Value of Patient Engagement Technologies презентация

of Patient Engagement Technologies

5% participation threshold is a challenge
Integration of patient engagement into a strategic initiative is the key
There is growing evidence that patient engagement impacts medical outcomes

at two health systems, both have the same EHR, PHR
When he logged into the second PHR, it prompted him, asking if he agreed to integrate his two medical records. He agreed.
The next time he saw his specialist at the first facility, she noticed that his records from the other system had been integrated into his record
Lessons:
Health information exchange works
Should be driven by the patient’s consent
Leads to a more engaged patient
This is what Meaningful Use is about

One Patient, One Record

obtain the greatest benefit from the healthcare services available to them”
This definition focuses on behaviors of individuals
Relative to their healthcare
That are critical and proximal to health outcomes
Rather than the actions of professionals or policies of institutions
Center for Advancing Health 2010

OUTCOMES

and transmit their health information within four business days of the information being available to the EP (for EPs only) More than 50% of all unique patients seen by the EP are provided timely online access to their health information
Provide patients the ability to view online, download and transmit their health information within 36 hours after discharge from the hospital (for Eligible Hospitals/CAHs only)
Use secure electronic messaging to communicate with patients on relevant health information (for EPs only) More than 5% of all unique patients seen

View, Download, Transmit

patient role is important
Having the confidence and knowledge necessary to take action
Actually taking action to maintain and improve one’s health
Staying the course even under stress
More likely to have a breast cancer screen or clinical indicators in the normal range (A1c, HDL, and triglycerides)
http://link.springer.com/article/10.1007/s11606-011-1931-2

Activate

hospital to engage and motivate the patient to participate in a portal and secure messaging
 87 percent – say they want to control their health data. (Accenture)

Medicare and VA patients now
Cerner just announced its participation

Additional Resources
Blue Button Plus -Learn how to structure a patient health record and how to transmit it to a patient’s location of choosing. 
Blue Button Connector – select a source, search to see if that source uses Blue Button, ID yourself, download

send and receive authenticated and encrypted health information over the Internet,

etc.
Problem list
Secure Messaging

the workflow in place to manage these
Triage workflow – similar to phone calls – who does prescription refills, appointment requests, when to escalate to the provider?
What about proxy access?
Releasing labs – immediate or after provider reviews?
What are the exceptions to release of data? Mental health, genetic testing, HIV, cancer diagnosis, others?

the point of care
Have patient/caregiver login day of or day before discharge
Education in waiting rooms
Online how-to videos
Educate patients about appropriate use of secure messaging
Mobile

Initiative?

incentives
Hurry to meet the minimum requirements
Stage 2 – more emphasis on having an impact on quality of care
Should not be another check

Organizations
To achieve these successfully, patient engagement essential

of patient education and remote patient monitoring
Reduce the average systolic blood pressures for 34 patients by 20 points in week
continuing to a 30-point drop in week five

a realist review
15 of the 18 Randomized Clinical Trials demonstrated significant positive effects on these outcomes
No studies found serious adverse consequences of patient portal implementations

JAMIA 2014

Clinic
50 percent reduction in the number of people with uncontrolled asthma among users of the device and app. 
App enables providers to check in more often with their patients and may help avoid asthma-related emergency department visits or hospitalizations.

Cardiac Rehab app
Led to a 40 percent reduction in admissions
only 20 percent of participants were admitted to the ER within 90 days
In the control group, 60 percent of participants were readmitted in the same timeframe

A Quasi-experimental Study and a Look Ahead
11,797 of 13,564 Patients accessed visit notes frequently
a large majority reported clinically relevant benefits and minimal concerns
virtually all patients wanted the practice to continue
With doctors experiencing no more than a modest effect on their work lives, open notes seem worthy of widespread adoption.
Annals of Internal Medicine 2012

helps them understand their health history better because it is all in one place
For 72% helps them monitor their laboratory results better
68% reporting that it makes it easier for them to give others important information about their health.
Use of the Blue Button for care coordination was most likely in patients with diabetes or lung disease, individuals who rated their computer ability higher, and those who had a system for organizing their health information.
High rates of satisfaction
Future work on the demonstrable impact of the Blue Button on health behavior and outcomes

portal following hospital discharge – JAMIA 2014 Out of 60 patients
108 discrepancies were seen
23 potential adverse drug events

Randomized controlled study of web-based patient education in first time colonoscopy patients
18% less sedation medication
14% decrease in procedure time
11% more knowledgeable

healthcare utilization
 Conclusions: No significant change in face-to-face visit frequency was observed following implementation of portal messaging.
Secure messaging and e-visits through a patient portal may not result in a change of adult primary care face-to-face visits.
Functionality of patient portal may change – enhancements, upgrades
Improved workflow may improve utilization

ROI

readmits


Technology
Mobile, remote monitoring

5% participation threshold is a challenge
Integration of patient engagement into a strategic initiative is the key
There is growing evidence that patient engagement impacts medical outcomes

Five Models of Patient Engagement Demonstrate Value http://blog.himss.org/2014/04/11/five-models-of-patient-engagement-demonstrate-value/
HIMSS Value Suite http://www.himss.org/ValueSuite

DIG DEEPER