TEDMED #GreatChallenges: Examining the Case for Patient Activation Measures

As the health care system continues to shift focus from an acute care system to a chronic care system, understanding patient engagement is increasingly important to health care providers. In 2004, researchers from the University of Oregon developed an assessment called the Patient Activation Measure (PAM) that allows clinicians to measure a patient’s knowledge, skills and confidence for managing their health and health care. Research indicates clinical sites using the PAM see between $260–$3,700 annual per patient savings.

Recently, TEDMED Great Challenges invited a panel of experts to discuss the PAM, the benefits of increased patient engagement, and potential barriers to patient activation: TEDMED Great Challenges: Making the Grade: Examining the Case for Patient Activation Measures. The Great Challenges of Health and Medicine Program sheds light on complex and persistent problems that affect millions of Americans and is sponsored by the Robert Wood Johnson Foundation.

The Panelists

Dr. Judith Hibbard is a professor of health policy at the University of Oregon’s Department of Planning, Public Policy and Management and the lead author of the Patient Activation Measure survey. She is an expert on consumerism in health care whose research focuses on consumer choices and behavior in health care.

Rebecca Burkholder is vice president of health policy at the National Consumers League. She manages work on health care issues including safe medication use, patient safety, doctor-patient communication and direct-to-consumer advertising.

Dr. Suzanne Mitchell is assistant professor of family and medicine at Boston University School of Medicine and a family physician and palliative medicine provider. She has published on the use of virtual reality and artificial intelligence agents for provider and patient education.

Sandra Elliott is executive director of iMPak Health, LLC, a health technology startup, and corporate director of consumer technology and services development at Meridian Health. She is responsible for daily operations, product development, strategy and market development at iMPak.

Emily Kramer-Golinkoff is the co-founder of Emily’s Entourage, a nonprofit that raises funds and awareness for cystic fibrosis research. She also works at the Penn Social Media and Health Innovation Lab and is an ePatient with advanced stage cystic fibrosis. She recently served on the Communication Task Force of the Cystic Fibrosis Foundation.

The panel was moderated by Gregg Masters, a recognized thought leader in health care social media and founder of HealthInnovationMedia.com. His work focuses on best practices in digital content development, curation, distribution and branding.

Key Insights

Dr. Hibbard explained that patients who have lower activation scores tend to feel overwhelmed with the task of managing health, have little confidence in their ability to do so, may be discouraged because of experiences of failure and may not understand their role in the care process. Understanding a patient’s level of activation helps clinicians tailor care plans for each patient that can increase engagement in their health management. Dr. Hibbard noted, “The idea is … to help people by breaking things down into smaller steps when they’re less activated … and what we have observed is when people do start to experience success their motivation increases.”

The panelists noted that the PAM is an important starting point for ongoing conversations between patients and providers. Panelist Elliott suggested several additional drivers of patient engagement: a sense of connection and trust between patient and provider, clearly communicated information from providers with actionable steps and patient confidence in their ability to do what’s being asked of them. As a patient with a highly involved illness, panelist Kramer-Golinkoff said, “My goal in my health is to be able to fully engage in the rest of my life … I think [this is] a jumping off point … there has to be efforts to align values and understand life context and goals, [which] often involves a much more nuanced and rich relationship with provider.” The panelists suggested clinicians need better training on how to have effective and efficient conversations with patients to encourage engagement.

Ultimately, all of the panelists agreed that managing chronic illness is a journey, and it is up to providers to help patients better understand how they can move forward successfully through collaborative and personalized care management. Health services professionals such as those from MHA@GW can play an integral role in helping providers and patients use tools such as the Patient Activation Measure to navigate through this journey.

MHA@GW is proud to support the Great Challenges Program at TEDMED, funded by the Robert Wood Johnson Foundation. Through weekly dialogues with TEDMED’s intellectually diverse community, we move toward a more meaningful understanding of the great challenges of health and medicine. Click here to learn more about the Great Challenges Program. To share your ideas, join in the discussion at #GreatChallenges.