February 22, 2024

Health education is a valuable tool in fall prevention strategies

Falls are one of the most common, harmful and expensive health risks facing seniors in the US. One in four Americans over the age of 65 falls each year, and by 2030 this number is predicted to rise to seven fatal falls per hour. important factor in fall prevention and can improve performance in Star Ratings and HEDIS measurements.

Increasing awareness of falls and fall prevention among health plan members

Falling poses a high risk of injury:

  • This is reported by the Centers for Disease Control and Prevention (CDC). 36,000 dead caused by falls in the US in 2020 among adults aged 65 and older, making it the leading cause of injury death in that age group.
  • The same CDC report also found that 2020 resulted in falls 3 million emergency room visits for older adults and costs approx $50 billion annually in medical costs, 75% of which are covered by Medicare and Medicaid.

However, it is a risk that can be limited through effective patient and member contact. A 2021 study found that fall prevention education improved awareness and some behavior change among older adults in community settings, depending on the quality and evidence-based nature of the solution. The study described falls prevention education as a relatively inexpensive intervention and noted that it was more effective when implemented by collaborating nurses or care managers.

“There is absolutely a connection between the HEDIS Fall Risk measure and health education,” said Michael Lauber, head of Payer Sales for Clinical Effectiveness at Wolters Kluwer, Health. “Fall prevention is an important aspect of caring for an aging population and focuses on an important HEDIS measure. With interactive, engaging health education that promotes falls prevention, payers and healthcare organizations can better manage care for their members and patients while improving their HEDIS scores and star ratings.”

The value of health education for patients and members

Recent surveys show that eight in 10 Americans still have questions after their healthcare visit and would welcome more educational materials relevant to their care. This doesn’t surprise Allison Combs, Head of Product – Payer, Clinical Effectiveness at Wolters Kluwer Health, who points to the extraordinary amount of stress healthcare providers experience in managing a nearly insurmountable workload. “Providers are doing their best to help patients like us,” she says. “But healthcare providers are busy, and there are not enough to treat the enormous number of patients. If you add to that the fact that we, patients who are also busy or worried about our upcoming surgery or even about something else in our lives, sometimes don’t hear everything they tell us.

That’s when a member engagement intervention can be a welcome experience, she explains, potentially avoiding patient physical and mental suffering and reducing health care costs and utilization. Combs gives the example of abdominal surgery, where many patients are not informed that a common side effect is painful gas.

“If you didn’t already know, just passing gas after surgery can be very stressful,” she says. “So you could end up back in the emergency department and be told, ‘No, everything’s fine. It’s just your abs and system getting used to themselves again.’”

This, she says, is one of many “preventable, painful and frightening scenarios” that education for members could help alleviate by providing clear explanations of what to expect after a procedure, which side effects or symptoms are cause for concern and which symptoms are common. and which are likely to resolve on their own, and how to manage them.

What are some health plan interventions to help prevent falls?

Falls aren’t just a problem for older adults, Combs notes. It can affect patients and policyholders of all ages, especially if they are not properly prepared for the risks following a surgical procedure.

“You’d be surprised how many people fall after having a procedure because they didn’t think to clean and prepare their home before the procedure,” she explains. “So they didn’t take into account that they would be on crutches and that they needed a wider path. It wouldn’t have occurred to most people unless a healthcare professional took the time to ensure they were aware of it and took action beforehand.”

While preparing members for the actual medical elements and after-effects of a procedure is part of most patient education programs, Combs says involving members in these important but often overlooked extras – such as cleaning, moving furniture and possible obstacles, and finding the right tools. assistance if these are tasks that members cannot perform themselves – are just as essential to fall prevention strategies and “also increasingly important in the Stars metrics.”

Asynchronous engagement helps with sensitive topics

Engaging members, especially older members, on topics like fall risk can be difficult, Combs acknowledges, because it carries a stigma and “sense of shame.” There is a real sense of loss of control or a loss of not being able to do everything you used to be able to do when we talk about health issues such as falls and mobility.

When in-person conversations with healthcare providers prove too embarrassing for patients to properly absorb the information they need or feel comfortable asking all their questions, payers and health insurers have an opportunity to fill the gap in a way that allows their members to feel more in control. “Payers need to provide mechanisms to help educate people asynchronously in a more private setting, where they can watch a video and take the time to understand it and think about these issues. Then hopefully they will have more confidence to talk to their loved ones or their healthcare provider or the care management nurse to seek additional help to prevent a health event.”

The risk of falling “increases when someone is more isolated,” Combs says. Fall risk increases by 23% among those who live alone and by 36% among those who report the least amount of social contact. In cases where members cannot easily connect with caregivers or care managers in person, asynchronous, interactive educational materials can help increase awareness of fall prevention strategies and encourage the early stages of dialogue with caregivers.

Member engagement solutions provide personal reach

Combs notes that payers need to meet vulnerable member populations where they are with educational materials that are accessible and personalized to their health care journey. This will not only help improve their overall well-being and understanding of their health, but also reduce the potential risk of events such as falls, while improving performance in star ratings and HEDIS measurements.

Interactive multimedia programs specifically focused on healthcare management, such as the EmmiGuide™ member engagement solution, do this by:

  • Providing health information they understand and can trust.
  • Providing diverse, equitable and inclusive content to represent people of different ages, identities and abilities.
  • Communicate with members in a way that is easy to understand and use, supporting healthy decision making and closing gaps in care.
  • Covering the important healthy aging topics that your members are most interested in, may not feel comfortable discussing in person, or may have questions about upcoming visits to healthcare providers.

Creating a fall prevention outreach plan

When Combs thinks about creating a fall prevention outreach plan for patients or health care plan members, she offers the following suggestions:

  1. Use different forms of contact: Phone calls are often more effective at initially engaging senior members, Combs says. But all generations, including “today’s younger seniors, are very digitally tech savvy,” she adds, requiring email or even text messaging communications. “They don’t consider themselves old. So they don’t think about falls,” which makes it all the more important to involve them at a younger age and educate them about risk factors.
  2. Adjust the scope for different types of member profiles, not just age. Because any age can be affected by fall risk, Combs would consider other factors, such as geographic location, to tailor the range. Fall prevention outreach and education can also be combined with visits and care management programs for other related conditions or regularly scheduled health care checkups “to help people think about that a little more in advance and plant seeds along the way,” she says. .
  3. Find creative ways to get members’ attention. In addition to educational programs, Combs suggests offering patients and members memorable “extras,” such as checklists on best post-operative preparation or fall prevention tips. “Give standards to patients,” she says. “Tell them to hold it level and walk around the house to test if they have enough room for when they get home from the hospital. In addition to the collateral, useful things like this really go a long way.”
  4. Keep in mind that not every member’s culture is the same. “Not only do you have to meet members where they are, but you also have to speak their language and understand their perspective on where they are in life,” Combs says. In addition to having educational materials available in different languages, she notes that it is also important to consider different voice user interfaces to represent different communities and to consider different cultural perspectives within engagement and educational materials. In cases where a person’s cultural background may hinder their comfort level in speaking with a healthcare provider, “having these materials in an asynchronous way, where they can explore them in privacy, helps them break away from any shame or those cultural challenges,” she says. say.

“We don’t like to admit that we have weaknesses, but when you’re dealing with health care, you have to get to the point where the goal of being as healthy as possible is paramount,” says Combs. It becomes the responsibility of healthcare providers and health plans to find ways to reach and engage patients and members to become active in their own care. “We as a system or as a society have to ask ourselves, have we given them enough tools to figure out how best to do that?”

eBook: Increasing Star Ratings and HEDIS Measures with Member Health Education

To learn more about personalizing member experiences, download the eBook “Drive Star Ratings and HEDIS Measures with Member Health Education.”

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