Christina Caraballo, MBA, describes how the use of integrated PHR platforms can enhance patient engagement and improve outcomes:
1. What is the benefit for care managers?
Patient engagement and consumer-centric healthcare through health IT are key focus areas in healthcare reform as a means to improve overall health outcomes and reduce readmissions. The challenge lies in providing interactive care management tools while promoting collaboration between patients, providers and family members. By leveraging gaming and connected health devices, integrated PHRs can facilitate behavioral change.
Gaming can provide care managers with tools to:
- Create and manage care plans for patients
- Monitor patient health metrics and care plan compliance
- Communicate with patient
2. What is the benefit for patients?
Gaming and connected devices can also provide patients with many self-service tools. These tools can help patients:
- Manage chronic disease
- Receive personalized care plans to help them manage their health and prevent hospital readmissions
- Inform and remind patients of actions they need to take
- Receive electronic copies of medical records
- Track key personal health information
- Receive alerts if key health metrics are not within a target range prescribed by their care manager
Examples of how integrated PHR platforms are working today.
- City of Los Angeles Department of Aging: Leveraging Gaming to Engage Patients: Health and Wellness Connection Seniors
The City of Los Angeles Department of Aging’s mission is to provide community-based services to seniors and their caregivers in order to offer the highest possible quality of life while they remain in the community. Through its Senior Health and Wellness Connection project, the Department sought a solution to enhance the physical, mental and emotional health of multi-ethnic, low-income seniors living in Los Angeles.
To engage patients, the Department implemented a HealthVault-integrated PHR solution powered by InstantPHR to help centers facilitate screenings, conduct health surveys and assist seniors in monitoring their blood pressure, blood-glucose levels and other health metrics.
Seniors in the program were given the opportunity to use Kinect for Xbox 360 to make exercise fun and to supplement other fitness activities such as tai chi. Using the personal health record tool, seniors and their wellness center caregivers were able to track activity levels and key health metrics, as well as review and share information with medical professionals and family members – all within one easy-to-use interface.
The community center-based program combined opportunities for:
- Increased physical activity
- Self-monitoring of chronic conditions
- Health education.
- MedStar Health: Empowering Patients with Self-Management and Collaboration Tools
Consistent with an institutional-wide focus on leveraging IT innovations to improve outcomes, the MedStar Health Institutes for Innovation and Diabetes conducted a pilot study to determine whether a diabetes-focused, patient-centric, web-based personal health platform could engage a diverse group of patients in self-care management.
The MedStar platform, eHealth2go (Get Real Health), provided tools for diabetes patients to collaboratively manage care with providers and family members. Patients utilized LifeScanOneTouch® glucometers that uploaded blood glucose data directly into the HealthVault-housed platform. This allowed patients to track readings and trends overtime and share them with a diabetes educator. Reports generated through eHealth2go spurred value-added communication at the time of provider visits because a record of information entered between office visits was captured through the portal.
In its pilot deployment to a predominantly minority and elderly diabetes patient population, MedStar patients saw significant reductions in blood glucose levels (181 mg/dl to 153 mg/dl) and in hemoglobin A1c (9.3% to 7.7%) over a three-month period. Improvement in e-health literacy was demonstrated and patients expressed satisfaction with the platform.
As our healthcare delivery system moves from a fee-for-service model to an outcomes-based model, access to personal health records through patient portals plays a key role in:
- Readmissions management
- Care transition management
- Chronic disease management
It is important to not only give consumers access to their personal health information, but also provide tools and resources that change health behavior. Engaging patients and their care management team to collaboratively work together improves outcomes and reduces costs.