Patient Centered Care

1. Patient – Centered Care
Unit 4: Supporting Patient – Driven Care Coordination
Lecture c – Information – Driven Patient Education
This material (Comp 25 Unit 4) was developed by Columbia University, funded by the Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology under Award
Number 90WT0004.
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

2. Supporting Patient – Driven Care
Coordination Learning Objectives
• Objective 1: Explain the importance of
patient – driven care coordination
• Objective 2: List ways a patient can use
technology to drive care decisions
• Objective 3: Describe the concept of
patient – initiated information exchange
2

3. Definition
• Patient education includes materials and
activities that provide information to
patients to improve their health behaviors
and health status. An educated patient is
better prepared to participate in their care,
prevent errors, improve their outcomes,
and impact the length of health care
interventions.
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4. Introduction
• How can we help patients to be full partners in
their health care?
• A knowledgeable and educated patient is better
prepared to participate in shared decision –
making
– For more information on shared decision – making,
see component 25 unit 7
• Patient education delivered during a hospital stay
or a clinic visit is not retained
• Patients who understand their hospital discharge
instructions are 30% less likely to be readmitted to
the hospital
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5. What do patients want?
• Information available on demand
• Information that is sent proactively
• Information that is personal
• Information that is interactive
• Emotional support that is available along
with the information
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6. Vision
• Patient empowerment through knowledge
• Interactive technology that allows the
patient to control acquisition of knowledge
• Education and information that is delivered
at a place and time when patient is ready
to learn
6

7. Technology
• Television
• Videos
• Internet
• Email
• Health education apps
• EHR driven patient education
• Patient portals
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8. Television
• Patient information delivered by television
is found in many inpatient settings
• These systems allow patients and families
to select and view health education of their
choosing during an inpatient stay
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9. Television (Cont’d – 1)
• Patient – driven; learn when ready and
able
• May not absorb information due to health
status
• May not include all topics needed
• Information is not customized to the
patient
• Relies on memory
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10. Video / DVD
• Flexible use:
– Hospital, clinic, or home – based
– View and review information when patient is
ready to learn
– Relies on memory
– Minimally interactive
– Not customized to patient needs
– Must have video or DVD player technology
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11. Internet
• There is a wealth of health information on
the Internet
• Information can be used either
independently by the patient to research
their health condition or the patient can be
linked or directed to health information on
the Internet by their health care provider
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12. Internet (Cont’d – 1)
• Patient can view and review when they are
ready to learn
• Web sites may be interactive and can
measure and reinforce learning
• Must have Internet access and viewing
device
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13. Email
• Vendors are working on email – based
products that will allow care providers to send
health information or links to resources to
patients based on specified criteria
• Can be automated
• Patient can view when they are ready to learn
• Greater personalization of information
• Provider can track patient learning activity
• Patient must have email address and device
to view information
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14. Health education apps and games
• More physicians and health care providers
are prescribing or recommending health apps
to patients as an educational and behavioral
change technology
– Mobile technology; patient can learn at any time
or place
– Interactive elements to measure, reinforce, and
practice learning
– Not yet widely adopted by physicians, but use is
growing
– Patient must have mobile technology and Internet
connection to use
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15. EHR – driven education
• Education is ordered in EHR and sent to
patient viewing device in hospital
• Patient views when they are ready to learn
• Completion of education flows back into
EHR, where caregivers can assess
understanding and reinforce education
• Requires specific vendor technology, but is
not offered by all vendors
15

16. Patient portals
• Episode – specific information is available
when the patient is ready to learn
• Information can be shared with family and
friends
• Portal may provide links to large health
information databases
• Patients and family can browse and
research health information
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17. Barriers
• Many technologies exist or are emerging to
support the goal of interactive and on – demand
patient education
• There are barriers that decrease the ability of the
patient to manage their own health education
needs
– Health literacy
– Language
– Culture
o Health care culture
o Environmental culture
– Technology
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18. Health literacy
• “The degree to which individuals have the
capacity to obtain, process, and understand
basic health information and services needed
to make appropriate health decisions”
– (Institute of Medicine, 2004)
• Skills to navigate the health care system
• Skills to communicate with health care
providers
• Majority of U.S. population possesses
intermediate level of health literacy
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19. Language
• Limited English proficiency impacts
comprehension of patient health
information
• Lower English literacy correlates with
decreased adherence to health promotion
behaviors from providers
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20. Culture
• Information – driven patient education can
only be successful if cultural factors support
acquisition and use of health information
– Health care
o Transition to partnership – based care model
o Empowered patient
– Environment
o Technology must be present
o Technology must support the patient in health behavior
change efforts
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21. Technology
• Equipment needed to view videos, DVD,
and TV – based interventions
• Internet connection is needed for
emerging patient education tools
• Email address is required for interaction
with health care providers
• Patients need to be able to understand
and use technology
21

22. Unit 4: Supporting Patient – Driven Care Coordination,
Summary – Lecture c, Information – Driven Patient
Education
• A knowledgeable and educated patient is better
prepared to participate in shared decision – making
• Technology can be used to improve the delivery of
health information so that the patient can view
information at the time and place where they are
readiest to learn
• Although barriers such as health literacy, limited
English proficiency, and culture exist, there are
many types of technology that have been designed
to empower the patient to gain the knowledge
needed to successfully manage their own health
22

23. Supporting Patient – Driven Care
Coordination References – Lecture c
References
Armenakis, A, & Kiefer, C. Social and cultural factors related to health, Part A:
recognizing the impact. Presentation presented at Global Health Education
Consortium; 2007.
The Beryl Institute. (2011). Patient satisfaction and patient education increase when
hospitals offer interactive technology. Enhancing the Patient Experience through the
Use of Interactive Technology. Available at:
http://www.theberylinstitute.org/news/60203/Patient-Satisfaction-and-Patient-
Education-Increase-When-Hospitals-Offer-Interactive-Technology.htm.
Cassano, C. (2015). Technology and patient education. Available from:
http://nursing.advanceweb.com/Features/Articles/Technology-Patient-Education.aspx
Frydman, G. (2014). Some underlying principles of patient-driven healthcare. Patient-
Driven Care. Available from: http://www.patientdriven.org/2014/03/some-underlying-
principles-of-patient-driven-healthcare/
Institute of Medicine. (2004). Health literacy: a prescription to end confusion. Available
from: http://nationalacademies.org/hmd/reports/2004/health-literacy-a-prescription-to-
end-confusion.aspx
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24. Supporting Patient – Driven Care
Coordination References – Lecture c
(Cont’d – 1)
References
U.S. Department of Health and Human Services. Health literacy - fact sheet: health
literacy basics. Available from:
http://health.gov/communication/literacy/quickguide/factsbasic.htm
U.S. Department of Health and Human Services. Health literacy - fact sheet: health
literacy and health outcomes. Available from:
http://health.gov/communication/literacy/quickguide/factsliteracy.htm
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25. Unit 4: Supporting Patient – Driven
Care Coordination, Lecture c –
Information-Driven Patient Education
This material was developed by Columbia
University, funded by the Department of
Health and Human Services, Office of the
National Coordinator for Health Information
Technology under Award Number
90WT0004.
25