Patient at Work - In the Era of PRO.

There is a widespread consensus that it is important to involve patient in their own care, both for the reasons of quality and safety in healthcare and for the sake of the patients' individual rights. The appreciation of patient participation and related notions such as patient empowerment, patient centered care, patient involvement, patient as co-producers of health et cetera, indicate that the role of the patient have changed over the last decades. It has changed from being a passive recipient of treatment to becoming an active and responsible agent. In this paper, we examine these new roles of the patients and discuss the challenges in realizing them. We include the notion of Patient Reported Outcome (PRO) and suggest that realizing this concept indicate a shift in the understanding of participation/empowerment. Participation of patients in a PRO paradigm means to provide patient with a highly-structured task both in terms of the kind of information the health care system requests, and in terms of how and when. It means to focus on what patients do. Further we suggest that a more precise term to denote the new role allocated to the patient would be patient work, not participation or empowerment. To recognize that being a patient is work, would imply a direct emphasis on competences required and the the time needed, on the division of labor and on the necessary condition for doing the work.