Posts Tagged ‘patient self management’

Infographic: Patient-Provider Partnerships Improve Overall Health

February 24th, 2016 by Melanie Matthews

Eighty-eight percent of patients believe that working with their healthcare professional as a partner helps them manage and improve their overall health, according to a new infographic by the Society for Participatory Medicine.

The infographic also explores the impact of tracking and sharing health data.

Evidence-Based Health Coaching: Motivational Interviewing in Action Validated in over 300 clinical studies, motivational interviewing (MI) remains the most patient-centered and effective approach for supporting better patient engagement and activation, disease self-care, treatment adherence and lifestyle management.

Evidence-Based Health Coaching: Motivational Interviewing in Action is the first MI video training series especially designed for clinicians who serve individuals at risk of, or affected by, chronic diseases. Whether you are serving in a wellness, disease management, or care management program, or a primary or specialty care setting, hospital or community program, this series will help you build the practical MI knowledge and skills you need to support your patient health and address the behavioral factors that are responsible for over 85% of avoidable healthcare costs.

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Infographic: eHealth Silver Surfers

August 28th, 2015 by Melanie Matthews

Silver surfers, digital-savvy seniors who use technology in their everyday lives, want to use ehealth for health management—a preference that makes them a desirable group for Medicare plans, according to a new Accenture infographic.

The infographic examines how silver surfers are using technology to manage their health and how health plans can take advantage of these opportunities.

eHealth Silver Surfers

2015 Healthcare Benchmarks: Telehealth & TelemedicineThe world of digitally enabled care is exploding: the number of patients using telehealth services will rise to 7 million in 2018, according to IHS Technology; healthcare apps and ‘wearables’ are trending in technology circles and healthcare providers’ offices; and CMS’s new ‘Next Generation ACO’ model is expected to favor expanded telehealth coverage.

2015 Healthcare Benchmarks: Telehealth & Telemedicine delivers actionable new telehealth metrics on technologies, program components, successes and ROI from 115 healthcare organizations. This 60-page report, now in its fourth year, documents benchmarks on current and planned telehealth and telemedicine initiatives, with historical perspective from 2009 to present.

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New Population Health Management Strategy for ‘Emergent-Risk:’ Arrest Trajectory of Compounding Conditions, Cost

June 11th, 2015 by Adam Kaufman, PhD, President & CEO, Canary Health

Adam Kaufman, PhD, president and CEO, Canary Health


For many years, healthcare organizations have invested in two approaches to population health management: First, wellness management for healthy populations who want to prevent illness, and second, disease/case management for the very sick who must adhere to physicians’ prescribed medical care.

Now, organizations are filling the gap between the healthy and very sick by investing in the ’emergent-risk’ population—adults with one or more pre-chronic or early-stage chronic conditions. Population goal: arrest the trajectory of compounding chronic conditions that compound declines in quality of life and compound increases in cost of care.

Consumer Engagement with Digital Health Self-Management

For many years, the natural worsening of chronic illness has been the focus of academic institutions, a few digital health innovators, and pioneering health plans. As a result of these efforts, a new class of digital health programs is now proven to arrest the trajectory of chronic illness. It started when Stanford’s Patient Education Research Center discovered that self-efficacy (a person’s belief in his or her own ability to achieve goals) had the strongest correlation to improved health outcomes. With this discovery, the concept of health self-management was born. Thus began the drive to engage and impact consumers.

Over the years, healthcare organizations across the United States began offering Stanford’s in-person workshops with notable improvements in health and with measurable reductions in cost of care. According to Stanford research, participants reduced pain, fatigue, depression, and A1C—and reduced ER visits and days in the hospital for up to one year.1 While results were impressive, the programs had one drawback for managers of population health: due to the cost and complexity of in-person delivery, the programs were hard to scale.

As web-based technologies advanced, the research community began to search for ways to harness digital innovation to scale evidence-based programs. In 2006, researchers at the University of Pittsburgh tested the first digital self-management program aimed at diabetes prevention. This digital translation2 of the NIH’s Diabetes Prevention Program3 (DPP) delivered outcomes that mirrored those achieved with the DPP’s in-person, self-management intervention—but at a fraction of the cost.

Data-Driven Insight: The Compounding Effect

As health plans began to adopt digital health self-management, data revealed deeper insights into individuals with prechronic and early-stage chronic conditions. Data from years of Canary Health research with a pioneering health plan shows that chronically ill patients add, on average, a new chronic condition every two to three years. These compounding conditions drive compounding increases in the cost of care—specifically in the areas of pharmacy, medical equipment, and outpatient care.

And without intervention, according to Advisory Board, each year 15 to 20 percent transition to the high-risk population of very sick individuals who require high-cost medical care. This trajectory of chronic illness translates into an additional $1,000-$3,500 in expenses per person, per year. With 80 million adults in this population, that’s an additional $80-$280 billion in costs each year to the U.S. healthcare system. If healthcare leaders don’t prevent this compounding effect, both health plans and providers will hit a financial tipping point where the cost of care puts both margins and mission at risk.

Proven Outcomes: Arresting the Trajectory of Chronic Illness

As health plans began to measure the ROI of digital interventions, a deeper look at results revealed the broader and longer-term impact4 of digital health self-management programs. For emergent-risk populations, the interventions accomplished the following:

  • Halted the progression of individuals’ preconditions to diabetes, heart disease and other conditions;
  • Slowed the progression of existing conditions, and;
  • Prevented compounding conditions and compounding costs of care.

On the heels of this research, the goal became “trajectory impact” at a population level: programs for the emergent-risk population are now designed to arrest the trajectory of compounding conditions and compounding costs of care. With digital technology’s ability to scale, entire emergent-risk populations can be targeted immediately for outreach and intervention.

And with the lower cost structure of digital technology, health self-management interventions can generate a return beginning one year after the intervention and continuing over the lifetime of each individual.

Citations:
1 Lorig K, Sobel DS, Stewart AL, Brown BW, Bandura A, Ritter P, González VM, Laurent DD, Holman HR. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care 1999; 37(1):5-14. View the abstract at http://www.ncbi.nlm.nih.gov/pubmed/10413387.

2 The digital translation of the DPP was described in the journal article from McTigue, et al. Using the Internet to Translate and Evidenced Based Lifestyle Intervention into Practice Telemedicine and e-Health Vol 15#9 November 2009. Read more at http://www.ncbi.nlm.nih.gov/pubmed/19919191.

3 The Diabetes Prevention Program (DPP), a major, multicenter clinical research study, discovered that modest weight loss through dietary changes and increased physical activity sharply delayed the onset of type 2 diabetes among pre-diabetic patients. The study showed that taking metformin also reduced risk, although less dramatically. Read more at http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram.

4 A two-year, controlled matched study by Canary Health for GEHA, a self-insured, not-for-profit association providing health and dental plans to federal employees and retirees and their families through the Federal Employees Health Benefits Plan. For a briefing on case study results, contact akaufman.canaryhealth.com

About the Author: Adam Kaufman is a health economist and the president and CEO of Canary Health. He speaks to audiences nationwide on the accelerating trend of chronic illness and the financial tipping point that threatens the margins and mission of American healthcare organizations and advises healthcare senior management teams on making strategic investments in their emergent-risk populations. Prior to serving Canary Health as President and CEO, Adam served as general manager of dLife’s Healthcare Solutions division. Kaufman has served as adjunct assistant professor in the economics department at the University of Southern California, and he is the author of a data analytics patent that predicts consumer engagement.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

4 Behaviors of the Highly Activated Patient

May 7th, 2015 by Patricia Donovan

The success of a population health intervention depends upon participants’ level of self-engagement. The Patient Activation Measure™ (PAM) designed to assess an individual’s knowledge, skill and confidence in managing their health, consists of a 13-item scale that asks people about their beliefs, knowledge and confidence for engaging in a wide range of health behaviors. Here, PAM developer Dr. Judith Hibbard, MPH, Dr.PH, describes some of the traits associated with a highly activated, engaged patient.

It is important to understand exactly what is happening with individuals at different levels and what is going to help them. We did several studies to find out if activation predicts behaviors, and to determine which behaviors it predicts. We did a national probability study and then replicated that study in the United Kingdom. They found almost exactly the same results as we had in the United States. Since then, there have been many more studies.

We found that people who scored higher on this measure were more likely to:

  • Engage in preventive behaviors like screenings or immunizations.
  • Engage in healthy behaviors, such as regular exercise and having a healthy diet.
  • Engage in more disease-specific self-management behaviors, such as monitoring or adherence.
  • Engage in more health information-seeking behaviors.

Once we saw these results, we began to look at the data a bit differently. We realized from the data that some behaviors don’t start until people move further along that dimension of activation.

Source: Three Pillars of Health Coaching: Patient Activation, Motivational Interviewing and Positive Psychology
health coaching
Judith Hibbard, MPH, Dr.PH, is a professor of health policy at the University of Oregon. For more than 30 years, she has focused her research on consumer choices and behavior in healthcare. Dr. Hibbard is the lead author of the Patient Activation Measure™ (PAM) and advises many healthcare organizations, foundations and initiatives.

4 Benefits of Online Health Communities in Chronic Care Management

July 12th, 2013 by Jessica Fornarotto

Can blogs, chats and forums replace a cadre of skilled healthcare providers? Probably not, but they can contribute to information exchange, self-management and collaboration among physicians.

Flummoxed by the rapid aging of Western societies, the scarcity of skilled providers to care for people with complex healthcare needs, and the threatened unaffordability of care, researchers recently looked at the use of online health communities (OHCs) as a tool to address some of these challenges.

The OHCs are Internet-based platforms that unite either a group of patients, a group of professionals, or a mixture of both. Members interact using modern communication technologies such as blogs, chats and forums.

There are four benefits to using OHCs in chronic care, according to researchers from the Journal of Medical Internet Research (JMIR):

  • Facilitate the Exchange of Medical Experience and Knowledge: Due to rapid advances in medical knowledge, many health professionals lack specific expertise and experience to address complex healthcare needs. Therefore, healthcare is increasingly organized within specialized networks whose processes occur largely offline during physical encounters, such as medical conferences.

    However, modern communication technologies now support professional networks online. Within OHCs, professionals connect and communicate more easily, regardless of their working place within the network, and regardless of time. OHCs can be used to develop disease-specific expertise among all community members, patients and professionals interested in a particular chronic condition.

  • Enhance Interdisciplinary Collaboration Across Institutions and Traditional Echelons: Healthcare delivery can become fragmented for chronic patients when they acquire relationships with multiple professionals and institutions. To manage complex patients with multiple comorbidities, health professionals must collaborate to make coordinated decisions and share responsibilities in health outcomes.

    OHCs offer a platform for supporting medical decision-making and interdisciplinary collaboration across professionals caring for complex patients. OHCs enable communication between community members, bridging geographical distances and enable interaction across institutions and traditional echelons.

  • Provide a Platform to Support Self-Management: Typically, patients have a passive role and lack the tools to self-manage their condition. However, modern patients search the Internet for medical information, wish to have open communication channels with their physicians, and prefer to participate in making treatment decisions. Supporting patients with chronic diseases like type 2 diabetes, arthritis, and asthma to self-manage their condition helps to improve the quality and safety of care and reduces costly and inappropriate use of healthcare resources.

    Chronic patients using online communication tools become more knowledgeable, feel better socially supported and empowered, and have improved behavioral and clinical outcomes compared to nonusers. Examples that include OHC principles are patient participation in online peer support groups and access to personal health communities (PHCs). PHCs allow patients to have access to medical records, control their own online information, and enable individualized health communication.

  • Have the Ability to Improve Patient-Centered Care: Patient-centeredness is about engaging patients to become active participants in their care to reduce healthcare utilization and improve efficiency, patient-doctor communication, treatment compliance, and health outcomes. OHCs enhance patient-centered care by improved access to personalized information, emotional support and patient participation.

    PHCs are essentially patient-centered, while they engage patients in their care process and tailor care to their individual needs. Professionals can benefit from patient peer-to-peer conversations that take place in OHCs by knowing that they have more effectively addressed their patients’ needs. Blog and forum items often involve aspects of patient-centered care, such as information and emotional support needs, patients’ willingness to participate in treatment decisions, or an experienced lack of continuity of care.

The researchers concluded that OHCs are a powerful tool to address some of the challenges chronic care faces today. Further evaluation should address user needs, risks, benefits, and cost implications before OHCs can be fully adopted in daily practice.

Infographic: Tracking Health Trackers

April 23rd, 2013 by Melanie Matthews

U.S. adults with multiple chronic conditions are more likely to track their health indicators, according to an infographic by Pathfinder Software, which is based on Pew Report findings.

The infographic also looks at how and why individuals are tracking their health status.

Tracking Health Trackers

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You may also be interested in this related resource: Best Practices in Contemporary Case Management.