you’re familiar with?

Joanne: So I think we’ve seen examples of good patient engagement in health systems that are very well resourced and health systems that are not well resourced by traditional means. I think here in Singapore it’s terrific that we do see, for example, patient conferences that are being held to try and make sure that at the end of the day, the patient’s voice is heard at a very high level and at a very publicly engaged level. Then in other settings where we’ve seen patient engagement activities that involves really working with patients and caregivers together, together with care navigators, especially when we are at key inflection points like transitions back into the community. These types of micro-engagements are also really important. I would not say that I’ve seen a model of any patient engagement ecosystem that is perfect, I don’t think there is such a thing, I think every health system needs to build a patient engagement model that works for them and that is very context specific.

What more do you think can be done to enhance patient engagement?

Joanne:  Yes, I think there are 3 things I would point to.

Firstly , creating safe spaces where patients feel they can really interact, where they can ask questions, where they are empowered to really be curious about what’s going on and to ask difficult questions of their providers so having that space and platform in a very structured way I think is really important where patients feel they can reach out to appropriate resources and be informed in a credible way because we now know today that patient engagement is really important but also that people are very open to a lot of resources out there in the google sphere that aren’t always the best. And so, a safe space, a protected space, where they can explore, and have credible information, I think is really important.

Secondly, I think it is really important to create champions for patients. So very often we see there is a cultural sort of mindset change that needs to take place where patients may feel like it’s the doctor’s role, it’s the specialist role, they’re the experts, we’re not the experts, and actually to see visible champions that they can relate to and they can connect with, I think is really import.

I think the third thing especially in situations where again there is a very particular type of doctor-patient interaction is that we actually need to teach people these tools, how to have dialogues, how to negotiate, literally sometimes how to speak to power and feel confident in themselves. I think all of that is really important. So these three things : building spaces, having champions, and giving people those tools for communication all of these things that we can work on together.

What can multistakeholder regional platforms like CAPE do to support advancing patient engagement in Asia?

Joanne: I think that’s great, having a space, having all of these different stakeholders come in and speak to one another from a place of mutual respect and recognition of expertise and experience I think is really a powerful thing to do.





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Melanie - CAPE website
Joanne Yoong, Senior Health EconomistCentre for Economic and Social Research, University of Southern California; CEO, Research for Impact  Japan
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