In Search Of Patient Engagement Presentation For Nmh Summit Feb 2012

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Topical presentation of available frameworks for provider patient engagement

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In Search Of Patient Engagement Presentation For Nmh Summit Feb 2012

  1. 1. In Search of Patient Engagement Presentation to National Medical Home Summit February 28th 2012
  2. 2. In Search of Patient Engagement?
  3. 3. In Search of Patient Engagement? Means or End?
  4. 4. It’s the messageRandomized control study for cancer patienteducation materials Times Logged On Portal Times Reviewed Data Not at Once More All At 20% than 26% Least Once Once 4% 43%Not at All At76% Least Twice 31% http://www.tandfonline.com/doi/abs/10.1080/10810730.2011.571338
  5. 5. Want More?UPMC Study • Portal use linked to patient DISATISFACTION • Portal non-use lined to SATISFACTION www.chcf.org/resources/download.aspx?id=%7BD030A73F...
  6. 6. In Search of Patient Engagement?
  7. 7. Measurement FrameworkPatient Activation Measurement Scale (Hibbard 2005) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361049/
  8. 8. Consider Behavioral EconomicsWhat’s it mean for Healthcare? • How attributes are presented relatively (80% vs Framing 20% fat) Free • Higher worth placed on “free” stuff • Making decisions and changes are always Default harder that doing nothing Loss Aversion • Rather “not win” than lose Social Influences • Peer pressure is stronger than we believe Sources: Dan Ariely, Predictably Irrational
  9. 9. What Is It To You?
  10. 10. What is it to You? • Meaningful • Practical • Measureable • Process driven • Outcomes related • Patient centric • Presents decision framework consistent with the way people make decisions
  11. 11. A DefinitionCenter for Advancing Health • “Actions individuals must take to obtain the greatest benefit from the health care services available to them." o focuses on behaviors of individuals, NOT professionals or policies of institutions. • Engagement is not synonymous with compliance. o Compliance means obedience o Engagement signifies that a person is involved in a process o Individual harmonizes information, advice, needs, preferences and abilities • Definition is agnostic about the many factors that have been shown to influence these behaviors http://www.cfah.org/pdfs/CFAH_Engagement_Behavior_Framework_current.pdf
  12. 12. DefinitionHIT Policy Committee • Patient Activation o Continues to manage his/her care o Measurable health outcomes o Has patient has been led in the “right direction” by his/her healthcare provider regarding his/her plan of care. • Patient Self-management o Self-management resources and tools o In accordance with patient preferences o Self-management of health risk behaviors o Seeks or manages preventive care http://www.google.com/url?sa=t&rct=j&q=hit%20policy%20committee%20measure%20concepts&source=web&cd=2&v ed=0CCYQFjAB&url=http%3A%2F%2Fhealthit.hhs.gov%2Fportal%2Fserver.pt%2Fgateway%2FPTARGS_0_11673_9 49211_0_0_18%2Frfc-measure-concept- list.xls&ei=BDU5T_SNB6X20gHfqrmmCg&usg=AFQjCNE4lEnct_6adY8ctBwlb9r2hhduxA&cad=rja
  13. 13. MeasurementKP Health Connect • Diabetes and HT patients • Secure patient-MD email in “context of EHR” o Average thread was 1.13 patient message and 1.16 provider message • Improved HEDIS measures for 11% of patients • Up to 6.5 percentage improvement for glycemic, cholesterol, BP screen and control • Not randomized – other factors (HMO, continuity of care) http://content.healthaffairs.org/content/29/7/1370.abstract
  14. 14. MeasurementTailored Health Coaching to PAM
  15. 15. MeasurementReduced Utilization and Costs Utilization Charges 0% 0% -5% -5% -10% -10% -11% -11% -10% -15% -13% -15% -13% -15% -15% -20% -20% -25% -22% IP ER -25% -30% -28% -30% -27% -35% -35% -40% -40% -39% -45% -42% -45% All < 65 65> All < 65 65> From Khan S, et al. The Effect of the Vermont Diabetes Information System on Inpatient and Emergency Department Use: Results from a Randomized Trial. Health Outcomes Research in Medicine 2010 1:61-66. Page 15
  16. 16. MEASUREMENTReduction in total costs Effect of PES Platform on Claims Paid Lowess Smoothing 500 Claims Paid per Member 400 per Month ($) 300 200 Control PES Group 100 -48 -36 -24 -12 0 12 24 36 48 Months Vertical line represents the start date for PES group patients and a randomly chosen date for control patients
  17. 17. In Search of Patient EngagementLinkedIn Group http://www.linkedin.com/groups?gid=4121119&trk=hb_side_g
  18. 18. Summary Points Patient Engagement is at the root of major changes in healthcare today An operating definition will emerge, and it will involve outcomes Plans and Providers will need to define and adopt strategies for Patient Engagement18
  19. 19. Thank YouFor more information:Jim RoseSenior Vice President, Business DevelopmentEmail: jim.rose@ptengage.comTelephone: (703) 537-5050
  20. 20. About Patient Engagement Systems Our Mission To improve care by offering technology that engages primary care providers and their patients to improve the management of chronic conditions in primary care settings.20
  21. 21. Rebirth of Disease ManagementResults of the Medicare Support Health DiseaseManagement Pilot Program • $400 million produced modest improvements in 14 of 40 process-of-care measures with no demonstrable savings WHY????? 1. Poor experimental design in commercial findings 2. Lack of personalization in care/treatment plans 3. Population regressed to the mean (see #1) 4. Lack of real time information to manage chronic care 5. No integration with primary care www.nejm.org/doi/full/10.1056/NEJMsa1011785

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