10/10/2017 What is Patient Advocacy? HOW DID WE GET HERE? Suzanne J. Fiscella, PA-C, MA, MS Conflict of Interest • Owner, Patient Best®, LLC • Co-founder, The Patient Education Movement, Inc. (Non-profit) • No other conflict of interest or payment received for articles, organizations, associations, and products mentioned 1 10/10/2017 AGING TO PERFECTION *www.census.gov 2 10/10/2017 1960’s NURSE FAMILY PHARMACY HOSPITAL TODAY – THE 2 EDGED SWORD 2017’s DOCTOR NURSE PHARMACY PATIENT CHARTS LABS CASE MANAGER HOSPITAL BACK OFFICE STAFF FAMILY PHYSICAL FRONT OFFICE THERAPY MEDICAL STAFF PROXY CLERKS HOME HEALTH X-RAY, MRI, NURSING CT SCAN, FACILTIES BONE DENSITY, ULTRASOUND PATIENT CALL CENTER 3 10/10/2017 BMJ APRIL 2016 4 10/10/2017 Medical Errors 1. Medications 8. Abandonment 2. Miscommunications 9. Emotional 3. Patient’s Chart 10. Neglect 4. Misdiagnosis 11. Financial 5. Physical 12. Unqualified Patient 6. Social 13. Non-compliancy 7. Time 14. Failed care coordination Where Do You Find Patient Advocacy? 5 10/10/2017 Lay and Clinical Patient Advocate Professionals are: • Case Manager* • Patient Navigator • Care Manager • Patient Advocate • Geriatric Case Manager • Community Health Worker • Geriatric Care Manager • Advocates for the --- Profession • Education Advocate • Advocates for change • Life Navigator • Advocates for society • Health Advocate • Consumer Health Advocate • Aging Life Care Professional™** • Ombudsmen • Life Care Coordinator • Senior Care Coordinator *American Case Management Association **Aging Life Care NURSES/REALTORS® • Advocacy in nursing finds its theoretical basis in nursing ethics. For instance, the ANA’s Code of Ethics for Nurses includes language relating to patient advocacy: • The nurse's primary commitment is to the patient, whether an individual, family, group, or community. • The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.* 6 10/10/2017 Patient Advocacy An Independent Business Education, Fees & Services • Courses to take: https://healthadvocateprograms.com/master-list *The profession, however, is so new that there are no state licenses, requirements or accreditation for its workers. There isn’t even a singular definition of a patient advocate. (Forbes, 2013) • CPPN = Certified Professional Patient Navigator (PCERI, http://patient- institute.org) • BCPA = Board Certified Patient Advocate (PACB, https://pacboard.org) • Fees: $30 - $500/hour; retainer fees; repeating fees; packages; products • Services: Assessment Defined; Shared Decision Making 7 10/10/2017 The Pros… • No education or experience needed, no certification or license* • BIGGEST SKILL NEEDED: Ability to listen and communicate • You are your own boss: You pick your clients • You work your own hours, own decisions • You pick your services and products with flexibility to change • You like to socialize and have a lot of contacts • You decide how much you want to earn • Self perpetuating business – family, friends, neighbors *The profession, however, is so new that there are no state licenses, requirements or accreditation for its workers. There isn’t even a singular definition of a patient advocate. (Forbes, 2013) …And the Cons • No regular paycheck; collections • Time Management Skills (24/7) • Commitment: 2 years to referrals • Need about $30,000 to upstart if you start up on your own • Will need marketing and legal, and business expenses • You must have liability insurance, attorney, accountant, IT, editor, and printing company 8 10/10/2017 SERVICES: • Medical / Navigational Assistance and Care Management • Medical Billing/Health Insurance /Medicare/Payer Assistance Home Health, Eldercare, and End of Life Planning Services • Transitional Housing • Specialties • Mediation and Negotiations • Prevention and Coaching DECIDE WHAT YOU WANT YOUR PRACTICE TO LOOK LIKE RESOURCES: http://patient-institute.org – The Patient Centered Education and Research Institute https://www.aphadvocates.org – The Advocate Connection https://healthadvocateprograms.com – The Alliance of Professional Health Advocates http://nahac.com – National Association of Health Advocate Consultants https://pacboard.org - Patient Advocate Certification Board 9 10/10/2017 10.