The document discusses research from a proprietary study conducted by Eliza Corporation in June 2013 on consumer attitudes towards advanced care planning. It finds that while over two-thirds of people have discussed end-of-life wishes, less than a third completed any documentation and only a third of those could easily be found. It also finds confusion around common terms and interest from consumers and caregivers in tools and resources to help with these conversations. The document recommends targeting health plan members, active duty military, and caregivers with messaging around documenting preferences now rather than in an emergency and ensuring others can find and honor those preferences.
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As PBS has always said, "the more you know," the better. The healthcare industry is awash with value-based care rhetoric, and the power of data-driven decision-making to transform care delivery and reimbursement. But without the context to meaningfully engage with each person AS a person - patient, health plan member, healthcare provider, caregiver - we are perhaps missing the "value" point. And this miss has implications across cost, quality, and experience Triple Aim goals.
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Understanding the vocabulary of health insurance helps in selecting and using coverage effectively. eHealthInsurance commissioned a national study to determine public awareness of select health insurance terminology and the specifics of health insurance coverage. Americans admit to a health insurance vocabulary deficit.
Only a fourth (23%) feel they are very sure of what the terminology used in their health insurance policy actually means.
A third are somewhat sure of what the terminology actually means (32%).
One-fourth are not very sure (13%) or have no idea (10%) what the terminology used in their health insurance policy means.
One-fifth report they don’t have health insurance (21%).
The public demonstrates its lack of familiarity with health insurance terminology by not knowing what some of the key abbreviations stand for.
Only one-third of Americans (36%) can volunteer that HMO stands for health maintenance organization.
Only one-fifth (20%) recall that PPO stands for Preferred Provider Organization.
Only one out of nine (11%) recalls that HSA stands for Health Savings Account.
When asked how sure they were with some of the specifics of their health insurance policy, most people said they were very sure of the amount of their co-payment (61%), but half or fewer were very sure they knew the amounts of other basic elements of their coverage:
Half said they were very sure of what they paid for their health insurance premiums (50%).
45% were very sure of their annual deductible.
41% were very sure of the level of their plan’s co-insurance.
35% were very sure of their maximum annual out-of-pocket costs.
For each of these items, one-fifth indicated that the questions were not relevant since they did not have health insurance (21%).
Nothing in our world is changing as quickly as healthcare. Patients are using search, social media and apps to diagnose symptoms, research physicians, schedule appointments, access medical records, connect with other patients and take a more active role in their health. At the same time the tremendous amount of data created by this activity means patients have a much larger digital footprint than ever before. Savvy healthcare marketers can use this data to attract new patients, improve care and collaborate with other healthcare professional. Learn how the patients of today and tomorrow are using technology as a key part of their healthcare and how you can be a bigger part of the Digital Patient Journey.
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drinking, negative social consequences, risky use, and altered physiological
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Understanding Consumer Attitudes, Barriers, and Motivations around Advanced Care
1. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
Understanding consumer attitudes, barriers, and
word-strings around advanced care
Eliza Corporation
June 2013
2. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
2
OPPORTUNITIES AND CHALLENGES
Who’s having advanced care conversations? How can we further engage them?
3. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
3
The good news
68.3%
29.3%
2.3%
Have you ever had conversations about end-of-life wishes
– either yours or someone’s you care about?
4. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
4
The not-so-great news …
28.2%
55.6%
16.2%
If yes, did you complete any documentation
about this conversation?
5. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
5
Now if we could only find it
34.7%
65.2%
If you did document your preferences, is it stored
somewhere that would be easy for a loved one or medical
staff to quickly find?
6. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
6
Opportunity knocks
43.6%
32%
24.3%
Do you wish there were a tool, like a conversation
starter, that would make/would’ve made that
conversation easier?
7. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
7
People will engage with their health plan on this topic
24.3%
18.9%
13.9%
11.6%
18.5%
5.8%
7.9%
If your health insurer offered resources to help you think
through and document your wishes, how likely would you
be to use these kinds of resources?
8. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
8
And it’s the government’s responsibility
6.1%
1.5%
2.7%
8.1%
15.4%
10.8%
55.2%
How important do you think it is for the government to
make sure all active duty military members have their
end-of-life wishes documented so that in the case of a
medical emergency or serious illness they get the care
they want?
9. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
9
Key considerations
Targeting
o Health plan members
o Active duty military
Messaging
o Record your preferences now – not when you’re sick
o Make sure others can find and honor your preferences
10. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
10
WORD-STRINGS AND TERMINOLOGY
What words do people use to describe advanced care planning?
11. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
11
We asked for terms to describe roles:
o “Loved ones who care for them at the end of their lives” – we expected CAREGIVER and
heard…
o “Person they designate to make healthcare decisions on their behalf” – we expected
PROXY and heard…
Confusing, inconsistent terminology
Don't know Family Caregiver Caretaker Power of Attorney
%Responses
Family Don't Know Power of AttorneyBeneficiary/ Executor Caregiver Guardian
%Responses
48%
24% 21%
4% 3%
32% 30%
15% 11% 10%
2%
12. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
12
“Do you know what these terms mean?”
Depending on who you talk to
13. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
13
“I’m concerned about final
expenses”
“the way that the doctors worded it
gave my father a lot of false hope”
“different departments need to
make sure that they are all giving
us the same message”
“have a regular conversation – not
just for the patient but for the
patient’s family as well”
“the doctor listened and wrote
down all her wishes”
14. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
14
Key considerations
Targeting
o The caregiving experience
o Families and spiritual advisors
Messaging
o Start simple, and define terms as you go along
o Acknowledge the tradeoffs
— Being at peace ranks high for many key segments
— Independence is a key theme for men, while comfort wins among women
15. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
15
CAREGIVERS AND HEALTH DATA
Connecting caregivers with the information they need
16. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
16
Caregivers are eager to access online health data
60% of caregivers say it is important to their
choice of health insurance to be offered easy
access to PHI
Nearly 70% of caregivers say the ability to
access their own PHI without asking their
doctor is important
17. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
17
Caregivers are eager to use online health data
Fewer than half of caregivers (48%) are
concerned about the safety and privacy of the
information in their online personal health
record; nearly one-quarter say they are not
concerned
Caregivers are more apt to take action on
health information found online without
speaking with a doctor
18. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
18
Caregivers are more apt to be early adopters of technology
19. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
19
Caregivers are more apt to access online and offline health
records
20. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
20
Key considerations
Targeting
o Caregivers
o Early adopters
Messaging
o Empower yourself to understand and honor loved ones’ values
o Empower your family to understand and honor your values
21. Proprietary and Confidential to Eliza Corporation. Copying or distribution by any method is prohibited without prior authorization from Eliza Corporation
21
QUESTIONS?
LET ME ASK THE EXPERTS BACK HOME.
Editor's Notes
Overview: Web-based survey conducted in January 2013 to a panel of 250 adult Americans that is representative of the US population in terms of age and gender.
Overview:Email survey (January 2012) of 100 adults representing a random population based on US Census. Quantitative and Qualitative . Survey developed specifically to support research of the Serious Illness Communication Checklist – a project spearheaded by the Dana Farber Cancer Institute under DrAtulGawande and team.
“Caregiver”: Experienced caregivers more likely to say YES“Power of Attorney for healthcare”:More older (56-90) vs younger (20-55) respondents know what this term meansExperienced caregivers more likely to say YESThose self reporting poor health more likely to say YES“Surrogate decision maker for healthcare”: More in the North vs South know what this term means
Potential word strings to focus on
79% of people say they want their families involved in early conversations about advanced care planning Note that 87% of people say they consider themselves religious or spiritual in some way, and 69% of them say there is someone in their life that consider their spiritual leader or advisor.Offer planning tools and checklists to help patients (and their families and/or spiritual leaders) early, so there is less pressure from the medical community (and more consistency) toward the end of life“If you’ve ever been in a situation in which you had to make tough decisions about a loved one’s care, you know how important it is to feel that you’re all on the same page when it comes to end of life preferences.”
Overview: Web-based survey conducted in February 2013 of 600 respondents, using a quota sampling technique that ensured representation based on 2011 US Census Data. The Office of the National Coordinator served as a subject matter expert for the survey development and has presented key findings from the report all the way up to the White House.