- The Johns Hopkins School of Nursing (JHSON) has received grant funding from the National Institutes of Health (NIH) to create a research facility targeted at supporting patient engagement in chronic disease management.
The Promoting Resilience in Persons with Multiple Chronic Conditions (PROMOTE) center aims to look at chronic disease management from a broad lens, forgoing traditional episodic care strategies. As the healthcare industry continues to embrace value-based care payment models, it will be essential for healthcare professionals to understand how to engage patients in health and wellness maintenance in place of episode-based care.
Specifically, PROMOTE aims to better understand the social determinants of health (SDOH), or the lifestyle and societal factors that influence an individual’s ability to be healthy. These factors can include poverty, housing status, educational attainment, and geographic location.
The SDOH often serve as barriers to patients engaging in chronic disease management plans. It is essential for medical professionals to understand the SDOH – and how to address them – in order to effectively drive patient access to chronic care management.
Additionally, PROMOTE researchers will work to improve the industry’s understanding of patient-centeredness and family engagement. In doing so, center leaders hope to provide a holistic view of patient engagement and chronic care management, thus developing strategies that are more feasible for patients’ lifestyles.
Too often, chronic care management plans neglect to consider a patient’s home life, for example. A patient who doesn’t have access to reliable transportation may struggle to appear at her regularly-scheduled care management appointments.
Understanding those lifestyle limitations could help providers design a chronic care management program that is more catered to that individual patient, helping her to connect with care and overcome what are often costly obstacles to wellness.
“With two out of three adults in the US experiencing multiple chronic conditions, the need for relevant research and scalable programs is urgent,” says Sarah L. Szanton, PhD, ANP, FAAN, center director and JHSON endowed professor for health equity and social justice.
“Our center takes a holistic view of the person, their environment, and their goals. The center will prepare clinician-researchers to design compelling solutions that are relevant to the home, family, social, and financial ecosystems that people live in. We want to change the question from ‘what is the matter?’ to ‘what matters most’ to the patient.”
PROMOTE plans to accomplish this by using human-centered design, a practice that utilizes patient and participant feedback to iterate a certain process. Based on patient feedback, a care manager may choose to implement a different medication adherence tool, for example.
The center will also maintain partnerships with state and federal policymakers, patient advocates, and other industry groups to ensure their chronic care management strategies remain within best practices frameworks.
The notion of patient-centricity in chronic disease management is not necessarily new, but current industry conditions still make it essential for researchers to develop strategies to establish better patient engagement.
In creating this center, leaders hope to create best practices that can positively impact the rest of the medical industry.
“Establishing this center will lead to a tremendous step forward in the way health care professionals respond to and design future interventions to the most pressing health issues,” said Patricia Davidson, PhD, MEd, RN, FAAN, a director at PROMOTE and dean of JHSON. “It’s not just a leadership opportunity for our school, but a transformational advancement for the whole of health care.”
Other industry experts agree that uncovering the SDOH is essential for developing a meaningful chronic disease management program. Patient non-compliance rarely comes from a place of obstinance; instead, patients face a set of barriers keeping them from practicing healthy behaviors.
High costs might hinder medication adherence, for example. Patients experiencing homelessness might overutilize the emergency department because it is the most accessible avenue for care.
As the healthcare industry continues its search for solutions to cost problems while aiming to improve patient care experiences, it will be essential for leaders to understand patient lifestyle needs to better target care management interventions.