Stephen Sproul, M.D., is medical director, EMR and clinical integration, at Advocate Physician Partners, which helps connect and integrate physicians with the Advocate Health Care system, based in the Chicago suburb of Downers Grove, Ill., and which encompasses 11 acute-care hospitals and one children’s hospital, more than 3,300 inpatient beds , and more than 250 care sites across northeastern Illinois. Over 4,500 physicians are affiliated with Advocate Physician Partners; of those about 1,200 are employed by the Advocate Medical Group, and the rest are aligned physicians partnering with the Advocate Health system across 13 hospitals in the Chicago metropolitan area.
Sproul, a family physician, continues to see patients about 16 hours a week. He taught family medicine in the family practice residency program at Advocate Lutheran General Hospital (the health system’s flagship facility) for 10 years, before becoming involved in direct administrative management at Advocate Health.
Sproul was one of a number of senior executives at patient care organizations around the country whose views and perspectives were solicited by leaders of the Scottsdale Institute, a not-for-profit membership organization of prominent healthcare systems, whose goal is to support its members on their jourey to clinical integration and transformation through information technology.
On July 16, leaders at Scottsdale Institute announced the creation of the SI Patient/Consumer Engagement Adoption Model™. The SI Patient/Consumer Engagement Adoption Model , as explained in the Scottsdale Institute’s press release on that date, “is an assessment tool and adoption model to help U.S. healthcare systems measure effectiveness in engaging patients and consumers in managing their own health and wellness. SI developed the SI Patient/Consumer Engagement Assessment© and SI Patient/Consumer Engagement Adoption Model™ in response to the growing demand as well as necessity for patients and consumers to participate directly in their own care as the healthcare industry moves from a volume-based, fee-for-service model to one based on value, accountable care and population-health management.”
The press release goes on to note that “The assessment tool and adoption model are available free of charge to all U.S. hospitals and health systems, whether members of SI or not. SI encourages all such organizations to participate.” Senior officials at Scottsdale Institute have confirmed to Healthcare Informatics that creation of the model was inspired by the widespread adoption of the HIMSS Analytics EMRAM Model for the adoption of electronic health records/electronic medical records (EHRs/EMRs) in hospitals, medical groups, and health systems, and that they hope that the creation of the model will help the leaders of patient care organizations discuss with greater ease and mutual comprehension some of the concepts around patient and consumer engagement, as patient and consumer engagement comes into its own as a strategic concept in patient care organizations around the U.S.
Here is the model:
Dr. Sproul, of Advocate Physician Partners, was among a large number of senior executives who were surveyed about the concepts embedded in the model and whose participation as survey respondents helped to shape its final form. The model was publicly unveiled in July with the press release announcement; sometime in mid-autumn, the leaders of the Scottsdale Institute will reveal in a published report their findings of where U.S. patient care organizations stand in relation to the various stages in the model.
Dr. Sproul spoke recently with HCI Editor-in-Chief Mark Hagland about his interest in the new model and in patient and consumer engagement as an important element in the patient and consumer engagement phenomenon in U.S. healthcare. Below are excerpts from that interview.
What is your specific interest in the Patient/Consumer Adoption Model™?
A couple of things. One, the other role I’ve taken on here at APP is that we’ve developed a program around helping our PC practices get NCQA certification for PCMHs, and I’ve been involved in that for about two years. I’m very interested in practice management and evolving new models of care. And I think patient engagement is one key. I’m particularly interested in how we engage patients in shared decision-making. And I think patient engagement is key to population health management as well.
Do you like the way in which the schematic, the model, presents adoption in this area?
Yes, I think there are some very key things in the schematic. What I found when I was thinking about our organization is that it’s hard to fit us into one level, because we’re doing one or two things at Level 5, and a few things at Level 4. For example, when it comes to population analytics for screening, disease management, and care, we’re doing that. And I think we do community partnerships for education, wellness, and healthy choices. We engage our communities, and we have mobile wellness.
So there are some things we’re doing at Level 5. Are we fully in the engagement strategies for all the communities we serve? Do we have patient representatives helping us design care? We have a ways to go on those. We’re solidly a Level 3 and are moving up to a Level 4 and 5. For example, in Level 4, we don’t yet do economic initiatives for a healthy lifestyle. But we do do health risk assessments, and try to help manage based on socioeconomic status, etc., we do some of that. We do refer patients to community and other resources; and we’re starting to do online alternatives to face-based appointments. So we’re moving up into Level 4 and are doing a couple of things that are at Level 5. Overall, I would say that we’re solidly at Level 3-plus.
Is there a need for this schematic, and will having this schematic actually promote action?
Yes, I do, I think there’s a value in this. Healthcare organizations respond to this type of evaluation of how well they do a certain type of thing. They respond to it and improve. And giving them a framework for this process of engagement helps them determine where they are. I think that’s helpful.
Most patient care organizations are not that far along on this, nationwide, correct?
Some of your larger organizations are moving fairly well along, but most community hospitals are probably still down in the Level 1 and 2 range. So if you talk to large organizations like Mayo [Clinic] or Kaiser [Permanente], or Intermountain Health, or Geisinger [Health System], they’re clearly further along here; some of them are further along than we are.
What are the key building blocks or foundational elements that may not be in place yet in most organizations, but that need to be put in place the next couple of years?
One is what we’ve been about here is creating a system where you create population health risk assessment, and the IT infrastructure to collect the data and understand it and then move towards engaging the population around that process. And combining that, one of the things that will have to happen over time, and we’re getting there in some places, is combining the social determinants of health data, such as food deserts, etc., combining that data with clinical data. And then the next step is encouraging representatives of populations to come in and do what we haven’t done here yet, which is getting those representatives to get involved in health design planning, and then promoting wellness and disease management at an individual level.
A lot of that will involve patient portals, and applications on their smartphones, and it will be constantly changing, with Baby Boomers moving into retirement, because they’re much more savvy than the current retirees with technology.
What should healthcare IT leaders be doing right now to prepare for the coming era of increased patient and consumer engagement?
Earlier on, we could have involved our community more in figuring out how they could be engaged in helping us design a care delivery system, and doing that upfront is very important, or else you miss the mark, I think. We’re very much aware that the social determinants of health are much more important in fact than the delivery of sick care, in determining the health of a population, and then supporting the primary care base in the community.
And then I think figuring out how you deliver care in a way that actually engages patients, is important. Our healthcare system has been one driving by volume, so that the amount of time providers have to actually engage patients and engage them in shared decision-making is so limited, because we’ve got one foot on the dock and one foot in the boat. We at Advocate see that as our future, the full consumer and community engagement, and are trying to navigate towards that.
Is there anything else you’d like to add?
Yes. After 30 years in this business, this is a very exciting time to come around to this [patient and consumer engagement] in primary care.
