I’ve been writing a lot about the benefits of patient-centered-care and patient engagement.One study published in Health Affairs examined the relationship between “patient activation levels” (which could also be called patient engagement) and care costs. In a companion piece to the study, the authors wrote that “patients who were more knowledgeable, skilled and confident about managing their day-to-day health have lower health care costs than those patients who lacked this type of confidence and skill.”
One great example of patient education not exactly hitting the mark and leaving the patient not fully engaged was told to me by a diabetic educator. I had gone for a consultation and education on how to manage a gestational diabetes diagnosis. After going over all the blood glucose values, when and how to test, when to be alarmed, etc., she asked me what I would do if I had three readings with numbers above my blood glucose level goal.
“Call my doctor,” I said. Her reply, “Excellent. You’d be surprised how many people keep great logs of their glucose readings but don’t call anyone when their levels are too high.” They understood that they were to track their glucose levels but didn’t realize they needed to report abnormal results to someone.
How can clinicians get patients to understand the nuances of their care so they will make those necessary phone calls? How can we educate patients so they understand the “whys” of the interventions and the steps they need to take to achieve their goals? To me, explaining they need to do a certain task or get a certain reading isn’t enough. They need to have some rational behind why it is important and what will be done with the information they gather.
Here are four interesting ways I found to help patients better understand care, interventions and concepts. I hope clinicians find these useful in educating and engaging their patients.
- The Youtube Back Pain Video
A trend I’ve noticed when people talk about healthcare is they lament that everyone wants a drug, surgery or a quick-fix for what ails them. That physicians and pharmaceutical companies just want us to take expensive drugs so they can make money off patients. Or they want to run extensive tests to make a buck. The funny thing is that when these same people get injured or sick, they often request medications or surgery to cure them. When interventions like weight loss, physical therapy, activity or conservative measures like ice, rest and over-the-counter pain relievers are offered, those are scoffed at. Suddenly when it’s their back, knee, neck, they want the latest tests to discover what is wrong.In July, NPR had a great piece on this concept regarding back pain. Patients with back pain often feel they need an MRI to get to the bottom of what is causing the pain. But often those tests aren’t necessary and the back pain can be resolved with exercise, ibuprofen and physical therapy. For those who remain unconvinced, Tulsa, Okla.-based primary care physician John Henning Schumann will show this low-back pain video by Dr. Mike Evans of Toronto. Something about this video convinces patients that conservative measures may just do the trick after all.
- Mayo Clinic’s Statin Choice/Aspirin Choice Decision Aid
Understanding risk vs benefit can be a tricky concept for patients to get their minds around. That’s why Mayo Clinic created this tool to help physicians and patients work through the concept together. The tool is meant to facilitate a dialogue on how to reduce the risk of heart attack. First, you calculate your risk using a risk calculator. Second, you see how interventions could affect your risk. Third, you get a blurb about pros and cons of treatment or no treatment. It’s a very simple and visual way to understand your options.
- The American Heart Association’s Heart360
Heart360 is an easy-to-use, free, web-based tool that helps patients understand and track factors affecting heart health like blood pressure, physical activity, cholesterol, glucose, weight and medications. Patients can upload data like blood pressure readings from their home blood pressure machines and send it directly to their health care provider. Patient information is stored in Microsoft’s HealthVault. It also provides patients with educational information and allows them to track progress towards their health goals. In a study of Heart360 at Kaiser Permanente Colorado in Denver, 54 percent of the Heart360/home monitoring group had reached their goal blood pressure, while 35 percent of the usual care group did.
- UCLA’s Interactive Patient Education Videos
The university has a series of videos called EMMI. The interactive videos can be found free online. The goal of the videos is to take complex medical information and make it easy for patients and family members to understand. The videos can help patients prepare for an upcoming procedure or manage chronic conditions. Patients can watch Emmi programs from home or anywhere with Internet access, and they can be shared with friends or family members. Each video is about 20 minutes long and patients can watch them as many times as they like.
I hope you find these tools useful in engaging and education your patients. And please share your favorite tools for increasing patient engagement in the comments section.
Jennifer Thew, RN, MSJ
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