The Best Care Management Teams Empower Patients like Abdel

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Abdel Qader is a 68-year-old Arabic immigrant who emigrated from Algeria with his parents when he was seven. All his life, he had been fiercely independent and proud of his heritage and American citizenship. After finishing college, he joined his father’s retail business and ultimately assumed control after his father’s untimely death from colon cancer in his late fifties.

In his mid-sixties, Abdel encountered his own health issues when he was found to have heart disease and diabetes. When his health became a concern, it was very important to Abdel to manage his health because of his independent nature and the demands of his thriving business interests. As a result, he sought a healthcare provider who could not only provide good care, but also allow him to be engaged in his care.

After some investigation, Abdel selected a health system in his community that had an excellent care management program. Not only was the primary care physician he selected well trained and compassionate, but he was also part of a health system that had a very effective care management program that would easily address Abdel’s needs to be involved.

Why the Best Care Management Teams Empower their Patients

Abdel was immediately assigned a nurse care manager and entered the system’s patient-centered medical home program. The care manager connected Abdel with a patient educator who was familiar with his clinical conditions. The educator instructed him about his conditions, as well as the treatment and dietary changes he had to understand. Abdel was eager to learn and quickly became adept at managing his conditions. He enthusiastically told his wife, “I can get instructions the very moment I need them,” and he considered the support “life-changing.” He contrasted that to the hurried care he received from his former physician, who did little to engage Abdel in his care.

Initially, Abdel emailed or phoned in his heart and diabetes data, but ultimately, he was given digital devices that gathered information on his heart rate, blood pressure, blood sugars, oxygen levels, and weight, and transmitted them electronically to the health system’s electronic health record, allowing the care manager to easily monitor the information in the organization’s care management system. The devices could also capture information on how he was feeling. If Abdel happened to gain a few pounds or experience a rise in his blood sugar, he would immediately get a call from his care manager. He was also advised about preventative care measures, including colon cancer screening to avoid his father’s fate.

Abdel thrived in this supportive environment and quickly became engaged with a gratifying sense of empowerment. He also continued to live a happy and productive life.

The Many Benefits of Patient Empowerment: Improves Outcomes and Lowers Costs

In prior stories about patients like Arline, Carlos, Keisha, Richard, Olivia, and Ruth, there is a constant underlying theme—the need to more actively engage patients in their care. In an AHRQ brief published in 2014 entitled “What We’re Learning: Engaging Patients Improves Health and Health Care,” the authors point out that patients who are actively engaged in their healthcare are more likely to stay healthy and manage their conditions by asking their doctors questions about their care, following treatment plans, eating right, exercising, and receiving health screenings and immunizations.

As modern healthcare becomes increasingly complex, patients often struggle to obtain and understand even basic health information, treatment, and services. Historically, patients have frequently lacked health literacy or a true understanding of their medical conditions. In addition, many health providers failed to provide the information patients needed to effectively be involved in or make good decisions about their own care and treatment. Even when patients do receive detailed information, they are easily overwhelmed without the support of an effective care management program.

As healthcare reform continues to evolve and delivery systems assume more responsibility and financial risks for patients’ outcomes and costs, there will certainly be more interest in expanding the role of patients in their care. A study reported in Health Affairs, conducted at Fairview Health Services (a large healthcare delivery system in Minnesota), demonstrated that patients without the skills to manage their healthcare incur costs up to 21 percent higher than patients who are highly engaged in their care. Engaging patients in their care is clearly important for improving outcomes and controlling costs.

The First Step in Patient Empowerment Is Patient Engagement

Patient engagement leads to patient empowerment and patient empowerment leads to health and wellbeing. Patient empowerment requires a process that allows patients to gain control over their health and lives, and increases their ability to act on issues that they themselves deem to be important. Empowerment tends to be a finely tuned aptitude that emerges as patients and providers work collaboratively and effectively together. Education and well-designed support are critical in this process because they provide patients the necessary skills, support, and confidence that inspire them to become active and successful participants in their care as a meaningful member of the overall care team.

The Importance of Patient Advocates: A Critical Role on the Care Management Team

Patient advocates are also important in patient engagement and empowerment. According to the National Patient Safety Foundation, an advocate is a “supporter, believer, sponsor, promoter, campaigner, backer, or spokesperson.” An effective advocate is someone a patient trusts who is willing to act on their behalf and can work well with other members of the patient’s healthcare team, such as doctors, nurses, and other care providers. The advocate is often a family member or friend, but the role can also be played by a well-designed care management program, especially by the patient’s care manager.

The Most Important Care Management Team Role Is Always the Patient

Patients deserve the right to play a key role in their care and health decisions. The right choice for any given patient generally depends on that patient’s wishes and life goals. The same illness might merit aggressive treatment in one patient, but minimal treatment in another, depending on how each patient assesses the pros and cons of that treatment and how it fits into their individual desires at any given time in their lives. An effective care management program has the capacity and capability to engage and empower each patient in a manner that allows them to successfully play this role.

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