Published on February 17, 2014
Patient Focus Within Healthcare Congresses Kent Bottles, MD Faculty, Thomas Jefferson University School of Population Health Chief Medical Officer, PYA Analytics IPCAA Conference Philadelphia, PA January 21, 2014
Patient Engagement/Activation • • • • • Judith Hibbard pioneered academic study Self management Collaboration with provider Maintaining function/preventing decline Access to appropriate and high-quality care
Patient Engagement/Activation • Patient Activation Measure (PAM) tool • 4-level scale of engagement and activation
Patient Engagement/Activation • • • • • Center for Advancing Health Jessie Gruman Identified 43 behaviors Grouped into ten categories “Actions individuals must take to obtain the greatest benefit from health care services available to them”
Patient Engagement/Activation • • • • • Find safe, decent care Communicate with healthcare professionals Organize healthcare Pay for healthcare Make good treatment decisions
Patient Engagement/Activation • • • • • Participate in treatment Promote health Get preventive healthcare Plan for the end of life Seek health knowledge
Klick Pharma ePatient Bill of Rights • • • • • Shared access to my data Attitude of collaboration and overall respect The patient is the largest stakeholder Transparency and authenticity Voice of the patient is legitimate clinical resource • Efficient communication with providers who utilize modern technology
Medicare Beneficiary Survey & Hibbard Survey • Only 30% of older Americans possess motivation and skills to actively engage • 23% embraced PAM behaviors • 12% want to remain unengaged • 29% don’t have knowledge to understand treatment regimens
Benefits of Patient Engagement • Patients on statins more likely than physicians to discuss symptoms/side effects • 23% reduction in surgical interventions with patients using shared decision making • Patients with high PAM scores – Perform self management behaviors – Use self-management services – Report high medication adherence
Jessie Gruman “As a savvy and confident patient who is flummoxed by so much of what takes place in health care, I am regularly surprised by how little you know about how little we patients know. You are immersed in the health culture…
Jessie Gruman But we don’t live in your world. So we have no idea what you are talking about much of the time. One way to help us feel competent in such unfamiliar environments is to give us some guidance about what this place is and how it works. What are the rules?”
Shared Decision Making • Approach where clinicians and patients communicate using EBM tools to jointly make decisions about treatment & care • Patients supported by decision aids to deliberate about consequences of different treatment options to arrive at informed preferences • It can increase patient satisfaction and decrease cost per-capita
Shared Decision Making • http://www.informedmedicaldecisions.org • Salzburg Global Seminar The Greatest Untapped Resource in Healthcare? Informing & Involving Patients in Decisions about Their Medical Care • The Salzburg Statement (http://www.bmj.com/content/342/bmj.d174 5)
Social Media and Patients • “Forget funeral selfies. What are the ethics of tweeting a terminal illness?” • Emma G. Keller • January 8, 2014, The Guardian • Lisa Bonchek Adams, Stage IV Breast cancer patient’s 100,000 tweets • Xeni Jardin’s tweets about cancer diagnosis and treatment journey
Social Media and Patients “I couldn’t stop reading – I even set up a dedicated @adamslisa column in Tweetdeck – but I felt embarrassed at my voyeurism. Should there be boundaries in this kind of experience? Is there such a thing as TMI? Are her tweets a grim equivalent of deathbed selfies, one step further than funeral selfies? Why am I so obsessed?”
Social Media and Patients • Heroic Measures • Bill Keller, The New York Times • January 12, 2014
Social Media and Patients • Standard bearer for an approach to cancer that honors the warrior • Raises false hope • Costs too much • Pegs patients like my father-in-law as failures
Lisa Bonchek Adams • Cancer can be fatal, even if caught early and the patient does everything right • Palliative care can be helpful to better life throughout all stages of major diseases • Clinical trials are not just last-ditch efforts • Metastatic cancer patients know it will kill them, but can still do things to prolong life and improve its quality
Social media and patients • • • • Zeynep Tukekci Social media works as a conversation Social media works as a community Journalists should not peruse, they should engage
3 Challenges for Healthcare Congresses • Support patient activation/engagement • Support shared decision making • Support the conversation and community that social media allows to occur
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CHAPTER 3 Quality in Healthcare: Concepts and Practice Phil Buttell, Robert Hendler, and Jennifer Daley I n the healthcare industry, quality of care is ...
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