Patient Engagement and Shared Decision-Making:

From Concept to Reality

Kellie Slate Miller, MSAugust 28, 2012

QC Brown Bag Forum Webinar Presentation

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Patient Engagement: The Missing Link

• Opportunity to engage patients in a dialog with their own health.

• Surveys continue to support the good news that most patients report a high level of trust with their health care providers.

• At the same time, data suggests that patients are sometimes reluctant to engage in collaborative discussions with physicians about their choices in health care.

• Why patients are often reluctant to actively engage in a collaborative discussion about their health care choices.

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2012 Research Study Led by Dominick L. Frosch, PhD

“Communicating with Physicians About Medical Decisions: A Reluctance to Disagree” • Showed that nearly all patients could envision

asking questions (93%) and discussing preferences (94%)

• Few felt they would actually voice a disagreement and challenge their doctor (14%)

• Those not willing to disagree, about 47% feared being labled “difficult” and 40% worried such actions would lead to a damaged relationship.

• 51% thought it might compromise care

(

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Consumer Engagement & Shared Decision Making

What We Say:

• Want patients to take active role in making decisions about their health

• Want patients to ask questions

• Want patients to express values & preferences

What We know:

• Patients – even well educated – are reluctant to ask questions

• Patients fearful of challenging provider recommendations

• Many patients feel physicians are authoritarian (vs. “authoritative”

(Archives of Internal Medicine article and state stats. here)

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Partnering with Patients Video Clip – engaging patients to become more involved in their health in Maine. Exploring what successful patient-provider partnerships look like in Maine.

http://youtu.be/EpcJuYTEEb4

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Patient Engagement Campaign

Take Charge of your health:

Step ONE: VISIT your Primary Care Provider

Step TWO: ASK Questions

Step THREE: KNOW and understand your health related numbers

Step FOUR: FIND and use community health resources and programs

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Better Health. Better ME! Partner Organizations:

Central Maine Healthcare CorporationConsumers for Affordable Health Care

Eastern Maine Healthcare SystemsGet Better Maine (Maine Healthcare Management Coalition)

Maine Association of Area Agencies on AgingMaineGeneral Health and Medical Center

MaineHealthMaine Primary Care Association

Maine Quality CountsSeniors Plus

Allied groups include: Maine CDC, MaineCare, MaineQuality Forum/Dirigo Health, Maine Medical Association, Maine

Osteopathic Association

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Additional Information for Patients:

Materials:• Getting Ready for appointments: 9 things You can Do to Get

Better Care

• 5 Things You Should Know when You Get a New Prescription

Websites:• http://familydoctor.org/familydoctor/en/healthcare-management/w

orking-with-your-doctor/tips-for-talking-to-your-doctor.html

• Institute for Patient and Family Care - http://ipfcc.org/

• Agency for Healthcare Research and Quality: http://www.ahrq.gov/questions

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Patient Engagement:What Physicians Can Do to Help Patients Get More

Engaged• Create a Safe Space• Use Your Team • Use the Tools

• AHRQ – www.effectivehealthcare.ahrq.gov/ehc/decisionaids/prostate-cancer

• MaineHealth – www.mainehealth.org/mh_body.cfm?id=7848 • Center for Advancing Care - http://cfah.org/ • Mayo Clinic –

http://shareddecisions.mayoclinic.org/decision-aids-for-diabetes • Foundation for Informed Decision Making –

http://informedmedicaldecisions.org/shared-decision-making-in-practice/decision-aids

Distribute the “Better Health. Better ME!” brochure and encourage your patients to use it

Request BHBM Brochures (free) for your Practice

Encourage use of the QC Pathways Brochures & request copies for your Practice

Share the Provider Tools with your medical staff to encourage them to create

What You Can Do In Your Practice

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Engaging Consumers – Partnering for Improvement

MHMC’s “GetBetterMaine” Reporting

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Contact Info / Questions• General information

• Lisa Letourneau MD, MPH: LLetourneau@mainequalitycounts.org

• Patient Engagement Campaign• Kellie Slate Miller, MS: kslatemiller@mainequalitycounts.org

• Maine PCMH Pilot: www.mainequalitycounts.org(See “Major Programs” “PCMH Pilot”)

• PCMH: Nancy Grenier: ngrenier@mainequalitycounts.org

• CCTs: Helena Peterson: hpeterson@mainequalitycounts.org

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