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Developing a New Paradigm for Addressing Health in the Age of The Affordable Care Act: Patient Engagement is more than Building Facilties \

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Presentation on theme: "Developing a New Paradigm for Addressing Health in the Age of The Affordable Care Act: Patient Engagement is more than Building Facilties \"— Presentation transcript:

1 Developing a New Paradigm for Addressing Health in the Age of The Affordable Care Act: Patient Engagement is more than Building Facilties \

2 Trust Respect Solutions Partnership Communication Flexibility Knowledge

3 Building inside out, so the communities become the ultimate project owners! A BIOPSYCHOSOCIAL APPROACH

4 PsychologicalSociological Biological Health BioPsychoSocial Model of Health and Illness In 1977, George Engel eloquently stated:"To provide a basis for understanding the determinants of disease and arriving at a rational treatments and patterns of health care, a medical model must also take into account the patient, the social context in which he lives and the complementary system devised by society to deal with the disruptive effects of illness, that is, the physician role and the health care system. This requires a BioPsychoSocial model."

5 In 1999, I changed Dr. Engel statement to reflect a more multidisciplinary approach to health disparities, a medical model that must take into account the complex nature of health disparities that involves more than problems with access. It takes into account community, the social context in which they live and the complementary system devised by society to deal with the disruptive effects of illness on their lives. That is a problem that can’t just be solved at the bench or in the clinic or by analyzing national datasets. PsychologicalSociological Biological Health BioPsychoSocial Model of Health and Illness

6 AHC-Community Engagement Define community and Identify partners Etiquette of CE Learn about the community Build a sustainable network of and for CEnR Recognize CEnR requires new methodologies Improve translation and dissemination plans Change institutional culture Aligning researchers, clinicians, and community motivations/goals into a common vision of healthy population Integrate partners in all project phases Michener et. al. 2012

7 Population Health System Integrator Patient Experience The System Integrator Creates a partnership across the medical neighborhood Drives PCMH primary care redesign Offers a utility for population health and financial management Per Capita Cost Prouctivity 28 Copyright 2011 by IBM Triple Aim Paul Grundy MD MPH IBM Director Healthcare Transformation Director Patient Centered Primary Care Collaborative

8 * FAROS expands the Freeman model to include CHW to navigate older Latinos through screening & PN at the point of suspicious findings onward to the community and life after cancer. FAROS Screening The Patient Navigation Model The Cancer Care Continuum Community Health Workers Community Health Workers Patient Navigators Health Referral Specialist

9 What is a navigator? Patient Navigators are trained, culturally sensitive health care workers who provide support and guidance throughout the cancer care continuum. Maintaining communication with patients, survivors, families, and providers. Arranging language translation or interpretation services. Coordinating appointments and timely delivery of clinical services. Facilitate: community outreach clinical trials access partnership building services referral Follow up Support groups Other navigation activities include: Facilitating financial support and helping with paperwork. Arranging transportation and/or child/elder care. Navigators possess the interpersonal and professional skills to build, trust, rapport, and effective working relationships with individuals and organizations.

10 Why is navigation important? More accurately identifies barriers to care Improves sharing of resources Enhances continuity of care, which may result in improved outcomes Improves quality of services Increases patient satisfaction

11 The Navigator’s Community

12 Trust, the critical factor…. Health Care System Multi-disciplinary Health Team Provider Navigator Major medican center Participant Community Clinical Trial Treatment Palliative Care Family Perception

13 How to Build Different Types of Trust Calculus Based TrustIdentification Based Trust Perform competentlyEstablish a common identity Establish consistency and predictability Capitalize on co-location Communicate accurately, openly and communicatively Create and achieve joint goals Share and delegate controlPromote shared values Show care and concern for others

14 When Trust is lost……… Violated expectations – when the confident expectations of the trustor are not met by the person they are trusting. Determinants of response to trust violation Magnitude of the offense Number prior violations Specific violate dimension

15 Steps to Rebuild Trust Calculus BasedIdentification Based Act immediately after the violation Reaffirm commitment to the relationship Apologize and give a thorough accounting of what happened Reestablish the emotional connection Be cognizant of the daily history of the relationship Make clear sacrifices to establish the importance of the relationship over your own self interests Provide restitution and penance Reinstate and renegotiate the psychological contract of the future Be trustworthy in future interactions

16 Obstacles to Rebuilding Trust Not aware of other people’s reactions Not able to understand the consequences of violating trust Don’t know how to take corrective action Ego or self-esteem threatened Legal implications

17 Everyone Needs…… An ENVISIONED FUTURE The next generation The future generation The past generation

18 Parting thoughts…. I believe that we have a voice inside us that tells us what is right and wrong, How we listen to that voice and act on it produces the people that we are” Integrity by Stephen Carter

19 QUESTIONS

20 Lovell A. Jones, Ph.D.Professor Emeritus U.T. Distinguished Teaching Professor University of Texas M.D. Anderson Cancer Center Co-Founder, Intercultural Cancer Council Chair, Board of Directors, Children and Neighbors Defeat Obesity (CAN DO) Houston Mulholland Drive Stafford, Texas CONTACT INFO:


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