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Patient Activation – The Blockbuster Drug of Patient Engagement

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“Even in an age of hype, calling something “the blockbuster drug of the century” grabs our attention. In this case, the ‘drug’ is actually a concept—patient activation and engagement—that should have formed the heart of health care all along.”

This quote is from a theme issue called “New Era of Patient Engagement” published by the well-respected health policy journal Health Affairs.  This caught our attention last year because it resonates with the vision for healthcare that NexJ and the Canadian Association for People-Centred Health have been working toward for many years.  Like most innovations, NexJ’s health solutions have taken a lot of thought, trial and error to learn what will best achieve the vision.  Patient activation has been a useful guide for designing solutions that empower patients and their communities of support.

Let’s start by looking at patient activation.  Judith Hibbard, the thought-leader in this field, calls patient activation, “understanding one’s own role in the care process and having the knowledge, skills, and confidence to take on that role.” The Patient Activation Measure (PAM) has been studied for over 10 years. There is growing evidence linking it with better outcomes, lower costs and improved patient experience.

PAM is assessed through a series of answers to questions that gauge whether people view themselves as managers of their own health and health care. People self-assess their level of agreement or disagreement with thirteen statements.  The statements are about their beliefs and confidence in managing health-related tasks and knowledge. For example, “I am confident that I can tell whether I need to go to the doctor or whether I can take care of a health problem myself”.   People are categorized into four levels based on a 0-100 scale.  Level 1 is the least activated and level 4 is the most activated.

Improving PAM has benefits. The evidence seems compelling:

  • More activated patients are less likely to use emergency departments or be hospitalized
  • They are more likely to adhere to treatment regimens and actively participate in decisions
  • They are more likely to use health information and engage in healthy behaviors
  • The greatest benefits can actually be achieved by improving the lowest activated patients
  • And, activation can be improved for the elderly, people with multiple chronic conditions, and/or people who are socioeconomically disadvantaged

Through NexJ’s own research and development (including many trials using Connected Wellness), we’ve concluded that information technology can enable patient activation through the delivery of efficient and effective patient education, by improving collaboration between patients and their team of caregivers, and by driving sustainable behavior change for wellness.  This is why the core solutions of Connected Wellness are:

  1. Education, delivered at point-of-care and providing patients with an audio and video record of the patient-provider interaction post-visit
  2. Collaboration, enabled by patient-friendly care plans, online scheduling and assessments, and secure messaging
  3. Motivation, acquired with the on-going support of a personal health coach

I’ll explore a range of topics in this blog, but I will likely often return to these three core principles/solutions.