For Patients – Information and Tools
The MiPCT is a patient-centered medical home effort to help to keep you well and to help you getter better when you are sick. Over one million patients in Michigan with Medicare, Medicaid, Blue Cross and Blue Shield of Michigan, Blue Care Network, and Priority Health coverage are covered by providers who participate in the MiPCT program. They know that information can help you to get the most out of your care.
This tab contains information for patients and for Care Managers and physicians who work with patients. All are electronic resources that have been reviewed by our Patient Advisory Council and Clinical Leadership teams.
The Michigan Primary Care Transformation Project (MiPCT) helps primary care doctors (those who focus on the care of children, adults and families over a lifetime) make sure that care patients have clinical advice when they need it, even if on nights or weekends. In MiPCT practices, Care Managers (specially trained nurses, social workers or other experts) are located right in your doctor’s office to help you improve your health and to coordinate care with specialists, hospitals and emergency rooms when you are sick. The Care Managers serve as the patient’s advocate to coordinate a patient’s care across providers, provide information and education to patients and their families, and use data to improve performance.
The Patient Advisory Council of the MiPCT is a group of patients who generously volunteer their time to provide a patient perspective on MiPCT design and programs and guided the development of this webpage for patients. The links are publicly available websites from national experts. We hope that they are helpful to you in being an informed patient.
Self-Management: The American Academy of Family Physicians has created this helpful article about “self-care”. It focuses on how you can better understand the steps you can take to keep a health condition in control. It is available at: This Site. Here it is in .pdf format.
The Agency for Health Research and Quality is a part of the federal government. They have a team of physicians, researchers and other experts who focus on helping to understand what works in health care and in the following article about navigating the health care system (This Site). Here is a summary in .pdf format. They include some very useful tips on talking with your doctor, as follows:
Questions To Ask Your Doctor
- Questions Are the Answer
Your health depends on good communication. Asking questions and providing information to your doctor and other care providers can improve your care. Talking with your doctor builds trust and leads to better results, quality, safety, and satisfaction.
Quality health care is a team effort. You play an important role. One of the best ways to communicate with your doctor and health care team is by asking questions. Because time is limited during medical appointments, you will feel less rushed if you prepare your questions before your appointment.
- Your doctor wants your questions
Doctors know a lot about a lot of things, but they don’t always know everything about you or what is best for you. Your questions give your doctor and health care team important information about you, such as your most important health care concerns.
That is why they need you to speak up.
- The 10 questions you should know (.pdf format )
- Questions to ask before your appointment (.pdf format)
- Questions to ask during your appointment (.pdf format)
- Questions to ask after your appointment (.pdf format)
- Build your own list of questions (This is an interactive online tool that will build a set of questions for you, based on your selections. Not available as a .pdf file.)
Research shows that patients who have a good relationship with their health care team receive better care and are happier with their care. Patients and families who engage with health care providers ask good questions and help reduce the risk of errors and hospital admissions.
TED Talk: How to Help Your Doctor Give You Better Care:
Have you heard of “TED (Technology, Education and Design) Talks? They are entertaining and informative short speeches that challenge speakers to “give the talk of their life” on a subject. This September 17, 2014 TED talk from Dr. Rishi Manchanda, a founder of HealthBegins, is about how to help your doctor give you better care. The video is available at: http://ideas.ted.com/2014/09/17/how-to-help-your-doctor-give-you-better-care/. Here it is in .pdf format. The following excerpt from Dr. Manchanda captures the key concepts he discusses in the video.
As a doctor in South Central Los Angeles, I’ve come to realize: my job isn’t just about treating a patient’s symptoms, but about getting to the root cause of what is making them ill — the “upstream” factors like a poor diet, a stressful job, a lack of fresh air.
Upstreamists like me — and we can be doctors, nurses or other clinicians — know that asthma can start in the air around us. We know that ailments such as depression, anxiety and high blood pressure can arise from chronically stressful conditions at work and home. We see how policies that deny opportunity, fairness and justice can be reflected in patients’ faces as well as in their DNA. And, just as important, we understand how to translate this knowledge into action. The upstreamist considers it her professional duty not only to prescribe a chemical remedy but also to tackle sickness at its source.
There aren’t nearly enough of these pioneers working in health care today, but our ranks are slowly growing. Want more information about the everyday facts that contribute to patient health? Watch my TED Talk (What makes us get sick? Look upstream). Interested in improving your own upstreamist health care? Below, six simple ways to start.
- Identify everyday risks in your home, workplace, school, community or society.
Create a list of the potentially unhealthy issues in your environment. Think of visible, known problems — and then flip the question and ask: What’s missing? Look for the absence of healthy alternatives. List as many concerns as possible, then categorize based on location: home, workplace, school, community and society. For example:
- Home: Faulty wiring in guest room; water leaks in basement; too many processed, carbohydrate-rich foods in pantry
- Workplace: Doughnuts served at office meetings instead of healthier snacks; no walking path around office; high stress and not enough social support at work
- School: Unhealthy school lunch options; not enough trees or plants; recess shortened by testing requirements
- Community: Need a speed bump on a busy local street; not enough green spaces for everyone; not enough child care or elder care; more fast-food restaurants than affordable markets
- Society: Housing or employment policies create unfair barriers or burdens; too little invested in prevention and public health
Some of these problems you might be able to fix yourself. For the others, the rest of this checklist offers different avenues.
- Ask your doctor, “Excuse me. Are you an upstreamist?”
There’s a reason why billions of dollars are spent each year by pharmaceutical and medical device companies on marketing that urges us to “ask your doctor about [insert brand-name drug or procedure here].” Because it works. Millions of people walk into their doctors’ offices and ask about brand-name products they’ve seen advertised. Evidence shows this significantly influences doctors’ prescribing, even though doctors often believe they’re immune to it. But we can deploy the same tactic to engage more clinicians in thinking about creating a better standard of care.
So, next time you visit your doctor, try asking: “Doctor, do you consider yourself an upstreamist?” If she’s confused by the question, it’s OK. Just share your own understanding of the ways in which your health begins where you live, work, eat and play.
- Share information about you and your community with your doctor.
More and more people are downloading mobile apps and donning wearable sensors to collect data on aspects of their daily lives (such as air quality, diet and exercise). The “quantified self” movement presents an exciting opportunity for all of us to support the upstreamist approach. If you’re motivated to discover patterns in your health and environment, download one of the many apps (iHealth, for example, tracks your blood pressure, physical activity and calories burned). Share your discoveries with your doctor; she can help you interpret your personal data. As a bigger thought: A whole neighborhood could aggregate its data to form a “quantified community,” helping health workers to spot common health problems or social needs that demand intervention.
Not a gadgethead? You can still help by sharing information about community resources with your clinic. Don’t underestimate the value of your own knowledge about local resources for healthy living. Is there a favorite park, walking trail, or exercise program you use? Do you know about a great farmers market or a housing lawyer who’s open to pro bono work? Tell your doctor about it. She and her colleagues can share that knowledge with other patients who may benefit.
- Rate your health care.
Every hospital and clinic is audited on a host of measures — details that get right down to the cleanliness of exam rooms, adequate stocks of medication, and patient satisfaction.
You can conduct your own assessment. Here are a few basic questions you can use to rate the upstreamist performance of your doctor, clinic and hospital, and to encourage them to understand health where it begins. Does your clinic or hospital:
- Identify the health and social needs of the community it serves?
- Have a dedicated person or team working to address the social conditions that make people sick?
- Screen patients for risk factors in their homes, workplaces and community?
- Connect patients with resources in the community that can help solve social needs?
- Help improve social and environmental conditions in the wider community?
- Reflect an upstreamist approach in the way it funds its work? (For example, paying its clinicians a salary, rather than reimbursing them based on the number and cost of services delivered.)
Share your results with neighbors and your city or county health department. Let your health plan, employer and union know that you’re interested, as a consumer, in using these measures to evaluate providers in your plan’s network.
- Vote with your feet.
If you ask local clinics these questions, you may find that the highest-scoring clinics also seem to offer the best quality and most personal care. Upstreamist clinics employ people who want to understand and improve health in its social context — which means they might just figure out that your migraines are due to the mold in your home, and then find you a tenant advocate instead of dosing you up with ineffective pain pills. If you realize you like your clinic’s approach to upstream health, tell your friends and encourage them to check it out if they’re thinking of switching. And if you’re looking to change doctors, vote with your feet — and your health care dollars — for an upstreamist clinic.
- Vote with, well, your vote.
Officials in town halls and city council chambers across the country make policy decisions every day that affect the health of our communities. Health implications crop up in places that might surprise you: Transportation issues and building codes, for instance, can profoundly influence a community’s wellness. Ask your local officials to use health impact assessments, a new tool modeled on environmental impact assessments, to gauge decisions that might seem, on the surface, unrelated to health. Or consider asking them to follow California’s lead — the state created a Health in All Policies initiative to factor health into a wide swath of state decisions.
In your own neighborhood, you can join or lead efforts to maintain safe parks and walkable sidewalks, expand healthy food options and limit pollution. If your clinic or hospital has a community advisory board, consider joining it. Finally, you can help by supporting efforts to provide nonpartisan voter registration services in your area. Evidence suggests that communities with higher civic participation rates tend to be healthier.
From Coverage to Care: A Roadmap to Better Care and a Healthier You (Get the .pdf booklet here)
”From Coverage to Care: A Roadmap to Better Care and a Healthier You” found at: https://marketplace.cms.gov/outreach-and-education/downloads/c2c-roadmap.pdf. This publication maps your path from selecting a plan to getting care and helps you to think about how you can get the most out of working with your doctors and nurses. The resource was written by the Center for Medicare and Medicaid Services:
- Step 1: Put your health first …Why are prevention and health coverage important?
- Step 2: Understand your health coverage…What words should I know? How much will it cost me to get care?
- Step 3: Know where to go for care …Where do I go when I am sick? What is the difference between the emergency department and primary care?
- Step 4: Find a provider …How do I find a provider that is right for me? What if I am assigned a provider?
- Step 5: Make an appointment…What information do I need and what questions should I ask when making an appointment?
- Step 6: Be prepared for the visit … What should I bring to the appointment? What questions should I ask during the visit?
- Step 7: Decide if the provider is right for you … Is this a provider I can trust and work with? If not, what do I do?
- Step 8: Next steps after your appointment … What do I do when I get home? How do I maintain my health?
Whiteboard Video: CCMI has produced a whiteboard video for patients and providers explaining the concept of self-management and self-management support. It was produced for our Ministry of Health and they have now authorized release. The YouTube URL is above (along with sharing advice from the video producer). Take a look and please feel free to share with anyone else you see fit.