1. Patient Engagement and Shared Decision-Making: From Concept to Reality Kellie Slate Miller, MS August 28, 2012 QC Brown Bag Forum Webinar Presentation

2. 2 Patient Engagement: The Missing Link Opportunity to engage patients in a dialog with their own health. Surveys continue to support the good news that most patients report a high level of trust with their health care providers. At the same time, data suggests that patients are sometimes reluctant to engage in collaborative discussions with physicians about their choices in health care. Why patients are often reluctant to actively engage in a collaborative discussion about their health care choices.

3. 3 2012 Research Study Led by Dominick L. Frosch, PhD “Communicating with Physicians About Medical Decisions: A Reluctance to Disagree” Showed that nearly all patients could envision asking questions (93%) and discussing preferences (94%) Few felt they would actually voice a disagreement and challenge their doctor (14%) Those not willing to disagree, about 47% feared being labled “difficult” and 40% worried such actions would lead to a damaged relationship. 51% thought it might compromise care (

4. 4 Consumer Engagement & Shared Decision Making What We Say: Want patients to take active role in making decisions about their health Want patients to ask questions Want patients to express values & preferences What We know: Patients – even well educated – are reluctant to ask questions Patients fearful of challenging provider recommendations Many patients feel physicians are authoritarian (vs. “authoritative” (Archives of Internal Medicine article and state stats. here)

5. 5 Partnering with Patients Video Clip – engaging patients to become more involved in their health in Maine. Exploring what successful patient- provider partnerships look like in Maine. http://youtu.be/EpcJuYTEEb4

6. 6 Patient Engagement Campaign Take Charge of your health: Step ONE: VISIT your Primary Care Provider Step TWO: ASK Questions Step THREE: KNOW and understand your health related numbers Step FOUR: FIND and use community health resources and programs

7. 7 Better Health. Better ME! Partner Organizations: Central Maine Healthcare Corporation Consumers for Affordable Health Care Eastern Maine Healthcare Systems Get Better Maine (Maine Healthcare Management Coalition) Maine Association of Area Agencies on Aging MaineGeneral Health and Medical Center MaineHealth Maine Primary Care Association Maine Quality Counts Seniors Plus Allied groups include: Maine CDC, MaineCare, Maine Quality Forum/Dirigo Health, Maine Medical Association, Maine Osteopathic Association

8. 8 Additional Information for Patients: Materials: Getting Ready for appointments: 9 things You can Do to Get Better Care 5 Things You Should Know when You Get a New Prescription Websites: http://familydoctor.org/familydoctor/en/healthcare-management/working- with-your-doctor/tips-for-talking-to-your-doctor.html http://familydoctor.org/familydoctor/en/healthcare-management/working- with-your-doctor/tips-for-talking-to-your-doctor.html Institute for Patient and Family Care - http://ipfcc.org/http://ipfcc.org/ Agency for Healthcare Research and Quality: http://www.ahrq.gov/questionshttp://www.ahrq.gov/questions

9. 9 Patient Engagement: What Physicians Can Do to Help Patients Get More Engaged Create a Safe Space Use Your Team Use the Tools AHRQ – www.effectivehealthcare.ahrq.gov/ehc/decisionaids/prostate-cancer www.effectivehealthcare.ahrq.gov/ehc/decisionaids/prostate-cancer MaineHealth – www.mainehealth.org/mh_body.cfm?id=7848 www.mainehealth.org/mh_body.cfm?id=7848 Center for Advancing Care - http://cfah.org/http://cfah.org/ Mayo Clinic – http://shareddecisions.mayoclinic.org/decision-aids-for-diabetes http://shareddecisions.mayoclinic.org/decision-aids-for-diabetes Foundation for Informed Decision Making – http://informedmedicaldecisions.org/shared-decision-making-in-practice/decision-aids http://informedmedicaldecisions.org/shared-decision-making-in-practice/decision-aids

10.  Distribute the “Better Health. Better ME!” brochure and encourage your patients to use it  Request BHBM Brochures (free) for your Practice  Encourage use of the QC Pathways Brochures & request copies for your Practice  Share the Provider Tools with your medical staff to encourage them to create What You Can Do In Your Practice 10

11. 11 Engaging Consumers – Partnering for Improvement

12. MHMC’s “GetBetterMaine” Reporting 12

13. Contact Info / Questions General information Lisa Letourneau MD, MPH: LLetourneau@mainequalitycounts.org LLetourneau@mainequalitycounts.org Patient Engagement Campaign Kellie Slate Miller, MS: kslatemiller@mainequalitycounts.orgkslatemiller@mainequalitycounts.org Maine PCMH Pilot: www.mainequalitycounts.org www.mainequalitycounts.org (See “Major Programs”  “PCMH Pilot”) PCMH: Nancy Grenier : ngrenier@mainequalitycounts.org ngrenier@mainequalitycounts.org CCTs: Helena Peterson : hpeterson@mainequalitycounts.orghpeterson@mainequalitycounts.org 13