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The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr. James Aw, Chief Medical Officer October 24, 2016

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Page 1: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

The Patient Engagement Journey:Evolution to a Health Inspiration ModelBrett Laschinger, Chief Operating OfficerDr. James Aw, Chief Medical Officer

October 24, 2016

Page 2: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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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.

Page 3: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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The Importance of Preventive Health

Page 4: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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U.S. Spend Per Capita on Prevention Health Services

Page 5: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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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.

Page 6: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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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.

Page 7: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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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

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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

Page 9: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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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

Page 10: The Patient Engagement Journey: Evolution to a Health … · The Patient Engagement Journey: Evolution to a Health Inspiration Model Brett Laschinger, Chief Operating Officer Dr

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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

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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

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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

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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

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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

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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?