Improving Population Health Management Strategies: Identifying Patients Who Are More Likely to Be Users of Avoidable Costly Care and Those More Likely to Develop a New Chronic Disease

Hibbard, Judith H.; Greene, Jessica; Sacks, Rebecca M.; Overton, Valerie; Parrotta, Carmen

doi:10.1111/1475-6773.12545

Cited by 66 publications

(71 citation statements)

References 17 publications

(33 reference statements)

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“…Patients commonly withhold medically relevant information from their physicians, a pattern that likely hinders the quality of care . Patient activation or engagement is associated with positive clinical and healthcare utilization outcomes . Patient‐mediated implementation interventions showed a positive impact on patient knowledge, decision making, communication, and behavior .…”

Section: Discussionmentioning

confidence: 99%

“…34 Patient activation or engagement is associated with positive clinical and healthcare utilization outcomes. 35 Patient-mediated implementation interventions showed a positive impact on patient knowledge, decision making, communication, and behavior. 36 Education materials may be developed for patients using plain language and visual representations.…”

Section: Social Influencesmentioning

confidence: 99%

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Using Implementation Science to Promote the Use of the G8 Screening Tool in Geriatric Oncology

Gulasingam

Haq

Johnson

et al. 2019

J American Geriatrics Society

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OBJECTIVES Evidence supports the integration of geriatric assessment in the care of older adults with cancer. The G8 screening tool is a validated instrument to target a geriatric assessment. Use of the G8 tool in clinical practice, however, is suboptimal. We systematically analyzed the barriers and facilitators to G8 tool use in oncology clinics and selected interventions tailored to the local context to enhance its uptake. DESIGN This qualitative study used semistructured interviews and site observations. SETTING St. Michael's Hospital, Toronto, Canada. PARTICIPANTS Ten participants including G8 tool adopters and stakeholders at St. Michael's Hospital were interviewed. MEASUREMENTS An interview guide based on the Theoretical Domains Framework (TDF) was developed to identify beliefs about G8 tool use. Barriers and facilitators to G8 tool use were mapped to the TDF domains and corresponding intervention functions from the Capability, Opportunity, Motivation, and Behavior model. Evidence‐based implementation strategies were selected from two databases. RESULTS Key TDF domains influencing G8 tool use behavior were social/professional role, goals, beliefs about consequences, and social influences. The behavior change domains were mapped to four mechanisms of change: persuasion (conduct local consensus discussions), modeling (identify and prepare a champion), education (distribute educational materials), and enablement (use materials to prepare patients to be active participants in understanding the evidence behind the G8 tool and answering questions accurately). CONCLUSION This study identified barriers to G8 tool use. Local consensus discussions, identifying and preparing a champion, using educational materials, and preparing patients to be active participants may be implementation strategies to improve G8 tool use. J Am Geriatr Soc 67:898–904, 2019.

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Section: Discussionmentioning

confidence: 99%

Section: Social Influencesmentioning

confidence: 99%

Using Implementation Science to Promote the Use of the G8 Screening Tool in Geriatric Oncology

Gulasingam

Haq

Johnson

et al. 2019

J American Geriatrics Society

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“…Public health management (PHM) is an approach in which healthcare organizations seek to "effectively manage the health of their total population, not just the patients who seek care" [3]. It is recognized as potentially effective for chronic disease prevention and care, but effective PHM faces multiple challenges, including a shortfall of healthcare resources.…”

Section: Public Health Management and Challenges In Healthcarementioning

confidence: 99%

“…For example, the AI provider could suggest that a patient contact her doctor if her blood pressure is out of range, and even alert a provider or connect a patient to a provider. The high rate of engagement of over 2.5 unique sessions per week, along with minimal associated cost is another promising sign for health outcomes and efficiency in the healthcare system, since increased engagement is known to reduce poor health outcomes [3].…”

Section: Measures Of Success With Aimentioning

confidence: 99%

The Future of Population Health Management: Artificial Intelligence as a Cost-Effective Behavior Change and Chronic Disease Prevention and Management Solution

Stein¹

2017

MOJPH

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Obesity and chronic diseases are pressing public health concerns, and population health management is one strategy to mitigate their consequences. Prevention and management are often possible through lifestyle changes, but the shortage of healthcare resources prevents large numbers of patients from receiving help in changing health behaviors. Artificial intelligence AI platforms have the potential to increase patients' access to care and deliver cost-effective, individualized care. Some interventions have already shown to be engaging to patients and effective for weight loss and other outcomes, and the future of AI in healthcare can include further research and specialized programs for a variety of chronic conditions.

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“…Did the intervention help the least activated become more activated, or did it mostly help those in the middle of the activation spectrum move up to the high end? These are consequential questions, as the least activated have the greatest potential of serious health declines in the near term . Interventions that are effective in reaching and impacting the least activated can have a significant and long‐term impact.…”

mentioning

confidence: 99%

Commentary for “The wellness incentive and navigation intervention improved health‐related quality of life among medicaid enrollees: A randomized pragmatic clinical trial”

Hibbard

Greene

2019

Health Services Research

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Improving Population Health Management Strategies: Identifying Patients Who Are More Likely to Be Users of Avoidable Costly Care and Those More Likely to Develop a New Chronic Disease

Abstract: Assessing patient activation may help to identify patients who could benefit from greater support. Such an approach may help ACOs reach population health management goals.

Cited by 66 publications

References 17 publications

Using Implementation Science to Promote the Use of the G8 Screening Tool in Geriatric Oncology

Using Implementation Science to Promote the Use of the G8 Screening Tool in Geriatric Oncology

The Future of Population Health Management: Artificial Intelligence as a Cost-Effective Behavior Change and Chronic Disease Prevention and Management Solution

Commentary for “The wellness incentive and navigation intervention improved health‐related quality of life among medicaid enrollees: A randomized pragmatic clinical trial”

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