TOPIC (and specific grantee requests) Patient Engagement Sharing information and decisionmaking with patients URL http://www.ipfcc.org http://www.ipfcc.org/advance/supporti ng.html http://www.ipfcc.org/tools/downloadstools.html http://www.healthaffairs.org/events/20 13_02_06_patient_engagement/ http://www.healthaffairs.org/events/20 13_02_06_patient_engagement/media/ agenda.pdf SUMMARY Website: Institute for Patient- and Family-Centered Care (IPFCC) - materials, links, tools for "promoting collaborative, empowering relationships among patients, families, and health care professionals". Bev Johnson is the President and CEO of IPFCC. Bibliographies and supporting evidence from IPFCC on patientand family-centered care, categorized by topic area (e.g., adult health care; discharge and transition planning; HIT; pediatric care; primary care, etc.) Downloadable tools (checklists, workplans, tip sheets, group exercises) from IPFCC, to help foster collaboration with patients and families, and patient-centered care in general Videos from Health Affairs' February 2013 briefing on Patient Engagement - Presentations by authors and other experts describing evidence & potential, the clinician's role, shared decisionmaking, and other aspects of the Patient Engagement issue. NOTE: Each video includes the Discussion that occurred after the presentation with Susan Dentzer (Editor of Health Affairs) delivering the "take-away" messages from each presenter. These 8-15 minute Discussion videos are a great way to get an overview of each panelist's points. Agenda for Health Affairs' February 2013 briefing on Patient Engagement - topics and presenter information for the six panel discussions at the briefing - see above for link to the videos Page 1 of 5
http://partnershipforpatients.cms.gov/p 4p_resources/tsppatientandfamilyengagement/tsppatient -and-family-engagement.html http://www.nationalehealth.org/patient -engagement-framework http://www.nationalehealth.org/cert Resources from CMS on patient, family and board engagement, including patient safety, care transitions, communication aids, guides to partnering with patients and families on policy development; checklists and other tools from The Empowered Patient Coalition; and other implementation resources and guidance. Patient Engagement Framework (from Nat'l. ehealth Collaborative): a model to guide healthcare organizations in developing and strengthening patient engagement strategies through the use of ehealth (electronic and other) tools and resources. The Framework is the result of nearly a year of collaboration and vetting by over 150 top experts in healthcare, IT, standards, consumer advocacy, and Meaningful Use criteria, and is designed to assist healthcare organizations of all sizes and in all stages of implementation of their patient engagement strategies. (The National ehealth Collaborative is a "publicprivate partnership that accelerates effective use of health IT to advance health and transform healthcare," and it developed the Framework in collaboration with ONC, the Office of the National Coordinator of Health IT.) Tool: Consumer ehealth Readiness Tool (CeRT) an online tool for measuring an organization s consumer engagement capabilities and practices, including "an extensive survey-based organizational assessment, real-time progress reports and a comprehensive resource center, addressing technology, infrastructure, culture, and outcomes measurement. The CeRT is mapped to the NeHC Patient Engagement Framework (see above). The CeRT is accessed via a one-year paid membership; fees depend on type and size of organization. Page 2 of 5
http://www.forbes.com/sites/danmunro /2013/08/17/patient-engagementblockbuster-drug-or-snake-oil/ http://healthecommunications.wordpre ss.com/2013/06/18/the-push-forpatient-engagement-who-benefits-themost/ http://content.healthaffairs.org/content /32/7/1299.full.pdf+html http://www.chcs.org/publications3960/ publications_show.htm?doc_id=126116 9 Opinion - re: "offloading tasks to the patient vs. truly partnering with them" - There is convincing evidence that patient engagement works, but there's a risk that organizations see it as a way to offload tasks to the patient, irrespective of their willingness, knowledge or ability to comply. Opinion - patient engagement: who benefits the most? - patient engagement is a physician-patient communication challenge and not an HIT challenge. I fundamentally disagree with anyone trying to force patients to do anything without the benefit of first explaining... what and why you want them to do something; asking for their feedback; teaching them how to do what it is you are asking them to do; and providing ongoing support to patients regarding what you asked them to do. Research Findings re: PAM - Patient activation matters, regardless of health status, provider - Patient Activation (i.e., the knowledge, skills, and confidence a patient has for managing his or her health care) leads to more positive experiences regardless of demographic characteristics and health status. This test of the Patient Activation Measure (PAM) questionnaire suggests that the care experience is transactional, shaped by both providers and patients; and that strategies to improve the patient experience, should focus not only on providers but also on improving patients ability to elicit what they need from their providers. (July 2013) Model program (ppt slides) - Patient engagement for highutilizer Medicaid enrollees - Powerpoint slides from a 2010 webinar; includes descriptions of using teams and motivational interviewing, among other topics, as implemented in WA (for adults with mental illness and/or chemical dependency, as well as physical health comorbidities) Page 3 of 5
Transportation Challenges http://thehealthcareblog.com/blog/201 3/07/30/stop-the-presses-a-diseasemanagement-program-worked/ http://www.ctaa.org/webmodules/web articles/articlefiles/medtoolkit.pdf http://web1.ctaa.org/webmodules/web articles/anmviewer.asp?a=151&z=5 http://ilpconnect.org Blog re:model program - Rural Iowa Medicaid diabetes disease management program works - includes web-based decision support system with daily self-reporting of self-management activities; care manager w/<250 participants; flagging of clinical variances; quarterly behavioral health screenings and referrals; and referrals to community based programs (e.g., Better Choices, Better Health, Stanford Chronic Disease Self- Management, local diabetes education programs). Results: improved medication adherence, attention to diet and selfconfidence regarding self-care skills. Toolkit: Medical Transportation Toolkit and Best Practices - from the Community Transportation Association of America; includes case studies, sample MOUs and contracts, guidance re: special populations, other resources Links from the Community Transportation Association of America - other resources and links Model program - "TRIP" Volunteer-based mileagereimbursement program in Riverside County CA - a "selfdirected mileage reimbursement service that empowers transit dependent unserved people to be self reliant", TRIP is a volunteer driver program that has become a national model for getting needed trips to frail individuals living alone or in rural areas. TRIP s unique feature is that the person needing the trip finds his or her own volunteer and TRIP provides the mileage reimbursement that makes it easier to ask that friend or neighbor for transportation assistance. TRIP is funded largely by local county sales tax funds, but also Older Americans Act and New Freedom dollars. Last year almost 85,000 trips were provided to almost 500 enrollees. Page 4 of 5
Incorporating patient engagement into workflows Meaningful Use Case Studies - describes processes of implementing patient portals, secure electronic messaging, and other tools, including how these new processes and information were incorporated into workflows Other/Misc. http://www.healthit.gov/providersprofessionals/patient-portal-benefitspatient-care-and-provider-workflow http://www.healthit.gov/case-studycategory/patient-and-familyengagement http://www.integration.samhsa.gov/ope rations-administration/workflow http://axialexchange.com/engagement/ methodology/ (same as above) SAMHSA-HRSA Center for Integrated Health Solutions - workflow resources page - although there's a focus on workflows between physical and behavioral health, this site also provides workflow tools and examples in other areas Ranking: Hospital Patient Engagement Index - a U.S. News-like index ranking hospitals on measures of patient engagement. They have completed rankings for FL, CA and TX, and are slated to release rankings from all other states "soon". The scoring and ranking process is described here. Page 5 of 5