Laura Makaroff, D.O. Pat Schmidlapp 10/23/2010

1. Building the Foundation for Practice Recognition and PCMH TransformationEngaging Patients in Practice Transformation Laura Makaroff, D.O. Pat Schmidlapp 10/23/2010

2. The Patient Experience

3. Why should we engage patients? IOM Crossing the Quality Chasm Report aims for an improved health care system • Safe • Effective • Patient-Centered • Timely • Efficient • Equitable

4. Helping the System IOM Crossing the Quality Chasm Report identifies ten rules for system redesign: • Care is based on continuous healing relationships • Care is customized according to patient needs and values • The patient is the source of control • Knowledge is shared and information flows freely • Decision making is evidence-based • Safety is a system property • Transparency is necessary • Needs are anticipated • Waste is continually decreased • Cooperating among clinicians is a priority

5. Joint Principles of the Patient-Centered Medical Home The Patient Centered Medical Home is an approach to providing comprehensive primary care for children, youth, and adults. The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians.

6. Joint Principles • Personal physician • Physician directed medical practice • Whole person orientation • Care is coordinated and /or integrated • Quality and Safety are hallmarks of the medical home: • Practices advocatefor their patients to support the attainment of optimal, patient-centered outcomes that are defined by a care planning process driven by a compassionate, robust partnership between physicians, patients, and the patient’s family. • Patients actively participate in decision-making and feedback is sought to ensure patients’ expectations are being met. • Patients and families participate in quality improvement activities at the practice level.

7. How do we do it? • Care of the individual patient • Practice improvement • Policy design and implementation

8. Key points • Asking patients what matters most to them is a critical step in engaging patients in their care. • Providers, patients, and families need new skills for this partnership. • There is no one-size-fits-all solution;patient engagement will look very different for different practices, patient populations, and individual patient-provider interactions. • Health IT has the potential to support patient engagement.

9. Goals • Respect preferences • Attend to emotional needs • Support autonomy • Share decisions with family and care team • Free flow of information

10. Engaged in their own Care • Communication and Information Sharing • Self-Care • Decision-making • Safety

11. Communication and Information Sharing

12. Patient Education

13. Patient Education

14. Self Care

15. Decision-making

16. Safety

17. Practice Improvement

18. Policy

19. Another Tool

20. If all else fails. . .

21. The Engaged Patient

22. References • Engaging Patients and Families in the Medical Home,AHRQ Publication No. 10-0083-EF, June 2010 • Center for Advancing Health (www.cfah.org) • www.HowsYourHealth.org • www.ncqa.org