Patient Engagement and Shared Decision-Making: From Concept to Reality

1. Patient Engagement and Shared Decision-Making: From Concept to Reality Kellie Slate Miller, MS August 28, 2012 QC Brown Bag Forum Webinar Presentation

2. 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.

3. 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 • (

4. 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)

5. 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

6. Patient Engagement Campaign Take Charge of your health: Step ONE: VISIT your Primary Care Provider Step TWO: ASK Questions Step THREE: KNOWand understand your health related numbers Step FOUR: FIND and use community health resources and programs

7. Better Health. Better ME!Partner Organizations: • Central Maine Healthcare Corporation • Consumers for Affordable Health Care • Eastern Maine Healthcare Systems • Get Better Maine (Maine Healthcare Management Coalition) • Maine Association of Area Agencies on Aging • MaineGeneral Health and Medical Center • MaineHealth • Maine Primary Care Association • Maine Quality Counts • Seniors Plus • Allied groups include: Maine CDC, MaineCare, Maine • Quality Forum/Dirigo Health, Maine Medical Association, Maine Osteopathic Association

8. 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/working-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

9. 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

10. What You Can Do In Your Practice • 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 10

11. Engaging Consumers – Partnering for Improvement

12. MHMC’s “GetBetterMaine” Reporting

13. Contact Info / Questions 13 • 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