What impacts patients ability to take charge?

Ann Lindsay MD

Determinants of Premature Mortality

Schroeder, NEJM 357; 12

15%

5%

10%

40%

30% SocialEnvironmentalMedicalBehavioralGenetic

“Why wouldn’t a person with a chronic condition do everything in their power to live long and feel well?”

What the Patient Brings: Activation Level

10-15% of the population*

20-25% of the population*

35-40% of the population*

25-30% of the population*

* Medicaid and Medicare populations skew lower in activation

What the Patient Faces: Domains

Domains

Domains: “What to do?Patient Activation Measure: “How to do it?”

PAM

Domains

1 2 3 4

Social

Access

Behavioral

MedicalTrajectory

Workflows based on patient variation

Patient Self-Management Barriers Social devastation (poverty, homelessness, lack of access to health care

services, etc) Lack of information Cultural disconnect Low functional health literacy Relative lack of life skills

Anxiety/disease-specific distress/depression

Humboldt Priority Care PAM Results

How was this achieved?