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Professional Patient Advocate

Professional Patient Advocate. Advocating helps today Teaching self-advocacy helps for a lifetime. The shifting paradigm. No longer a physician controlled relationship Patients expected to comply or they will receive less attention

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Professional Patient Advocate

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  1. Professional Patient Advocate Advocating helps today Teaching self-advocacy helps for a lifetime

  2. The shifting paradigm • No longer a physician controlled relationship • Patients expected to comply or they will receive less attention • Changes in reimbursement to reflect FFS, and changes in therapeutic outcome and process • Risk adjustment for payment strategies • Penalties for non-participating physicians

  3. From Confusion to Fusion "Go to the people, live with them, learn from them....Start with what they know, build with what they have...."Lao Tzu Jeffrey Harris Untangled Healthcare Untangled HealthcareAssisting communities to monitor and improve healthcare www.untangledhealthcare.com www.untangled health.com All presentations on Slide share Jeffharris@untangled healthcare.com

  4. The new payment model • Process and Outcome Measures • Fee for Service • Improvement from Baseline • Accountable Care Organizations Carrot and Stick

  5. We can’t boil the ocean but we can teach people their right to access 28% of 500 persons with no previous healthcare visit in prior year to death

  6. The Patient Advocate ProcessTransition Management Assist with reporting outcomes to PCP • Discover Bio-Psycho-Social History Goals, Wants, Needs Functional Status Physical Social Cognitive Compliance Comorbidity • Activate Insurance Exchange Primary Care Medical Home Patient Contract • Monitor Patient Compliance Disease Self Mastery Learning Barriers Identify and link community resources: Transportation, Meals on Wheels, Patient Peers • Evaluate • Assist • Educate Primary and Secondary Prevention Self Monitoring Resource Utilization Urgent Care Guidelines Communication Skills

  7. Alphabet Soup HITECH Act Enforcement Final Rule The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology. 

  8. The tools you use will be dependent on the stages of development in your local environment Manual transcription errors of critical information used to influence critical treatment decisions continues to be the largest source of “therapeutic misadventure”

  9. Office of National Coordinator For HIT

  10. Data Set Considerations Addressed by standard

  11. Graphic Representation of National InitiativeData Exchange Illustrated Non Integrated System Integrated System with e-HR PHR PCMH Single Practice EMR Silo • EHR Various Labs Specialist • LIMS • EHR Local hospital affiliate • f • EHR • PACS Communication Barrier Hospital System Imaging • Sure • Scripts Pharmacy Health Info Exchange Local Pharmacy

  12. Resources

  13. Resources

  14. Selecting providers

  15. Payment ResourcesDon’t forget PAP Programs

  16. Activating Patients

  17. My PHR

  18. How I connected my system • Located physician with knowledge of health data interchange and motivation to heal • Located surgeons who would treat me as equal • Located tools online that worked and were interoperable • Created my own accounts {HealthVault, Connected to • Connected to CVS, SPINN secure Communication and LabCorp

  19. Decision Support

  20. Details of record source

  21. Medication Reconciliation Who ordered drug Where did record come from Is this patient staying with medical home or Dr. Shopping

  22. Family History

  23. Monitoring

  24. My Droid Diabetes Meal and Insulin Managers

  25. Choosing a hospital

  26. If patients are readmitted is that the hospital issue or does it say something about the supporting community?

  27. What we have known for 20 years but just now have the incentives aligned In conclusion, patients hospitalized with CHF have a high risk for readmission after discharge. Patients with a history of hospitalization as a result of CHF, longer hospital stay, and a history of hypertension are at increased risk for readmission, and our data suggest that socioeconomic factors, including poor follow-up visits, poor professional support, and no occupation, are also potentially important predictors. Therefore a systematic CHF patient management system that coordinates care in the hospital, outpatient, and home settings is clearly needed to reduce the morbidity and mortality of patients with CHF and thus lower the over-all costs for the treatment of these patients.

  28. What Scenarios are Patient Advocates Likely to Face

  29. Meaningful Use Time Line

  30. What has changed in last decade • HITECH Act Bush administration effort to create a standardized electronic health record • Physician Protection and Patient Safety Act: Charles Randle • Accordable Care ActPresent Administrate ion Effort to alter reimbursement for first contact, comprehensive and continuous care (Primary Care Medical Home and Insurance Reform

  31. Diabetic with healthy feet Good Self Management What is the difference between an engaged patient and one without influence to engage Diabetic Gangrene Prior To Amputation • My feet forever please

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