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Values-based interventions in patient engagement for those with complex needs

Values-based interventions in patient engagement for those with complex needs
Values-based interventions in patient engagement for those with complex needs
The objective was to evaluate a novel intervention that integrates a psychological, values-based approach with coordinated care management. This paper describes an integrated comprehensive health record system to enhance engagement with a subset of those with complex needs; those who are high-needs, high-cost (HNHC). Patients are selected after conducting data analysis on the most costly and complex patients of a payer system that works with HNHC patients. Specifically, the Patient Care Intervention Center in Houston TX, applies the values-based intervention to HNHC patients. This pilot study reports data from 18 HNHC patients over 6 months; specifically, outcomes related to daily functioning, depression, working alliance, stages of change, and overall well-being. Additionally, this paper reports preliminary findings from qualitative monitoring of provider experiences implementing the values-based approach and integrated evaluation. HNHC patients improved their daily functioning over 4 months but no other significant changes were found over time. Patients self-reported mild depression, strong working alliances with their provider, being in the contemplation phase of change, and moderate well-being. There also was variation when patients completed the assessments and data points were collected. Although this is a small sample and short time frame, preliminary results suggest that the intervention has a positive impact on HNHC patient daily functioning. Provider accounts of the implementation describe using the evaluation items to inform their interactions with patients, and also suggest that patient literacy level impacts when data can be collected. Other changes to the approach are suggested.
values-based intervention, complex needs, High needs, High cost, care coordination
1942-7891
Barker, Stephanie
c13c8f44-ca6f-497d-8eca-006707beeddf
Maguire, Nicholas
ebc88e0a-3c1e-4b3a-88ac-e1dad740011b
Das, Sophiya
ea39001c-3a97-43ae-bf5c-c28f9893759a
Bryant, Victoria
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Mahata, Kallol
e0b5c531-aefc-4c05-846a-c00b25c1a6c6
Buck, David
753a2f37-5031-4cc7-9f00-8065d65d782e
Barker, Stephanie
c13c8f44-ca6f-497d-8eca-006707beeddf
Maguire, Nicholas
ebc88e0a-3c1e-4b3a-88ac-e1dad740011b
Das, Sophiya
ea39001c-3a97-43ae-bf5c-c28f9893759a
Bryant, Victoria
31c9f1f5-46d6-4050-ba60-a655a8789b98
Mahata, Kallol
e0b5c531-aefc-4c05-846a-c00b25c1a6c6
Buck, David
753a2f37-5031-4cc7-9f00-8065d65d782e

Barker, Stephanie, Maguire, Nicholas, Das, Sophiya, Bryant, Victoria, Mahata, Kallol and Buck, David (2019) Values-based interventions in patient engagement for those with complex needs. Population Health Management. (doi:10.1089/pop.2019.0084).

Record type: Article

Abstract

The objective was to evaluate a novel intervention that integrates a psychological, values-based approach with coordinated care management. This paper describes an integrated comprehensive health record system to enhance engagement with a subset of those with complex needs; those who are high-needs, high-cost (HNHC). Patients are selected after conducting data analysis on the most costly and complex patients of a payer system that works with HNHC patients. Specifically, the Patient Care Intervention Center in Houston TX, applies the values-based intervention to HNHC patients. This pilot study reports data from 18 HNHC patients over 6 months; specifically, outcomes related to daily functioning, depression, working alliance, stages of change, and overall well-being. Additionally, this paper reports preliminary findings from qualitative monitoring of provider experiences implementing the values-based approach and integrated evaluation. HNHC patients improved their daily functioning over 4 months but no other significant changes were found over time. Patients self-reported mild depression, strong working alliances with their provider, being in the contemplation phase of change, and moderate well-being. There also was variation when patients completed the assessments and data points were collected. Although this is a small sample and short time frame, preliminary results suggest that the intervention has a positive impact on HNHC patient daily functioning. Provider accounts of the implementation describe using the evaluation items to inform their interactions with patients, and also suggest that patient literacy level impacts when data can be collected. Other changes to the approach are suggested.

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Pilot paper JPHM Manuscript Revision - Accepted Manuscript
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More information

Accepted/In Press date: 31 July 2019
Published date: 10 September 2019
Keywords: values-based intervention, complex needs, High needs, High cost, care coordination

Identifiers

Local EPrints ID: 433510
URI: http://eprints.soton.ac.uk/id/eprint/433510
ISSN: 1942-7891
PURE UUID: e0ca2ad7-20d0-450c-86bf-b316de902e17
ORCID for Stephanie Barker: ORCID iD orcid.org/0000-0002-2886-4113
ORCID for Nicholas Maguire: ORCID iD orcid.org/0000-0003-4295-8068

Catalogue record

Date deposited: 23 Aug 2019 16:30
Last modified: 17 Mar 2024 02:52

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Contributors

Author: Sophiya Das
Author: Victoria Bryant
Author: Kallol Mahata
Author: David Buck

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