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The biggest opportunity to improve health care after Covid-19? It's hiding in plain sight.

By Vidal Seegobin

March 11, 2021

I really like an article that Politico published called, "How Covid-19 could make Americans healthier." It's a solid inventory of all of the ways that the pandemic can force much-needed but often delayed structural changes to health care. Think areas like "elevating public health" and "putting primary care at the center of the system."

Case study: How VA San Diego used patient activation to uncover barriers to self-management

But it has one glaring omission: The pandemic has provided the opportunity to better partner with people to help them stay healthy.

In June 2020, Advisory Board launched a direct-to-patient survey in Australia. We selected Australia for a few reasons:

  • A close to 50-50 mix of publicly and privately insured patients;
  • A mix of urban and rural populations;
  • A federated model where hospitals are managed at the state level; and
  • Australia had the benefit of time to learn from the global experience and adapting accordingly. 

The most striking finding emerged when we asked respondents about their changing habits because of lockdowns and the pandemic. The survey found 57% of respondents "wanted to be more proactive about their overall health and wellness." Meanwhile, 43% of respondents indicated that they wanted to take their mental health more seriously, and 44% wanted to improve their diet and exercise habits.

People can disagree with how much stock to put into these responses, but the subgroups of the population that responded in higher numbers were:

  • Women;
  • People who know someone who contracted covid-19; and
  • Individuals with chronic conditions.

In my opinion, this means there's a clear and present opportunity to build the self-management capabilities of these cohorts.

Easier said than done

Patient self-management remains one of the holy grails of health care. Nearly all of an individual's success at preventing or managing a condition happens outside the health care setting. And because the key to self-management is behavior change, which is incredibly difficult, it's easy to fail. But I have two pieces of good news:

  • One of the key ingredients to effective self-management is the motivation, willingness, and desire to change—and I think the survey data points to that being present right now; and
  • Our research shows that, when turning patients into active partners in their care, we need to work toward a meaningful goal for the end-user, not our end goals. 

The second element seems obvious, but we rarely anchor care goals in terms of patients' activities, events, or priorities. Health care defines success in biometric indicators, but people define success using metrics such as vacations or time spent with loved ones.

Our research teams have been capturing best practices on self-management for several years. We've hyperlinked some of the best ones on this page for your review.

I want to reiterate that I 100% support the spirit of the article that kicked off this conversation. The pandemic is a unique opportunity for us to improve health care performance. When we look back at how we rose to the occasion, performed, and improved because of a pandemic, I'd love to say that we got better at enabling people to take better control of their health and wellness.

Patient Activation Measure

An emerging tool for patient self-management

It’s difficult to activate a patient without a clear understanding of where the patient is and what we can do to support them.

The patient activation measure—or PAM—is an emerging tool to help us direct and focus this work. In this brief we investigate the evidence of PAM’s efficacy and the current state of application.

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