learning in action networks session...sex heredity (source> belen health, j. hunt) communication:...
TRANSCRIPT
Learning in Action Networks Session
Patient Engagement
Light the Fire Within
Successfully Engage Your Patients
Rebecca Durham Larry Garrett and Korey Capozza
HealthInsight
This material was prepared by HealthInsight the Medicare Quality Improvement Organization for Nevada and Utah under contract with the Centers for Medicare amp Medicaid Services (CMS) an agency of the US Department of Health and Human Services The contents presented do not necessarily reflect CMS policy 10SOW-UT-2013-PO-78
Who has a patient engagement program
in place now
Session Objectives
bull Learn what patient engagement is and
why itrsquos all the rage
bull Develop a plan for assessing health
literacy
bull Incorporate tools to encourage patients
to ask questions
bull Put it all together and walk away with a
plan of action
Patient Engagement
Blockbuster Drug of the Century
Korey Capozza MPH
Consumer Engagement Director
HealthInsight
kcapozzahealthinsightorg
What is Patient Engagement
Actions that people take
for their health and to
benefit from care
Institute for Healthcare Improvement
ldquoIf patient engagement were a drug it would be the blockbuster
drug of the centuryrdquo
Leonard Kish 2012
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Light the Fire Within
Successfully Engage Your Patients
Rebecca Durham Larry Garrett and Korey Capozza
HealthInsight
This material was prepared by HealthInsight the Medicare Quality Improvement Organization for Nevada and Utah under contract with the Centers for Medicare amp Medicaid Services (CMS) an agency of the US Department of Health and Human Services The contents presented do not necessarily reflect CMS policy 10SOW-UT-2013-PO-78
Who has a patient engagement program
in place now
Session Objectives
bull Learn what patient engagement is and
why itrsquos all the rage
bull Develop a plan for assessing health
literacy
bull Incorporate tools to encourage patients
to ask questions
bull Put it all together and walk away with a
plan of action
Patient Engagement
Blockbuster Drug of the Century
Korey Capozza MPH
Consumer Engagement Director
HealthInsight
kcapozzahealthinsightorg
What is Patient Engagement
Actions that people take
for their health and to
benefit from care
Institute for Healthcare Improvement
ldquoIf patient engagement were a drug it would be the blockbuster
drug of the centuryrdquo
Leonard Kish 2012
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Who has a patient engagement program
in place now
Session Objectives
bull Learn what patient engagement is and
why itrsquos all the rage
bull Develop a plan for assessing health
literacy
bull Incorporate tools to encourage patients
to ask questions
bull Put it all together and walk away with a
plan of action
Patient Engagement
Blockbuster Drug of the Century
Korey Capozza MPH
Consumer Engagement Director
HealthInsight
kcapozzahealthinsightorg
What is Patient Engagement
Actions that people take
for their health and to
benefit from care
Institute for Healthcare Improvement
ldquoIf patient engagement were a drug it would be the blockbuster
drug of the centuryrdquo
Leonard Kish 2012
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Session Objectives
bull Learn what patient engagement is and
why itrsquos all the rage
bull Develop a plan for assessing health
literacy
bull Incorporate tools to encourage patients
to ask questions
bull Put it all together and walk away with a
plan of action
Patient Engagement
Blockbuster Drug of the Century
Korey Capozza MPH
Consumer Engagement Director
HealthInsight
kcapozzahealthinsightorg
What is Patient Engagement
Actions that people take
for their health and to
benefit from care
Institute for Healthcare Improvement
ldquoIf patient engagement were a drug it would be the blockbuster
drug of the centuryrdquo
Leonard Kish 2012
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Patient Engagement
Blockbuster Drug of the Century
Korey Capozza MPH
Consumer Engagement Director
HealthInsight
kcapozzahealthinsightorg
What is Patient Engagement
Actions that people take
for their health and to
benefit from care
Institute for Healthcare Improvement
ldquoIf patient engagement were a drug it would be the blockbuster
drug of the centuryrdquo
Leonard Kish 2012
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
What is Patient Engagement
Actions that people take
for their health and to
benefit from care
Institute for Healthcare Improvement
ldquoIf patient engagement were a drug it would be the blockbuster
drug of the centuryrdquo
Leonard Kish 2012
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
ldquoIf patient engagement were a drug it would be the blockbuster
drug of the centuryrdquo
Leonard Kish 2012
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
ldquoThe drug is actually a concept
that should have formed the
heart of health care all alongrdquo-Health Affairs Feb 2013
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Carman et al Health Affairs 32 No 2 (2013) 223-228
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Strategies Cont
bull Shared Decision MakingDecision aids
bull Self Management education and training
bull Coaching
bull E-healthtelemedicine
bull Motivational Interviewing
bull And many morehellip
Coulter et al J Ambulatory Care Manage Vol 35 No 2 pp 80ndash89 Mitler
et al Milbank Quarterly Volume 91 Issue 1 pages 37ndash77 March 2013
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
The Opportunities are Hugehellip
Research shows patient engagement
1 Leads to better health outcomes
2 Improves quality and safety
3 Helps control costs
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
-
-
Examples
Patient provider
partnered care
teams
Shared Decision
Making
Self Management
Education
E Coaching
Intervention Care team
collaborates with
CAD patients to
manage meds
coordinate care
change
lifestylehabits
Patients who received
assistance with
treatment decisions
from a trained health
coach were compared
to patients who
received usual support
Intervention
6-week in-person
training workshops
on how to manage
any chronic
condition led by non-
medical
professionals
Patients randomized
to a text messaging
protocol for diabetes
support had
Results Reduced overall Fewer surgeries Reduced disability ~2 drop in A1c and
mortality by 76 hospitalizations and fatigue and distress a 9 reduction over
percent and lower costs for the reduced the control group
cardiac mortality intervention group hospitalizations and
by 73 percent compared to the usual ER visits cost
care group savings
Reference Delate et al Veroff et al Health Lorig et al Med
Pharmacotherapy Affairs 2013 Care 1999 Jan
2010 37(1)5-14
Quinn et al Diabetes
Care 2011
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
An Issue of Ratios
The health-care system has
traditionally delivered care for acute
events but illness is lived in long
ongoing periods
-Matthew Holt Health 20
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
62-yr-old Patient with Diabetes Using Text Message Support Program
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Environment
Determinants of health
Social
network
Sex Heredity
(Sourcegt Belen Health J
Hunt)
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Communication It All Starts Here
bullPeople prefer to be treated by clinicians who are
good listeners and skilled at informing advising
and educating
bull Informed patients tend to have better health
outcomes
bullBut patients understand less than you probably
realize hellip
bullAll strategies designed to strengthen
patient engagement should focus on improving
health literacy
Coulter et al J Ambulatory Care Manage
Vol 35 No 2 pp 80ndash89
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Learning in Action Networks Session
Health Literacy Larry Garrett PhD
Rebecca Durham
HealthInsight
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
What is Health Literacy
bull Whether individuals can find and understand health information
bull Whether they can use that information to make health decisions
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Patient Adherence
bull 40-80 of medical information given is forgotten
immediately half retained is incorrect1
bull Physicians thought 89 of patients understood
medication side effects only 57 of patients
understood2
1 Kessels RP (2003) Patients memory for medical
information Journal of Social Medicine200396(5)219-222
2 Training to Advance Physicianslsquo Communication Skills
Retrieved from AHRQ Website
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
The Problem of Health Literacy
A 2003 national assessment of 19000 adults measured
health literacy skill levels
bull 12 proficient
Calculate employee share of healthcare costs from a chart
bull 53 intermediate Determine a healthy weight from a BMI chart
bull 22 basic Gather basic health info from a 1-page article
bull 14 below basic
Circle the date of an appointment on an appointment slip
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Maria Age 55 is Newly Diagnosed with Diabetes
Her doctor needs to explain what diabetes is
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Her doctor recommends she keep her
intake of carbohydrates to 40g at each
meal
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Language Barriers
Translated materials are helpful but they
are not enough
Echocardiogram
Ecocardiograma
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Contributing Factors
bull Level of education
bull Cultural and language barriers
bull Stress
bull Other priorities
bull Differences by gender race and ethnicity
insurance status perceived health status
language spoken before starting school
age education poverty level
(US Department of Education 2003)
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Tools for Providers
bull The Rapid Estimate of Adult Literacy in Medicine -
Short Form (REALM-SF)
o A 7-item word recognition test to provide clinicians with a
quick assessment of patient health literacy
o httpwwwahrqgovprofessionalsquality-patient-
safetyquality-resourcestoolsliteracyindexhtml
bull Newest Vital Sign (NVS)
o An assessment tool that uses a nutrition label that is
accompanied by 6 questions and requires 3 minutes for
administration
o httpwwwannfammedorgcontent36514fullpdf
bull The Test of Functional Health Literacy in Adults
o A 50-item reading comprehension and 17-item numerical
ability test taking up to 22 minutes to administer
o httpwwwncbinlmnihgovpubmed8576769
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Summary of Todays Visit Test Brown Mrs
03252013 visit with
Treatment bull Start Lisinopril 20 MG 1 tablet Orally once a day bull Start Synthroid 88 MCG 1 tablet Orally po QD bull Start Lasix 40 MG 1 tablet p o QD bull Start Metolazone 25 MG 1 tablet Orally only if directed bull Slarl Polassium Chloride 10 MEQ 1 tablet Orally Four times a day Patient Instructions I recommend daily weights Call us if you notice edema Follow a low sodium diet L imit fluids Discussed risk oflow and high potassium with diureticsACEs and K To ER if uncontrolled SOB or chest pain Call us if orthostatic hypotension arises DOE or if it is h ard to breathe when you lie flat
We need to check your labs in one months time You are Diagnosed with bull 428oCHF unspecified bull 4011 Essential hypertension benign bull 7823 Edema
Central City Clinic Medical 461 South 400 East Salt Lake City UT 841113302 801-539-8634
Note generated by eCHnicaWorks EMRIPM Software (wwweCinicaWorkscom)
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Learning in Action Networks Session
Table Discussion
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Tools for Patients
bull We know that patients who are
activated have better outcomes
bull How do you help patients become
more active during their office
visits
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Tools for Patients
bull National Patient Safety Program
(NPSF) ndash Ask Me 3
bull Agency for Healthcare Research
and Quality (AHRQ) ndash Questions
Are the Answer
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Ask Me 3 Ask Me 3trade is a patient education program designed to promote communication between health care providers and patients in order to improve health outcomes The progrmiddotam encourages patients to understand the answers to three questions
1 What is my main problem 2 What do I need to do 3 Why is it itnportant for me to do this
Patients should be encouraged to ask their providers these three simple but essential questions in every health care interaction Likewise) providers should always encourage their patients to understand the ansvvers to these three questions
Studies shomiddot~ that people who understand he3lth instructions make fevver mistakes when they take their medicine or prepare for a medical procedure They may also get well sooner or be able to better manage a chronic health condition
wwwnpsforg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Ask Me 3 in Motion
httpwwwyoutubecomwatchfeature=player_
embeddedampv=B3EB-icaNKQt=53s
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
AHRQ-Agency for Healthcare Research and Quality
Questions are the Answer
wwwahrqgovquestionsaretheanswer
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Questions are the Answer
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Get More Involved With Your Health Care
What is the test for middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddot~
How many times have you done this procedure
When will I get the results
Why do I need this treatment
bullbullbullbullbullbullbullbull Are there any alternatives
bullbullbullbullbullbull What are the possible complications
bullbullbullbullbullbullbullbull Which hospital is best for my needs
How do you spell the name of that drug
Are there any side effects
Will this medicine interact with medicines that Im already taking
For more questions I
WVIINahrqQCMquestionsaletheanswer
middot~ I~-middotamp IJiiiiHt J(( AgMcy frr Healthcan Research and Ouafty bull __ Ntlafltfng ElClelence rn H85111 OM bull wwwllhrqgoy bull
AHRO P~tion No 09(10)-M026C Replaces AHRO Publication No 07-ltM014
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Learning in Action Networks Session
Table Discussion
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Learning in Action Networks Session
Wrap Up
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
What Does It All Mean
Providers
We must change or improve how we provide medical information
ConsumersPatients
We must ask or remind our providers to provide information in ways we best understand
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg
Questions
kcapozzahealthinsightorg lgarretthealthinsightorg
rdurhamhealthinsightorg