Improving patient self-management

Innovations

Kidney Transplant Center Required Completion of Education Class Prior to Medical Assessment, Leading to More Patients Completing Evaluation 05/21/12

A transplant center established a mandatory education session for newly referred patients, leading to a significant increase in the percentage of patients (particularly African Americans and people of lower socioeconomic status) completing the enrollment process.

Statewide Program Supports Medical Homes Through Multidisciplinary Teams, Easy Access to Information, and Incentives, Leading to Lower Costs and Better Care 05/18/12

A statewide program supports physician practices through multidisciplinary community-based health teams, preventive health expertise, easy access to needed information via electronic systems, and financial incentives, leading to lower utilization and growth in health care spending and enhanced provision of appropriate services.

Health System Offers Routine Tests Without Need for Physician Order, Enhancing Access for Small but Growing Number of Satisfied Patients 05/04/12

A health system allows patients to receive certain routine laboratory tests without a physician's order, enhancing access to these tests and generating positive feedback.

Online Patient Access to Visit Notes Generates Positive Early Reviews From Patients and Primary Care Physicians 03/01/12

Primary care doctors offer patients online access to office visit notes, generating high levels of satisfaction and multiple benefits for both patients and physicians.

Culturally Competent Disease Management Improves Self-Monitoring and Blood Pressure Control in Hypertensive African Americans 02/09/12

A health plan–sponsored disease management program targeting African Americans combines home blood pressure monitoring with culturally competent education and counseling, leading to better self-monitoring and blood pressure control.

Outreach Workers Connect Low-Income Individuals Living in Rural Areas to Home- and Community-Based Services, Reducing Costs and Nursing Home Placements 02/01/12

Community outreach workers identify residents at risk of nursing home placement and arrange for them to receive appropriate home- and community-based services, leading to fewer nursing home placements and significant cost savings.

Care Coordination, Peer Support, and Discretionary Fund Improve Quality of Life and Reduce Costs for Adults with Serious Mental Illness 01/14/12

Intensive, person-centered case management, peer support, and a discretionary fund for adults with serious mental illness leads to better access to treatment, job training, and employment; fewer suicide/self-harm attempts, hospitalizations, incarcerations, and days of homelessness; and lower mental illness-related costs.

Pharmacists Support Employees and Physicians in Managing Chronic Conditions, Leading to Better Care and Disease Control, Lower Costs, and Higher Productivity 01/10/12

Pharmacists provide ongoing chronic care management support to employees and their physicians, leading to greater adherence to recommended care processes and self-management behaviors, lower costs, higher productivity, and a significant return on investment.

Case Managers Remotely Monitor Chronically Ill Medicare Beneficiaries Each Day, Reducing Mortality and Costs 01/09/12

Case managers remotely monitor Medicare beneficiaries with chronic conditions via a messaging device that asks and records answers to disease-specific and general health questions each day, leading to lower mortality and costs.

Hospital Enhances Access to Healthy Food Through Onsite Pantry and Cooking Classes, Leading to Better Diet and Health for Low-Income Families 01/04/12

A hospital-based food pantry and cooking classes enhance access to healthful food for low-income families, generating high levels of satisfaction and improvements in diet and health.

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