+1,1,1
Search

Blog


The Truven Health Blog


The latest healthcare topics from a trusted, proven, and unbiased source.


Need More Evidence that Patient Education Can Reduce Readmissions? Start Here.


By Arti Bhavsar/Tuesday, August 26, 2014
Arti Bhavsar imageAs healthcare practitioners and administrators, we are keenly aware of the complexities associated with preventing readmissions. Common questions that come to mind when tackling the readmissions dilemma include: What patient care and education interventions can we implement? Do we have a solid transition of care program? What is the cost impact to my organization, from direct costs to loss in reimbursement? Most importantly, how can we embed sustainable programs to avoid readmissions? 

Take for example the impact of medication management related issues as a factor for readmissions. In an evaluation conducted by Feignbaum, et al. at Kaiser Permanente, researchers studied factors contributing to readmissions within 18 hospitals (1).  Medication management issues impacted 28 percent of preventable readmissions and were identified as one of the top five areas for to prioritize for organizational intervention programs. Upon interviewing 189 patients and caregivers, researchers found that 32 percent of patients indicated they would have liked to have received more communication regarding their medications, and of these, 73 percent of caregivers indicated that lack of information was one of the components that lead to a readmission (1). This data, coupled with a recently published article by Mixon, et al. focusing on post-discharge medication errors, highlights a significant area of opportunity to prevent medication management related issues. The study indicates that medication errors ranging from omissions, commissions, and misunderstanding in indication, dose, and frequency were found in 50 percent of patients after hospital discharge (2). The groups most impacted were those with low health literacy and numeracy scores (2). These statistics are sobering and should make us want to re-evaluate our current approach towards medication-related patient education in order to improve our practices to reduce the risk for patient harm and eliminate avoidable readmissions. 

When creating a strategic approach to reduce medication management related readmissions and errors, organizations should consider the following areas of improvement:
  • Integrate medication handouts into Electronic Health Records (EHR) to optimize clinician work flow and enhance the patient discharge process
  • Provide patient education handouts that adhere to health literacy standards to improve patient comprehension and retention of medication management related topics with tools designed for those with greatest risk of non-compliance (low health literacy and numeracy)
  • Embed a “Teach-back Process” to validate patient and/or caregiver comprehension of the medication management related information provided
  • Provide low-literacy aids to augment learning with tools such as pill-boxes, text messages, and/or daily medication schedules
These interventions are not only meaningful for the clinical outcome improvement results they can provide, but they are also aligned with safety, regulatory standards, and compliance standards that lead to higher reimbursement payments. These incented standards range from reduction in readmissions related to medication management events, to attestation for Meaningful Use Stage II criteria for integrated patient education and improving patient satisfaction scores as evaluated by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. 

Pharmacists, physicians and nurses, it’s time to ask yourself how your organization is approaching medication-related patient education. Has your organization mobilized the medication-related experts who impact care decisions at the point of care? Do you have the opportunity to improve your work flow to make time for caregivers to exercise best practices in education on discharge? Do you know how many patients you are discharging with medication errors? These questions can help you on the journey to reduce your medication management related risk and improve your organizational approach.

Arti Bhavsar, Pharm.D.
Consulting Manager

Factors that Create Lasting Patient Engagement


By Katie Cornwell/Monday, March 3, 2014
Katie Cornwell imageA recent article in Health Care Finance News examines the important relationship between meaningful patient engagement and a patient’s subsequent adherence to their prescribed treatment and prevention plans, both of which often require a change or changes in patient behavior. Recognizing that patient understanding and engagement are “fundamental prerequisites” to adherence means that sophisticated interventions designed to foster adherence  and behavior change are unlikely to be effective if the patient doesn’t first achieve basic comprehension of the what and the why behind their condition and treatment.

In order to establish that baseline knowledge, providers need to be able to provide information that is personal and meaningful to the patient, at that specific point in their care.  Instead of following a one-size-fits-all approach, they need to be able to tailor their education to the unique details of that patient’s current status, diagnosis, and care plan, and then deliver it in a method that meets the patient’s learning needs. It should also allow the patient to process the information at his or her own pace—and refer back to it when needed. When patients are presented with information that is both meaningful and manageable, they are much more likely to feel comfortable enough to begin to own it and act on it, and feeling empowered to acting on it is what leads to adherence and real behavior change.

Katie Cornwell
Product Manager, Patient Education Solutions

Patient Activation Matters! Does Your Patient Health Education Solution Engage and Activate?


By Heather Du Mez/Wednesday, October 30, 2013
Heather Du Mez imageWith the proliferation of patient health education solutions designed to take patient engagement to the next level, how can you ensure the solution you choose engages your patients and increases their “activation?” Do your patients understand their role in the care process, including the knowledge, skills, and confidence to take on that role?

Research continues to demonstrate that highly activated patients are more likely to have better outcomes:
  • Highly activated patients have lower healthcare costs (1)
  • Patients with higher activation levels are more likely to have normal systolic blood pressure, triglyceride and HDL levels, a healthy weight, and less likely to visit the emergency room or become hospitalized (2)
  • Highly activated patients have more positive care experiences (3)   
At Truven Health Micromedex® Solutions, our collective experience of providing patient education solutions to thousands of hospitals world-wide, has resulted in evidence-based patient health education content that is designed to engage and activate. The content, found in our Micromedex® CareNotes® Solution, adheres to health-literacy standards (written at a 5th-to-7th grade reading level, in plain, easy-to-understand language) and  leverages ADDS (actionable, direct, directive, streamlined) design principles. CareNotes are:
  • Actionable. Instructions emphasize how to complete a task, including crucial details and steps describing the behavior a patient must change, or the actions a patient must perform. 
  • Direct. State information directly and concisely. The message is not complicated with extra words or unnecessary medical terms. 
  • Directive. Tell the patient what to do and what not to do, so the patient is not left to guess whether directions are necessary or merely suggested.
  • Streamlined. Remove information that is not necessary in order to highlight need-to-know information.
This approach is responsive to the research around activation and best represents the needs of our customers to keep their patients actively engaged in their own health care.

What innovations is your hospital or staff making to promote activation and to ensure the patient experience is interactive? What do you think are the most critical imperatives for activation improvement? Post a reply and share your ideas. Sharing our collective experiences is a great way to learn what is and is not working among your peers.

Learn more about how our comprehensive editorial process and procedures promote patient activation to improve health literacy, motivate patient behavior, and increase compliance.

Heather Du Mez, RN, BSN
Editorial Manager

How Hospital Pharmacy Can Integrate Technology to Impact HCAHPS Scores


By Tina Moen/Friday, September 27, 2013
Tina Moen imageQuality care and finance. The balance of these essential elements holds the key to the future of how we provide healthcare. Multidisciplinary care is more important than ever in caring for patients, and looking at the whole picture is the best way to care for the whole patient. The Centers for Medicaid and Medicare Services (CMS) agrees. How your hospital scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is becoming increasingly important, especially since under the CMS Value Based Purchasing (VBP) program,
reimbursements are partially based on those scores.

How can pharmacists use their expertise to impact patient satisfaction and boost HCAHPS scores?

HCAHPS wants to know, if during the hospital stay, did the patient receive new medication? If so, how often did staff tell the patient what the medicine was for, and did staff describe possible side effects in simplified terms?

Pharmacists can directly impact these questions by combining clinical expertise with technology. We can make every reasonable effort to:
  • Explain to our patients why they are taking new medications – when prescribed, at first dose, and at discharge.
  • Use clear wording to help patients understand why they are taking a medication and what they can possibly expect as a result.
  • Give them patient-specific medication handouts and discharge instructions.
  • Make ourselves available to patients and to staff, to answer medication related questions.
And with technology, we can ensure we are educating our patients by scaling our efforts and making our available manpower more efficient. One of our clients, Arkansas Methodist Medical Center, is using Micromedex® Pharmacy Intervention to set alerts to remind their clinical pharmacists which patients are on new medications, develop protocols with simplified terminology for all pharmacists to follow uniformly, and then track their progress. View the video to see how they are making this work for them.

As pharmacists, we can also leverage Micromedex clinical decision support, embedded within the Pharmacy Intervention solution, or accessible via the 2.0 platform, to access the talking points within the Clinical Teaching section. Clinical Teaching highlights the most pertinent medication information and serves to inform clinicians on what patients need to know about medication use, safety, and side effects.

Lastly, we can use Micromedex Patient Education, as a standalone or embedded in the hospital EHR, to provide high-quality, evidence-based, consistent education to our patients. Health education resources are written in simple to understand language, an active voice, and at a 5th to 7th grade reading level. Patient-specific handouts and discharge instructions can be printed, and also made available to your patients via a patient portal and email.

Using Micromedex Solutions, we can compare internal benchmarks, which can be captured and quantified, to customize how pharmacy can improve care for patients. With these trusted solutions, we can make sure that the pharmacist and patient have all of the knowledge necessary to make informed decisions while aligning directly with HCAHPS standards. Well-honed tools help us adapt to the dynamic nature of the practice of pharmacy and no doubt solidify a blueprint for future regulatory and value based reimbursement programs.

Tina Moen, PharmD
Chief Clinical Officer

RSS