Titling a blog entry has become a source of creative entertainment for me. Sometimes I capture interest, and other times I miss the mark. Not sure where this one lies, but do you remember when there were only Saturday morning cartoons, and specifically the Super Friends? In one house, they had Superman, Batman, Robin, Aquaman, and seemingly every other weekend, the Wonder Twins came to visit. Just like a real family today. Clearly, was a show before its time.
Whenever the Wonder Twins came across dire times that warranted their heroism, they would fist-bump and say: “Wonder twin powers, activate!”
For the Accountable Care super heroes to survive dire times, ACO patients must understand their role in the care process, and have the knowledge, skill, and confidence to carry it out. Fiscally and imperatively, ACOs need to hold down costs to share in the savings and most importantly retain members, as they are free to move in/out of the ACO unlike the managed care cartoons of the 90s.
Patient activation touches all of the 33 ACO metrics, and helps to:
- Make informed choices about providers
- Engage in effective self-management
- Collaborate with providers
- Are sufficiently satisfied to remain within the system
How this helps?
- Engages in more preventive and healthy behaviors
- Engages in more disease specific self-management behaviors
- Engages in more health information seeking behaviors
What to do?
- Many of the behaviors we are asking of people are only done by those in highest level of activation
- When we focus on the more complex and difficult behaviors–we discourage the least activated
- Start with behaviors more feasible for patients to take on, increases individual’s opportunity to experience success
Why (my favorite question when I watched Super Friends and now for that matter)?
- More likely to seek out and use information to make health care choices
- Engage in more healthy behaviors
- Have better care experiences, are more satisfied
- Have fewer care coordination problems
- Less likely to be hospitalized or use ED
- Less likely to be re-admitted to hospital
- More likely to have bio-metrics in normal range
- More likely to have overall lower costs
Activation Model Requires a Patient Centered Approach. How this works?
- Give the patient’s agenda attention and priority
- Ask–don’t tell
- The goal is to build capacity–not just compliance
- Listening, joint-problem solving, affirmation
What new engagement means…
- Start where the patient is or meet them where they are at
- Encourage realistic steps–creating opportunities to experience success. Lead them.
- Build on strengths
- Use measurement to assess and to track progress
What a sample patient activation could look like….
Medication Management
__ Demonstrates effective use of Medication Management System (medication organizer, flow chart, etc.)
__ For each medication, understands the purpose, when and how to take, and possible side effects
__ Demonstrates ability to accurately update medication list
__ Agrees to confirm medication list with PCP and/or Specialist
Red Flags
__ Demonstrates understanding of Red Flags, or warning signs that condition may be worsening
__ Reacts appropriately to Red Flags per education given (or understands how to react appropriately)
PHR
__ Understands the purpose of PHR and the importance of updating PHR
__ Agrees to bring PHR to every health encounter
Follow Up
__ Can schedule and follow through on appointment(s).
__ Writes a list of questions for PCP and/or specialist and brings to appointment
Healthideation.org 