the patient engagement journey: evolution to a health … · the patient engagement journey:...
TRANSCRIPT
The Patient Engagement Journey:Evolution to a Health Inspiration ModelBrett Laschinger, Chief Operating OfficerDr. James Aw, Chief Medical Officer
October 24, 2016
2
Who We Are
Established over 25 years ago, Medcan is a global leader in assessing the overall well-being of our patients and inspiring them to live well.
Partnered with over 1,000 corporate accounts and 40,000 patients.
Over 65 physicians and specialists on site, with a broad roster of complimentary health care disciplines.
66,000 square feet in downtown Toronto, Canada.
3
The Importance of Preventive Health
4
U.S. Spend Per Capita on Prevention Health Services
5
A Broad Suite of Wellness Services for a Mostly Healthy Patient Base Seeking Better Quality of Life
Fitness Weight Management
Nutrition Mental Health
Annual HealthAssessment
Year-Round Care
Keeping Busy People Healthy
Live Well. For Life.
6
Our Business Challenge: Five Year Goals
Increase return rates for existing
patients
Broadenhealth
improvement take-up
Extend care to new
populations
All of these goals require patient engagement in a preventive or health inspiration model of care.
7
History of Patient Engagement at Medcan
COLLABORATIVE IN HEALTH IMPROVEMENT
Greatest Potential
21%Latent Potential
29%
Repackaged Potential
24%Little Potential
26%
PROA
CTIV
EFATA
LIST
IC
AUTONOMOUS IN HEALTH IMPROVEMENT
8
Levels of Patient Involvement
Apathetic Engaged Activated
Paternalistic physician-patient relationship: “My doctor tells me what to do”
Patients react to health concerns as opposed to proactively engaging in health behaviour to prevent disease
Patients are interested in their health and armed with knowledge about their health status
Patients understand they have health care options and have the ability to make positive changes in their health
Patients are actively engaged in decision making about their health: “My doctor and I work together”
Patients are working proactively to change their health status with a focus on prevention
9
The Medcan Model for Patient Activation
MedcanModel for
Patient Activation
Treat acute concerns
Understandpatient
motivations
Coordinate team-
based care
Increase health
literacy
Coach on modifiable behaviours
Measure success
10
Getting to Know the Patient: “n of 1”
Treat Acute Concerns Our Annual Health Assessment,
partnered with our Year-Round Care services, diagnose conditions and provide acute care where needed
We are investigating additional mental wellness stations to add to our Annual Health Assessment
Understand Patient Motivations This spring, we launched a new
Preparation Package: a complete medical and wellness profile completed by the patient before their assessment
This new profile includes psychographic questions aimed at understanding a patient’s health motivations
Mental
SpiritualEmotional
Physical
Nutrition
SleepStress
Fitness
11
Psychographic Patient Profiling
•58% say they only visit their physician when they are sick (versus using doctor as a health advisor for on-going support)
•84% agreed that they work with their doctor to figure out what is best (versus having the doctor tell them exactly what to do)
Relationship with Physician
•86% agree or strongly agree that they exercise to keep themselves healthy and feeling good
•86% say they feel similar or very similar to people who watch what they eat in order to stay healthy
Opinions on Diet and Exercise
•94% do not agree that as far as health is concerned, there is not much they can do except deal with sickness when it comes
Fatalistic vs. Proactive
•37% say they are likely or somewhat likely to use support to accelerate their personal and/or professional goals
Support to accelerate
goals
12
The Power of Coordination: Delivering on the Promise
Coordinate Team-Based Care Personal Care Consultant (PCC): One
of the major responsibilities of the PCC is to work with the patient following their assessment to make health goals and support them in achieving them
Our PCC is a registered nurse who is also training on patient engagement and activation
Full coordination requires technology (ie. EMR) to connect providers: “one patient, one view”
Personal Care
Consultant
Physician
Nurse Consultant
Referral Coordinator
Specialists
Fitness Team
Registered Dietitian
13
Improving the Health IQ
Increase Health Literacy• We are currently in development on
a new tool called the “Health Map” to be launched this winter
• This document will act as a guide for the patient on the current status of their health (medical and wellness metrics), as well as how that compares to previous visits
• We are also working with clinical directors on patient-facing briefs on topics related to modifiable behaviours such as fitness and weight loss
14
Patient Activation to Achieve Better Outcomes
Coach on Modifiable Behaviours We offer many programs at Medcan that involve coaching to
modify risk factors Our PCC will also be working with patients to help coordinate
these teams and coach them through achieving their goals
Measure Success We currently survey our patients after their assessment, with a
focus on patient-reported experience measures (PREMs) We are looking to include more patient reported outcome
measures (PROMs) by borrowing from tools such as EQ-5D, but also developing relevant questions in-house
We will also be looking to use a patient activation measurement tool, ie. PAM, which looks at the four main stages of activation:
Believing the 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 stress1
1. Hibbard, J. H., Stockard, J., Mahoney, E. R., & Martin, T. (2004). Development of the Patient Activation Measure (PAM): Conceptualizing and MeasuringActivation in Patients and Consumers. Health Services Research , 39 (4), 1005-1026.
Outcome Data
PREMs
PROMs
PAM
Clinical
15
The Future: Inspiration, Activation, Prevention
Quantified Health: how can we better capture the day-to-day activity and challenges of each patient?
Genomic Medicine: what inherent challenges does the patient have to overcome to be at their best health?
Psychographics and Population Health: how can we use our understanding of motivations for individual patients and apply this to a large-scale population?
Outcome Measurement: what are the best tools to measure success for both an individual and for a population?