Krames StayWell Blog

May is National High Blood Pressure Education Month. Prepare Now.

Hypertension is a huge burden on the health care system. According to the latest American Heart Association statistics, one in three adults in the United States has high blood pressure, putting them at increased risk of heart diseases, stroke, heart failure and kidney disease. And many aren't even aware they have it. National High Blood Pressure Education Month offers the perfect opportunity to raise awareness and motivate behavior change before the problem gets worse.

Some key lifestyle changes that help to control high blood  pressure include: losing weight, becoming physically active, choosing foods low in salt and sodium, limiting alcohol intake and taking care to lower stress levels. Visit the National Heart Lung and Blood Institute website for more information to include in your outreach programs, so participants better understand high blood pressure, and the steps to control or reduce the risk of health problems. In addition, integrating patient-centered resources into your education initiatives is an effective way to engage patients in their care. This results in better outcomes, reduced readmissions and higher patient satisfaction.

To find patient education resources that help support your National High Blood Pressure Education Month initiatives, click here. Also be sure to visit www.kramesstore.com for other patient education topics related to your specialty.

Could the Patient Engagement Tipping Point Be at Hand?

Wouldn’t that be cool?

An unanticipated outcome of all the discourse – a lot of it nasty – surrounding the health care reform debate – is that perhaps larger segments of the population may start to become really engaged in their health self-management. Regardless of whether one supports the individual mandate as a good compromise to bring universal access within the current commercial insurance framework; or one believes the individual mandate starts the US down the slippery slope toward socialized medicine; or one believes that the individual mandate does not go far enough in countering the influence of the big insurance companies and should provide at least a public option; there is the possibility that all these individuals – each with very different ideas about who and how their insurance coverage should be provided – will start to begin thinking about taking a more active role in maintaining their health.

This presents us with a really great opportunity.

As much as you can, steer clear of the politics and focus the moment on the need behind the need. Because it’s not really about insurance, it’s about feeling good. It’s about health.

In late June or soon thereafter, the Supreme Court is going to rule on the individual mandate, severability and the future of the Patient Protection and Accountable Care Act aka Obamacare. That event and flurry of analysis will be followed by two national nominating conventions and the presidential election where heath care policy will figure prominently.

There are going to be so many opportunities in the near future to bypass the politics and engage patients, consumers, members, and employees about what they can be doing to manage their health in many stages of their lives – from starting a fitness program to understanding some emerging symptoms and a new diagnosis; to deciding on a course of treatment be it medication or surgery through rehabilitation, or chronic care management through palliative care.

Are you ready to enter into meaningful health care conversations that will promote patient engagement?

Patient education strategies to support National Public Health Week (April 2-8)

National Public Health Week kicks off on April 2. Every year the American Public Health Association organizes this observance around a theme designed to highlight issues important to improving health. This year’s theme is A Healthier America Begins Today: Join the Movement.

We love that this is a call to action for both consumers and public health activists. But changing behaviors and creating healthy habits can be difficult. Here are three suggestions for effectively motivating change with health education.

1. Make it personal.
It’s easy to dismiss health issues as things that happen to others. That’s why it’s critical to get people involved right from the earliest stages of change. For instance, Stop High Blood Pressure includes a self-assessment to help people evaluate their risk and identify ways they can minimize it.

2. Model specific behaviors.                                                                  
People learn more readily be observing and doing than simply being told. Rather than provide broad instructions such as eat foods that are high in fiber and low in fat, show them how with food substitution charts, and strategies for cooking and eating out like those found in You Can Manage Your Cholesterol.

3. Break it down into small steps with clear goals.
People are more motivated when they believe they can succeed. By dividing topics into small parts, people can set SMART (specific, measurable, achievable, rewarding, trackable) goals that lead to self-efficacy. Take a look at Adding Activity to Your Life and My Quit Smoking Plan for examples.

Like the theme says, join the movement. Feel free to share these educational strategies to support your Public Health Week campaign. Also feel free to share your own advice for encouraging healthy lifestyles.

Introducing the new kramesstaywell.com

kramesstaywell.com – our single online destination for patient education and health communication needs.

We´re pleased to announce the launch of kramesstaywell.com. This new website integrates krames.com and staywellcustom.com into a single destination for a more seamless online experience.

While you can still shop for patient education on www.kramesstore.com, our new website showcases the entire breadth and depth of solutions brought together when Krames and StayWell Custom Communications merged last year.

Providers can find a broad range of enterprise-wide patient education and marketing solutions to engage patients and consumers at every touch point along the continuum of care. Watch the Engage 360™ video for an overview or check out specific solutions such as Krames On-Demand, video solutions, health portals and custom publications.

Payors can explore solutions for health management, plan communication and employer programs. Text messaging programs, clinical communications, interactive symptom checkers, and comprehensive health and wellness portals are just a few of the innovative offerings highlighted.

There’s also access to FREE white papers, research and presentations within the About Us section. For more information on everything we offer, check out our Products & Solutions for detailed descriptions of products, solutions and/or services. Be sure to update your kramesstaywell.com bookmarks for quick and easy access to all the information and resources.

Please take a few moments to explore our site and let us know what you think! Share your feedback below or via our Facebook page.

Mind the gap! Current research shows communication is still lacking when it comes to shared decision-making support

Despite a wide-spread movement toward patient-centered care, current research indicates that communication gaps continue to threaten the patient’s ability to participate in true shared-decision making. 

A blog post earlier this month from the Wall Street Journal, brought attention to a new study that examined the decision making process of fee-for-service Medicare beneficiaries who had surgery for prostate cancer or elective coronary artery stenting. 

Surveyed about their experiences, only 10% of the stent patients recalled that they were presented with alternative options to consider.  By comparison, more than half of the prostate cancer patients (64%) indicated that a serious alternative to the surgery was presented.

Additionally, while the majority (77%) of patients who received stents reported talking with their doctors about the reasons for stents, very few (19%) recalled their physicians discussing with them the cons of the procedure.  And only 16% said they were asked about their treatment preferences.  This comes again in contrast with the prostate cancer patients, where the majority (63%) reported that they did discuss the cons and that most (76%) were asked about treatment preferences.

The healthcare industry cannot advance patient-centered medical care without improving the physician-patient communication encounter.   This means providing not only the dialogue but the resources necessary for engagement and understanding, so that patients feel as though they are partners in their care thereby empowered to participate in decisions about their own health.  As the Agency for Healthcare Research and Quality (AHRQ) reports in their discussion of shared decision-making, there are many positive benefits to improving the quality of medical consultations, including increased compliance, improved outcomes, and a decrease in demand for health care resources. 

Providing information relative to the pros, cons and alternatives to a medical procedure or treatment is not only a fundamental principal of shared-decision making, but also of informed consent, and new resources in print, electronic, and mobile formats make the delivery of that information even easier.  Consider how you and your organization can leverage these tools to improve consultations with your patient population and close the gap on shared decision-making support.

Stage 2 Meaningful Use, Patient Engagement, and You

CSC recently published a fascinating report Moving Ahead with Stage 2 of Meaningful Use which reports on a survey they conducted of CIOs who are members of CHIME (College of Healthcare Information Management Executives).   Among the findings were that a high percentage of Hospitals and Eligible Providers that have attested for Stage 1 chose to defer on the meaningful requirements relating to coordinating care and engaging patients.

Within hospitals, only 41% met requirements for providing e-copies of discharge instructions, only 38% met requirements of providing patients with educational materials, and only 32% provided patient with e-copies of their information.    For Eligible providers, only 37% provide patient access to their electronic information.  In Stage 2, these optional menu set requirements will most likely become mandatory.   Additionally, proposed Hospitals and Eligible providers will need a mechanism to track that certain percentages of patients have actually accessed provided electronic information.

At Krames StayWell, our mission revolves around solutions for patient engagement – before, during, and after clinical encounters.  According to the CSC study organizational readiness and vendor product readiness were primary reasons for deferring some of these patient and family engagement requirements.  On our end, we strive to offer content solutions that can be integrated from within your health IT systems including Epic, Cerner, and Meditech but we also offer applications that can connect with your systems via 2-way HL7 interfaces.  We have also invested in utilizing the 3MM Healthcare Data Dictionary so our content carries metadata for over a dozen taxonomies including ICD-9, CPT, SNOMED, LOINC, and RxNorm meaning the heath record can trigger content with a level of specificity and sensitivity designed to encourage patient engagement that can add tremendous value to your patient portals.

Sometime in Q3 2012, we can expect to see the final rules for Stage 2.  We think we are heading in the right direction to support our customers but would love to hear about some of the challenges you are having surrounding patient and family engagement – from meaningful use perspective and beyond.  Please add you comments below.

2012 National Health Observance Patient Education Resources

National Health Observances provide an opportunity to increase awareness of important health issues. To help you plan your efforts for the year, we’ve identified key health observances for each month and patient education that you can use to support your efforts. Listed below are just a few upcoming health observances.

February:

Sponsored by the American Heart Association every year, Heart Month serves to educate the public on ways they can combat the leading cause of death for men and women in the U.S.

Because vision loss often occurs slowly, it can be hard to catch early. Prevent Blindness America started AMD/Low Vision Awareness Month to raise awareness for macular degeneration and other vision problems.

March:

National Nutrition Month® is an educational campaign sponsored annually by the American Dietetic Association. It is designed to promote the importance of making informed food choices and developing sound eating and physical activity habits.

American Diabetes Alert Day® is held on the fourth Tuesday of every March to help people understand their risk of developing Type 2 diabetes and how they can take steps to improve their health.

The importance of sufficient sleep is highlighted during National Sleep Awareness Week®, a weeklong awareness campaign sponsored by the National Sleep Foundation.

Start planning now to motivate behavior change and make a positive impact on people’s lives.

Click here for the full listing of 2012 National Health Observances.

Do you have any go-to resources that you use to organize and prepare for National Health Observance efforts? Share them below.

ACOs and How to Encourage Patient Accountability

     Accountable Care Organizations — at their core — are an attempt to lower healthcare costs by countering fragmented, episodic sick care with a system of “accountability” for the overall health of patients. That accountability lies with a group of providers who will get to share in cost-of-care savings provided they meet quality benchmarks as well as lowering costs.

To work, however, patient engagement is critical. While the reasons may be numerous, the fact remains that by and large people are not focused on wellness. Most folks don’t think about their health until they are sick. US Citizens are not taught to maintain and manage their health.

So, they are used to seeing healthcare professionals when they get sick. Upon a diagnosis, people will be motivated to adhere to doctor’s recommendations while their problem is acute. Why? Because they want to feel good and they want to get back to the place where they no longer have to think about their health.

The fee-for-service, volume-driven health care system is in fact supported by the fact that people are not deliberately health conscious. Therefore, when they don’t feel good, they’ll support pulling out all the stops until they can feel good again. And what happens upon cure or, at least symptom remission if the condition is not immediately life-threatening? People fall back into their old habits until such a time when they experience acute illness again. 

An ACO seeks to change the paradigm by focusing on provider behavior with the carrot of extra payment upon providing cheaper care to patients without sacrificing quality.  That is why meeting quality measures are part of the equation.   But what about the patients?   Is there anything inherent in the ACO model that is going to motivate them to start becoming more health conscious?   Not without effort.   That is why patient engagement or patient accountability is going to be critical for the success of an ACO.

Patient engagement needs to extend beyond existing moments in care.   Because patients can opt out of seeking treatment from ACO providers, it is critical from the outset that an ACO engage their patient panel and provide the benefits about seeking care from within the ACO.  Just as hospitals and health plans publish community/ member newsletters, it makes sense for an ACO to also be reaching out into their community of patients and promote health self-management along with a listing of the services and providers that make up an ACO.

While much has been made of the importance of an EHR as the technological underpinnings of an ACO that facilitate sharing data and coordinating care, just as much thought needs to be given to how the patient portal can be leveraged to engage the patient in ongoing care.   This must extend beyond providing mechanisms for making appointments, filling prescriptions, or accessing lab results.  It has to include access to contextual information for the patients that will interpret the data that has been ported over from the EMR into the PHR and include patient-centric, behavior-based content that helps the patient successfully manage their health and avail themselves of the principles behind the Accountable Care / Coordinated Care model.

And while the PHR is a natural bridge from clinical-data to consumer-facing health content, to drive engagement creating accountability, care needs to extend beyond the PHR interface.   And this care should not be limited to strictly digital formats because we cannot ignore that different people have different learning preferences.  No one can argue about the potential cost savings, speed, and data capture benefits inherent in digital solutions such as interfacing with a text-messaging platform, engaging in an online health self-management program, or completing a Risk Assessment on the web.  But if people don’t utilize those tools then they have no value.   Offering print-based solutions such as mail-based patient education interventions, chronic-care newsletters, or comprehensive workbooks can be just as effective in meeting the end goal of lowering costs and improving outcomes even if you don’t capture all of the data associated with the distinct interactions that comprise the offline interventions.

The jury is still out regarding the impact and efficacy of the Accountable Care Organization.  In those instances where the goals of lowering costs, meeting quality guidelines, and sharing savings are achieved, my guess is that those entities will also have spent a good deal of time and effort of engaging their patients and creating a high degree of patient accountability for health self-management. 

Helping Patients and Staff with Patient Education

There is little argument that quality patient education resources help patients in many ways.   My definition of “quality” includes such attributes as patient-centric, application of health literacy design principles, behavior-oriented, and, of course, scientific accuracy.   When implemented as part of the patient education process,  you can see increases in patient satifsfaction, reductions in avoidable readmissions, and better outcomes.   But there is another important benefit – staff efficiency.                            
We recently surveyed caregivers across the country in an attempt to quantify the impact patient education resources had on workflow.  The results were quite interesting.  Here is some of what we learned:

• On average, a nurse will spend 3 hours and 20 minutes a day with every patient
• Of that time, approx. one third or 1 hour and 20 minutes a day is spent educating  patients
• Of the education time, 40% is spent reviewing patient education materials with patients/families.
• On average, nurses believe  that quality education materials will save them almost an hour in streamlining the entire education  process over the course of a hospital stay which equates to about $26 in cost savings per patient

Considering the escalating costs of care coupled with the accelerating nursing shortage, the relatively small investment in education resources – in print and digital – can deliver a high return for your organization.

Click on the following link to download a copy of our Research Brief on this topic and good luck with your education programs.

Three Health Care Trends to Watch in 2012

2011 was an eventful year. It began for us on January 1 when Krames Patient Education and StayWelll Custom Communications came together to form the Krames StayWell Company. As you might imagine, bringing together two long-standing organizations, each with its own rich culture, presented a series of challenges, a few rough patches, and thankfully a lot of triumphs as we saw a team of professionals come together, share best practices, and work hard to support a growing client base across the health care markets.

Our evolution was unfolding within a rich tapestry of changes in the healthcare market place including:

• The first full year of Stage 1 Meaningful Use. Through November, CMS had paid out over $2billion in Medicare and Medicaid reimbursements to physicians and hospitals. Participation in the program now stands at over 154,500 providers. 
• PPACA or Healthcare Reform began to significantly impact the health care ecosystem. ACOs is now a standard part of our vocabulary. And, with the recent rulings by CMS, I imagine that the impact of Medical Loss Ratios is going to influence a lot decisions on how care can be efficiently and effectively delivered as well as redefining what exactly makes up “care.” Stayed tuned for some really interesting discussions on that topic.
• Lean economic times. It seems that we have been skating on the precipice of a double-dip recession for a long time. Unemployment is hovering in the 9 – 10% range. Investing in infrastructure and weathering short term impacts of change become much more difficult when the economy is stalled.

It has been a interesting year.  An eventful year.  A good year.

With the holiday season upon us, I suggest the following trends will make 2012 another interesting year: