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Quantified Patient


By Allison Proffitt  
 
October 21, 2013 | Health care and the life sciences industry’s success ultimately turns on patient investment and compliance. No matter how brilliant the finding, how good the drug, how effective the treatment, it is only as good as the patient’s ability and willingness to participate. 
 
Last week, Aaron Krol, the talented new science writer at Bio-IT World and Clinical Informatics News, explored how data-driven methods can be brought to bear on patients’ lives inside and outside the clinic. In a three part series, Krol looked at efforts to quantifying this most-essential piece of the healthcare puzzle and how doing so could bring about huge changes in the industry. 
 
Judith Hibbard’s Patient Activation Measure (PAM) was adopted by organizations including the AARP, Fairview Health Services in Minneapolis, and the Kaiser Permanente Center for Health Research as a measurement tool for large-scale patient studies. Since then, a staggering array of health variables has been shown to correlate with PAM scores: exercise, diet, smoking, preventive screens and immunizations, substance abuse, obesity, emergency room visits, levels of triglycerides and LDL, and medication adherence. 
 
The team at Eliza Corporation faced a disturbing question: if they themselves—the “over-informed, over-resourced” insiders—weren’t following all the recommended health measures of diet, exercise, and preventative screenings, what did that mean for everyone else? Eliza identified eleven life-context variables that can affect compliance like work stress and caregiver status and built a vulnerability scale. When applied to patient data, the findings were striking. If you compare those patients who scored highest on the vulnerability scale against those who scored lowest, the claims data shows an average difference of $4,000 worth of insurance claims over the course of a year.
 
These efforts are gaining traction. The National Quality Forum released a report endorsing patient-reported outcomes-based performance measures—PRO-PMs—a year ago, and has started a project to recommend specific PRO-PMs for development, and to spread awareness of qualified PRO-PMs to members of the health care industry, policymakers and the medical education system. That project just closed nominations for its committee on October 15, and will hold its first multi-stakeholder meeting of providers, insurers, policy experts, public health organizations and patient groups on October 22.
 
Patient engagement is essential to real changes in health, but has, as Krol points out, “sometimes been resigned to the cabinet marked ‘Important – Deal With When Measurable.’” It looks like that time is approaching. 
 
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