Friday, June 8, 2012

Patient Engagement and Technology - Improving Care and Lowering Costs

Today's healthcare community met at Wilmer Hale in Waltham to discuss the effect of patient engagement to improve care and lower costs.  The opening presentation from patient Mary-Angela DeGrazia-DiTucci quickly grounded the audience and reminded us what the event was all about.  Mary-Angela spoke about her multiple digestive illnesses and how technology has empowered her to be an informed, educated patient for herself and her community.  Mary-Angela's presentation is available here.
 
Dana Gelb-Safran, SVP Performance, Measurement & Improvement with BCBSMA, keynoted the session and opened with a bleak outlook of the cost of care in the U.S.. In addition, she said that based on most metrics, including life expectancy, the U.S. is in the bottom third of overall health of all developing countries.  BCBS has set out to change this with their AQC model, launched in 2009 to have AQC providers accountable for quality and cost.  80% of their network is now under the contract with good results and it underscores the importance of patient engagement. Not necessarily providing the patient every service they want, but providing them their health.  Dana's presentation can be found here.

An interesting statistic that Dana presented was that patient trust makes a profound difference of successful behavior change. She also presented Patient Reported Outcome Measures (PROMs). National policy will say its time to move this theory from research to practice. There are significant challenges in doing this and it requires a cultural changes. However, what we can learn from the patient are the core elements of health and that we need the delivery system to rise to the challenge. The only way to get this is with a standardized, validated set of questions that need to take their place in the delivery system as a part of how we diagnose and guide treatment decisions. Technology is going to play a key role in gathering and analyzing this information.

 Dr. David Judge, Medical Director, Ambulatory Practice of the future, MGH, Kamal Jethwani from Partners Center for Connected Health and Joshua Feast, CEO at Cogito Health presented their views on the promise and effects of patient engagement for better outcomes.  They discussed our ability to create a patient-centered culture instead of a provider-centered culture. At the Center for Connected Health they believe that technology is a primary driver for improved patient engagement and improved care.

An audience member asked for a working definition of patient engagement. A few answers were provided but overall, patient engagement is when patients actively participate in their health and seek information and guidance and share back this information.  It is when patients will take action and try to measure against their goals or the probability that anyone at a given time will take a major step in their health.

But who is going to pay? The technologies must show an ROI while providing better outcomes. Payment reform and the new AQC model can help the provider organizations pay. Technology break-outs that support better health at a lower cost are easier to support (and pay for) now.

Safran concluded the session by asking the panelist to provide one thing that makes them optimistic:
1. Regulations give us a strong foundation to move forward.
2. There is a huge commitment behind the scenes, and the interaction between all groups, and the patients taking responsibility, will help us move forward.
3. Dr. David Judge - He is optimistic that changes in the way we pay for care will allow us to work with patients in a better way.
4. Kamal Jethwani is more optimistic and, encouraged now vs.3-5 years ago. The industry is ready, clinicians are ready, patients are all creating the perfect storm and in 3-5 years healthcare in the U.S. will be different.

MassTLC's healthcare cluster is under new leadership with Dr. David Judge, Director, Ambulatory Practice of the Future, MGH, and George Brenckle, CIO, UMASS Memorial Health Center. David and George are co-chairing the group and stayed after the session to guide a discussion with MassTLC member organizations on plans for the fall. Stay tuned for more programs on patient-centered care and hearing the results of UMASS Memorial's overhaul of their back-end systems.

Thanks to all that joined and participated in the morning.

-Christine Nolan

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