Model Public Report Elements: A Sampler

C. Consumer Engagement Tools

An important focus of any public report should be to help consumers become more engaged in managing their health and health care. Consumers can become more educated and active participants in their care when they have concrete tools and tips to help them effectively use information and navigate the health care system.

The range of behaviors expected of consumers has grown dramatically in recent years. For example, advances in medical technology and pharmaceuticals make it possible for people with chronic conditions to live longer and better lives, but only if they can effectively manage the demands of complex medication and lifestyle regimens. The increasing specialization of care and expanding number of tests and treatments have led to significant improvements in care but have increased the burden on patients for coordinating services from multiple providers and keeping track of complicated information about their medical history.

Public reports cannot possibly meet all the growing demands on consumers to become more knowledgeable and engaged in managing their health and medical care. But by even partially addressing the need for practical guidance and tools for engagement, sponsors of public reports can play an important educational role. They also can make their Web sites more relevant to the needs and concerns of their target audience.

This section identifies tools and other engagement strategies that public report sponsors can use to help consumers in three key areas:

  1. Evaluating and selecting a high-quality provider.
  2. Preparing for visit to a doctor or hospital, and
  3. Partnering with doctors to manage a chronic disease.

For each of these engagement areas, specific examples are provided that illustrate approaches or provide resources and tools that the authors consider to be effective and consistent with good public reporting practice.

1. Evaluating and selecting a high-quality provider

Public report sponsors focused on a consumer audience need to understand that simply publishing quality data is not enough to engage consumers in using information to make health care decisions. Quality information is only one of many considerations, and perhaps not the primary one, entering into a consumer's choice of a provider. Therefore, public reports should help consumers easily access and use the information most relevant to them and should present the information in terms that resonate with their concerns and preferences. In this sense, reports should aim to meet consumers where they are, which may require sponsors to segment their audiences so that they can target different groups with different needs.

Another important consideration in providing guidance on selecting providers is that most consumers, when asked, would prefer comparative performance information on individual practitioners. However, most report sponsors do not have access to physician-level information and instead are limited to information about hospitals or medical groups. In the absence of physician-specific performance information, reports can still provide guidance on steps that consumers can take to gather available information and make good decisions.

The following examples demonstrate tools and strategies to help consumers evaluate and select a high-quality provider.

Below is an example of a guide that helps consumers make health care decisions using information about quality. The guide is based on research about the information people want and need when choosing health plans, doctors, treatments, hospitals, and long-term care providers. It shows how consumers can use information about quality to improve the health care services they and their families receive. It also describes quality measures, including consumer ratings, clinical performance measures, and accreditation—what they are, where to find them, and how to use them. In addition, the guide has checklists, questions, charts, and other tools to help users make appropriate health care decisions. The "Choosing a Doctor" section features a step-by-step worksheet to walk through the process of selecting a doctor.

Title: Your Guide to Choosing Quality Health Care

Sponsor: Agency for Healthcare Research and Quality

URL: http://archive.ahrq.gov/consumer/qnt/

Screenshot of AHRQ Web page with Your Guide to Choosing Quality Health Care, Choosing a Doctor. the guide has eight sections, such as Decide What You Want and Need in a Doctor, Make a List of Doctors, and Check on Quality.

The following example is a step-by-step guide to choosing a doctor. This guide encourages patients to take several steps in researching their physician options, starting with seeking a referral from a trusted source and checking physician qualifications. The tool also emphasizes the importance of patients learning more about their specific medical issues.

Tool: How To Choose a Doctor

Sponsor: Consumer Reports

URL: http://www.consumerreports.org/health/doctors-hospitals/your-doctor-relationship/how-to-choose-a-doctor/getting-started/getting-started.htm  

Screenshot of Consumer Reports page, Your Doctor Relationship. Links include Overview, How to Choose a Doctor, How to Talk to Your Doctor, and Check up on Your Doctor. The How to Choose a Doctor page is shown with a photo of a doctor and a patient. Links include Getting started, generalist or specialist, how to check credentials, questions to ask, and when to get a second (or third) opinion.

Below is a an example of a guide designed to help consumers understand the birth process, review comparative information on hospitals and physicians, and promote an open dialogue about their wishes with their physician and other care providers. Information is included on all Virginia hospitals providing obstetric services and includes rates of cesarean delivery and episiotomy, as well as descriptions of hospital obstetric programs, services available, and quality practices. Similar information on close to 600 physicians includes their performance rates, education, location, foreign languages spoken, and other information. The guide is endorsed by the National Partnership for Women and Families and the Virginia Section of the American College of Obstetrics and Gynecology.

Title: Obstetrical Services: A Consumer's Guide

Sponsor: Virginia Health Information

URL: http://vhi.org/ob_guide/ob_intro.asp  

Screenshot of obstetric care guide Web page, including image of guide, description of guide, and link to guide. Includes link to compare hospitalsk, with photo of a hospital, and link to compare physicians, with photo of a female doctor.

2. Preparing for a visit to a doctor or hospital

A central part of engaging consumers to be active participants in their health care is emphasizing the importance of preparing for medical encounters. Consumers need to know that taking charge of their care, planning what they would like to achieve, and asking questions of their provider is not only acceptable, but also critical to achieving good health care outcomes. In helping to make these behaviors normative, it is important to provide tools that will assist consumers in planning for their medical encounter in an easy-to-use, step-by-step fashion.

The following examples demonstrate tools and strategies to encourage consumers to prepare for their medical encounters.

The following is an example of a patient education campaign featuring television public service announcements (PSAs) developed by the Ad Council to encourage patients to ask their providers questions. The campaign highlights a list of 10 key questions for patients to ask and provides an online tool for patients to build a customized list of questions to bring to their medical visit. Additional tips are provided for patients getting medical tests, planning for surgery, and getting prescriptions. Report sponsors may want to embed the PSA in their Web-based report.

Tool: Questions Are the Answer

Sponsor: Agency for Healthcare Research and Quality

URL:

Below is a Web site that advises patients on three basic questions to ask every time they talk with a doctor, nurse, or pharmacist. The questions are: (1) What is my main problem? (2) What do I need to do? (3) Why is it important for me to do this? The Web site also includes brief tips on communicating clearly with a provider.

Title: Ask Me 3

Sponsor: National Patient Safety Foundation

URL: http://www.npsf.org/askme3/for_patients.php  

Screenshot of Ask Me 3 Web page with a photo of a female doctor talking to a patient and a list of the three questions. Links include when to ask, who needs to ask, what if I still do not understand, your doctor wants to answer, and tips for clear health communication.

The following is a guide for how to prepare for a doctor's visit, including things to do prior to and during the visit. Videos are featured, including physicians talking about how to make the most of your time with your doctor (one version with an English-speaking physician and another with a Spanish-speaking physician) and a consumer talking about being an engaged patient. A downloadable tool to track medications also is included.

Tool: Preparing for Your Doctor's Appointment

Sponsor: The Partnership for Healthcare Excellence

URL: http://www.partnershipforhealthcare.org/patients_and_caregivers/preparing_for_your_doctors_appointment/  

Screenshot of The Partnership for Healthcare Excellence Web page on preparing for your doctor's appointment. The page has a photo of a female patient reviewing a chart with a male doctor and links to information on choosing a doctor, taking medication safely, preventing infection, preparing for a hospital stay, comparing hospitals and nursing homes, and planning end of life care. The page has tabs for various groups such as physicians and hospitals and is set to patients and caregivers. The page also includes links to videos.

Below is a three-step tool for consumers to create an action plan, including: (1) Prepare for your appointment, featuring a customizable checklist of questions to print; (2) Ask questions and understand the answers, featuring tips on how to interact with your doctor during your visit; and (3) Follow up and follow through, featuring activity log tools and links to many other resources.

Title: Take Charge

Sponsor: Healthy Memphis Common Table

URL: http://www.healthymemphis.org/take_charge.php?s=consumer  

Snapshot of three-step tool with a box for each step that includes a photo, description, and link. Prepare for your appointment shows a man and woman at a computer; ask questions and understand the answeers shows a man and woman talking with a doctor; and follow up and follow through shows a woman at an exercise class.


Other examples of resources for preparing for a visit to a doctor or hospital

Title: Making the Most of Your Medical Appointments

Sponsor: Partner for Quality Care, an initiative of Oregon Health Care Quality Corp

URL: http://www.partnerforqualitycare.org/appointments.php

Description: Tips for what to do before, during, and after a medical appointment. This downloadable brochure is consumer friendly and features two frames of a patient/doctor interaction—contrasting a scenario where the patient does not ask any questions with another modeling the patient asking questions.

Title: Quick Tips for Talking With Your Doctor

Sponsor: Puget Sound Health Alliance

URL: http://www.pugetsoundhealthalliance.org/resources/documents/QuickTipsChecklist.pdf (PDF File; Plugin Software Help)

Description: A worksheet to assist patients in preparing for their medical visit. Includes areas to list questions and another to outline personal health goals. An area to record notes during the visit also is included.

3. Partnering with doctors to manage a chronic disease

Successful management of a chronic disease requires a daily commitment from patients to monitor their health status and to work toward achieving health goals. A strong partnership between patients and their providers is vital to this process. Consumers can benefit from tips and tools that help them understand what their role is in managing their disease and how to work with their providers to make sure their care plan is a good fit for their unique circumstances.

The following examples show tools and strategies to help patients partner effectively with their providers in managing chronic disease. The D5 for Diabetes example further illustrates how a report focused on addressing consumer needs for support in managing chronic disease can be designed to effectively introduce performance information on medical groups. It presents scores on various providers and shows how they vary in helping their patients manage this condition.

Below is a site for patients, family members, and health care providers who want to work together to improve health, health care, and quality of life for people with chronic conditions. The site provides support for those who want to work together, in a new health partnership, to improve patient self-management. The site features a number of articles for patients on being active in heath care and self-managing conditions. A recent guide for providers contains a number of practical tips and resources for engaging patients in self-management: Partnering in Self-Management Support: A Toolkit for Clinicians is available at http://www.newhealthpartnerships.org/provider.aspx?id=1544.  

Title: New Health Partnerships

Sponsor: Institute for Healthcare Improvement

URL: http://www.newhealthpartnerships.org/PatientsPuzzlePiecePrint.aspx?id=40&linkidentifier=id&itemid=40  

Screenshot of New Health Partnerships Patients and Families Web page with links to information on self-management of chronic conditions and introductory text about self-management.

The D5 Web site shown below was born out of consumer focus group findings indicating that consumers with diabetes would be more likely to pay attention to health care quality data if they were presented information specifically concerning their chronic condition. The D5 brand frames Minnesota Community Measurement's five-part diabetes quality measure as goals that patients should be working toward in partnership with their doctor. Quality ratings are available on an inside tab for consumers ready to use them, but the emphasis is on raising patients' awareness of the five goals for managing their own diabetes. In addition, a catalog of free, downloadable communications tools was added to the site to assist stakeholders in delivering this campaign message (http://thed5.org/catalog/index.php ).

Title: The D5 for Diabetes

Sponsor: Minnesota Community Measurement (MNCM)

URL: http://thed5.org  

The site below features written patient story vignettes, accompanied by images of the narrator. The videos discuss taking control and partnering with doctors when living with diabetes.

Title: Patient Stories

Sponsor: Better Health Greater Cleveland

URL: http://www.betterhealthcleveland.org/For-Patients/Diabetes/Patients--Stories.aspx  

Screenshot of the D5 Web page with the five goals for living well with diabetes. An arrow points to the five goals of controlling blood pressure, cholesterol, and blood sugar, being tobacco free, and taking aspirin daily. The page also has link to view clinics to compare their performance on D5 goals.



Another example of a resource for partnering with doctors to manage a chronic disease

Title: I Can! Challenge

Sponsor: Aligning Forces for Quality South Central Pennsylvania

URL: http://www.icanchallenge.com/home-page.html

Description: A targeted health improvement challenge for those with diabetes or heart disease in York and Adams Counties. The challenge features five citizens who were followed weekly via the local Fox station on a 12-week program to self-manage their health and is an example of modeling a popular reality TV show (i.e., The Biggest Loser). This video link tells the story of the final week: http://www.icanchallenge.com/fox43-videos/celebrating-success-during-the-final-week.html

Current as of November 2011
Internet Citation: Model Public Report Elements: A Sampler. November 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/pubrptsampler/pubrptsampl2c.html