2. Your team for today’s discussion:
S. Whitney Bowman-Zatzkin, MPA, MSR
Director, Flip the Clinic
whitney@fliptheclinic.org | @MsWZ
Thomas Workman, Ph.D.
Principal Researcher, American Institutes for Research
tworkman@air.org
Claire Brindis, Dr.P.H.
Director, Philip R. Lee Institute for Health Policy Studies
Professor, Pediatrics and health Policy
Director, Bixby Center for Global Reproductive health
Executive Director, Adolescent and Young Adult Health, National Resource Center
Claire.Brindis@ucsf.edu
Amanda Otero
Health Care Organizer, TakeAction Minnesota
amanda@takeactionminnesota.org
3. Paving the Road for Patient and
Family Engagement
Thomas
Workman,
Ph.D.
Kris2n
L.
Carman,
Ph.D.
American
Ins2tutes
for
Research
4. #
Kris%n
L.
Carman,
Pam
Dardess,
Maureen
Maurer,
Shoshanna
Sofaer,
Karen
Adams,
Chris%ne
Bechtel
and
Jennifer
Sweeney
(2013).
Pa%ent
And
Family
Engagement:
A
Framework
For
Understanding
The
Elements
And
Developing
Interven%ons
And
Policies.
Health
Affairs
32(2),
223-‐231
6. Using the roadmap
• Catalyze efforts –
5 Simple Actions
• Organize current
work, identify
opportunities for
pushing further
• Unify efforts and
identify opportunities
for partnerships
6
The
power
of
[the
roadmap]
will
only
be
fully
realized
when
everyone
takes
ac%on.
Only
then
will
we
realize
the
power
of
shared
goals
and
partnerships.
Only
then
will
we
discover
the
power
of
the
pa%ent
at
the
center
of
healthcare.”
-‐
SUE
COLLIER
Clinical
Content
Development
Lead
American
Hospital
Associa%on/Health
Research
Educa%onal
Trust
7. Community and partnership
• Download and share the roadmap
www.patientfamilyengagement.org
#PFEroadmap
• Make a commitment
www.patientfamilyengagement.org/commitments
• Share a resource
www.patientfamilyengagement.org/resources
7
8. Let us know how we can help
Kristin L. Carman, PhD
Vice President, Health and Social Development Program
American Institutes for Research
202-403-5090, kcarman@air.org
Thomas Workman, Ph.D.
Principal Researcher, American Institutes for Research
301-592-2215, tworkman@air.org
Pam Dardess, MPH
Principal Researcher, American Institutes for Research
919-918-2311, pdardess@air.org
AIR’s Center for Patient & Consumer Engagement
www.aircpce.org
8
9. Strategies and Tactics
for Achieving
Meaningful Consumer
Engagement in Health
Care
Claire D. Brindis, Dr. PH., Dana Hughes, Dr.PH,
Laura Schmidt, Ph.D., Laurie Jacobs, Ph.D.,
Caitlin Kennedy, Ph.D.
Philip R. Lee Institute for Health Policy Studies,
University of California, San Francisco
June 13, 2015
10. ACA & Consumer Engagement
• ACA & patient-centered care
– Hospital Consumer Assessment of Healthcare
Providers and Systems (HCAHPS)
• ACA & consumer engagement in system
redesign
– CMS’ state demonstrations to integrate care for dual
eligible patients
– CMMI’s testing of new service & delivery models
• Role of advocates in consumer engagement
10
12. 12
Atlantic Philanthropies‘ Campaign
for Better Care
Ultimate goal:
Better quality care, better patient experiences with
care and more affordable care for low-income older
adults and other vulnerable populations
Strategy 1:
• Design and test models of consumer engagement in
institutional decision-making which assure the
inclusion of the perspectives of vulnerable populations
and their families (and result in the ultimate goal)
Strategy 2:
• Identify methods to sustain this work over time
13. A Multidimensional Framework for
Patient and Family Engagement in Health and Health Care
Levels of
Engagement
Consultation
Involvement
Partnerships &
Shared Leadership
Direct Care
Patients receive
information
Patients asked about
treatment preferences
Decisions based on
patients’ preferences,
medical evidence, &
clinical judgment
Organizations
design &
governance
Organization surveys
patients about care
experiences
Hospital involves
patients as advisors
or advisory council
members
Patients co-lead hospital
safety & quality
improvement committees
Policy Making
Policy agency’s focus
groups ask patients
about health care
issues
Patients’ research
priorities used by
public agency in
funding decisions
Patients equally
represented on agency
committee deciding how
to allocate health
program resources
13
Continuum of Engagement
Carman KL, et al. S. Patient and Family Engagement: A Framework For Understanding The Elements And Developing Interventions and Policies. Health Affairs 32 (2013)
14. A Multidimensional Framework for
Patient and Family Engagement in Health & Health Care
Levels of
Engagement
Consultation
Involvement
Partnerships
& Shared Leadership
Direct Care
Patients receive
information
Patients asked about
treatment preferences
Decisions based on
patients’ preferences,
medical evidence, &
clinical judgment
Organizations
design &
governance
Organization surveys
patients about care
experiences
Hospital involves
patients as advisors
or advisory council
members
Patients co-lead hospital
safety & quality
improvement committees
Policy Making
Policy agency’s focus
groups ask patients
about health care
issues
Patients’ research
priorities used by
public agency in
funding decisions
Patients equally
represented on agency
committee deciding how
to allocate health
program resources
14
Continuum of Engagement
Carman KL, et al. S. Patient and Family Engagement: A Framework For Understanding The Elements And Developing Interventions and Policies. Health Affairs 32 (2013)
15. 15
Centers
for
Medicare
and
Medicaid
Services
State
Demonstra%ons
to
Integrate
Care
for
Dual
Eligible
Individuals
Primary
Care
Transforma%on
Ini%a%ves
to
Speed
Adop%on
of
Best
Prac%ces
Accountable
Care
Health
Care
Innova%on
Awards
Comprehensive
Primary
Care
Ini%a%ve
Partnerships
for
Pa%ents
Pioneer
ACOs
Community
Catalyst
Na4onal
Partnership
for
Women
&
Families
Rutgers
/PICO
16. Community Catalyst
16
• Work to build a nationwide network of local &
state health advocacy organizations &
coalitions
• Share expertise via technical assistance
Organizational
Focus
• Shape state policy development &
implementation to incorporate consumers
• Institutionalize consumer involvement in
state policy & provider/health plan activities
Primary
Campaign for
Better Care
Goals
• Support state advocates
• Setting: Urban & rural communities & state
capitols
Campaign for
Better Care
Approaches
17. National Partnership
for Women and Families
17
• Advocate at the federal level for policies & laws
that help women & families
• Support effective implementation at local &
state levels
Organizational
Focus
• Support implementation of consumer
engagement provisions for hospitals,
primary care practices, & ACOs
Primary Campaign
for Better Care
Goals
• Provide technical assistance/consultation to
CMMI & providers
• Setting: Localities where CMS demonstrations
are taking place
Campaign for
Better Care
Approaches
18. PICO
18
• Utilize faith-based community organizing to
address problems & concerns within
congregations & communities based on
shared values
Organizational
Focus
• Empower consumers at the local level to
improve individual & community health/well-
being
• Achieve Medicaid savings for high utilizers &
return savings to local communities
Primary Campaign
for Better Care
Goals
• Engage in community organizing among Hot
Spotter patients & community members
• Direct patient support as part of care
management
• Setting: Communities served by local
participating PICO federations
Campaign for
Better Care
Approaches
19. 19
Slide Title. Arial Bold, 32pt
Approaches to
Consumer
Engagement
Community
Catalyst
National
Partnership
PICO
Consumers serve on
decision-making bodies
Creation of formal
mechanisms for obtaining
consumer feedback on health
services & health service
needs
Technical assistance on
decision-making bodies,
other engagement
techniques
20. 20
Slide Title. Arial Bold, 32pt
Approaches to
Consumer Engagement
Community
Catalyst
National
Partnership
PICO
State-level oversight bodies that
include consumers & their
advocates
Standards, regulations, &
monitoring approaches that best
serve the interests of
consumers.
Consumer use of programs that
help individuals & family
caregivers be more engaged in
their health
Facilitate consumers and their
advocates in conversations with
22. 22
Slide Title. Arial Bold, 32pt
Tactics
Community
Catalyst
National
Partnership
PICO
Federal advocacy
State advocacy
Technical
Assistance
Information sharing/
learning networks
Community
Organizing
Coalition building
Training
27. Lessons Learned
What matters:
• Flexibility
• Relationships
• Opportunities for collective learning
• Focus on both the system & local level
27
28. Lessons Learned (continued)
Other Essential Ingredients:
• Provider/clinician investment and
commitment
• Consumer engagement recognized as a
vital component of system reforms
28
29. Lessons Learned (continued)
Common challenges:
• Consumer health literacy
• Health care system’s complexity
• Fear of feasibility of changes
• Lack of buy-in by professionals
29
30. Implications & Future Questions
• For advocates:
– Does consumer engagement make a difference?
• For evaluators & researchers:
– The need for:
• Metrics
• Sustainable & scalable models
30
39. • You want to plan around people’s priorities,
needs, preferences.
• You want to understand if/how your plan will
impact people.
• You need to simplify complex information for
patients or the public.
• You need policy or funding to achieve your
HST goals.
You might need consumers/
advocates if…
40. Where can I find them?
• Patients
• Community organizations
• Advocacy organizations
• Everywhere!
42. Key Points
IMAGE
• Be mindful of your gift to/for
others in healthcare
• Consumers and clinicians
should be flexible, creative,
and maintain a spirit of
adventure
• Huge gains are possible
• Be bold
• Patients and clinicians have permission to
experiment, inform, and explore healthcare together.
Graphic:
Flip
the
Clinic
43. Thank you!
Graphic:
Flip
the
Clinic
S. Whitney Bowman-Zatzkin, MPA, MSR
Director, Flip the Clinic
whitney@fliptheclinic.org | @MsWZ
Thomas Workman, Ph.D.
Principal Researcher, American Institutes for Research
tworkman@air.org
Claire Brindis, Dr.P.H.
Director, Philip R. Lee Institute for Health Policy Studies
Professor, Pediatrics and health Policy
Director, Bixby Center for Global Reproductive health
Executive Director, Adolescent and Young Adult Health,
National Resource Center
Claire.Brindis@ucsf.edu
Amanda Otero
Health Care Organizer, TakeAction Minnesota
amanda@takeactionminnesota.org
