Anthem has trained its staff of care consultants in 15 States across the country to offer training in shared decisionmaking to health care providers.
The training is part of the Indianapolis-based health insurer's value-based, patient-centered care payment program, Enhanced Personal Health Care (EPHC). EPHC provides support for making changes to the delivery system that drive better care. Anthem care consultants support EPHC-contracted providers by offering tools and training to improve quality across key elements of patient-centered care. These elements include expanded access, shared decisionmaking, proactive health management, coordinated care delivery, adherence to evidence-based guidelines, and care planning built around the needs of the individual patient.
Shared Decisionmaking as a Quality Improvement Tool for Providers
EPHC leaders aimed to improve the adoption of shared decisionmaking among EPHC providers. Anthem care consultants would provide shared decisionmaking tools and training as part of their quality improvement support for providers. To prepare the care consultants to offer this type of support, EPHC leaders planned a Web-based shared decisionmaking training for the Anthem care consultants based on the Agency for Healthcare Research and Quality's (AHRQ) SHARE Approach workshop. Representatives from the EPHC team attended an AHRQ-sponsored SHARE Approach Workshop in Colorado, where they learned about valuable shared decisionmaking concepts, tools, and resources.
Jennifer Neer, an EPHC business change manager who attended the workshop, was seated at a table with two providers not affiliated with Anthem, and was encouraged by "the excitement that they had about the approach and how it could be used with patients not only to improve the interaction…but to really have quality care and to understand what the patient was going through."
"The excitement that they had about the approach and how it could be used with patients not only to improve the interaction…but to really have quality care and to understand what the patient was going through."
Organizing a SHARE Approach Web-based Training
After the AHRQ workshop, the EPHC team created an interactive, Web-based workshop for a geographically dispersed group of 83 Anthem care consultants.
Offered twice in July 2015, the full-day mandatory training drew largely on the SHARE Approach Workshop resources available on the AHRQ Web site, including:
- A 5-module curriculum.
- PowerPoint presentations.
- A participant guide.
- A facilitator's guide.
While AHRQ's SHARE Approach resources are designed for in-person trainings, the EPHC team found they could readily adapt them for the Web-based workshop. To replicate the interactive nature of in-person SHARE Approach workshops, the Web-based workshop featured:
- A virtual chat where people could post questions and comments.
- Virtual whiteboards for participants to respond to questions from the trainers.
- Polling questions.
Participants embraced the interactivity. At one point they posted more than 1,000 messages to the chat room. Following the training, several colleagues confided that they had been expecting a long, tiring day. They were pleasantly surprised to instead be part of an engaging event that offered practical resources for shared decisionmaking.
Post-event survey results reflected participants' informal comments to the training team. People appreciated the interactivity of the training, and the comprehensive and flexible resources. Comments included, "solid tools to enhance and encourage higher development of shared decisionmaking."
Putting the SHARE Approach to Work
Anthem care consultants tap SHARE Approach resources as they support EPHC providers in the field. A couple of care consultants have conducted hour-long presentations on shared decisionmaking for providers. Anthem care consultants are also using AHRQ's SHARE Approach tool to help providers prepare for the shared decisionmaking requirement for recognition as an Accountable Care Organization, or for accreditation by the National Committee for Quality Assurance.
The SHARE Approach is a five-step process for implementing shared decisionmaking, which offers physicians and other health care professionals the training and tools to help patients compare the potential benefit, harm, and risk of various treatment options for their conditions through meaningful dialogue about what matters most to the patient. The five steps are:
Gearing Up to Train Providers
To further promote shared decisionmaking, Anthem is rolling out a shorter 3½-hour provider Web-based workshop to be offered twice in July 2016. As of April, 54 providers had signed up for the Web-based workshops. They are also planning to train an additional 40 Anthem care consultants at the end of the year.
Participants reflect the mix of primary care providers under contract with EPHC. They include quality managers and care coordinators with large and small family and pediatric practices. Debra Southard, a senior care consultant for Anthem in Mason, Ohio, noted that she expects most participants of the upcoming interactive webinar will use the concepts learned in the SHARE Approach training to directly engage patients in shared decisionmaking.
Neer added that the value of shared decisionmaking is "engaging and getting the patient's voice, really improving communications between the provider and the patient, and the patient having an understanding of what the options are, what the impact on them may be, and being able to trust their provider understands their decision. It gives the patient the power to make their own decision."
About the Educators
As a business change manager with Anthem's EPHC program, Jennifer Neer leads program innovation development. Her scope of responsibilities includes implementation of AHRQ's SHARE Approach training, program development for new EPHC associates, and support for quality improvement initiatives.
She holds a master's degree in social work from the University of Wisconsin-Oshkosh and an MBA from Lakeland College in Wisconsin, where she is licensed as an advanced practice social worker.
Debra Southard is a Senior Care Consultant for Anthem's Enhanced Personal Health Care Division in the Ohio Market. She has 28 years of extensive clinical and administrative experience in family practice and enjoys sharing her vast knowledge of patient-centered care integration and practice transformation. As a motivated leader, she enjoys mentoring and assisting clinical teams to achieve practice goals to improve the patient experience, enhance clinical outcomes, and streamline workflows.