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Meeting the Challenge of Patient Engagement

   August 26, 2015

Valerie Overton, DNP, FNP-BC

Hibbard developed PAM to give physicians a starting point for determining how motivated, confident, and knowledgeable their patients are. The tool is gaining traction with healthcare providers. According to Insignia Health, the Portland, Oregon–based company that licenses PAM, there are 140 health systems, hospitals, and physicians who use the tool in the Unites States and United Kingdom.

Minneapolis-based Fairview Health Services, a nonprofit health system that includes seven hospitals and more than 40 primary care and specialty clinics, has been collecting PAM scores on patients who visit the system's primary care clinics since 2010.

Valerie Overton, DNP, FNP-BC, vice president of quality and innovation at Fairview Medical Group, which is part of Fairview Health Services, says the medical group began measuring patient activation because leaders believed it would help capture the value of patients' health.

"We believe that one of the most important moves of the future for primary care is not only an emphasis on the measurement of disease-related outcomes but the measurement of health outcomes," Overton says. "As we move forward as an accountable care organization, we will be able to talk about how much health we produce for dollars spent."

A study of PAM scores collected from 33,163 Fairview Medical Group patients in 2010 found that patients with a PAM level of 1, the lowest, incurred a higher cost ($966) than patients who were PAM level 4, which is the highest level of activation. These patients' healthcare costs were $799. The results proved to Overton that PAM is a valuable tool, but clinicians were reticent to use PAM actively, she says, because it wasn't clear that if patients' PAM levels changed, their clinical outcomes would, too.

"Clinicians are evidenced-based," says Overton. "There's a time investment that it takes for clinicians to interact with patients, and clinicians really want to understand, 'If I'm going to change my approach, it really is going to make a difference.' "

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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