Patient Reported Outcomes (PROM)

BethWhen you think about health care, what comes to mind? For some, it’s a pursuit of wellness connecting mind, body, and spirit. For others, health care is like a car’s transmission – you don’t really notice or appreciate it until it’s making a noise, or completely broken. People in the middle of a crisis or transition in a significant relationship can feel especially stressed, which we all know affects our health. Some may find themselves both ill and alone for the first time.

My name is Beth, and I am writing a series of articles designed to help you navigate today’s complex health care system. I am a nurse by training, but several years ago I became interested in the study of “quality” care – especially for patients who are in the hospital. None of what I write will be an endorsement for a particular hospital or care system, nor is any of the content meant to recommend any course of treatment. Simply, I will be giving you information so that you can make educated choices about your own health care. I invite your comments and conversation.

One of the hot topics in primary health care these days is Patient Reported Health Outcomes (PROM). Some provider practices, and even some employers and insurers are starting to use patient-generated information to help them assess how the patient feels about their general state of health, or target areas of specific concern for health needs.

The engagement of patients in their own health assessment serves at least two purposes: using the voice of the patient in ways that may not be solicited during the face-to-face provider encounter; and getting the patient to start to really pay attention to how they assess critical components of their health status. Sort of completes the three-legged stool: the first leg is the provider assessment, the second is the patient accessing their health record; and the third is actually giving the patient a full partnership through self-assessment. Whether these PROM initiatives have long-term effects in health status improvement is still being studied.

I ran across a really cool web-based health assessment that you might want to take a look at. The website is www.howsyourhealth.org and you can complete an online assessment from an array of health status components. At the end of the assessment, you receive information based on the responses to the “checkup”. This summary can serve as a checklist of discussion items for your next provider visits, but there are also resources for reading and action you can take on your own. It doesn’t require a password or for you to identify yourself. You can also save any or all of the documents in case you want to track your progress on any health improvement interventions you work on. Enjoy!

Leave a reply

Don’t Blink, You’ll Miss It – Health care in a rapidly changing world

Beth“Don’t blink or you’ll miss it!” We city kids always joked about the little towns we’d drive through on our Sunday drives or on the way to summer vacation. Trees, crops, and barns interrupted by a brief braking to pass a bar, church, and post office. That’s how it seems with health care these days. Politics aside (and not discussed here), the delivery and payment for health care is changing so rapidly “don’t blink or you’ll miss it”!
After a change in a significant relationship, you may find yourself navigating the healthcare system one your own for the first time, or at least from a very different perspective. You may have moved away from your former residence, you may now be responsible for finding new healthcare coverage, or even finding a new provider. All of these are much more challenging than they were a year ago.
Before you think about making any changes in coverage, read the plan. Know the plan. Don’t be afraid to call the plan and ask questions – over and over – until you know what your coverage costs, and the benefits you have. Hospitals, physician groups, and insurers are aligning together in new ways called Accountable Care Organizations. The goals of the ACO’s are to deliver high quality care while saving money through lowered costs. Take a look at this website for more information. The ACO concept has been around for a couple of years, but new strategic alignments are being created all the time, even here in Wisconsin. Make sure you fully understand whether your plan is part of an ACO, and how that ACO affects availability and locations of primary and hospital care.
One of the key factors that your hospital and providers know is a success to their healthcare delivery model is “consumer engagement”. That means that your participation and satisfaction in your own healthcare experience is a primary driver for ACO sustainability. What does all that mean? In short, insurers and providers are spending MORE money than ever to find new ways to effectively educate and communicate with you, the consumer. You are likely to be invited to answer surveys, engage your health record electronically, create and work toward health goals, and do more “home-work” related to any chronic health conditions you may have (like high blood pressure, diabetes, obesity, etc.)
Likely, your outpatient provider and hospital are now offering patient advocacy services. These advocates can help you get resources you need to become more active in your own healthcare. From understanding your bill and insurance benefits to accessing post-discharge assistance, advocates and other professionals are helping consumers in ways that effectively “connect” you and try to make you feel more “in control” of your health. Your hospital or clinic is also engaging social media, like Facebook, or electronic newsletters with advice or news about the latest developments in health care. All of these strategies are designed to achieve a greater and safer patient health outcome.

Health care is changing at an historically accelerated pace – don’t blink!!!

Leave a reply

In Pursuit of Wellness

BethSubmitted by Beth Dibbert

When you think about health care, what comes to mind? For some, it’s a pursuit of wellness connecting mind, body, and spirit. For others, health care is like a car’s transmission – you don’t really notice or appreciate it until it’s making a noise, or completely broken.

People in the middle of a crisis or transition in a significant relationship can feel especially stressed, which we all know affects our health. Some may find themselves both ill and alone for the first time.

My name is Beth, and I am writing a series of articles designed to help you navigate today’s complex health care system. I am a nurse by training, but several years ago I became interested in the study of “quality” care – especially for patients who are in the hospital. None of what I write will be an endorsement for a particular hospital or care system, nor is any of the content meant to recommend any course of treatment. Simply, I will be giving you information so that you can make educated choices about your own health care. I invite your comments and conversation.

Whether you have visited your local emergency department, or provider/physician clinic, or have been a patient in the hospital recently, you may have received a “patient satisfaction survey” in the mail. The survey often contains questions about the timeliness of your visit, how the food was, or whether it was quiet at night. Most surveys ask about whether your provider or nurse communicated information about your medications or care plan in ways you could understand.

Many insurers, including the federal government (aka Medicare) require certain types of providers or organizations to collect and publicly report the results of these surveys. If you have a specific comment, whether it’s a kudos or complaint, those are forwarded straight to the provider for an opportunity for a direct response to you.

Soon, there will be an additional set of questions that will be included in hospital patient satisfaction surveys. The three new questions are part of a bundle called “Care Transition Measures”. Simply, hospitals are required to prepare you for discharge – whether you are going back home or on to another care setting (like a nursing home). And for good reason! Medicare is now financially penalizing certain hospitals for re-admissions of certain patients within 30 days. Unnecessary re-admissions are costly and dangerous for patients and the health care system.

Let’s have a look at the questions:

Question 1: During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my healthcare needs would be when I left.

Question 2:  When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.

Question 3: When I left the hospital, I clearly understood the purpose for taking each of my medications.

Hospitals will be scored on the number of questions that received a “Agree” or “Strongly Agree” in each of the questions multiplied by the number of patients that were eligible to receive a survey. Hospitals will be focusing more and more on equipping patients and their families or other caregivers in how to manage their health issues outside of the hospital. They will work hard to teach and communicate with you, and ask you several times whether you understand what they are trying to show you.

You and your caregivers have the responsibility to speak up, ask questions, and otherwise seek out information, until you are sure that you understand. Are going through a significant change in a relationship, to the extent that you are managing your health all by yourself? You should ask around to find out who might help serve as a healthcare “buddy” for you. Someone who at least knows the basics about where your medication list is, or who your regular provider is. Someone you can call on when you are ill, or who might be okay with listing their name as a contact person should you become hospitalized.

Transitioning out of the hospital can be tricky, whether you are going home or to another care setting. It’s important to have another set of ears, and perhaps another voice if you are not able to speak for yourself. Hospitals are paying attention to how you will be able to cope after you leave. You should do all you can, too.

Leave a reply

Follow Margaret on Facebook!