Survey tools assess a patient’s knowledge, skill, beliefs, and confidence in self-managing health care and decisions, key points in patient activation.
Increased patient activation is proven to improve health outcomes and value-based care measures.
An important aspect of medical care is patient activation, which describes when patients become actively involved in their own care. This subset of patient engagement is an important predictor of outcomes.
Activated patients have the health education, skills, and confidence to manage their own health care and decision-making. They tend to follow up on their care, attend regular appointments, contact their provider earlier for complications, and ask questions about medications and side effects.
They are less likely to return to the hospital after discharge, or to have a failed treatment plan. Levels of adherence with medications, diet, and chronic disease management are usually very high, leading to lower mortality rates overall and longer, healthier lives.
In the age of value-based care (VBC), practitioners should be increasing patient activation, which is not always easy. The first task of an improvement strategy is to find a way to assess patient activation and determine which tactics work best.
The PAM Assessment
The Patient Activation Measure (PAM) survey tool asks patients a series of questions in four areas:
- Prevention
- Unhealthy behaviors
- Clinical indicators
- Utilization of services.
The survey tool assesses a patient’s knowledge, skill, beliefs, and confidence in self-managing health care and decisions, then scores a result on a 100-point scale.
One of the most comprehensive PAM studies, published in 2012 by the Journal of General Internal Medicine, showed clear correlations between patient activation and several patient outcomes. For example, for every additional 10 points of patient activation, the probability of outcomes like an ED visit, obesity, or smoking was one percentage point lower. The likelihood of having positive outcomes like a preventative mammogram, or normal cholesterol levels was one percentage point higher.
The Important Role of Data Acquisition and Analytics
Typically, primary care providers use a lengthy, involved assessment that patients fill out in the office before a visit or via a patient portal. Because emergency providers also are under pressure to leverage patient activation data and increase engagement, there are condensed versions that can be integrated into the patient assessment.
But the data required to improve clinical outcomes doesn’t stop at these assessments. Using emergency medicine performance analytics, 72-hour ED revisits can be monitored and improved upon, and frequent ED utilizers can be identified and addressed. Analyzing key measures like these help emergency physicians monitor protocol adherence and make strategic decisions that ultimately improve clinical outcomes.
Even organizations that have stored large amounts of information may not be benefiting from it. At d2i, we help fill that gap and drive positive results by monitoring a host of key metrics, and our Client Success Team can work with you to determine what data to track and create a tailored action plan that works for your organization and its goals.
Improvement Strategies
To achieve higher activation, providers should be made aware of specific interventions that increase activation step-by-step, beginning at the patient’s current level.
For instance, shared decision-making has shown to be a highly effective way to engage patients in the treatment plan, helping them feel more invested in their outcomes.
Moderate physician involvement in activation strategies also can be effective. In 2018, JAMA published a study that clearly showed improvement when physicians identified hypertension patients with low activation levels. They sent each patient a letter, followed by a phone call to review the letter and remind patients of upcoming visits.
The study notes that effective strategies for improving low activation include patient teach-back strategies, using written handouts, the patient portal, and access to data.
Let Our Analytics Team Help You Pull It All Together
d2i specializes in using data to improve processes and create better patient outcomes. Emergency physicians interested in leveraging their patient activation data, monitoring adherence to protocols, and improving clinical outcomes will appreciate our purpose-built drill paths that provide access to root-cause analysis with just one click.
Our team can efficiently partner with your clinical staff to create something unique to your patient population and based on evidence-based practices and proven research. Contact d2i or request a demo to learn more.