Traditional healthcare delivery methods are based on clinicians providing care to patients rather than partnering with them in their care. More emphasis needs to be placed on assessing a person's capacity to be engaged in his or her care, exchanging information and jointly determining care goals. If we are to deliver care that truly encourages people to be the manager of their care journey, providers need to focus on these parts of the process more fully. This model helps make the transition from provider-driven services to a collaborative model of care.
The ICM was designed to be a roadmap for including patients and families in collaborative goal-setting and activating them in their own care. When providers begin to treat the patient-clinician relationship as a partnership rather than a one-way conduit of instructions, they can tailor interventions to help patients achieve their goals with greater success. An aspiration-based approach—taking into account the patient's health goals and treating the whole person–has a much greater chance of success than a problem-based approach of treating just the disease or condition.
Grounded in systems theory, the ICM was developed by researchers, reviewed by clinical experts and informed by feedback from clinicians and patients. Members of the O'Neil Center Advisory Councils provided input over the course of the development of the model. It takes into account scientific and nursing processes to design appropriate interventions and care plans based on a combination of clinical goals and a person's capacity to engage in their care.
In developing a plan of care, it's vital to discuss and understand what matters most to each person. This approach helps bring to the forefront what people want their health for, such as walking a loved one down the aisle or realizing a lifelong dream, and encourages greater engagement in setting goals and managing daily health. Understanding the whole patient—their living environment, family support system, daily routines and expectations—is an essential component of the care equation. The benefits are mutual for patients and providers: early evidence shows that patients who are more involved with their care have better outcomes and lower healthcare costs.
Further refinement of the ICM is ongoing. The O'Neil Center is conducting a multisite study to test an instrument called the Person Engagement Index (PEI) that can be used to measure a person's capacity to engage in their care. An institutional review board-approved study is in the beginning phase of data collection at four health providers: Kaiser Permanente Baldwin Park Medical Center, Community Medical Regional Center, Florida Hospital Celebration Health, and Carolinas HealthCare System. The tool is targeted for completion in the second quarter of 2016. Once it is validated, the ICM will be tested in the practice setting.
Change is never easy, particularly for a system as important and complex as healthcare. Making the time to incorporate the ICM into daily practice might be seen as an initial challenge, but the benefits can offset potential complications later in the care process, such as non-compliance or hospital readmissions, that would have a negative impact on outcomes and costs.
True healthcare reform takes place when patients, families, clinicians and all healthcare providers come together to help people become active participants in the care process. The ICM is an important step toward helping patients and families become better informed health consumers, improving the care experience and creating healthier communities and populations.
The ICM can be viewed online here.
Karen Drenkard, Ph.D., is senior vice president and chief clinical/nursing officer at GetWellNetwork, a patient engagement solutions provider based in Bethesda, Md.
