Ohio Health Quality Improvement Plan

In f o r m e d a n d ActivatedPa t ie n t s a n d In d iv id u a l sInform and activate patients and individuals to promote deeper involvement inimproving their health and in making health care decisions.The concept of patients being more actively involved in their health and health care is a dramatic change from the currentstate where most Americans place responsibility for their health and illnesses in the hands of their doctors. Despite clearbenefits of being involved in our own health and health care, our behavior has not kept pace with advances in medicine,technology and health care services. Obtaining the benefit of these advances to prevent, manage and cure disease dependsincreasingly on one’s own energy, knowledge and skills, regardless of whether one is well or sick. 7An informed, engaged and activated patient is one with a clear understanding of his or her own health condition(s), theskills to self manage, and the ability to share responsibility with the provider for the plan of care. Nearly 90 percentof the care a person needs to manage a chronic disease must come directly from the patient. Evidence is growing thatself-management interventions, such as self-monitoring and decision making, lead not only to improvements in healthoutcomes and health status, but also to increased patient satisfaction and reductions in hospital and emergency room costs.It is important to note the difficult challenges this entails. The shift to activation and shared responsibility cannot be donealone; it requires the help of the health care provider and the support of family, friends and the community. It is not justabout giving patients and individuals better resources to make decisions. Much of the health care system is now drivenby extensive marketing to patients and individuals that increase health care costs by encouraging unhealthy habits and theconsumption of high cost health care products and services. Counteracting these messages effectively is not going to beeasy or inexpensive.For this collaborative transformational strategy, activation is defined as “actions that individuals must take to preventdisease and obtain the greatest benefit from knowledge of both disease prevention and the health care services andcoverage options available to them through the health care system.”The Informed and Activated Patients Team identified two broad aims of engaging and activating patients and/orindividuals: managing health care and managing health. (1) Managing health care involves those actions related eitherto the role of patient in the medical encounter or to that of consumer-purchaser of health care services. These two verydifferent roles are expected to work in seamless coordination as patients/consumers navigate the course of seekingcare and making treatment decisions. (2) Managing health involves those actions shown to prevent disease and thoseassociated with the successful self-management of chronic disease. The objective is to encourage, empower and assistpatients and/or individuals to develop the aptitude to acquire and utilize competencies for:• Healthy lifestyle choices• Health care coverage decisions• Health care treatment decisions• End-of-life decisions• Cultural transformation to informed and activated patients who are valued partners in all aspects of the envisionedpatient-centered health care system.The following principles characterize an optimal culture of informed and activated patients and individuals:• Partnerships (or shared decision making) between patients and providers/practice teams must be underscored.Collaboration and dialogue are essential to the success of the patient-provider partnership and patient-centeredmedicine. Health care and services based on shared decision making increases the likelihood of safe and quality careand positive health outcomes.• A commitment to shared responsibility between patients/individuals and their social environment or the materialconditions of one’s life that impact the well being of individuals and populations. This social environment includes the7 Gruman, J. (2008) A New Definition of Patient Engagement: What is Engagement and Why is it Important. Center for the Advancement of Health.Washington, D.C. 2008.16