Assigment .Apa seven . All instructions attached.

C H A P T E R 5

Consumer Engagement/Activation Enhanced by Technology

BACKGROUND AND PERSPECTIVE

• Organizations like Aligning Forces for Quality (AF4Q) intend to put the patient in charge of their healthcare data.

• There is evidence that communicating with patients about their healthcare decisions yields optimal outcomes.

• As per 2011 Cochrane systemic review of 86 clinical trials, patients’ use of evidence-based decision aid led to:

• improved knowledge of options • more accurate expectations of possible benefits and harms • more consistent choices with informed values • greater participation in decision making

• The Centers for Medicare & Medicaid Services (CMS) considers patient engagement a quality metric under Health Information Technology for Economic and Clinical Health (HITECH) Act.

• It is also a major focal point of stage 2 of MU of HER.

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INTRODUCTION (Cont.)

• Office of the National Coordinator (ONC) established the website (www.healthit.gov) to promote consumer engagement.

• The National Quality Strategy report is provided to Congress annually. • It defines the status of health improvement efforts throughout the country.

• Flex Medicare Beneficiary Quality Improvement Program provides technical assistance and national benchmarks to participating hospitals.

• This improves healthcare outcomes in person-centered care.

• National Prevention Strategy endorses preventive healthcare tactics aimed at the top national health concerns.

• Affordable Care Act (ACA) expands health insurance coverage in three ways: • By subsidizing private plans offered through health insurance marketplaces. • By increasing eligibility for Medicaid. • By banning insurance practices that penalized people with minor health problems.

• Accountable care organizations (ACOs) are charged with providing high-quality care to assigned beneficiaries while also meeting quality metrics and financial targets.

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PATIENT CARE-RELATED ENGAGEMENT APPROACHES

• Patient Engagement in Health and Health Care Framework given by Carmen et al. presents: • Different forms of engagement ranging (from consultation to partnership) • Different levels of patient engagement (from direct care setting to organizational design, governance and policy

making) • Factors affecting the patient engagement

• Center for Patient- and Family-Centered Care Healthcare Information and Management Systems Society (HIMSS) expanded the Carmen framework to include meaningful use (MU) categories.

• These support provider efforts to meet the HER federal requirements.

• Language clarity and health literacy are important.

• DNA analysis in guiding healthcare decisions is becoming more common.

• The website Health Tech and You (www.healthtechandyou.com) is a site: • Dedicated to the use of technology to support self-management of health. • Provide patient-generated data to providers and appropriate caregivers via the fitness apps and wearable

devices.

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PROVIDER APPROACHES/COMPETENCIES

• Interprofessional approaches to care delivery are most successful.

• The interdependencies of the core interprofessional team competencies are: • Utilizing informatics • Providing patient-centered care • Applying quality improvement • Employing evidence-based practices

• Patient engagement improves patient outcomes and decreases the cost of delivery.

• Social construction of family health has contextual, functional, and structural dimensions.

• Neuman Systems Model views client as an open system with physiological, psychological, sociocultural, developmental, and spiritual variables.

• These respond to external stressors.

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PROVIDER APPROACHES/COMPETENCIES (Cont.)

• Institute for Patient- and Family-Centered Care (IPFCC) recognizes the: • Vital role families play in ensuring health and well-being of family members of all ages • Emotional, social, and developmental support.

• Hospital Readiness Assessment document is an extensive survey. • It rates a hospital’s patient and family centeredness characteristics.

• Students and working professionals must maintain proficiency in core areas of patient-centered interprofessional competencies.

• Using the Nancy Staggers model of information technology, 216 competencies were categorized. • The range of competencies were quantified to computer skills, informatics knowledge, and informatics skill.

• Precision medicine focuses on individuals and the unique needs of each family member.

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PROVIDER APPROACHES/COMPETENCIES (Cont.)

• i2b2 program: • Is an example of an NIH-funded National Center for Biomedical Computing (NCBC) • Charged with initiating development of national computational infrastructure for biomedical computing.

• Citizen science encourages members of public to voluntarily participate in the scientific process.

• American Lung Association’s COVID-19 Citizen Science research initiative is one of the latest citizen science initiatives.

• Collective community impact initiatives ensure effective use of resources. • This improves social and health status.

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TECHNOLOGY AND HEALTH COACHING FOR HEALTH BEHAVIOR CHANGE • Patients empower consumer movement.

• Provides patient-generated health information (PGHI).

• Give patients the tools to understand: • what makes them sick • how to stay healthy • what to do if their condition worsens

• Technology-based personal health record (PHR) and mobile applications are important for consumer engagement efforts.

• Clinicians can use the Level of Engagement with Health Care framework. • To identify trustworthy apps to recommend to patients.

• Work with health and wellness coaches and use mobile devices to manage chronic illnesses. • This reduces costs at the individual, community, and organizational levels.

• AMA has approved New Category III Current Procedural Terminology (CPT) Codes for health coaching services reimbursement.

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HEALTHCARE COSTS AND TECHNOLOGY

• Report by the Consumer Union: • The current approach to healthcare reform is unsustainable. • Good quality healthcare can be delivered for less money.

• Characteristics of a learning healthcare system are: • Science and informatics—real-time access to knowledge and digital capture of the care experience • Patient-clinician partnership—engaged, empowered patients • Incentives—aligned for value and full transparency • Culture—leadership-instilled culture of learning and supportive system competencies

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SUMMARY

• In light of the COVID-19 pandemic, patient engagement/activation has gained traction to maintain efficient healthcare delivery.

• Government also encouraged patient activation by providing value-based reimbursement initiatives.

• Community science promotes patient engagement by involving the community in healthcare delivery.

• Use of technology to engage patients helps in reducing the delivery costs of healthcare.

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