The lesson learned, says Overton, is that PAM isn't only useful for physicians and patients, but also for the system. "You can't care manage or case manage everybody. If you're going to deploy scarce resources, PAM can help you figure out which subpopulations to deploy your resources to."
Patient engagement is high-tech and high-touch
Technology and patient engagement go hand in hand at Geisinger Health System, the Danville, Pennsylvania–based integrated health system with nine hospital campuses, a multispecialty group practice, and a health plan. With one of the industry's most mature electronic health record systems, GHS has been able to leverage patient data and technology to help get and keep patients engaged.
Interestingly, the patient engagement strategy at GHS was largely informed by Hibbard's research into patient activation, says Albert Bothe, MD, FACS, executive vice president and chief medical officer for GHS. "Dr. Hibbard's work was a demonstration that effective care wasn't just the skill of the provider," says Bothe. "It correlated the engagement of the patient with the recommended treatment."
Bothe says Geisinger doesn't use the PAM questionnaire, but it did use the concept of helping patients get activated earlier in their treatment by providing them access to websites that explain upcoming procedures. The strategy that began seven years ago has developed into what is now a robust approach to engage patients with a combination of high-tech tools and high-touch providers.
"An engaged patient is a healthier patient for us," says Gregory Moore, MD, PhD, chief emerging technology and informatics officer, and director for the Geisinger Institute for Advanced Application. "If you're a Geisinger patient, you've become used to multiple individuals reaching out to you and in different ways. It's not unusual for a nurse navigator to call and say, 'Hey, I notice you have a couple of open care gaps. You haven't gotten to that eye exam we've scheduled for you. Can we assist in getting you a ride there, or can I make that appointment at a more convenient time for you?' "
Closing those gaps in care is a key way that Geisinger measures patient engagement, and it's also used as provider incentive. Moore says physicians have 20% of their salary "on the line" for meeting quality metrics, one of which is closing care gaps. "You only get credit for closing your patients' care gaps if it is 100%," says Moore. "The metric that matters is not the number of care gaps, but how many times we get to 100% of care gaps closed."
Moore describes the GIAA as think tank and research lab for patient engagement, big data, and big concepts like population health. "We're the ideation part," he says.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.